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5. New vaccine development
Fifty years ago in the UK, there were measles epidemics bi-annually. Hundreds of thousands of children were affected. Even in the second half of the twentieth century, there were more than 100 deaths associated with many such epidemics.
Many general practitioners today have never seen a case of measles. This has come about from safe and effective vaccines, available to all children, irrespective of their background and circumstances.
Meningococcal C Vaccination: A Success Story
In the winters of 1998 and 1999, over two thousand children and teenagers fell ill with meningitis or septicaemia caused by the bacterium Meningococcus C. Around 10 per cent died in each year. Meningococcal infection was the commonest cause of death in children aged one to five years and the commonest infectious disease cause of death in children and young people.
Although there was a vaccine it gave only limited protection and this waned after a few years. In under twos, those most at risk from Group C meningococcal infection, the vaccine did not work at all.
New vaccine developed
It was clear that a new vaccine was needed. After identifying that vaccine manufacturers could develop new conjugate Group C meningococcal vaccines, more investment and an accelerated research programme was implemented. The result was that by 1999, the UK was the first country in the world to launch an effective vaccine for Group C meningococcal infection.
Campaign launched
The immunisation campaign launch in November 1999 aimed to offer the vaccine to everyone under the age of 18 years by the end of 2000. It was the largest vaccination programme since the introduction of the polio vaccine some 40 years earlier.
Vaccine was delivered to the NHS immediately and the groups most at risk were vaccinated first. By the end of 2000, everyone in England under 18 years had had the chance to be immunised. The result has been a dramatic reduction in the disease.
Effective immunisation
After 18 million doses had been distributed, there had been only 18 vaccine failures. This suggests a vaccine efficacy of 92-97 per cent depending on the age of the recipient.
Overall, in 1999 there were 599 reported cases of Group C meningococcal infection - in 2001, this had been reduced to 82. This represents an 86 per cent reduction overall.
Ongoing Progress
Getting Ahead of the Curve proposed that efforts to ensure high uptake of vaccinations are maintained and that research efforts are enhanced. Five key areas were identified:
- Extending the use of existing vaccines to larger numbers of people - in particular the influenza vaccine and pneumococcal vaccine;
- Switching from oral polio vaccines to the injected form when global progress on polio eradication is at an appropriate point;
- Identifying how best to use new varicella and pneumococcal vaccines;
- Stepping up research and investment to bring forward new vaccines;
- Contributing to international research to develop a vaccine against HIV infection.
Work to date:
- Wider use of influenza vaccine, and both plain polysaccharide pneumococcal vaccine for the elderly and conjugate for children, are currently being reviewed or evaluated. The assessments are looking at the cost-effectiveness and the scientific circumstances for routine use.
- A switch from oral to injected polio vaccine needs to be timed with the WHO Programme for the Global Eradication of polio. The four polio reservoir countries of the world (India especially, and Pakistan, Bangladesh and Nigeria) have very close links with the UK. When polio is eliminated from those countries, or at negligible levels, then there will be no risk of polio importation and that will be the time to switch. Progress is good to date and hopefully a decision will be for a change in about two years.
- The UK Vaccine Evaluation Consortium has recently been awarded renewed funding to take forward studies on new vaccines, especially pneumococcal vaccines and meningococcal vaccines as they become available. There are also resources included for additional vaccine safety studies should they be needed. The Consortium covers all aspects of vaccine trials and is co-ordinated by the team at the PHLS Communicable Disease Surveillance Centre.
- Getting Ahead of the Curve acknowledged the need for more effective communication on vaccines for parents. A new website has recently been launched called 'MMR The facts' that contains comprehensive information for parents about the MMR vaccination and an opportunity for to send in their questions and concerns to experts.
Flu Vaccination Campaign
Influenza (flu) is a highly infectious illness caused by a virus - the influenza virus. It tends to start suddenly with symptoms such as fever, chills, headache, aching
Influenza (flu) is a highly infectious illness caused by a virus - the influenza virus. It tends to start suddenly with symptoms such as fever, chills, headache, aching muscles and feeling generally unwell, together with a cough or sore throat. It is usually much more than a simple head cold, although people sometimes call a heavy cold 'flu'. Colds are more likely to start gradually with a sore throat and stuffy or runny nose and to be less severe.
Flu is spread by coughs and sneezes from people who are already infected with the virus and it can spread very rapidly.
Influenza is around every winter. Most of it occurs within a few weeks, so that a lot of people are ill at the same time. The viruses are always changing, so this winter's flu will be slightly different from last winter's. If it is a very bad year, this may amount to what is called an epidemic. How much flu there will be each year is difficult to predict.
For most people, flu is a nasty experience. For some it can lead to more serious illnesses such as bronchitis and pneumonia, which may require treatment in hospital. Sadly, every winter a lot of mainly older people die from influenza.
Two years ago a change in policy offered free flu immunisation to all people aged 65 years and over, as well as those in at risk groups. In the first year of the campaign we achieved 65 per cent uptake (against a minimum 60 per cent target), which improved to 68 per cent last year (against a minimum target of 65 per cent). It is very clear that the national and local publicity campaign played a significant part in successfully achieving this uptake.
This year a 70 per cent target uptake rate has been set. The publicity campaign will help to build on last year's success, and remind all people in the at risk groups, as well as those aged 65 and over, of the importance of being immunised.
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