Pharmacies and Child Vaccinations Essay

Vaccinations train the immune system in the body to fight against infectious diseases.  They contain a dead or weakened pathogen that will not cause any symptoms of the disease. The immune system will continue to produce antibodies due to the foreign antigens on the surface of the pathogen. Memory cells are produced and will remain in the body so when the same antigen triggers an immune response it will be faster and the pathogens are destroyed.(Pappas, 2010). The World Health Organisation have stated ” Vaccination is one of the most cost-effective health interventions available, saving millions of people from illness, disability and death each year.” (World Health Organization Regional office for Europe, 2019)

Vaccinations not only protect individuals who have them but also the people who surround them as the disease is less likely to occur if less people can catch the disease. This is called herd community. The more people are vaccinated the less likely it is for people to catch different diseases. (Pappas, 2010). For example, in the United states since the MMR vaccine was introduced it became unlikely for children across the country to have these diseases. However negative speculation in the media about vaccines particularly MMR  members of the general public to become wary and some have come to the belief that vaccinations are not necessary. (Smith et al., 2008).

Mrs Hall has seen negative comments in the media regarding vaccinations, particularly MMR and is unsure of whether it is necessary for her daughter Sophie (04/07/18) to receive the vaccinations required at 12 months ( one year ). Sophie received the routine vaccinations that all babies in the UK are given at eight, twelve and sixteen weeks old.

(Assets.publishing.service.gov.uk, 2018)

At the age of one Sophie will receive the routine vaccinations:

(Assets.publishing.service.gov.uk, 2018)

 Haemophilus influenzae type b (Hib)

Haemophilus influenzae type B otherwise known as Hib is a type of bacterium that causes several different severe diseases such as:

• meningitis
• septicaemia
• pneumonia
• epiglottitis

These are just some of the numerous infections that people particularly children can develop due to Hib. Meningitis is the most serious illness that can develop as a consequence of Hib bacteria. At least 1 in every 20 children can die as a result of contracting meningitis from Hib bacteria. Despite the high statistics of children that survive many suffer from long term conditions such as hearing impairment and physical and mental disabilities.

The symptoms of Hib depend upon the infection that is developed from Hib bacteria for example if the infection was meningitis the symptoms may include headaches and vomiting whilst if it was pneumonia the symptoms may include coughing and having difficulty in breathing.

(nhs.uk, 2016)

Meningitis 

” Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges).”  It can become fatal quickly if not treated fast enough.  Meningitis can lead to septicaemia ( blood poisoning) and permanent damage to the nervous system. It can appear either as a viral or bacterial infection, of the two bacterial meningitis is more dangerous.

The symptoms of meningitis include:

• a fever
• vomiting
• headaches
• a rash
• seizures
• fatigue

There are other symptoms of meningitis and can appear in any order, however not all symptoms turn up. Meningitis vaccines can be used as protection against certain strains of meningitis.

(nhs.uk, 2019)

Pneumococcal Infections

The bacterium Streptococcus pneumonia causes pneumococcal infections which can cause septicaemia, pneumonia and meningitis. In the most severe cases they can lead to long term conditions and death. People that are most vulnerable to these infections are babies, seniors and people with long term illnesses.

Pneumonia is one of the illnesses that is caused by pneumococcal infections. it is a bacterial infection that can cause the tissue in the lungs becoming inflamed.

Symptoms of pneumonia can develop over one or two days. These can include:

• coughing – producing thick yellow, green, brown or blood stained mucus
• breathing difficulties
• fever
• Increased pulse
• chest pain

These symptoms are common. The more severe symptoms can include:

• coughing up blood
• headaches
• fatigue
• nausea
• being short of breath
• muscle and joint pain
• disorientation

The Pneumococcal vaccine helps to protect against pneumococcal infections and is offered as part of the routine immunisation for children at 8 weeks, 16 weeks and 12 months. Adults over the age of 65 will receive one shot of the pneumococcal vaccine whilst people with long term conditions may receive the vaccine every five years.

There are two types of pneumococcal vaccines one for children under two years called PCV whilst adults over the age of 65 will receive the pneumococcal vaccine PPV. The vaccine should not be given if people have a fever or an allergy to one or more of the ingredients in the vaccine whilst females who are pregnant or breast feeding should not have the vaccine.

(nhs.uk, 2019)

Measles

Measles are a viral illness that spreads quickly and is most common in children. However it clears up between 7- 10 days and is not very serious. Once having measles it is unlikely that you will get the virus again. Symptoms of measles appear around 10 days of being infected with the disease and can include:

• runny nose, sneezing
• cough
• sore, red eyes
• a fever
• small greyish white spots on the inside of the cheeks

A few days later after the symptoms a brown-red rash will appear and spread across the body. Complications can occur and lead to more severe illnesses like pneumonia. Common complications that can occur are:

• diarrhoea and vomiting, which can lead to dehydration
• middle ear infection, which can cause earache
• eye infection
• inflammation of the voice box
• infections of the airways and lungs (such as pneumonia, bronchitis and croup)
• fits caused by a fever

Less common complications can include hepatitis, meningitis and misalignment of the eyes. There is a greater risk if a pregnant female contracts measles as it can lead to miscarriage, stillborn, premature birth or a low birth weight.

