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Vaccines: Hundreds of years in the making, Millions of lives saved

We’ve probably all heard more about vaccines over the past three years than ever before.

Developing and delivering the COVID-19 vaccine was essential to our route out of the pandemic and back into normal life.

Yet vaccines are not something new, and they are not solely used to help us escape global health crises – they are there to prevent them.

In the first in a series, we’ll explore the origins of vaccines and how they work, previous success and current use, and touch on vaccine scepticism and safety.

Scroll down to read on or use the buttons to skip to different sections.


History

As far back as the 1400s, people all around the world were trying to prevent illness by deliberately exposing healthy people to small amounts of smallpox.

The practice became increasingly widespread, reaching Europe in the early 1700s.

Smallpox transmitted easily and became very widespread. 1 in 3 people who got it would die, and in the 18th century, it accounted for 400,000 deaths a year in Europe.

In 1796, English Physicist Edward Jenner created the first vaccine as we now know them. It used matter taken from a cowpox sore – a much less dangerous source – to provide resistance to smallpox.

The word vaccine takes its name from this discovery, with vacca being the Latin word for cow.

Years of extensive testing followed, and despite rumours spreading that it would turn you into a cow, by the early 1800s, it was shown to protect people effectively against smallpox.

A certificate confirming a patient had received a smallpox vaccination.

Universal childhood vaccination followed in the US and UK in the 1840s-50s. Vaccination was compulsory in this country when it was introduced in 1854.

By 1971, the programme had been so effective that vaccinations in the UK were stopped as new cases were so few and far between.

The World Health Organisation declared smallpox eradicated in 1980, making it the first and, so far, only disease to be globally wholly wiped out through vaccination.

How they work

Vaccines teach the immune system how to recognise and fight off specific disease-causing germs.

As we’ve discussed, this was first done by exposing healthy people to the same virus they were targeting.

But, of course, vaccines have become much more advanced and considerably safer.

Modern vaccines contain weakened, inactive or, in some cases, synthetic versions of the disease. People are protected against the disease without getting ill first.

Our immune systems create a memory of how to fight off the virus and can then repel it again.

How long the vaccination protects us depends on the type of virus it is defending us against.

Some viruses – like flu or COVID-19 – can replicate quickly and create new strains of themselves. Others, like smallpox or measles, are more stable and don’t change. That’s why some vaccinations offer lifelong protection, and others must be ‘topped up’ or regularly boosted.

Successes

In the post-war years, routine vaccination of children became the norm. Polio, which once infected 1,000 children a day, was eradicated in Europe in the early 2000s (although it still exists in other parts of the world.)

Cases of other previously common diseases like diphtheria and meningitis are now sporadic in the UK due to mass vaccination.

More recently, in the first year of COVID-19 vaccinations, nearly 20 million deaths were prevented worldwide.

A sticker saying ‘I’ve had my COVID vaccination on an iPhone. Photo by Nick Fewings on Unsplash.com

Every year, 3 million deaths are prevented worldwide by childhood vaccinations. But in 2021, nearly 1 in 5 children weren’t fully protected – the lowest rate in over a decade.

Scepticism and Safety

Scepticism and worries about vaccination have existed as long as vaccines themselves.

We’ve mentioned the ‘turn you into a cow’ rumours from the 1800s and other stories, tales, misinformation, and, in some cases, academic papers have suggested side effects or links to further illnesses.

In 1998, a published study suggested the Measles, Mumps and Rubella (MMR) vaccine caused autism. Despite being a small, uncontrolled speculative study, it was widely publicised, and vaccination rates began to fall.

More than a dozen large-scale studies followed. None showed any connection between the MMR vaccine and autism.

Eventually, the authors retracted their original study. Subsequent measles outbreaks in the UK and America were attributed to the fall in vaccination rates following the controversy.

The NHS website has an excellent section on vaccine safety, possible side effects, and the rigorous testing each jab must undergo before being used.

There is also a helpful video with a parent asking a GP why vaccines are safe for their child. Follow the link above or tap the image below to see the video and read more.

The NHS Vaccines schedule

The NHS vaccination programme protects a range of diseases from childhood, adolescence and into old age. The NHS routine childhood immunisation programme was revised in September 2023. This is the new complete immunisation schedule.

Your child’s vaccines should be recorded in their ‘red book’. Don’t hesitate to contact your GP practice if you are unsure or think your child may have missed a vaccination.

The NHS routine childhood immunisation programme was revised in September 2023. This is the new complete immunisation schedule.

