World Im­mu­niza­tion Week—cel­e­brat­ed in the last week of April—aims to pro­mote the use of vac­cines to pro­tect peo­ple of all ages against dis­ease. Im­mu­ni­sa­tion saves mil­lions of lives every year and is wide­ly recog­nised as one of the world’s most suc­cess­ful and cost-ef­fec­tive health in­ter­ven­tions. Yet, there are still near­ly 20 mil­lion un­vac­ci­nat­ed and un­der-vac­ci­nat­ed chil­dren in the world to­day. The theme for World Im­mu­niza­tion Week this year as se­lect­ed by the World Health Or­ga­ni­za­tion (WHO) is Pro­tect­ed To­geth­er: Vac­cines Work! The cam­paign will cel­e­brate ‘Vac­cine He­roes’ from around the world—from par­ents and com­mu­ni­ty mem­bers to health work­ers and in­no­va­tors—who help en­sure we are all pro­tect­ed through the pow­er of vac­cines.

In 2017, the num­ber of chil­dren im­mu­nised (116.2 mil­lion) was the high­est ever re­port­ed. Since 2010, 113 coun­tries have in­tro­duced new vac­cines, and more than 20 mil­lion ad­di­tion­al chil­dren have been vac­ci­nat­ed. But de­spite these gains, all of the tar­gets for dis­ease elim­i­na­tion—in­clud­ing measles, rubel­la, and ma­ter­nal and neona­tal tetanus—are be­hind sched­ule, and over the last two years the world has seen mul­ti­ple out­breaks of measles, diph­the­ria and var­i­ous oth­er vac­cine-pre­ventable dis­eases.

This year’s cam­paign is in­tend­ed to raise aware­ness about the crit­i­cal im­por­tance of full im­mu­ni­sa­tion through­out life. To achieve this goal, WHO and part­ners aim to:

Demon­strate the val­ue of vac­cines for the health of chil­dren, com­mu­ni­ties and the world.

High­light the need to build on im­mu­ni­sa­tion progress while ad­dress­ing gaps, in­clud­ing through in­creased in­vest­ment.

Show how rou­tine im­mu­ni­sa­tion is the foun­da­tion for strong, re­silient health sys­tems and uni­ver­sal health cov­er­age.

In Trinidad and To­ba­go (T&T) we should feel proud, as the WHO re­ports that we have a well-or­gan­ised and suc­cess­ful im­mu­ni­sa­tion pro­gramme, with rates of cov­er­age ex­ceed­ing 90 per­cent; at least from records up to 2006. The Min­istry of Health (MOH) states that this pos­i­tive im­mu­ni­sa­tion sta­tus is di­rect­ly re­lat­ed to the re­silient, vig­i­lant and com­mit­ted ap­proach of the na­tion­al Ex­pand­ed Pro­gramme on Im­mu­niza­tion (EPI) of the Min­istry of Health to re­duc­ing the preva­lence of all vac­cine-pre­ventable dis­eases.

De­spite such good re­ports in T&T, with­in re­cent times there have been out­breaks in many parts of the world of vac­cine pre­ventable dis­eases such as measles. This de­vel­op­ment, which has be­come a great cause of con­cern for the au­thor­i­ties of WHO, has been a di­rect re­sult of the An­ti-Vac­ci­na­tion move­ment in­ter­na­tion­al­ly. Vac­cine hes­i­tan­cy is a re­luc­tance or re­fusal to be vac­ci­nat­ed or to have one’s chil­dren vac­ci­nat­ed. Hes­i­tan­cy re­sults from pub­lic de­bates around the med­ical, eth­i­cal and le­gal is­sues re­lat­ed to vac­cines. It has ex­ist­ed since the in­ven­tion of vac­ci­na­tion, and pre-dates the coin­ing of the terms ‘vac­cine’ and ‘vac­ci­na­tion’ by near­ly 80 years. The An­ti-Vac­ci­na­tion cam­paign has re­sult­ed from grow­ing move­ments in sev­er­al re­gions against cer­tain vac­ci­na­tions, and re­sult­ed in the in­crease of vac­ci­na­tion hes­i­tan­cy among some par­ents who fear harm­ful side ef­fects. The spe­cif­ic hy­pothe­ses raised by an­ti-vac­ci­na­tion ad­vo­cates have been found to change over time. Vac­cine hes­i­tan­cy of­ten re­sults in dis­ease out­breaks and deaths from vac­cine-pre­ventable dis­eases. It has been iden­ti­fied by the World Health Or­ga­ni­za­tion as one of the top 10 glob­al health threats of 2019. It con­tra­dicts over­whelm­ing sci­en­tif­ic con­sen­sus about the safe­ty and ef­fi­ca­cy of vac­cines. With­in the med­ical com­mu­ni­ty how­ev­er, there is no de­bate over the safe­ty of vac­ci­na­tions, which are rig­or­ous­ly test­ed and con­tin­u­ous­ly mon­i­tored for ad­verse ef­fects. “The ben­e­fits of vac­ci­na­tion great­ly out­weigh the risks, and many more ill­ness and deaths would oc­cur with­out vac­cines,” says the WHO.

