Value of Vaccines Fast Facts and Myths

(As taken from a GlaxoSmithKline Pamphlet)

Fast Facts
Vaccination is a proven method for controlling and in some instances eradicating disease.  Every year due to vaccines, approximately three million deaths are prevented and 750,000 children are saved from disability.  With the exception of clean, safe drinking water, no treatment has rivalled vaccination in its ability to reduce mortality rates.  Immunisation campaigns are among the most successful and cost-effective public health interventions. Some experts suggest they have saved in the vicinity of 20 million lives in the last two decades.4
Globally, 24 million children – almost 20% of children born each year – do not have access to the complete routine immunisations which are recommended to be scheduled for their first year of life.  In 2002, the World Health Organisation (WHO) estimated that 1.4 million deaths among children under five years of age were due to diseases that could have been prevented by routine vaccination; accounting for 14% of global mortality in children of this age.
Vaccines have been demonstrated to dramatically reduce and, in some instances, eradicate disease: The global eradication of smallpox has resulted in savings of US$1.3 billion a year in treatment and prevention costs ever since. Polio cases fell by over 99% from over 300,000 per year in the 1980s to fewer than 2,000 in 2009.7 Over 20,000 deaths from neonatal tetanus are prevented annually due to high rates of vaccine coverage.

Since the introduction of the rotavirus vaccine in national immunisation programmes in 2006, considerable reductions in severe and fatal cases of childhood diarrhoea have been observed in countries with a range of economic statuses.
“Vaccines prevent children from death and disability, enabling families to break out of a cycle of poverty and ill health.” GAVI Alliance Economic benefits of vaccines Vaccination is one of the most cost-effective public health measures available, presenting an economic benefit for individuals, communities and nations with healthcare systems.2 Immunization reduces the social and financial costs of treating diseases, offering opportunities for poverty reduction and greater social and economic development. For example, a Kenyan study estimated that a one week ‘supplemental immunization activity’ against measles carried out in 2002 – in which approximately 13 million children were vaccinated – would result in a net saving of $12 million in healthcare costs over the following ten years; during which time it would prevent over three million infections and 125,000 deaths.
Socioeconomic benefits of vaccines Vaccines have been used to protect those in greatest need of protection against infectious diseases, such as pregnant women, cancer patients and the immunocompromised. Investment in the area of vaccination is an important contributor to poverty reduction, improved quality of life, and economic development and prosperity.12 High levels of vaccination can also offer ‘herd immunity’ – this is a state at which immunisation levels in a given population are so high that even the small minority not immunised may be protected.
What are vaccines?

The vaccine concept is based on stimulating the body’s defence mechanisms against a specific pathogen to establish this immunological memory. By definition, all effective vaccines lead to the development of immune memory, by mimicking the threat of an infection and providing antigens derived from the specific pathogen. The ability to generate immune memory is the key attribute of the adaptive immune system, which is crucial for the long-term protection of individuals and populations. Through the addition of compounds called adjuvants, a vaccine’s ability to elicit a strong, durable protective immune response can be enhanced, therefore making them more effective. ‘Adjuvant Systems’ are specific combinations of individual adjuvants.

Vaccines have an impact around the world In Kenya, introduction of Hib (Haemophilus influenzae type B) vaccine into the routine childhood immunisation programme reduced the incidence of Hib disease among children younger than five years of age by 88%, reducing overall mortality in under-fives by 4%. The launch of RotarixTM saw hospitalisations in Brazil due to rotavirus gastroenteritis decrease by almost 60% in children younger than five, in post vaccines period. Up until 1999, meningitis C was the most common cause of death in children in the UK aged between one and five. Through the introduction of various vaccines for meningitis C, including MenitorixTM, incidence rates of meningitis have fallen significantly; since 2000, the meningitis C vaccination programme has prevented over 9,000 cases of serious disease and more than 1,000 deaths.

