Vaccines in practice - 2009

Meningococcal B vaccines: what does the future hold?
Linda Glennie and Robbie Coleman
pp 1-3
Neisseria meningitidis is the most frequent cause of bacterial meningitis in the UK and there were over 1,500 laboratory confirmed cases in 2007. Although the disease is not common, it remains the leading infectious cause of death in UK children. People who survive the illness may experience a wide range of long-term sequelae, including hearing loss, neurological morbidities, psychosocial problems, amputations, distorted bone growth, scarring and renal dysfunction.
Comment: Swine flu: where are we headed?
Peter M English
pp 3-3
Swine flu – or influenza A/H1N1v, to give it its more formal name – has probably been occupying your mind considerably over the last few weeks. Perhaps you are one of the troops who were commanded, as by First World War generals, not so much to ‘go over the top’, but rather to stay on the beach playing King Canute, reciting the incantation ‘Tamiflu’ (which was supposed, you were told, to contain the oncoming tide) long after the waves of the epidemic had overtaken you.
Pandemic influenza vaccine development
John Oxford
pp 4-6
Although the flu strain swine H1N1 has emerged quickly and caught us completely by surprise, we are not ill-prepared due to the United Nations’, the WHO’s and the UK government’s prior commitment to preventing H5N1 bird flu. Indeed, this H5N1 virus will remain a significant threat even while we experience swine H1N1. To give context, I would like to look back to the 20th century. Our sense of defence has not just come from influenza, but attacks from other viruses that have illustrated what can be achieved if the counter-attack effort is global.
Herd immunity and reproduction numbers
Peter M English
pp 7-9
Herd immunity exists when the proportion of the population that is susceptible to an infection is so low that each case of disease will infect fewer than one other person. In this situation, the disease will die out; most people who are susceptible to the disease are unlikely to encounter it, so they are effectively protected against it. Vaccination programmes contribute to herd immunity. Vaccine uptake levels required to provide herd immunity depend on the infectiousness of the disease; the more infectious the disease, the greater the proportion of the population that must be vaccinated.
Explaining the vaccination supply chain
Judith Moreton
pp 10-11
Criticism from primary care about supply of childhood vaccines tends to escalate in response to specific events, such as the introduction of a new vaccine, a change to the routine schedule, or the implementation of catch-up programmes. Such criticism is generally unfounded and may be due to a lack of knowledge and understanding of the UK’s rigorous processes for central purchase and supply, which have ensured uninterrupted supply of childhood vaccines for many years.