Sev­er­al re­cent schol­ar­ly re­views have de­bunked a 1998 study that linked the vac­cine for measles, mumps, and rubel­la to autism. Nonethe­less, this study and oth­er works by its dis­cred­it­ed au­thor, An­drew Wake­field, con­tin­ue to dis­suade fam­i­lies from get­ting their chil­dren vac­ci­nat­ed; for some al­ready skep­ti­cal of vac­cines, such work of­fers con­fir­ma­tion. In T&T how­ev­er, vac­ci­na­tions are man­dat­ed, as our coun­try’s Pub­lic Health Im­mu­niza­tion Act, with re­gard to nurs­ery and pri­ma­ry schools, for­bids ad­mis­sion in­to such schools with­out the pre­sen­ta­tion of an up­dat­ed cer­tifi­cate of im­mu­ni­sa­tion. This is part­ly the rea­son why we have a suc­cess­ful im­mu­ni­sa­tion pro­gramme.

2018 was al­so an­oth­er suc­cess­ful year for T&T’s EPI. While there was an up­surge of measles cas­es in the Caribbean, Latin Amer­i­can re­gion and many oth­er parts of the world, T&T had not re­port­ed such cas­es dur­ing that time pe­ri­od due to its ex­cel­lent im­mu­ni­sa­tion cov­er­age for pre­ventable dis­eases. How­ev­er, be­ing part of the Caribbean, T&T was still at risk due to com­mu­ni­ca­tion of its neigh­bours through trav­el. This saw an in­creased vig­i­lance by T&T for cas­es of measles and health pro­mo­tion through ad­vo­cat­ing vac­ci­na­tion.

In try­ing to con­tin­ue this ex­cel­lent track record of T&T’s EPI, I would like to en­cour­age cit­i­zens to be vac­ci­nat­ed and al­so have their chil­dren vac­ci­nat­ed. It is very im­por­tant for all cit­i­zens to note that all med­ica­tion, even vac­ci­na­tion, have the pos­si­bil­i­ty of ad­verse re­ac­tions. Af­ter hav­ing a vac­cine, there will be those who would have a mild ad­verse re­ac­tion. In most cas­es the com­plaint will be swelling in the arm at the in­jec­tion site, some may de­vel­op a mild fever and in some rare cas­es a mi­nor rash. These are self-lim­it­ing, pose no threat and they go away af­ter a rel­a­tive­ly short pe­ri­od of time. If there is any ad­verse re­ac­tion, med­ical staff is equipped to deal with it. In T&T thus far, there have been no re­ports of ad­verse re­ac­tions to vac­ci­na­tions. The Min­istry of Health pro­vides im­mu­ni­sa­tion ser­vices at no charge to cit­i­zens of Trinidad and To­ba­go through the EPI avail­able at all health cen­tres through­out T&T. The Min­istry’s goal is to have every cit­i­zen of Trinidad and To­ba­go ful­ly im­mu­nised.Ac­cess­ing vac­ci­na­tion is ex­er­cis­ing your right to health care.