GSK is at the forefront of vaccine technology with significant advances to optimise protection from infectious diseases. 70% of our pipeline is based on vaccines containing Adjuvant Systems (AS). GSK has been investing in AS technology for almost 20 years. We have a large portfolio of adjuvant systems on which to draw to enrich the company’s expanding vaccine pipeline.

GSK is committed to providing global access to vaccines GSK is committed to making our vaccines available to developing countries and developed countries. For over 20 years we have made our entire vaccine portfolio, such as our combination vaccines, available at preferential prices to developing countries using a tiered pricing system. In 2010, GSK delivered 1.4 billion vaccine doses to 179 countries – this equates to almost 3 million doses each an every day. Over 70% of the vaccine doses distributed in 2010 were to developing countries.

Are vaccines safe?

Today, vaccines have an excellent safety record. Vaccine manufacturers can only sell their vaccines after they have satisfied regulatory authorities of the positive risk/benefits balance of the vaccines. All vaccines must be evaluated by the relevant national vaccine committees, for example the Joint Committee on Vaccination and Immunisation (JCVI).

Are vaccines safe in babies and children?

Regulatory authorities carefully assess the data available for each vaccine before they grant it a license, and it is only once authorities are satisfied that the benefit outweighs the risks in children, that a vaccine will be authorised for use in this age group. Babies and children are given vaccines at a young age because this is when they are most vulnerable to vaccine preventable diseases. Routine vaccination helps to protect children from diseases that can be detrimental to their well-being.

Are vaccines dangerous for the immune system?

No evidence suggests that the recommended childhood vaccines can ‘overload’ the immune system. In contrast, from the moment babies are born they are exposed to numerous bacteria and viruses on a daily basis.

Do vaccines contain harmful ingredients?

Vaccine manufacturers can only sell their vaccines after they have satisfied regulatory authorities of their safety as well as their efficacy. If a vaccine contained a harmful ingredient it would not be deemed to be safe by the authorities and would not be licensed for sale.

Do vaccines cause disease and illness?

Vaccines prevent up to 3 million deaths and save 750,000 children from disabilities every year.2 Some vaccines may very rarely cause side-effects, which are almost always short-term in nature.

Do vaccines cause autism?

There is no scientific evidence that any vaccine formulations, including those containing thiomersal/thimerosal (contains ethyl mercury), cause neurodevelopmental disorders such as autism. The WHO’s Global Advisory Committee on Vaccines Safety (GACVS) reviewed this issue in 2002 and concluded that there is no evidence of toxicity in those exposed to thiomersal in vaccines,20 and in 2008 maintained the view that there is no evidence supporting any change in WHO’s recommendation for thiomersal-containing vaccines, including for low-birth-weight infants where indicated.

Do vaccines work?
Most childhood vaccines are 90-99% effective in preventing disease. They have kept children healthy and saved millions of lives around the world for more than 50 years.

Is it really necessary for babies/children to be vaccinated?

Maternal immunity passed to a baby by its mother only lasts for a few months and does not protect them against the vast number of vaccine preventable diseases they may encounter.19 It is therefore highly recommended that babies and children are vaccinated.

Are additional vaccine doses really needed once one dose has been administered?

Multiple doses are generally needed to provide sufficient stimulation of the immune system and booster doses may be needed to induce or maintain persistent immune responses.

Is ongoing vaccination necessary?

Many diseases which used to be major childhood killers are now rare. However, in certain parts of the world, some of the pathogens that cause vaccine preventable disease are still common and can be passed on to individuals that are not protected by vaccination. For this reason the need for vaccination is ongoing.

Why do newer vaccines cost so much?

Although highly effective, older vaccines such as the polio vaccine are based on well-established technologies that have been in widespread use for many decades. They are single antigen vaccines, which mean that they contain a single molecule designed to trigger production of an antibody and as a result are relatively simple and inexpensive to produce. In contrast, newer vaccines often contain multiple antigens and use advanced technologies (such as GSK’s Adjuvant Systems) designed to enhance their efficacy, which is needed for some diseases. These innovations induce a more enhanced, targeted stimulation of the immune response, producing strong, sustained and a broad protection that is of an improved efficacy to older vaccines.

