history and aims of immunisation 220916 [read-only] · history and aims of immunisation dr brenda...
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History and aims of immunisationyDr Brenda Corcoran
National Immunisation OfficeNational Immunisation Office
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Objectivesj• To examine the history of immunisation
• To explain the aim of immunisation
• To develop an understanding of the role of the following agencies in relation to immunisation
Th N i l I i i Ad i C i (NIAC)– The National Immunisation Advisory Committee (NIAC)– The Department of Health (DoH)– The Health Service Executive (HSE)– The National Immunisation Office (NIO)– The Health Protection Surveillance Centre (HPSC)
• To understand the importance of infectious disease surveillance in Ireland
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Smallpox
Variola virus
Infected humans 10,000 years ago
Known in China 11th century BC
Inoculation described 6th century BC
1796 vaccinia virus isolated
Edward Jenner (1749 –1823)
www.immunisation.ie
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SmallpoxSmallpox
“More mites die from vaccination than from thethan from the disease they are supposed to besupposed to be inoculated against”
George BernardGeorge Bernard Shaw 1929
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SmallpoxSmallpox
1977 Last reported case Somaliap
1980 WHO declared eradication
CDC Public Health Images Library (PHIL) id# 131 Source: CDC/Barbra Rice
www.immunisation.ie
CDC. Public Health Images Library (PHIL) id# 131. Source: CDC/Barbra Rice
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PolioPolio
Endemic for thousands ofEndemic for thousands of years
1955 Inactivated polio vaccinevaccine
1962 Live oral polio vaccine
www.immunisation.iePhotos courtesy of www.polioeradication.org
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PolioPolio
Immunisation campaigns in Cuba and Eastern EuropeCuba and Eastern Europe
Wild polio virus eradicated in large areas
Basis for eradicationBasis for eradicationPhoto courtesy of www.polioeradication.org
www.immunisation.ie
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Polio
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Polio 2016Polio 2016
74 i 2015• 74 cases in 2015• 26 cases to date in 2016• 3 in non endemic countries• Pakistan/ Afghanistan/ NigeriaPakistan/ Afghanistan/ Nigeria
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Average USA Annual Morbidity Due to Vaccine Preventable Diseases in the 20th Century compared with Morbidity in 2013Diseases in the 20th Century compared with Morbidity in 2013
(for pre-1990 vaccines)
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Aim of immunisationAim of immunisation
Th i f i i ti i th ti f di i• The aim of immunisation is the prevention of disease in individuals or groups.
• Examples – 1980 elimination of smallpox (WHO)p ( )– 1991-Elimination of polio from the Americas
Achie ed b• Achieved by – a comprehensive immunisation programme achieving the World
Health Organisation target uptake of 95% for childhood vaccines and 75% for influenza vaccines
– intensive surveillance of these diseases
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Multidisciplinary components of an immunisation system
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The National Immunisation Advisory Committee (NIAC)
• Independent committee of the RCPI• Independent committee of the RCPI
• Variety of experts
• Advises the Department of Health and Children
• Produces the National Immunisation Guidelines for Ireland B dBased on – best evidence regarding the safety
and efficacy of vaccines – the disease burden– the disease burden– pharmacoeconomic analyses
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The Department of Health (DoH)The Department of Health (DoH)
Responsible for making policy decisions regarding the• Responsible for making policy decisions regarding the immunisation programme including changes to the current immunisation programme
The Health Products Regulatory Authority (HPRA) (formerly the Irish Medicines Board)(formerly the Irish Medicines Board)
• Regulatory body responsible for licensing of vaccines• Regulatory body responsible for licensing of vaccines and ensuring their quality and safety and efficacy
• Responsible for monitoring and evaluation of adverse p gevents following immunisation
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HSEHSE
• Responsible for the implementation of the primary childhood, school immunisation andprimary childhood, school immunisation and seasonal influenza vaccination programmes
• Delivered by general practitioners (GPs)• Delivered by general practitioners (GPs), practice nurses, pharmacists, community health doctors and public health nurses and supportdoctors and public health nurses and support staff
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The National Immunisation Office (NIO)The National Immunisation Office (NIO)
Coordinating Unit • Standardised implementation of all publicly funded immunisation
programmes• Protocols and immunisation training• Protocols and immunisation training • Information materials for the general public• National immunisation website www.immunisation.ie• Vaccine contracts and the HSE National Cold Chain delivery
Service to provide vaccine deliveries to all GPs, hospitals and HSE clinicsHSE clinics
• Development of a national IT database • Currently different PCI IT systems modified with any changes y y y g
to schedule• School immunisation system
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Health Protection Surveillance Centre (HPSC)
• Responsible for surveillance of vaccineResponsible for surveillance of vaccine preventable diseases
• Monitors immunisation uptake data from each• Monitors immunisation uptake data from each HSE area and reports on uptake rates
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Importance of surveillance - Hib catch up 2006
120
100
120
ses
Hib vaccine, 1992
Hib catch‐up, 2005
60
80
mbe
r of Ca
Hib booster, 2006
20
40
Num
0
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Year
Source: HPSC
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Impact of Hib campaign
Source: HPSC
www.immunisation.ie
Source: HPSC
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Importance of surveillance Mumps notifications in IrelandMumps notifications, in Ireland
2008-week 20 2009*National Outbreak Control Team convened 26/03/09
Source: CIDR HPSC *2009 data provisional
Source: HPSC
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Mumps notifications 2008 and 2009
MMR campaign in senior cycle of 2nd level schools
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Vaccine uptake rate at 24 months 1999 2016Vaccine uptake rate at 24 months 1999-2016
Target 95%g
Source: HPSC
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Quarter 1 2016 D3 immunisation uptake rates (%) by LHO, in those 24 months of age in Ireland and Dublinin those 24 months of age in Ireland and Dublin
(source HPSC)
N
EW
DLS
DL
SO/LMCN/MN
DN
G
MO RNMH
LS/OY
LD/WH
LHCN/MN
KE/WW
DN
DW
DNW
DSW DSDSE
DNC
DSC
DNWDNC
0 - 79
L
CE
TS
NC
WX
LS/OY
CW/KK
WWTN/EL
DW
DSW DSDSEDSC
0 7980 - 8485 - 8990 - 9495 - 100No Data
KY NC
NSL
WC
WD
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Quarter 1 2016 MMR immunisation uptake rates (%) by LHO, in those 24 months of age in Ireland and Dublinin those 24 months of age in Ireland and Dublin
(source HPSC)
DL
N
EW
MO RN
SO/LMLH
DNS
CN/MN
G
CE
RNMH
LS/OYKE/WW
LD/WH
TN/EL
WW
DN
DW
DNW
DSW DSDSE
DNC
DSC
DSC
DNCDNW
DW
85 - 8980 - 840 - 79
% Immunisation Uptake
L
KY
TS
NC
NSL
WX
WD
CW/KKTN/EL DSC
DSE DSDSW
No Data95 - 10090 - 94WC
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Economic benefits of immunisation
www.immunisation.ie
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Economic benefits of immunisationEconomic benefits of immunisation
www.immunisation.ie
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Why Immunise?Why Immunise?• Immunisation is one of the most cost
effective and safest of all health interventionsinterventions
• Immunisation has saved more lives than any other public health intervention apart y p pfrom the provision of clean water
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More information
online only
http://www.immunisation.ie/en/HealthcareProfessionals/ImmunisationGuidelines/
www.immunisation.ie