Nowadays there seems to be a jab for everything. Radhika Holmstrom wades through the controversy to ask which ones you should be getting Flu labs are rolling round again, year 8 schoolgirls are due their HPV shots and there are plans to roll out TB inoculation. But ever since vaccinations were introduced, people have been arguing the pros and cons of injecting your baby-or your child’s-with a low dose of virus or bacterium to stimulate your body’s antibodies.
Some people are simply opposed to vaccinations, feeling that they overload the body with toxins and focus too much on antibodies rather than the immune system. Others take issue with specific vaccines-notably MMR. There are worries about the chemicals involved, such as the mercury-based preservatives thimerosal used in some vaccines, which was once argued to be linked to neurological disorders and autism. On the other hand, people argue that vaccination has saved millions of lives and that it’s crucially important to keep up a level of ‘herd immunity,’ so disease doesn’t spread.
Here we examine five of the hot-topic vaccines and the arguments that have put them under the spotlight to help you decide whether to have them or not.
- The Background : It’s easy to dismiss the killer flu headlines as not applying to you, but over 600 people dies of flu last year. Currently, there’s no one-shot vaccine to cover all strains of influenza (although researchers are working on this), so the content of the vaccine varies annually. The good news is that this year, it will protect against the H1N1 virus-the dreaded ‘swine flu’.
- The Controversy : There have been worries that the H1N1 vaccine has been possible link to the rare nerve disease Guillain-Barré syndrome, dating back to a similar epidemic in 1976. However newer vaccines are safer and the most recent view of the evidence to date suggests an incidence of a case per million vaccinations. The statistics on the syndrome are pretty unproved-whereas flu can be fatal.
- Should You Or Shouldn’t You? : Yes, even if you’re not in the high-risk groups. There are different makes of vaccine available, so if you’re concerned about thimerosal (which is in some brands) you can opt for another. From this year, pregnant women will be offered a seasonal flu vaccine, At the moment, you’re also entitled to a free jab under the age of 65 if you have asthma or another condition that’ll put you at more risk of flu. Otherwise, it will cost about 15 from a clinic or high-street pharmacy.
- The Background : It’s 13 years since the triple jab was linked to autism, and the argument still rumbles on. “MMR concerns are the front-runner for parents contacting JABS,” says a believer whose son was severely brain-damaged by an MMR vaccine and founded the support group JABS(Justice Awareness & Basic Support) for families concerned about the effects of vaccines. “It’s not the vaccine causing the rise in autism diagnosis,” counter-argues a professor of paediatric infection and immunity at Oxford University. “Those studies which look at it carefully are very convincing.”
- The Controversy : Herd immunity has broken down in a number of cases-an outbreak of rubella (German measles) in 1996 led to 12 babies born with congenital rubella syndrome, which results in sight and hearing loss, as well as heart and developmental problems. Single vaccines are an option, but “they would result in more children being unvaccinated for longer”. “You also have to stick to the schedule (the triple jab came in because parents let it slip) and cover all three conditions-including getting boys vaccinated for German measles, because they can pass it on the pregnant women.”
- Should You Or Shouldn’t You? : Overall worldwide medical opinion is that every child should have the MMR jab, as the pros outweight the cons. You can also have it as an adult, if you haven’t previously been immunised.
- The Background : Since September 2008 there has been a national programme to vaccinate girls aged 12 to 13 against the strains of the human papilloma virus (HPV) which are linked to cervical cancer. “It’s not 100 percent, and we don’t know how long it will protect for, so this generation of girls will still need screening. The Cervarix vaccine on offer is proving effective and might lead to smears becoming obsolete in the future. For example, in Australia, one of the first countries to introduce a vaccination programme, pre-cancerous abnormalities in young women vaccinated before they started having sex have dropped by around half.
- The Controversy : “The HPV vaccine has generated different issues around the world”. Concerns in the UK range from teenage promiscuity to the potential side effects: from swelling and nausea to fainting and dizziness. “Around 22 to 25 parents have contacted JABS, and not all their daughters have recovered.
“Most of the side-effects are minor and transient. “There’s about 25 per cent uptake and apart from one, where there was a pre-existing condition, there have been no adverse effects.”
- Should You Or Shouldn’t You? : It’s advisable for girls between 12 and 13 years old, and it is worth asking about Gardasil (which protects against genital warts) for boys too. Older women can have the vaccine as well-although you’ll probably have to pay for this – and you will need to continue having regular cervical smears. “If you’re already positive for these HPV strains the vaccine won’t get rid of the infection-it can only prevent you getting new infections.
- The Background : A lot of us still associate TB with consumptive Victorian poets, but it’s on the rise in the UK. The only available vaccine at the moment is the BCG: the one most of us remember getting as a teenager. Now some health specialists are proposing that all newborns throughout be vaccinated. “TB is a serious issue in the capital, and this in of the options that could prevent it spreading.
- The Controversy : This isn’t a vaccine that provokes much opposition-perhaps because the memory of the disease is still so devastating. “When it’s given at birth-as it throughout the developing world-it protects against TB lung disease”. Where the current vaccine breaks down is in its coverage in other countries. “In the developing world it’s less effective against lung disease, although it does seem to protect against TB meningitis. “But it’s only a travel risk if you’re going to live with local people for more than a month.”
- Should You Or Shouldn’t You? : The general consensus is yes, if you’re living in an area where your baby’s offered it. Unvaccinated adults under 35 are recommended to have the vaccination if they’re working with people or animals who are likely to have TB.
- The Background : Who knew? There is a chickenpox vaccine. In the Us it’s routine to have it as a fourth element added to the MMR vaccine, but it’s not usually available on the NHS-leaving chickenpox as one of the few childhood illnesses that still sweep through the primary-age population.
- The Controversy : One reason the chickenpox vaccine is not routine is that health professionals focus on MMR take-up. Also, cutting childhood chickenpox could increase the incidence of shingles (which can cause lasting pain and nerve damage) when the virus is reactivated in older people. “Older people need to keep their immunity boosted by some contact with chickenpox”. And while chickenpox doesn’t pose the danger of, say, measles, it can be nasty. “We see children with complications such as joint damage, severe skin infections or even septicaemia”. “One in 20 people reach adulthood without having it, and if they do then catch it they can be extremely ill”.
- Should You Or Shouldn’t You? : Yes, if you’ve made it to adulthood without catching it, particularly if you’re planning a pregnancy, as it can affect the baby’s development or the baby can be born with the disease. It’s also worth it for those spending time with small babies. You can get hold of it privately for children if you’re interested. On the other hand, plenty argue getting chickenpox is good for building general immunity.
Others jabs to think about…
Professor Finn suggests other vaccines you won’t routinely get at your GP, but are worth asking about:
- Babies Rotavirus : A common cause of winter diarrhoea and vomiting-hundreds of infants end up in hospital every year. Taken orally rather than by infection.
- Adolescents: Combined Help A&B And Meningitis Booster Help A is waterborne and outbreaks are rare in the UK, but common in countries with less clean water. Help B is principally a sexually transmitted disease (common in areas like south-east Asia) so it’s useful for young people when they start traveling. The meningitis booster covers strains that adolescents develop.
- Adults: Whooping Cough Whooping cough immunity wears off in adolescence, so a booster dose is a good idea, particularly if you’re around babies before they’ve been immunised, as you could get it and pass it on to the baby-and the killer cases are in babies who get the infection.