Immunisation ... the difference between life and death

In light of the current measles outbreak in sections of the United States and Mexico, the Ministry of Health has embarked on an aggressive measles-prevention campaign to ensure that all children across Jamaica are immunised against the highly contagious and sometimes fatal disease.

Measles, which is caused by a virus, is airborne and spreads quite easily through the coughs, sneezes and even breathing of an infected person. It may also be spread through contact with saliva (kissing) and nasal secretions.

Complications from contracting the disease include pneumonia and can lead to blindness, brain damage, deafness and death, especially in young children.

One infected person on a flight or cruise ship into Jamaica could lead to a national health crisis, especially in light of the fact that, in recent years, a high percentage of children have not been properly immunised against the disease.

“Many countries of the world still have annual cases of vaccine-preventable diseases. These can easily spread to other countries through international travel,” stated Minister of Health Dr Fenton Ferguson, speaking last week at the launch of the Measles Prevention Campaign.

“Jamaica, a well-established tourist destination, has to remain vigilant and, therefore, do all that we can to reduce any possible impact on the population.”

Ferguson said the immunisation statistics in Jamaica revealed that measles-vaccination coverage has fluctuated from a low of 81 per cent in 2011 to a high of 94 per cent in 2013.

“The coverage for the second dose (booster) is even lower. The target coverage for both doses is 95 per cent or greater. What the data is telling us is that, while parents make it a priority to ensure that children under two years are vaccinated, the level of interest to immunise children two years and older is trending downwards,” he said.

He informed that to close the gap, the health ministry has taken the decision to offer the completed dosage of Measles Mumps Rubella (MMR) vaccinations earlier.

“For children born July 2013 and after, we are now offering the booster dose of the MMR vaccine at 18 months old instead of four to six years. This is being done to close the existing gap and to get children immunised during the ‘active’ vaccination period when other vaccines are being offered and uptake is greater,” Ferguson explained.

MULTIMILLION-DOLLAR PROGRAMME

Although the approximate $54.4 million measles-prevention campaign will heavily focus on the MMR vaccine, including the booster dose, other immunisation vaccines will be available.

The main objectives of the campaign are to immunise every child in Jamaica, and provide adequate protection against the current threat of measles and other vaccine-preventable diseases such as rubella.

The campaign, which will run from February 16 to May 8, will be done in three phases, targeting 195,000 children, from age one to six years, right across Jamaica.

The first phase will target children attending clinic for routine immunisation services; phase two will seek to capture children at basic, infant, primary schools and day care centres; and phase three will focus on community outreach for those who were not immunised in phases one and two.

Parents can visit any public-health centre across the island to get their child immunised, free of cost.

“The targeted population will be vaccinated unless they can provide documented proof of receiving two doses of the MMR vaccine and any other compulsory vaccine they may not have received,” Ferguson said.

The health minister said everyone has a role to play to ensure that children are adequately vaccinated prior to entry to school, noting that this requirement ensures that disease outbreaks are prevented, thus protecting the lives of children and adults.

VACCINES SAFE

In the meantime, acting chief medical officer Dr Marion Bullock DuCasse has dismissing concerns about the link between immunisation and autism, assuring that the vaccines are safe.

“I have to state categorically that the association with vaccination and autism is unfounded. This has been scientifically proven,” Bullock DuCasse said at the press conference last week, noting that part of the campaign is aimed at educating the public about the vaccines and changing this misconception.

Over the years, persons have raised concerns that autism might be linked to the vaccines children receive. These fears were related to different aspects of vaccines, including the ingredients.

However, evidence from international studies, examining trends in vaccine use and changes in autism in children, does not support the association between thimerosal and autism.

Thimerosal is one of the vaccine ingredients that has been studied specifically. It was previously used as a preservative in many recommended childhood vaccines.

However, in 2001 thimerosal was removed or reduced to trace amounts in all childhood vaccines except for one type of influenza vaccine, and thimerosal-free alternatives are available for influenza vaccine.

