Diseases like tetanus, mumps,
Haemaphilus influenzae type b (Hib) infections, rotavirus
infections, measles, pertussis (whooping cough), polio, rubella (German
measles) and diphtheria, which used to occur very commonly in our
country and around the world, can be well prevented by means of
vaccination. Small pox – one of the most deadly diseases in human
history – is only a story now, and now remains only for teaching purpose
to life science students in classes and laboratory, just because of the
vaccine.
After the launch of Expanded Programme on
Immunization (EPI) in 1974 (by the World Health Assembly), when the
immunization rate was just 5%, lives of 2-3 million children have been
saved each year [1], and about 750,000 children are saved from
disability. All ailments have financial, physical and mental burden on
family. Likewise, the diseases that can be prevented by vaccines cause
the similar burden in form of early and untimely deaths, suffering of
kids and family, frequent visits to healthcare providers and multiple
hospitalizations. As these can be prevented by vaccination, the impact
of infectious diseases has been reduced greatly.
"The Doctor of the future will give no medicine
but will interest his patients in the care of the human frame, in diet
and the cause and prevention of diseases." – Thomas Edison
If we look around, we will find that only clean water
and education are among those basic human rights, which can give a
competition to vaccination. It is very unfortunate that despite the
success story of vaccination programs, which resulted in only rare
occurence of fearsome diseases, large number of vehemently protesting
antivaccine lobbies exist.
Various independent experts and agencies like WHO
have often shown that the vaccines are far safer than the treating
medicines. But the obvious success and effectiveness of vaccines in
disease prevention has drawn the attention of public towards its safety.
The safety record of vaccines in modern days is extremely good, and most
of the "vaccine scares" proved to be a hoax. These hoaxes about the
excellently safe vaccines often result in fall in coverage of
vaccination, and cause the poor control and re-emergence of diseases. In
days of fast internet, easily accessible search engines, and numerous
print and electronic media thriving for attention, the unnecessary
vaccine safety issues are commonly reported, while reviews of vaccine
benefits are being neglected. A Medline search over the past five years
using the keywords "vaccine risks" scored approximately five times as
many hits (2655 versus 557) as a Medline search using "vaccine
benefits" as keywords [2]. This reflects the fact that negative aspects
of vaccination get much more publicity than positive aspects.
Any movement that is good for community initially
faces the problem, and same happened with vaccination also since the
time of the father of immunology – Edward Jenner. But the unfortunate
part is this that it is still facing the unnecessary anger of vociferous
antivaccine lobby. To defeat these wrong allegations is to refute false
claims at the earliest opportunity by providing scientifically valid
data. For the promotion of individual and public health, vaccines are
one of the most excellent measures, and without any doubt it deserve
better press.
Vaccination in Government Set-up
"Primary Health Care is essential health care made
universally accessible to individuals and acceptable to them, through
their full participation and at a cost the community and country can
afford [3]." One element of primary health care is "immunization against
major infectious diseases [3]." The first key principle of primary
health care is "equitable distribution" [3]. There should be no social
injustice. Therefore, in vaccination our government sets up targets to
ensure maximum coverage against the most prevalent diseases based on
epidemiological data, to all the needy and vulnerable group of
population, as the resources are limited.
Vaccination in Private Set-up
In private set up, it is the duty of the healthcare
professionals to offer protection against all the available vaccine
preventable diseases. Now it’s a call of the parents for opting or
opting out as they are explained in detail for the need of vaccine.
Because there is direct contract between the health care provider and
parents of children, we have to look at all the possible medicolegal
aspects also. As it is not a matter of extra burden on state’s limited
resources, those who can afford can opt in.
When we look at the history of vaccination in our
country, the pediatricians have stood in the vanguard for vaccination.
Hepatitis B, HiB, MMR, IPV, Rotavirus and PCV vaccines were all first
advocated to be used by Indian Academy of Pediatrics (IAP) amongst its
members, and then they were introduced in the government program as and
when resources were available; and resources do not mean just money but
also infrastructure. The stand of IAP on various vaccines has thus been
vindicated in the last two decades by the introduction of above
vaccines, and by the imminent introduction of PCV and Rotavirus vaccine,
both of which will be scaled-up by the government in the whole country.
Diseases which can be prevented by vaccines cause the
physical, mental and financial burden in form of early and untimely
deaths, suffering of kids and family, frequent visits to health care
providers and multiple hospitalizations. Sickness in the household is
one of the major factors that pulls down a brute majority of the
families below the poverty line. Thus sickness is major contributor to
poverty in the country. Parents are forced to lose time from work to
care of their sick children. The vaccines are one of the excellent
cost-effective interventions to increase the productivity of the
individual, family, society, and thus the nation. Each dollar spent on
vaccination leads to a saving of sixteen dollars for the country.
When we immunize large number of individual children,
it also helps those people of community who cannot be vaccinated (eg,
people suffering from immunodeficiency, cancer, those on
immunosuppressants, too young to vaccinate), and to few who do not
respond to specific vaccine. Here comes the concept of "herd immunity"
and "source drying". Let’s at least make a herd effect if we can’t
vaccinate all our kids for all vaccine preventable diseases, and give
our nation more healthy and productive days of life, so that we could
see a dream of healthy and prosperous India come true.
The maximum coverage of vaccination will also provide
the following benefits to the society:
• Better health, better disease-free life and
savings for community
• Improvement in life expectancy
• Resistance to development of antibiotic
resistance
• Women empowerment
• Travelling to endemic zones for particular
disease becomes easy and less distressing
• Economy will become robust
• Equity will prevail in society/community
• Prosperity and peace in society and country
• Other public health benefits
Our quality of life improved over last few decades
just because of vaccines. This is the very tool, which demolished the
deadly fort of smallpox and eliminated other diseases like tetanus and
polio. Freedom from polio has protected generations from a difficult
life and gave them opportunity to feel blessed that they live in the era
of vaccination. Now a day, our kids do not have to be absent from their
school to fight the battle with whooping cough. Parents are no more
unassisted to see the bodily suffering of their children in the battle
of disease and body’s natural response. If we consider all these
benefits of vaccination in economical terms, we find that all these
hours are directly converted into productive work, less lost hours and
more administrative benefits; these all show a road of more prosperous
and efficient society.
In this way, we can conclude that a robust and
comprehensive immunization program will hit hard to the poverty and
inequities in community, and will strengthen our public health.
"The aim of the medicine is to prevent disease and
prolong life; the ideal of medicine is to eliminate the need of a
physician." – William James Mayo
References
