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Immunisation a public health issue

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prevention of serious diseases and their complications ... Pre-clinical trials. volunteers and protocols. clinical trials. Phase I studies. Phase II studies ... – PowerPoint PPT presentation

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Title: Immunisation a public health issue


1
Immunisation - a public health issue
  • Judith Moreton
  • Programme Manager

2
Aims objectives of immunisation
  • prevention of serious diseases and their
    complications
  • protection of individuals and communities
  • containment of outbreaks
  • elimination of certain diseases, e.g. tetanus
  • eradication of diseases, e.g. smallpox (1980)
    polio (target date 2005)

3
World situation
  • World Health Organization (WHO) - Expanded
    Programme on Immunization (EPI) 1974
  • six target diseases diphtheria, tetanus,
    pertussis, polio, measles tuberculosis
  • inequity to vaccination programmes RD
    funding of new existing vaccinesimmunisation
    safetyState of the Worlds Vaccines and
    Immunization, WHO, 2002

4
Decisions to introduce a vaccine
  • is the disease important enough?
  • can a safe and effective vaccine be produced?
  • is it acceptable to recipients, their parents or
    carers?
  • is it cost effective?
  • can enough people in the target group be
    immunised to make the programme effective?

5
Different types of vaccines
  • Inactivated vaccineskilled whole organisms e.g.
    pertussisinactivated bacterial toxins, e.g.
    diphtheria tetanusacellular vaccine e.g.
    pertussis
  • Polysaccharide vaccinesplain polysaccharide
    e.g. pneumococcal for over 2spolysaccharide
    conjugate e.g. Hib, MenC
  • Live attenuated e.g. MMR, polio BCG
  • Combination vaccines e.g. DTP-Hib, MMR

6
Development of safe, effective vaccines
  • Pre-clinical trials
  • volunteers and protocols
  • clinical trialsPhase I studiesPhase II
    studiesPhase III studies
  • licensure
  • immunisation policy

7
Monitoring vaccine safety
  • routine testing before release
  • Phase lV studies - Post-Licensing Evaluation
  • Yellow card system
  • studies of vaccine safety cohort
    studies case-control studies record linkage

8
Contraindications precautions
  • Contraindications severe local or systemic
    reactions to preceding doseslive vaccines
    because of disease temporary contraindications
    live vaccines in the immunosuppressed due to
    treatment - chemotherapy, radiotherapy, high dose
    corticosteroids, organ transplantation with
    concurrent immunosuppressive treatment
  • Precautionsincreased risk of reaction or
    compromised immunity

9
Adverse events
  • all medicines, including vaccines can cause
    adverse events
  • three general categorieslocalsystemicallergic
  • real v myth

10
Benefits and risks
  • the benefit of the vaccination outweighs the risk
    of the disease and associated morbidity and
    mortality
  • the risk of adverse events to an immunisation
    outweighs the risk of the disease and associated
    morbidity and mortality

11
Successful immunisation
  • production of a safe and effective vaccine
  • maintaining cold chain from point of manufacture
    to administration
  • ordering and storage
  • consent
  • injection into correct site using the correct
    technique
  • ? Immune response in individual

12
Public professional knowledge
  • Bi-annual tracking of mothersknowledge about
    immunisationattitudes towards immunisationexperi
    ence of immunisation servicesresponse to
    advertising using key indicators
  • annual health professional surveyimpact of
    publicityawareness evaluation of
    materialsassessing the needs of GPs, practice
    nurses health visitors

13
Information
  • Resourcesleaflets, factsheets, FAQs, websites,
    green book, posters, videosprofessional mailings
    - CMO letters/updates
  • Advertising TV radio, parent and professional
    journals, newspapers
  • press public relations

14
Professional responsibility
  • responsibility of being reliably informed
  • responsibility of not just simply providing the
    facts, but of our own informed opinion and
    support for immunisation
  • responsibility for promoting immunisation as the
    most important of all medical interventions

15
It is every childs right to be protected against
infectious disease. No child should be denied
immunisation without serious thought as to the
consequences, both for the individual child and
for the community
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