Immunizations in children

Vaccination as a method of preventing infectious diseases has changed human life expectancy, which is why the global medical community seeks equal access to vaccines between developing and developed countries.

The COVID-19 pandemic, in addition to high mortality rates, also negatively affected the implementation of vaccination programs. The restriction of movement, the economic recession and the perception that vaccination of children can be postponed without repercussions, led to particularly low rates of vaccination coverage throughout the pandemic.

The notion that most vaccines concern diseases that have historical value and do not create epidemics, such that they can lead to adverse outcomes or loss of life, is not recent.

Its proponents use simplistic approaches, without scientific documentation, which unfortunately often find listening ears. The adoption of such views poses serious risks to public health. The reduction or elimination of many infectious diseases is due to what we call herd immunity. That is, the situation in which mass vaccination creates an “immune wall” preventing the spread of the pathogen. This is also the cornerstone of preventive medicine. In other words, the achievement of high vaccination rates in the community and especially in the pediatric population in order to protect public health.

The technology surrounding the creation of quality vaccines has made leaps and bounds. Vaccines are safe and vaccination contraindications are few in number and very specific. The chance of an adverse outcome after a natural disease is much higher than the chance of serious side effects after a vaccination. All vaccines are subject to safety and efficacy studies before the licensing process, which is particularly rigorous through international organizations such as the European Medicines Agency, the US CDC and the World Health Organization (WHO).

Greece has a modern and extensive vaccination program for children and adolescents. The National Vaccination Committee (NEC), responsible for the creation of the program, analyzes national data from the registration of infectious diseases, vaccination coverage, pharmacovigilance and cost-benefit data from the use of vaccines. This analysis provides the necessary information so that decisions about the program and the need to strengthen it are based on scientific data and not on empirical opinions.

Human Papilloma Virus Vaccine

For 2022, the committee approved full reimbursement of the Human Papilloma Virus (HPV) vaccine in boys as well after years where the vaccine was given exclusively to preadolescent and adolescent girls. Therefore, based on the new vaccination program, the vaccine against HPV is indicated for boys and girls aged 9-11 years, in the form of two doses, in order to prevent cervical cancer and cancer of the oropharynx, larynx, penis and anus, as well as benign diseases such as perinatal warts. After 15 years, 3 doses of the vaccine are administered, while there is the possibility of administration up to the age of 18 until the end of 2023. This is therefore an excellent development in the field of preventive medicine, as this specific vaccine leads to the avoidance of infection and against consequently avoiding the cancers associated with the virus. The vaccine has been in use for about 15 years, is safe, and the efficacy data is very encouraging. Global use of the vaccine could lead to a reduction in the incidence of HPV-related cancer by up to 90% in men and women.

Rotavirus vaccine

Two more vaccines that become particularly important due to the start of school activity for all age groups without individual protection measures (face mask) are those against rotavirus and meningitidococcus serogroup B.

The rotavirus vaccine is included in the basic vaccination of infants and must be completed before the 4th or 6th month depending on the vaccine used. Rotavirus is a frequent cause of hospitalization of infants and toddlers due to dehydration from gastroenteritis. It spreads widely in the community, in nurseries and schools creating local outbreaks. As the vaccine is in oral form, it is easy to administer, does not cause discomfort and pain and has a good safety profile. Its use has brought great benefits to patients as well as to the health systems of the states that use it as it has prevented epidemics within hospital units, thus safe care of children with serious illnesses, while avoiding the spread in daycare centers and schools.

Meningococcal serogroup B vaccine

Meningococcal serogroup B vaccine has been widely debated in recent years, as the National Immunization Committee’s guideline is for administration and full reimbursement only to high-risk groups. This fact has divided doctors and patients, as the disease can affect the healthy population with adverse outcomes, such as disability or loss of life (8-10%). So the argument of those who request the generalized use of the vaccine concerns the severity of the disease, the difficulty of early diagnosis and the fact that meningococcal disease has a higher incidence in infants and toddlers. The vaccine is effective and safe, so it fulfills its main purpose. Its non-reimbursement in the general population mainly concerns cost-benefit criteria rather than efficacy or safety. With these data, the administration of the vaccine is beneficial on an individual level and is recommended for all age groups with the only disadvantage being the financial burden on families. The vaccination committee examines the epidemiological data annually and if they change, the guidelines will be revised as well.

Vaccination is an investment in a safe and quality life. It is the responsibility of agencies, parents and caregivers to ensure full access and completion of the vaccination program for all children, which will highlight the values ​​of prevention and equality in health.

Written by:
Nikos P. Spyridis
Pediatrician Infectious
Director of MITERA Pediatric Clinic

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