WhenDiseases protected againstVaccine givenTrade nameUsual site
8 weeks oldDiphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenza type b (Hib) and hepatitis BDTaP/IPV/Hib/HepBInfanrix hexa or VaxelisThigh
Meningococcal group B (MenB)MenBBexseroLeft thigh
Rotavirus gastroenteritisRotavirusRotarixBy mouth
12 weeks oldDiphtheria, tetanus, pertussis, polio, Hib and hepatitis BDTaP/IPV/Hib/HepBInfanrix hexa or VaxelisThigh
Pneumococcal (13 serotypes)Pneumococcal conjugate vaccine (PCV)Prevenar 13Thigh
RotavirusRotavirusRotarixBy mouth
16 weeks oldDiphtheria, tetanus, pertussis, polio, Hib and hepatitis BDTaP/IPV/Hib/HepBInfanrix hexa or VaxelisThigh
MenBMenBBexseroLeft thigh
1 year old (on or after the child’s first birthday)Hib and Meningococcal group C (MenC)Hib/MenCMenitorixUpper arm or thigh
PneumococcalPCV boosterPrevenar 13Upper arm or thigh
Measles, mumps and rubella (German measles)MMRMMRvaxPro or PriorixUpper arm or thigh
MenBMenB boosterBexseroLeft thigh
Eligible paediatric age groupInfluenza (each year from September)(each year from September)
Live attenuated influenza vaccine LAIV
Fluenz TetraBoth nostrils
3 years 4 months old or soon afterDiphtheria, tetanus, pertussis and poliodTaP/IPVBoostrix-IPVUpper arm
Measles, mumps and rubellaMMR (check first dose given)MMRvaxPro or PriorixUpper arm
Boys and girls aged 12 to 13 yearsCancers and genital warts caused by specific human papillomavirus (HPV) typesHPVGardasil 9Upper arm
14 years old (school Year 9)Tetanus, diphtheria and polioTd/IPV (check MMRstatus)RevaxisUpper arm
Meningococcal groups A, C, W and YMenACWYNimenrixUpper arm
65 years oldPneumococcal (23 serotypesPneumococcal polysaccharide vaccine (PPV23)Pneumovax 23Upper arm
65 years of age and olderInfluenza (each year from September)Inactivated influenza vaccineMultipleUpper arm
65 from September 2023ShinglesShingles vaccineShingrixUpper arm
70 to 79 years of age (plus eligible age groups and severely immunosuppressed)ShinglesShingles vaccineZostavax (or Shingrix if Zostavax contraindicated)Upper arm

Selective immunisation programmes

Target groupAge and scheduleDiseaseVaccines required
Babies born to hepatitis B infected mothersAt birth, 4 weeks and 12 months oldHepatitis BHepatitis B (Engerix B/HBvaxPRO)
Infants in areas of the country with tuberculosis (TB) incidence >= 40/100,000Around 28 days oldTuberculosisBCG
Infants with a parent or grandparent born in a high incidence countryAround 28 days oldTuberculosisBCG
Children in a clinical risk groupFrom 6 months to 17 years of ageInfluenzaLAIV or inactivated flu vaccine if contraindicated to LAIV or under 2 years of age
Pregnant womenAt any stage of pregnancy during flu seasonInfluenzaInactivated flu vaccine
From 16 weeks gestationPertussisdTaP/IPV(Boostrix-IPV)

Additional vaccines for individuals with underlying medical conditions

Medical conditionDiseases protected againstVaccines required
Asplenia or splenic dysfunction (including due to sickle cell and coeliac disease)Meningococcal groups A, B, C, W and YMenACWY
MenB
PneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
InfluenzaAnnual flu vaccine
Cochlear implantsPneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
Chronic respiratory and heart conditions(such as severe asthma, chronic pulmonary disease, and heart failure)PneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
InfluenzaAnnual flu vaccine
Chronic neurological conditions (such as Parkinson’s or motor neurone disease, or learning disability)PneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
InfluenzaAnnual flu vaccine
DiabetesPneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
InfluenzaAnnual flu vaccine
Chronic kidney disease (CKD) (including haemodialysis)haemodialysis)
Pneumococcal (stage 4 and 5 CKD)
PCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
Influenza (stage 3, 4 and 5 CKD)Annual flu vaccine
Hepatitis B (stage 4 and 5 CKD)Hepatitis B
Chronic liver conditionsPneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
InfluenzaAnnual flu vaccine
Hepatitis AHepatitis A
Hepatitis BHepatitis B
HaemophiliaHepatitis AHepatitis A
Hepatitis BHepatitis B
Immunosuppression due to disease or treatmentPneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
Shingles vaccineShingrix – over 50 years of age
InfluenzaAnnual flu vaccine
Complement disorders (including those receiving complement inhibitor therapy)Meningococcal groups A, B, C, W and YMenACWY
MenB
PneumococcalPCV13 (up to 10 years of age)
PPV23 (from 2 years of age)
InfluenzaAnnual flu vaccine

Extra vaccines may be offered to people with long-term health conditions or weakened immune systems.

As we said, the red book will have records of childhood vaccinations, as will the records held by GP surgeries. You may also see your jab history by logging into our online system.

If you believe you, your child, or someone else you care for has missed any vital vaccinations, please get in touch with your GP practice as soon as possible.