References
1 UNICEF. Vaccines bring 7 diseases under control. The progress of nations 1996 – Health. February 2006. Available at: http://www.unicef.org/pon96/hevaccin.htm (accessed 18th April, 2011)
2 Ehreth J. The global value of vaccination. Vaccine 2003; 21: 4105-4117
3 Plotkin S, Orenstein W, Offit P. A short history of vaccination. Expert Consult. Vaccines. 2011
4 UNICEF. A short history of vaccination. Fact Sheet – Immunization 2010. Available at: http://www.unicef.org/media/media_46851.html (accessed 18th April, 2011)
5 WHO, UNICEF, World Bank. State of the world’s vaccines and immunization, 3rd edition. Geneva, 2009
6 WHO. Immunzation surveillance, assessment and monitoring. Available at: http://www.who.int/immunization_monitoring/diseases/en/ (accessed 19th April, 2011)
7 WHO. Poliomyelitis fact sheet. November 2010. Available at: http://www.who.int/mediacentre/factsheets/fs114/en/index.html (accessed 18th April, 2011)
8 UNICEF. Improving equity by eliminating maternal and neonatal tetanus. Available at: http://www.unicef.org/publications/files/5524_Unicef_6pg_final.pdf (accessed 18th April, 2011)
9 Patel et al. Real-world impact of rotavirus vaccination. The Pediatric Infections Disease Journal 2011; 30(1): S1-S5
10 GAVI Alliance. GAVI and its role in achieving the Millennium Development Goals. Available at: http://www.gavialliance.org/media_centre/features/gavi_mdgs.php#MDG1 (accessed 19th April, 2011)
11 WHO. Fact sheet – Immunization against diseases of public health importance. March 2005. Available at: http://whqlibdoc.who.int/fact_sheet/2005/FS_288.pdf (accessed 9th May, 2011)
12 Andre F.E. et al. WHO. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of the WHO 2008; 86(2): 81-160
13 Garcon, N. et al. Understanding modern vaccines – Perspectives in vaccinology. Elsevier. 2011; Vol 1 Issue 1
14 Akumu A.O. et al. WHO. Economic evaluation of delivering Haemophilus influenza type b vaccine in routing immunization services in Kenya. Bulletin of the WHO 2007; 85(7): 511-518
15 Safadi et al. Hospital-based surveillance to evaluate the impact of rotavirus vaccination in Sao Paolo, Brazil. Pediatr Infect Dis J 2010; 29(11): 1019-22
16 Department of Health. Meningococcal C vaccine (Meningitis C) Factsheet. October 1999. Available at: http://www.nhs.uk/Planners/vaccinations/Documents/mencfsht[1].pdf (accessed 4th May, 2011)
17 Health Protection Agency. Meningococcal infection factsheet. 2011 Available at: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733822509 (accessed 3rd May, 2011)
18 GSK Challenging the world of Vaccines Corporate Brochure 2011
19 Centers for Disease Control and Prevention. Vaccine Safety – Frequently asked questions about multiple vaccinations and the immune system. 2011. Available at: http://www.cdc.gov/vaccinesafety/Vaccines/multiplevaccines.html (accessed 19th April, 2011)
20 WHO. Global Advisory Committee on Vaccine Safety. Weekly epidemiological record 2002; 47: 389-404
21 WHO. Joint WHO-CDC conference on laboratory quality systems, Lyon, April 2008 – joint statement and Recommendations. Weekly epidemiological record 2008; 32: 285-292
22 American Academy of Pediatrics. Vaccine safety: The facts. 2008. Available at: http://www.cispimmunize.org/pro/pdf/VaccineSafety_parenthandout.pdf (accessed 18th April, 2011)

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