(nhs.uk, 2018)

Mumps

Mumps is also a viral infection that can be very contagious. Mumps causes painful swelling on the sides of the faces under the ears. Other than the swellings symptoms of mumps can include:

• headaches
• joint pain
• high temperature
• nausea
• abdominal pain

Mumps is not a very serious illness but it can lead to more severe diseases like tonsillitis, meningitis, swollen testicles and ovaries. However these conditions improve once the infection passes.

(nhs.uk, 2018)

Rubella

Rubella otherwise known as German measles is a disease that causes a spotty rash which people normally recover from within 7 days. Complications occur when a pregnant female contracts the disease which can lead to miscarriage or problems after birth.

The main symptom for rubella is a red-brown rash that is easily spotted after 2-3 weeks of contracting rubella. Other symptoms of rubella can include:

• aching fingers, wrists or knees
• a high temperature of 38C or above
• coughs
• sneezing and a runny nose
• headaches
• a sore throat
• sore, red eye

Measles, Mumps and Rubella can be prevented by taking the vaccination MMR at or around 12 months and a second dose at around 36 -40 months ( 3 years 4 months).

(nhs.uk, 2018)

Vaccinations and the media

In recent years, the rate of vaccinations has been vastly influenced by both the media and literature, whether the information is positive or negative. The anti vaccine content causes concern for members of the general public particularly parents with young children. This leads parents to consider whether vaccinations are completely necessary. However, despite the growing concern of a small percentage of parents believing in anti vaccination, a vast majority believe the benefits outweigh the risks. Modern vaccines are safe and cost effective and the side effects that occur are mild at best and short lived. The most severe side effect is likely to be an allergic reaction to one or more of the ingredients in the vaccine. This is incredibly rare with ‘ less than 1 in a million’ (Giroir, Redfield and Adams, 2019) (Vk.ovg.ox.ac.uk, 2019) NHS (2019).

The more people vaccinated the rarer the disease becomes and even those that have not been vaccinated are less likely to contract the disease as the people around them are immune to them. This is called herd community. (Pappas, 2010).However due to the increasing concern of side effects, parents are less likely to have their children vaccinated, which can lead to the increase of these diseases occurring, for example the global measles outbreak. The vaccine for measles is part of the MMR vaccine and requires two doses. However for the last several years, the vaccination for the first dose has stopped at around 85% globally, whilst the second dose stops at 67%. According to the WHO a 95% global coverage is needed to prevent outbreaks. (World Health Organization, 2019). However the controversial thoughts in the media and forms of literature discourages parents from inoculating their children not just against MMR but various types of diseases.

For example, social media. Brunson 1 found peoples’ decisions are influenced heavily through what is called the people ‘s network as they are more likely to look at social media and therefore base their decisions on what they read on online blogs, twitter or face book regardless whether the information is true or false. (Wachob and Boldy, 2019).

For instance MMR and its link to autism. It began with the study by Dr Andrew Wakefield in 1998 who claimed that MMR might cause autism or bowel disease. However since then his work has been discredited and his title as a doctor has been rescinded. (nhs.uk, 2018).  In addition, critics pointed out flaws in his study such as his small sample size. (Sathyanarayana Rao and Andrade, 2011). Furthermore several studies over the last nine years such as the Danish study (Hviid et al., 2019 )conducted with over 650,00 children have proven there is no link between autism and MMR. Despite this the publicity gained caused fear to grown and stop both children and adults being vaccinated, and the measles outbreak that occurred has been linked to the decreased rate of vaccinations. (Sathyanarayana Rao and Andrade, 2011).This shows how an incorrect portrayal of vaccination led to a global negative impact regarding vaccinations.

On the other hand, despite the negative speculations regarding vaccinations the WHO continue to campaign about global vaccination and many other articles and journals continue to be published about the positive effects of vaccinations for instance ‘This Is The Truth About Vaccines’ published by the New York Times highlighting the positive impact of vaccines and the negative impact the decrease of vaccines can and will have.

In addition the negative portrayal of vaccines highlights the importance of healthcare professionals in giving guidance to the public and providing the accurate information to increase the uptake of vaccinations. As pharmacists are at the frontline and one of the first points of contact for the public, they could provide leaflets on up to date information regarding vaccines, the diseases they protect against and their side effects in particular. As side effects are one of the main concerns of parents. This would help ease parents and comfort them knowing the benefits which heavily outweigh the risks.

In addition pharmacists could provide several routine vaccinations that both adults and children require to increase the uptake of vaccinations to make it easier for the public to access as the GP are often booked particularly around the summer season due to holiday vaccinations. The collaboration between GP’s and Pharmacies would increase the uptake of different vaccinations similar to the flu vaccination. (Collaboration between GPs and pharmacists key to increased flu vaccine uptake, 2017).

In conclusion, Mrs Hall should have Sophie inoculated. Routine vaccinations are important in babies and young toddlers as they protect them against diseases.

References

• Collaboration between GPs and pharmacists key to increased flu vaccine uptake. (2017). The Pharmaceutical Journal. [online] Available at: https://www.pharmaceutical-journal.com/news-and-analysis/news/collaboration-between-gps-and-pharmacists-key-to-increased-flu-vaccine-uptake/20203796.article?firstPass=false [Accessed 10 Jul. 2019].
• Vk.ovg.ox.ac.uk. (2019). FAQs about vaccines | Vaccine Knowledge. [online] Available at: http://vk.ovg.ox.ac.uk/faqs-about-vaccines [Accessed 10 Jul. 2019].
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