Vaccines in practice - 2008

Should we introduce compulsory vaccination?
Peter M English
pp 1-3
Given the overwhelmingly positive benefits of vaccination, it seems odd that the question of compulsory vaccination should ever arise. Why would anybody turn down the offer of vaccination? Routine vaccination primarily benefits the person being vaccinated, and is very safe. The diseases prevented are serious, so refusing vaccination (in the absence of contraindications) does not seem rational. Nevertheless, some people actively refuse to be (or have their children) vaccinated; and others find it too difficult to attend.
Comment: HPV: the programme begins but the controversy continues
Peter M English
pp 3-3
Since the first issue of Vaccines in practice, the major events in UK vaccine policy have been the announcement of the choice of product for the human papillomavirus (HPV) vaccination programme; and that the programme has commenced. It is too early to be clear about how well the programme is going, but initial reports have been good. This is a credit to the primary care organisations – especially the wonderful school nurse managers – across the country and to how well they have done, not least in finding the necessary staff. We have to hope that other crucial work will not consequently be left undone this time around (as I am told it was during the meningitis C campaign).
Group B streptococcal vaccines: a review
Chaam L Klinger
pp 4-5
Group B streptococcus (GBS, also known as Streptococcus agalacticae) causes serious disease in newborn babies. We have known since the 1970s that neonatal sepsis caused by GBS affects about 0.7 per 1,000 live births in the UK, and is fatal in 8% of cases. GBS is also a significant cause of stillbirths and prematurity. More recently, GBS has been seen to cause infections in adults, especially older people and the chronically ill.
Biology of immune responses to vaccines in older people
Wayne A Mitchell, Ryan C Pink and Richard Aspinall
pp 6-8
With increased life expectancy, the growing challenge is how to ensure we stay healthier for longer. As we age, our immune systems become less able to combat potential pathogens. We need to adapt our immunisation strategies in order to give best protection to older people. In this review we look at the current vaccination strategies to protect older people against influenza and pneumococcal disease.
ESPID 2008: innovations in vaccination
Peter M English
pp 9-9
I was delighted to hear, last year, that the 2008 European Society for Paediatric Infectious Diseases (ESPID) conference would be in Graz, Austria. As my wife comes from South Germany, I was already well disposed to German-speaking countries; even more so after recent skiing trips to Austria.
Maintaining the cold chain
Roy Fey
pp 10-11
‘The equipment and the people that keep vaccines cold, from the manufacturer to the child [or adult], are together called the cold chain.’ This is the most succinct yet comprehensive definition of the cold chain that I have found. It correctly stresses the fact that the cold chain relies on people as much as on equipment and delivery systems. Although refrigerators will fail on occasion, in common with any machine, many reports of ‘fridge failures’ (using this term to cover all instances of incorrectly stored vaccines) are due to human error.