Vaccines in practice - 2011


Should we be preparing for an H2 flu pandemic?
Roy Fey
pp 1-3
I can hear the questions: ‘Haven’t we just had a pandemic?’, ‘Won’t it be many years until the next pandemic?’ and ‘Why should the next pandemic be caused by an H2 virus?’. All good questions, which I hope I can answer in this article. One answer would be that we need to continue to prepare for the next pandemic, even if we have just suffered one. But why focus specifically on H2? For that question I need to review influenza epidemiology and the history of pandemics.
Comment: Changing policies
Peter M English
pp 3-3
In October 2011, the Netherlands are due to implement universal hepatitis B vaccination. Regular readers will know that I, and others, have argued previously for universal hepatitis B vaccination in the UK. The UK government’s advisory group on immunisation is actively considering adding hepatitis B vaccination to the universal infant schedule. Perhaps the Dutch decision will encourage a similar move in the UK or, at least, provide data that would help the UK make a good, evidence-based decision.
How do vaccines interact?
Ifeanyichukwu O Okike and Shamez Ladhani
pp 4-6
The current UK childhood immunisation schedule protects against diphtheria, tetanus and pertussis (whooping cough; DTP); polio; Haemophilus influenzae type b (Hib); meningococcal serogroup C (MenC); thirteen pneumococcal serotypes; and measles, mumps and rubella (MMR) infections. Since each component requires two to four vaccine doses, this would result in infants receiving 25 injections in the first year of life, with up to seven injections required at some of the visits. Moreover, as more effective vaccines against an increasing number of pathogens are licensed, it is clear that combination vaccines are the only realistic way to achieve high coverage and efficient service delivery of current and future immunisation programmes.
Vaccination in the immunocompromised child: a review of the evidence
Elizabeth A Calton, Juliet C Gray and Saul N Faust
pp 6-9
Children with impaired immunity are at particular risk of vaccine-preventable infectious diseases. Immune defects are heterogeneous in nature and may be congenital, acquired, or a temporary or ongoing result of treatment for cancer or haematological disease. Guidelines for the vaccination of these children in the UK were issued by the Royal College of Paediatrics and Child Health (RCPCH) in 2002, and are supplemented on an ongoing basis by advice in the Department of Health (DH) Green Book to reflect changes in the routine childhood immunisation programme. The approach is condition specific, with vaccines omitted or added to the routine programme based on the nature of the immunocompromise. There remains, however, uncertainty about which vaccines will be safe and effective in individual patients, and about the timing of vaccines where immunosuppression is temporary. Research continues to provide new evidence about the optimal vaccination schedule in the immunocompromised child.
New approaches to vaccination
Peter M English
pp 10-11
We all know vaccination is good and better value for money than any other medical activity. But how can we make it even better? In this article I’m going to look at ways in which vaccination is developing. In particular I shall consider ways in which current vaccines can be improved, new vaccines developed, and in which policy may change.

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