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  • Writer's pictureAnne O

Measles and the Case for Immunization.

Globally, measles infection rates quadrupled and all regions of the world are purportedly affected. Africa reportedly has the highest burden at 700% increase in cases. In Nigeria alone, 6,000 cases and 15 fatalities were recorded by March 2019.

Measles is a relatively common infection in rural parts of Africa particularly in areas where healthcare access is a challenge, whereas a rare occurrence in many developed cities of the world until its resurgence. Its reemergence in cities like New York has helped raise red alerts to a possible decline in immunization compliance in places where hitherto there has been little or no occurrence for several years. Pertussis has also been reported to be emerging in areas erstwhile was regarded eradicated.

Sometime ago, one of my kids asked me what chickenpox was, having read about it in a novel called “Diary of a Wimpy Kid”. He wanted to know how one could be infected. Whilst I summarized the disease to him, his face lit up when he learnt that he was highly unlikely to be infected with chickenpox because of the vaccination shots he had received when he was younger. His relief made me reflect a little longer and reckon that at least, I had done something commendable for my little ones. Even more, I am happy that they would not have to go through the inconveniences and illness I went through when I contacted chickenpox during my undergraduate studies. The tiny keepsakes hidden on parts of my skin remind me of the advances medicine has made that enables me dodge damaging and debilitating infections daily.

In the centuries when humanity lived before vaccines, millions of people died from infections and epidemics as these diseases ravaged cities, settlements and countries. Tuberculosis, known as consumption in medieval times, is said to have killed millions of people. The same goes for smallpox which not only caused fatalities in its millions but also defaced those who managed to survive. The earliest report of vaccinology dates back to the 10th century amongst the Chinese however, modern documentation is accredited to physician Edward Jenner who in the 17th century used cowpox pustules to rave up the immune system against smallpox infection. He tried out this experiment after he observed that milk maids infected with cowpox were known not to be infected with smallpox. His work paved the way for attempts and successes at developing vaccines for other infective diseases across the world.

Currently, there are over twenty vaccines available in the world today. Smallpox was eradicated from the world in 1977 and by 1979 it was declared eliminated because of the laudable efforts of health systems in ensuring that vaccination coverage and compliance were given priority. In year 2000, the United States was declared measles free, sadly, that has since changed. The figure of measles cases in a number of cities has shown an even increasing number since the beginning of 2019 and necessitated local laws for vaccination to be introduced. Another drawback was in 2016 when a wild polio virus was detected in Nigeria after it had been declared non-endemic by WHO a year prior. This happened after five years of nil presentation of the strain. Currently, three countries in the world are reported to still have incidences of wild polio virus.

During my time in high school, I recall a junior student who had been out of school return with a lower limb paralysis and consequently a limp. It was heart breaking to learn that she had suffered a vaccine preventable infection. Still, it is ever so disheartening meeting people who end up with deafness, blindness, paralysis and cerebral palsy from vaccine preventable infections.

Acceptance and compliance to vaccination has been on the low lately. This has been attributed to factors such as migration; refugee crisis; and the fear or concern that vaccines cause more harm than good. While efforts are made to combat the spread of infections from migration, the utmost dilemma has been to debunk the claims linking a certain vaccine to autism. Ironically, this isn’t the first time vaccination has been linked to an undesirable side effect. Sudden Infant Death Syndrome also known as SIDS was first linked to vaccination. This link was attributed to infants been vaccinated coinciding with reported cases of SIDS. Evidence however proved that SIDS and vaccination had no correlation. The cause of SIDS was eventually proved to be linked to the prone sleeping position. Fortunately, this aided in increasing awareness towards educating new mothers on laying their babies in the supine position rather than the prone position.

In the case of autism, a doctor was the originator of the link between autism and vaccination. He presented an article linking autism to the MMR vaccine after he claimed to have conducted some research. His article was eventually withdrawn after it was proven that his claims were fraudulent having been accused of falsifying data. Little did it help that his co-authors retracted the article and withdrew their claim. Furthermore, rigorous scientific research done to ascertain the risk has seen no link to the MMR vaccine and autism. Yet, the link and claims still fuel a lot of the antivaccination claims present to date.

Being a mother, I must admit that every vaccination appointment comes with some form of anxiety. I am keen for them to pass quickly as I prep my kids on the painful jabs they are sure to receive. Still, I know that the discomfort of the shots is nothing compared to dealing with diseases and complications they will be shielded from. Vaccines, like most other drugs, have side effects. For the most part, these undesirable effects are mild reactions. In my experience as a recipient, mum and physician, I find that these reactions are mild and pass quickly if any. Some of the mild to moderate reactions include transient fever, rash or pain or soreness at injection site. The more severe reactions (including seizures and anaphylactic reactions) are rarely encountered in normal patients.

Suffice it to say that one cannot underrate the gains and successes medicine has achieved through vaccination. It is a joy to consider that the world is protected from fatal epidemics by infective diseases today because of the advancement of vaccinology and modern medicine. To decline (and not prioritise) vaccinating one’s self and one’s loved ones is at the expense of our present and future wellbeing, as well as those of generations to come.

We all must do our best to ensure that vaccine preventable diseases are eradicated and completely eliminated from our world. We have done it with smallpox and are well on our way with polio. Science and its advancement in health will make minimal progress if we are not committed to the cause of getting ourselves and loved ones vaccinated. Doing this means that the resources that have been expended are not a waste and future funds can then be used to combat other healthcare challenges such as cancer. We all have a role in ensuring the collective wellbeing of the world and of our offspring. Together we can!

Dr Anne Olowu writes from Lagos, Nigeria.

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