Journal of Medical Sciences

Immunization: ​Lifetime Prevention of Infectious Diseases


Is there still a place for immunization in this modern medical world?

We rarely hear of diphtheria or polio, so what is the point in having our children stuck with needles? And aren’t the vaccines they use now just as dangerous as the infections used to be?

The fall in the number of cases of these once-dread diseases is not due to the use of antibiotics nor to the disappearance of the germs that cause them, but to the widespread regular use of immunization.

How does the immune system work?

When some bacteria or viruses invade the body and cause a disease, they also stimulate the body’s defense mechanisms to produce chemicals known as antibodies. These substances can then react with those germs should they ever invade the body again and thus prevent the infection from developing.

Sometimes these antibodies remain in the blood. In other cases the cells that produce the antibodies have been “programmed” – just like a computer – and should the germ or foreign protein enter the body, the immune system immediately produces a further supply of antibody to resist its influence. This is why one attack of most of the infectious diseases gives a lifetime immunity against another attack.

In the process of immunization, this immunity against the disease is produced without having to develop the disease itself. The vaccine used may be made from the toxin or poison produced by the germ, as in Tetanus Toxoid, used to immunize against tetanus.

The vaccine may contain the germ itself, but killed so as not to cause infection, such as the cholera vaccine. Or the vaccine may contain the live virus but changed or attenuated so that it will still induce immunity but cannot cause the disease, as in the rubella or German measles vaccine.

There has developed recently a vocal minority, often motivated by different reasons, which opposes the routine use of immunization of children. One group denies the “‘germ theory” of disease and at the same time advocates the use of large amounts of vitamin C or ascorbic acid to prevent or treat many infectious diseases. Other opponents base their arguments on a distrust of medicine and propose “natural” or herbal remedies.

Make no mistake, these germs have not disappeared from our community. Infection is rare, because so many in the population are immune – due to having been immunized. From time to time there are small outbreaks of some infectious disease, such as diphtheria, usually in unimmunized people.

There are side-effects from the use of these vaccines, just as there are side-effects with ALL medical treatment. What the doctor, and his patient, has to do is to balance up the good effects of the treatment against the bad effects and then make a decision about proceeding with that treatment or not.

Childhood immunization and vaccines

A baby’s immune system is not fully developed in the first few months of life, but it may be at risk of certain diseases, so immunization is started early. Some immunity is obtained and “booster” doses are given from time to time so as to re-stimulate the immune system and produce sufficient antibodies.

Breast milk, and particularly the secretion of the first few days after birth, colostrum, is rich in chemicals called Immunoglobulins. It will give the baby immune substances when his own body cannot yet deal with foreign protein or germs. If for whatever reason, a woman decides not to breast feed, and it is her decision to make, then she should at least put the baby to the breast for the first few days so that it gets this colostrum.

Routine immunization should be carried out in infants to protect them against tetanus, diphtheria and whooping cough. The Triple Antigen contains all three. This is followed by the oral Sabin vaccine to protect against poliomyelitis. It has now been recognized that more than the initial three doses are necessary to give full immunity.

Measles remains a serious disease and an effective safe vaccine is available. This is usually given at the age of 12 months. After the age of two, the whooping cough part of Triple Antigen is dropped, because it causes reaction in the older child and by this time the disease is no longer life-threatening. CDT (combined diphtheria and tetanus) is used instead.

It has been found that some adults have a low immunity to diphtheria and are therefore at risk of getting this disease or passing it on to their children. An adult form of CDT is available.

At around 12 years, Bacillus Calmette-Guerin (BCG) vaccine is given to those whose Mantoux test is negative. In the past, nearly all of us came into contact early in life with tuberculosis (TB) and developed a partial immunity. This meant that if we later caught TB then it was a slow progressive illness rather than a rapid, severe and often overwhelming infection.

Now children do not come in contact with TB, because it is uncommon, and therefore do not have this partial immunity. Their Mantoux test is therefore negative. BCG vaccine stimulates this partial immunity, just as the normal mild contact with TB used to do.

Rubella, or German measles, is a mild infection and causes no problems except if a woman develops it during pregnancy. Then the virus can cross the placenta and affect the baby, causing deafness, blindness, heart problems, generalized disorders or multiple defects.

A vaccine to prevent rubella is available and there is a campaign to immunize all schoolgirls before they reach child-bearing age. Adult women who are not immune to rubella should also receive this vaccine. It is not necessary for males to be immunized for rubella.

Smallpox vaccination is required for travel to some other countries. It is not advised for routine immunization as the side effects of the vaccine are, in this country, likely to be greater than the risk of developing the disease. Immunization against other diseases, such as cholera, yellow fever and plague, may be required if you travel abroad, but are not given as a routine.

NOTE: There is no room for complacency and most doctors, conservative or trendy, would still recommend routine immunization to protect your children. If you have an alternative lifestyle, you may disagree with this advice but do not let ideology blind you to proper scientific opinion.

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