The uptake of children’s vaccines remained “steadily high” in Malta during the coronavirus pandemic when the vast majority of children were given the jabs listed in the National Immunisation Schedule, Public Health Superintendent Charmaine Gauci explained.
On the occasion of World Immunisation Week this week, the United Nations reported that some 67 million children partially or fully missed routine vaccines globally between 2019 and 2021 because of lockdowns and healthcare disruptions caused by the COVID-19 pandemic.
The situation in Malta, however, remained stable and vaccine uptake remained “steadily high” with uptakes ranging between 89 and 99 per cent, depending on the type of vaccine, during the years 2019, 2020 and 2021.
“Despite the disruptions caused by the pandemic, that came to Malta in 2020, the uptake of these vaccines was immediately high. During the height of the pandemic, several measures were taken to ensure that parents felt safe when taking their children to be vaccinated at the Primary Health Care immunisation clinics. This was done by keeping these clients segregated from those attending the rest of the health centre and, as far as possible from infective cases,” Gauci said.
Moreover, in 2020, the Scheme for the Administration of Scheduled Vaccines in Private Practice was introduced.
Paediatricians and general practitioners in private practice who register with this scheme are now provided with vaccines by Primary Health Care to be administered in private practice. Through this scheme, parents can take their children to their paediatrician or private GP for the administration of vaccines, paying only the fee for administration.
“During the uncertain times resulting from the COVID-19 pandemic, the fact that parents could take their children to be vaccinated by a medical professional of their choice may have also aided in maintaining the high uptake of vaccinations in Malta,” Gauci said.
Paediatrician Mark Buttigieg said that while vaccine hesitancy in Malta existed, as parents questions the need for certain vaccines for their children, uptake remained high.
“As a general rule vaccination is one of the single most important primary prevention methods. We don’t vaccinate for nothing. We vaccinate against serious, life-threatening conditions and we continue because they are not eradicated,” he said, adding that the Maltese Paediatrics Association, of which he is president, works closely with Public Health authorities.
“During the height of the pandemic, several measures were taken to ensure that parents felt safe when taking their children to be vaccinated at the Primary Health Care immunisation clinics”
Understanding vaccines
Malta’s National Immunisation Schedule includes the six-in-one vaccine that covers diphtheria, tetanus, pertussis, polio, hib and Hepatitis B; besides the vaccines for measles, mumps and rubella (MMR), pneumococcal disease, chickenpox (varicella), rotavirus, Hepatitis A, meningitis and the human papilloma virus.
While these are the recommended vaccines, only four are legally compulsory and include diphtheria, tetanus, polio and rubella. These are all given as combination injections, with the first three falling under the six-in-one vaccine and rubella within the MMR vaccine.
Hepatitis A, the chickenpox vaccine and rotavirus vaccines are not offered for free as part of the national vaccine schedule and are only available privately.
THE SIX-IN-ONE
Polio is caused by a virus which is found in the stool and saliva of infected individuals and is easily spread through hands and objects. Polio can cause paralysis, meningitis, lifelong disability and sometimes death.
Diphtheria is caused by a bacteria which is spread by coughing. The disease affects the throat and airways of an infected person. It can lead to very serious complications including multiple organ failure and muscle paralysis.
Tetanus is caused by a bacteria which is found in soil and animal manure. The disease is known as “lockjaw” and can occur if the tetanus bacteria enters a deep wound or open cut in the skin. It starts with severe spasms of the jaw muscles but later spreads to the rest of the body and can cause death.
Pertussis is also known as “whooping cough”. It is caused by a bacteria which is spread by coughing. The disease causes severe bouts of coughing and can lead to pneumonia, chronic lung problems, seizures, brain damage, and sometimes death. The complications are more common in infants and young children.
Haemophilus influenzae type b (Hib) is a bacteria which is spread by droplet infection through coughing or sneezing. Many people harbour this bacteria in their throat but are not affected by it. However, they can still transmit the illness to infants and children. Hib can cause meningitis that may lead to hearing loss, brain damage and death, pneumonia, septicaemia, sudden and complete obstruction of the airways leading to death (epiglottitis) and severe middle ear infections.
