It is vital to control diseases such as polio; why is the UK cutting global vaccine funding? | Helen Bedford

wLet’s talk again about polio, a disease that spread in the 1950s and paralyzed thousands of children every year. The successful introduction of the polio vaccine in 1956 in the UK, and later more widely, has resulted in the elimination of this once-feared disease from Europe, and indeed from the largest part of the world Following the successful global eradication of smallpox in 1980, polio is the next human disease on the list for eradication.

But despite all the progress, we’re not there yet. The first case of paralytic polio in nearly a decade was reported in New York state in July, and a few days later it was reported that vaccine-derived virus had been found in sewage from a neighboring county. Now a related virus has been reported in several samples of London’s sewage, prompting authorities in the capital to offer a booster dose of the polio vaccine to all children between the ages of one and nine years This year Israel had its first case of polio since 1989.

Over time, the threats of infectious diseases have diminished, but the need for vigilance never has. During the worst of the Covid-19 pandemic, rates of routine childhood immunization fell around the world, including the UK, and have not fully recovered.

Public health measures introduced, such as increased hand washing, mask use, and physical distancing, resulted in reduced cases of some infectious diseases, including some that are vaccine-preventable. However, the pandemic has also given rise to conspiracy theories, including in relation to Covid-19 vaccines. Although a small minority of people in the UK adopted them, they were very vocal, received a lot of media coverage and there was an increase in vaccine skepticism in general, creating a perfect storm. The increase in the number of unimmunized people, the lack of background strengthening of immunity from natural infection and the abandonment of public health measures means that there is a very real danger that we will see an increase in the rates of some of the diseases currently controlled by vaccination.

So how to respond? The resurgence of polio and the spread of monkeypox remind us that infectious diseases do not respect national borders. As well as a moral duty, it is in our own interest to ensure that infectious diseases are controlled as effectively as possible worldwide. For polio this is only possible through vaccination. However, the UK government has cut its contribution to the global polio eradication effort. While it is understandable that all budgets are being reviewed in these economically difficult times, this is not the time to cut back on something as vital as polio eradication. MPs must be aware of this change and its harmful effects.

Closer to home, we need to make sure there is easy access to accurate information about vaccines and the diseases they prevent. Along with polio, most people will have had no experience of diseases such as diphtheria, which before the introduction of vaccination in the 1940s would kill thousands of people every year in the UK.

The success of a vaccination program is often said to be its worst enemy, as success equates to little or no disease, and thus not only removes the reminder of the severity of the disease, but that people consider vaccination no longer necessary. The current situation is a clear reminder that this is not the case. Convincing some people to accept a (Covid-19) vaccine to protect themselves from a pandemic disease that was killing literally millions of people in real time was hard enough. It is even more difficult, perhaps, to encourage part of the public to accept a vaccine for a disease that has practically died out.

But it is not impossible, as evidenced by the high uptake of the vaccine across the UK as a whole, with more than 90% of 12-month-olds receiving three doses of the primary vaccines, including polio. The cause for concern is the wide disparity in uptake between areas, with almost a third of 12-month-olds in some parts of London not fully covered. This large gap in immunity leaves the potential for the spread of devastating diseases, including polio.

Minimizing this vaccine uptake gap depends on several key factors. The public requires reliable, accurate and timely information in the form that suits them best: written, digital or verbal. Many people need a conversation with a knowledgeable health professional they trust to discuss the pros and cons of the vaccine and answer their concerns; this takes time, which is very important in the NHS. For polio, the argument is clear: it is a devastating disease that can be effectively prevented with a very safe and well-established vaccine.

However, for some people the barriers to vaccination are more practical. It is well recognized that younger children in large families, as well as those living in more disadvantaged circumstances, are less likely to be vaccinated. The practical difficulties of accessing vaccination clinics with multiple conflicting priorities to manage can, despite the best intentions, leave vaccination low on the list. It may be too expensive to take time off or pay for the trip to the clinic. Vaccination becomes a low priority in the face of concerns about the rapidly rising cost of living. This puts the ball firmly in the NHS’s court. We must ensure that services meet the needs of the whole population with local adjustments. Could there be vaccinations in different settings: community centers, religious meeting places or youth clubs, perhaps?

Vaccination saves 2-3 million children’s lives every year worldwide, but we can’t rest on our laurels. The public needs to be reminded of the seriousness of disease and the safety and effectiveness of vaccines, and that until a disease is eradicated globally, we must continue to vaccinate.

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