In fact, the 1998 study that had linked autism to the MMR vaccine was later discredited.

A scientific review by the Institute of Medicine (IOM) concluded that “the evidence favours rejection of a causal relationship between thimerosal-containing vaccines and autism”.

The US Centers for Disease Control and Prevention has also publicly supported the IOM conclusion that there is no relationship between vaccines and autism rates in children.

Like any medication, however, vaccines can have side effects, but they are rare. Studies have shown that most children who get the MMR shot have no side effects.

AGAINST THE LAW

Under Jamaica’s 1986 Public Health Act, it is compulsory for every child to be immunised, beginning from birth to age six years, and it is free of cost at all health centres across Jamaica. It is against the law for any child to attend school without being fully immunised. Schools are mandated to get a copy of the immunisation card for each student upon registration. Failure to comply with the regulations can result in prosecution in a court of law. The regulations only allow for exemption from vaccination based on medical reasons, not religious or philosophical beliefs.

Adults should check immunisation cards to ensure children are fully immunised. If you have any concerns, discuss it with your health-care provider. Adults should also speak with their health-care-provider if they have any concerns about their own status.

“When the Region of the Americas eliminated locally transmitted measles in 2002, it was largely accomplished through a mass immunisation campaign, such as the one that is now under way,” Ferguson explained.

Thanks to that programme, Jamaica eliminated locally transmitted measles in 1991.

SYMPTOMS

- Measles signs and symptoms appear 10 to 14 days after exposure to the virus.

- Symptoms typically include: fever of over 40ºC (104ºF), dry cough, runny nose, sore throat, inflamed eyes (conjunctivitis), aches, diarrhoea and skin rash.

- Two to three days later, small white spots may appear in the mouth. These are known as Koplik spots.

- Three to five days after, flat red rashes usually start appearing on the face then it spreads to the rest of the body.

TREATMENT

- There is no specific treatment for measles.

- The use of vitamin A during treatment is recommended by the World Health Organization to decrease the risk of blindness.

- Paracetamol may be safely used to treat the symptoms of pain and fever.

- Antibiotics may be prescribed to treat any complications associated with contracting measles

PREVENTION

- The best prevention for measles is to be vaccinated against the disease.

- The MMR vaccine is given to children over 12 months of age.

- A second (booster) vaccine is given between the ages of four and five years, but has now been reduced to 18 months.

- Adults can also get booster doses of MMR.

FACTS YOU NEED TO KNOW

- Measles is a highly contagious viral infection which can be found worldwide.

- Complications from contracting measles include blindness, brain damage, deafness and death, especially in young children.

- The risk of death from measles is higher for adults and infants than for children.

- Measles is also known as rubeola or ‘English measles’, not to be confused with Rubella. Rubella is also known as ‘German measles’ or three-day measles.

- Measles, which is caused by a virus, is airborne and spreads quite easily through the coughs, sneezes and even breathing of an infected person.

- Measles may also be spread through contact with saliva (kissing) and nasal secretions.

- It only takes a small amount of respiratory droplets from an infected person to cause an infection

- You can get measles if an infected person coughs or sneezes in their hand and then touches something without sanitising their hands, then you touch the item or surface soon after, then wipe your nose, mouth or face.

- Persons are infectious to others three to four days before the rash appears and four days after they have begun appearing on the body

- You can catch measles just by being in a room where a person with measles has been, up to two hours after that person is gone.

- Pregnant women who get measles have an increased risk for early labour, miscarriage, and low birth weight infants.

- Almost everyone who has not had the MMR shot will get measles if they are exposed to the virus.

- Adults can get measles, so if any adult is unsure if they were immunised as a child, they should speak with their healthcare provider.

- If you already had measles, your body has built up its immune system to fight the infection, and you cannot get it again.

yourhealth@gleanerjm.com