Hepatitis B is caused by a virus which is spread through contact with infected blood or other body fluids. A mother who has the hepatitis B virus can pass it on to her baby during pregnancy and childbirth. The hepatitis B virus affects the liver and may lead to liver failure and death. Sometimes, people infected with the virus show no symptoms of disease, but they are still at risk of developing serious liver problems and liver cancer.
HEPATITIS A
Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It is transmitted from contaminated food or water or from close contact with a person or object that is infected. Mild cases of hepatitis A do not require treatment and most people who are infected recover completely with no permanent liver damage. Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.
MEASLES, MUMPS and RUBELLA (MMR)
Measles is caused by a virus and is spread by sneezing and coughing. It is very infectious and unprotected persons are very likely to become ill if exposed to the illness. Measles starts with symptoms of a cold, which then progresses to a high fever, cough, watery eyes and a red rash on the face and body. Measles infection can lead to severe complications and death through pneumonia, encephalitis (inflammation of the brain) and a rare disabling brain illness that can occur even after recovery from the measles infection.
Mumps is caused by a virus and is spread by sneezing and coughing. It causes fever, headaches and a painful swelling of the parotid glands which are found just below the ears. Mumps can lead to serious complications including hearing loss, meningitis (inflammation of the lining of the brain), cardiomyopathy (inflammation of the heart muscle), kidney failure, joint inflammation, and inflammation of the testes or ovaries that can lead to infertility.
Rubella is caused by a virus and is commonly known as ‘German Measles’. It is spread by sneezing and coughing and causes a rash, sore throat and swollen glands in the neck. Although rubella is a mild disease in children and rarely causes complications, it can be very dangerous in adults and can lead to very serious consequences to the foetus of a pregnant mother. If the mother catches German measles during pregnancy, the child can be born with hearing loss, blindness, brain damage and heart problems.
PNEUMOCOCCAL DISEASE
Pneumococcal disease is caused by a bacterium which is commonly found in the nose and throat of healthy individuals. This bacterium spreads by sneezing or coughing and can cause serious illness in some, especially infants and young children under five years. Pneumococcal disease can cause meningitis leading to hearing loss, brain damage or death, septicaemia (blood infection), pneumonia (lung infection) and middle ear infections.
CHICKENPOX (VARICELLA)
Chickenpox is caused by a virus which is highly contagious. It causes widespread itchy blisters all over the body. The illness is spread very easily by sneezing, coughing or contact with the chickenpox blisters. Most cases of chickenpox are mild but blisters may lead to ugly skin scars. Sometimes the illness may lead to complications such as pneumonia (lung infection) and encephalitis (brain infection). If a pregnant mother gets chickenpox, the baby may be born with skin scarring and/or limb deformities.
ROTAVIRUS
Rotavirus is a virus that can cause severe diarrhoea and vomiting in infants. This may lead to dehydration and hospitalisation. It is spread from the stool of infected children, from hand to mouth and by touching contaminated surfaces or objects.
HUMAN PAPILLOMA VIRUS
Human papilloma virus (HPV) is the most common sexually transmitted infection. Most people who have HPV, do not know that they are infected. Some types of HPV can cause genital warts and other types are known to cause cervical cancer as well as anal, genital and head and neck cancers. HPV is spread through sex and genital contact even when the infected partner has no signs or symptoms. Very rarely a woman with genital HPV can pass the virus to her baby during childbirth and this can cause the formation of warts in the baby’s respiratory tract.
MENINGITIS
Meningococcal disease is a serious bacterial illness and is caused by meningococcus bacteria. Meningitis is an infection of the fluid surrounding the brain and spinal cord. Meningococcal disease also causes blood infections. Anyone can get meningococcal disease. But it is most common in infants less than one year of age and in teenagers. Meningococcal infections can be treated with drugs such as penicillin. Still, about 1 out of every ten people who get the disease dies from it, and many others are affected for life. A number of vaccines are currently available that offer protection against serotypes A, B, C, W and Y. (Source: health.gov.mt)
For more information on vaccines and when to give them to your child, visit https://deputyprimeminister.gov.mt/en/phc/pchyhi/Pages/Vaccines.aspx. For more children’s health-related articles, click here. For more Child articles, follow this link.
Claudia Calleja is a Times of Malta journalist.