Common Questions
IMMUNISATION

Smallpox vaccinations are no longer required? Is this true? Not only is it true, but it represents a remarkable medical accomplishment. As a result of the World Health Organization (WHO) eradication program, the world is now considered free of smallpox; the last naturally occurring case was in Somalia in 1977. Thus, since 1982, smallpox vaccination certificates are no longer required of foreign travelers by any country. Because the risk of reaction to the vaccination is now greater than the risk of catching smallpox itself, distribution of the vaccine to civilians was discontinued in 1983. Today, the smallpox vaccination is recommended only for the relatively few people who work with rare viruses in high-security laboratories or who are involved in the production, testing and storing of the vaccine. To prevent the spread of smallpox through an accident, the number of laboratories working with the virus has been reduced to six in various countries around the world. What are the chances of having a dangerous reaction to a vaccination? They are very slight, and with good reason. Today’s vaccines are produced from highly purified material and are subjected to exhaustive testing, in laboratory animals and in clinical trials, before they are approved for release and public use. As a result, they are considered safe and effective. Nevertheless, adverse reactions do occur. Although rare, such reactions, which may be minor or severe, can be produced by any vaccine. Minor reactions usually consist of fever, and of swelling or redness at the site of the injection, as well as muscle aches or joint pains. More severe responses can include hypersensitivity reactions, ranging from hives to severe allergic shock, or anaphylaxis. Much less common but more serious are reactions in which the whole body is affected, such as paralysis, following the polio vaccination. It is important to remember, however, that these reactions are extremely rare, and in most cases the risk to children in not being vaccinated against infections such as whooping cough, measles or polio far outweighs the risk of side effects from the vaccine. If I experience a severe reaction to a vaccine, what should I do? Bad reactions to a vaccine do occur, but it’s often hard to establish a direct cause-and-effect relationship between inoculation and reaction. If you do develop what you think is a bad reaction, you should contact your doctor immediately. Make sure the incident is included in your medical records. Your doctor, in turn, should report the incident to the manufacturer and to the health department. 1. How important is it for my child to receive her shots for German measles mumps and measles? These are extremely important inoculations, and the facts concerning them are worth repeating. German measles (rubella) is usually a mild disease consisting of fever and a rash; but it can cause birth defects if a pregnant woman becomes infected with the virus in her first three months (or possibly later) of pregnancy. Thus the general guidelines for German measles vaccine are that it should be given to all girls between their tenth and sixteenth birthday in Australia, and aged eleven in New Zealand. In addition, women of childbearing age should be checked (by a blood test) for immunity, or even arrange to be vaccinated without testing. They are usually advised to avoid pregnancy for three months after vaccination, although studies have not in fact shown an increase in birth defects if the pregnancy occurs earlier. A convenient time to get this done is immediately after a pregnancy, or else when the doctor prescribes a contraceptive. The vaccine is a modified live virus and is administered by injection beneath the skin. A single dose provides lifetime immunity for most people. Mumps is caused by a virus that affects the parotid salivary glands in the mouth. In teenage and adult males, the virus may also endanger the testicles (possibly causing sterility). In women, the ovaries and breasts may become inflamed. The disease can also cause inflammation of the brain, and this may lead to deafness. The mumps vaccine is a live, modified virus that is given in a single injection. It is recommended for all children between 12 and 15 months in Australia, but not in New Zealand. It is also recommended for adolescents and for adults who have not had mumps or who lack antibodies to mumps. Because it is prepared in eggs, people with severe egg allergies shouldn't receive the vaccine. Measles, the well-known childhood disease of fever and rash, is also caused by a virus and may sometimes spread to the brain, causing deafness and mental retardation. The vaccine is a modified live virus that is highly effective and is routinely recommended for all children aged 15 months. As with the mumps vaccine, it is not recommended for children with severe allergies. Some Australian authorities now recommended a combined vaccine for measles, mumps and rubella (MMR) to be given at the age of 15 months. Each vaccination, however, may be given separately as needed.