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.