HEALTH FILE: Protecting our youth against killer diseases
Teenagers in Gwent are becoming better protected against three potentially fatal or disabling diseases, thanks to the success of a health board vaccination campaign – but increases in cases of another dangerous illness, particularly for the very young, is causing concern.
LESS than three years ago uptake in Gwent of the threein- one teenage booster vaccination, which protects against polio, tetanus and diphtheria, was woefully low.
Barely one in every six 16-yearolds received it during the last quarter of 2009, and in Blaenau Gwent the rate was just one in 20.
To address a stark discrepancy between Gwent and the rest of Wales, Aneurin Bevan Health Board and Public Health Wales launched two initiatives.
School nurses were charged with delivering the three-in-one jab to teenagers, instead of it being given through primary care, as was previously the case across much of Gwent.
And the Get Protected campaign was launched, through which all teenagers of the appropriate age were provided with information leaflets on the importance of the vaccination.
Public Health Wales has subsequently reported that in the year to March 2012 uptake rose 52 per cent across Gwent – but Dr Gill Richardson, director of public health with Aneurin Bevan Health Board, said the improvement has been even better.
“We are vaccinating in Year 10 and those figures are now in the mid-70s in terms of percentage,” she said.
“In two years, that’s an astronomical increase.”
Polio, diphtheria and tetanus are very rare in the UK these days, due to successful long-term vaccination programmes.
At age 18 a person should have had five vaccinations against these diseases, beginning at one year old.
Booster vaccinations are necessary as immunity decreases slightly as people grow, but the fifth injection is regarded as the boost necessary for lifelong protection.
The problem is that by the time this comes around teenagers are by and large less engaged with primary care, while secondary schools do not have health visitor input.
Polio is a highly infectious virus that attacks the nervous system and can cause permanent muscle paralysis. If it affects the chest muscles or brain it can kill.
Tetanus, caused when germs from the likes of soil and manure get into cuts, burns or bites, also affects the nervous system and can cause muscle spasms, breathing problems and death.
Perhaps the least known of the three, diphtheria can also kill in severe cases, or damage the heart or nervous system. Beginning with a sore throat, it can quickly lead to breathing problems, and be spread by close contact with an infected person.
Dr Richardson said school nurses deserve much praise for the success of teenage booster initiatives, having taken on the task following the introduction of the HPV (human papilloma virus) vaccination programme for 12- 13-year-old girls.
HPV vaccine protects against 70 per cent of viruses that can cause cervical cancer.
“When HPV vaccine came in it was funded to be delivered through school nurses, so we discussed with them the possibility of moving to a system of them delivering the teenage booster too,” said Dr Richardson.
“For quite a small investment and a lot of goodwill, they’ve done an amazing job.”
Whooping cough is now a concern
WHILE teenage booster rates are on the up, there remains work to do to increase uptake of other vaccinations, in Gwent and across Wales.
MMR (measles, mumps and rubella) vaccination, where a 95 per cent uptake is the aim, does not achieve that target regularly enough overall, or in enough individual parts of Wales, for the first dose at age two, and more particularly for the second at age five.
Whooping cough – which can lead to pneumonia or brain damage, and from which babies are the most at risk – is a disease also causing concern among public health experts.
UK-wide, more than 2,500 cases have been reported this year, the highest for 15 years, and there is a fear that with many visitors coming to these shores – including Wales – for the Olympic Games, the situation could worsen.
The USA is currently reporting outbreaks of whooping cough, and the illness is also circulating widely in Australia and New Zealand.
Dr Richard Roberts, head of Public Health Wales’ vaccine preventable disease programme, said children and young adults not up to date with vaccinations are at risk, either while on holiday abroad or in the UK while mixing with visitors from countries where there are outbreaks.
“Meeting new people increases the risk of spreading infection, and people can be infectious before they have any symptoms,” he said.
“It’s important for young adults and parents to check that they or their children have received all of the routine vaccinations offered free of charge on the NHS. It’s never too late to catch up on missed doses.”
● Children who receive all scheduled vaccinations from two months to 16 years will be protected against measles, mumps, rubella, diphtheria, polio, whooping cough, tetanus, meningitis C, pneumococcal infection and Hib (a bacterial infection that can cause severe pneumonia or meningitis in young children).