SAFETY IN NUMBERS
Should you, shouldn’t you – there’s so much conflicting advice out there, what’s a new mom supposed to do? With the latest information on vaccines and herd immunity you can make an informed decision
It’s been over 200 years since the first vaccination was given. Since then millions of lives have been saved, thanks to a host of vaccines being made freely available across the planet. Yet, in some firstworld countries parents are choosing to opt out of state vaccine programmes. The effects are starting to be seen with breakouts of diseases that have been practically non-existent for decades. Measles, for example, was declared eliminated in the US 15 years ago. But in 2014 an unvaccinated traveller visited Disneyland, was exposed to a person suffering from measles, and went on to infect more than 100 people. Similar outbreaks have been seen in Australia, Canada and Europe.
South Africa also experienced a measles outbreak between 2009 and 2011 with 18 000 cases, according to the National Institute for Communicable Diseases (NICD). There were a significant number of deaths and long-lasting damage to children from this outbreak. Additionally, South Africa experienced a total of 15 cases of diphtheria – and four deaths from this bacterial infection – between April and July 2015.
The measles virus, which, according to the World Health Organisation (WHO), is one of the leading causes of death among young children, is so contagious that 90 percent of the people close to a person who is not immune to it will also become infected. This is why maintaining what doctors term “herd immunity” for this virus, among others, is critical.
THE UMBRELLA OF IMMUNITY
Vaccines work in two ways, explains Dr Melinda Suchard of the Centre for Vaccines and Immunology at the NICD. “The first way is the obvious way, in that it will protect your child from acquiring that disease. The second way it works is preventing your child from spreading the disease. So having your child vaccinated will in fact prevent your child being a link in the transmission into somebody else,” she says.
This is very important because there are some people who just cannot be vaccinated. Children who are too young (below the age at which you can give a vaccine; for measles, for example, younger than six months); or children with specific medical conditions and compromised immune systems, such as leukaemia, are unable to be vaccinated. Dr Suchard also explains that vaccines are not effective for everyone, so there will be about five percent of the community who are susceptible to infections even though they have been vaccinated. “Vaccinating your child helps protect the whole community. It’s also critical to have high vaccination levels as part of a coordinated global effort to try to interrupt transmission of dangerous circulating viruses and bacteria and to ensure coverage if there is an infected traveller who comes into the country, or any importation of a virus,” she says. A success story of global vaccination programmes is the eradication of smallpox in the 1970s, which means no one needs to be vaccinated against it anymore.
Smallpox may be one less vaccine your baby requires, but over the course of the next 12 years she will get close to 20 shots. Getting your head around the fact that she needs to be injected with a disease to ultimately protect her can be difficult, but understanding how vaccines work should allay your fears.
Whether you decide to vaccinate your child by following the government Road To Health card, or go to a private clinic, really comes down to questions of cost and convenience and what your time or budget allows. At a state clinic all the vaccines on the Department of Health’s Extended Programme on Immunisation (EPI SA) are offered for free. The disadvantage is that you can’t book an appointment so you may experience long waits at the baby clinic. You also won’t get the “personal touch” and follow-up contact you get from a private nursing sister. However, you could always contact the vaccine helpline Amayeza on 0860 160 160 for advice and information.
The major benefit of the EPI SA is that all the vaccines are offered for free, whereas if you go to a private clinic you will have to pay for each vaccine as well as an additional consultation fee, which can range from R100 to R300.
“In the past, at some of the private clinics you could also get some of the vaccines from the state so you wouldn’t have to pay for them, but this was stopped at the end of last year,” says Sister Ingrid Groenewald, a registered nurse and private midwife. It can become very expensive if you don’t have medical aid to cover it. “The vaccines your baby needs at six and 14 weeks can add up to almost R2 000 for each visit and if you are already earning less because you are on maternity leave or haven’t been paid out your benefits yet, this can cause financial pressure,” says Sr Ingrid. She recommends you start putting aside some money for the vaccines while you are still pregnant, or asking friends or family to gift the money for vaccines instead of giving your baby toys or clothes at birth.
The quality of state and private supplied vaccines don’t differ. “Both schedules are excellent,” confirms Dr Suchard. “The state schedule is based on what is going to protect South Africans from a herd immunity perspective,