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Doubts have been raised over the safety of vaccines for
measles, meningitis C, and most recently polio in the UK.
The Association of the British Pharmaceutical Industry (ABPI)
addressed this, and the danger of public complacency toward
the importance of vaccination, at a press conference on
13 September 2000.
The speakers highlighted that many infectious diseases are
controlled through vaccine programmes, and that such programmes
were responsible for wiping out smallpox and the near eradication
of polio and measles.
Worldwide, three million lives are saved annually through
vaccination programmes, and more coverage could save the same
number again. A further eight million lives could be saved
by the vaccines currently in research, including those for
pneumococcus, influenza and hepatitis B and therapeutic vaccines
for cancer and HIV.
Fears surrounding vaccines
The risk of infectious disease within a community decreases
as the proportion of the population vaccinated increases
('herd immunity'). As this is also true in reverse, publicity
that turns individuals against vaccines can therefore impact
on the nation's health.
A link between the measles, mumps, rubella (MMR) vaccine
and inflammatory bowel disease and a form of autism has
been alleged through research by the Royal Free Inflammatory
Bowel Disease Group (RFIBDG) in London. However, several
subsequent studies from UK, Swedish and Finnish groups disagree
with these findings.
As a result of this RFIBDG report, uptake of the MMR vaccine
has declined in some parts of the UK, and this could lead
to a measles epidemic. Similar situations occurred in Ireland
and the Netherlands, leading to five preventable deaths,
and vaccine coverage dropped from 81% to 31% following a
campaign against pertussis vaccine in 1974.
More recently, thousands of adverse reactions reported shortly
after vaccination with meningitis C vaccine continue to
fuel these public fears. And now, Medeva's polio vaccine
is in the headlines over concerns that it could be contaminated
with the BSE agent.
Why vaccines are 'safe'
The ABPI stresses that vaccines are safe, due to a number
of factors:
- Thorough testing before receiving marketing authorization
- Once marketed, safety is monitored by the Medicines
Control Agency (MCA) in the UK and the European Medicines
Evaluation Authority (EMEA) in the European Union
- Independent bodies provide advice on vaccines and
policy: the Joint Committee on Vaccination and Immunization
(JCVI), the Committee on the Safety of Medicines (CSM)
and the Immunization Division of the Communicable Disease
Surveillance Centre (CDSC)
The vaccine success story
Vaccination is a highly cost effective medical intervention,
according to the ABPI, especially in consideration of the
direct as well as indirect medical costs. Savings go to
the UK's National Health Service, the Department of Social
Services, local authorities and individual employers.
Smallpox and polio are two highly feared infectious diseases.
Worldwide vaccination initiatives have led to the eradication
of smallpox and the elimination of polio is drawing closer
- $300 million spent now to achieve this will save the $1.5
billion spent annually on polio related healthcare.
The future of vaccines
Vaccination programmes save nearly three million lives worldwide
each year, yet have the potential to save that number again,
and, new vaccines currently in research could save a further
eight million lives.
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Deaths
Worldwide Caused by Infectious Diseases (1997)
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|
Infectious
Disease
|
Number
of Deaths
|
| Acute
lower respiratory tract infections |
3.7
million
|
| Tuberculosis |
2.9
million
|
| Diarrhoea |
2.5
million
|
| AIDS/HIV |
2.3
million
|
| Malaria |
1.5-2.7
million
|
| Measles |
960,000
|
| Hepatitis
B |
605,000
|
| Hib
meningitis and pneumonia - childhood deaths |
400,000-700,000
|
| Neonatal
tetanus |
248,000
|
* Diseases
represented in bold type are vaccine preventable
Source: ABPI Report ('Prevention is Better than Cure');
WHO
New vaccines for pneumococcus, influenza and hepatitis B
are nearing the market, while among others in the pipeline
are those for rotavirus, hepatitis A, meningococcus B and
B&C. Therapeutic vaccines, such as those for cancer and
HIV, are further from the market.
Novel delivery systems, such as intranasal delivery of influenza
vaccine, will provide alternatives to injectable vaccines
but will need to offer strong incentives for use by general
practitioners, who will not receive the usual fee for administering
injections.
Find out more about the vaccines market in the new report
from IMS HEALTH Consulting:
"Strategic Assessment of the Vaccines Environment." The
report covers the five main European markets, and looks
at all aspects of childhood immunization, influenza and
occupational health, and travel vaccines. For further details
please contact Vanessa Hilton-Barber via e-mail at
vhilton-barber@uk.imshealth.com.
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