8 Feb 2013

Immunisation

Immunisation and cancer screening are the two of the leading forms of healthcare prevention practiced by the NHS. Most women will have smear tests regularly during their pre-menopausal years, and then breast screening when they are older. Men are increasingly offered prostate checks, and both genders are being offered bowel cancer screening. These screening tests are designed to catch early neoplasms, and in doing so, save lives.
Immunisation is routinely practised on children, from 8 weeks old until approximately 16 years. Immunisations carried out after that point are either for holiday/employment means or immunologically compromised patients.
In cancer screening, patients have the right to refuse. They might be exhorted to attend, for QOF measures and for their personal health, but they're under no obligation to go.
However, families who choose not to immunise their children are denounced.

 Childhood immunisation has been part of the NHS since it's inception, and was part of public health schemes long before that. The Diphtheria/tetanus/polio vaccine was administered regularly from the early 1960s, and as more vaccines have been developed, more have been offered. My children are immune to diphtheria, tetanus, polio, meningitis C, haemophilius influenzae type B, whooping cough, pneumonia, measles, mumps and rubella.
Pre-immunisation, these diseases killed millions. My grandmother suffered diphtheria in the days before the NHS, immunisation and penicillin. She was in an isolation hospital for months, forced to lie down constantly and kept away from her family (except her sister who was in with her). She watched other children on the ward die. This was not uncommon. Families who couldn't afford to send their children to hospital, if their child was suffering from a notifiable disease, were legally culpable. The child would usually die without good nursing. In my days working for the NHS, we had several patients suffering from ongoing disabilities from polio infections in their childhood, some dating from as late as the 1950s. For these families, a simple immunisation would have been a lifesaver.When I summarised patient notes, it was rare to find a patient growing up pre-1965 who didn't suffer from one of the childhood diseases that we now consider rare.
The MMR jab was not developed until the 80s. I suffered from mumps in 1988, and my brother suffered measles around the same time - neither of us were immunised, as we were too old when the vaccine became available. Cases of measles are now on the rise, as the herd immunity offered by mass vaccination wanes. This is largely due to the Wakefield Report, which linked autism to MMR vaccination, a report that has since been deemed false, and fraudulent.

There are many reasons that parents do not vaccinate their children. There are worries of autism/neurological illness, or a distrust of vaccination ingredients. Others do not believe the theory of vaccination. The common thread, from what I've seen on the internet, is fear inspired by ignorance. In one story I read, a woman refused to vaccinate because the immunisation contained ingredients she didn't know. This reminds me of the time my dad went through his PC and deleted every file he didn't recognise, and then wondered why his computer didn't work.

However, more common is the reluctance to introduce drugs to a newborn's baby. From conception, pregnant women are told not to smoke, not to drink, not to take medication unless it's necessary, not to eat raw fish, to cook meat properly, to avoid cheeses, with the clear message being "If you do, and something happens to your baby, it is YOUR FAULT."
Then, almost as soon as the baby is born, women are enjoined to take their precious newborn to a clinic to have an enormous needle stuck in it's leg, full of chemicals.

And if parents refuse to vaccinate their child, through fear, or ignorance, or cultural belief, or just because they don't want to, society vilifies them. They are called child abusers. Their friends are reluctant to let them play with their children, schools and nurseries are reluctant to take them on. The child and it's parents are punished for failing to conform to the biomedical patriachy. "The NHS has these lovely vaccinations, that could save your child's life, and you don't want it? You ungrateful swine, we hope you get diphtheria, just to prove how amazing we are!"

I remember telling a nurse, who I was friends with, that I wanted my eldest to have his first MMR and HIB/Men C booster separately. She looked at me askance and immediately started having a go about there being no proven link to autism. She could see no other reason why I didn't want my son exposed to two lots of vaccine at once. Nonetheless, after ranting at me like I was an idiot for a few minutes, she accepted my request. My reasons had nothing to do with fear of vaccination - I think vaccination is a wonderful thing - but because my son (like me) reacts badly to immunisation. He gets poorly, and has a localised reaction every time. I didn't want him to have to suffer a double lot of ouch if he didn't need to, and if he was allergic to the MMR, I wanted a clear cause. As it was, he had classic measles-type rash ten days after immunisation and was poorly for a day or so. I knew what had caused it, and didn't worry or panic. My younger son has the constitution of a horse, so there was no need to space out his immunisations. He also had the post-MMR rash.

There is definitely a feeling within the NHS that immunisation is not a parental choice, but a duty. Although a parent needs to give signed consent for administration, it is assumed that they will give this, and any questions are construed as dissent.

There are now a generation of parents and grandparents who do not remember life pre-vaccination. They do not remember fearing that an URTI would mutate into diphtheria. They do not remember worrying that a viral rash would be early measles.Parents are now able to look after their children without worrying about deadly childhood disease, meningitis excepted. There is very little education available on the components and benefits of immunisation, to the average first parent, because consent is assumed - some cursory leaflets and a bit of information in the 0-5 year book. Infectious childhood diseases, which are still rife in certain parts of the world, are assumed eradicated, the need to immunise questionable.

It does nobody any good to call anti-vaccination parents stupid, to act as though they are single handedly ruining the NHS and all it has striven for. Instead, the NHS needs encourage questions on how vaccines work, their ingredients and their necessity, with practitioners able to give answers there and then. An informed choice is better than blind conformity.

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