On the commemoration of this year’s World Immunisation Week, the essence of routinely immunising infants against vaccine preventable disorders remains paramount.
In this interview with Victoria Ojeme, Consultant Paediatrician, National Hospital Abuja, Dr. Shatima Dennis Richard, speaks on the challenges and prospects of routine child immunisation in Nigeria.Excerpts:
ACTIVE vs passive immunisation: Immunisation is a process of boosting immunity against infectious agents such that when you come in contact with these infectious agents in the natural way you’re already primed.
Your immune system is already prime such that they will be in a better position to fight it and you don’t take ill.
There is active immunisation and there is passive immunisation. Passive immunisation means I will just harvest antibodies from a donor and use it to protect you. The advantage is that it works immediately, giving you immediate protection.
Your immune system doesn’t partake in developing such antibodies.
Disadvantage: The major disadvantage of passive immunisation is that it short-lives. Once the antibodies are degraded, you become vulnerable. It’s active immunisation that we usually talk about as paediatricians. You are given an allergen or antigen that will stimulate your immune system and your immune system produces antibodies.
Natural memory cells
We call it active because your immune system is participating actively in its production. More importantly, they also leave behind what we called memory cells.
Now, when you come in contact with the natural infectious agents in future, because of the priming and the production of the natural memory cells, they will be able to kill the infectious agents very fast because they are prepared. That’s what immunisation is all about.
Key issues: The key issues related to immunisation are the facts. First, your immune system has to be normal, because if you’re immune compromised, there is no way you will be able to respond to the challenge by antigens.
Second, it has to be given in the correct dosage, meaning the person’s immune system can process this vaccine and be able to respond appropriately. These are the key issues.
Now, there are other issues about how they are stored, how are they supposed to be administered, who is in charge, and how is it supposed to be controlled, etc.
Babies are most vulnerable, in the sense that you and I went through all the infectious agents, came in contact with it, God helped us we went through it. But for babies, their immune system is not that strong.
Therefore, if you ask yourself, in the 1960s, you heared that a woman gave birth to 13 children and only two survived, that’s purely the survival of the fittest.
Many of them died from infections that you and I are actively preventing nowadays. So you can see that immunisation especially as it has to do with child survival strategy is very important. We immunise to boost their immune system and help them withstand these infectious agents in early childhood.
That’s actually why it’s so important for babies to be immunised. We don’t want a repetition of what happened in the 1960s. So you can see that immunising children is a very important aspect of child survival.
Cultural and religious impediments: My priority is to make sure people immunise their children. I will also want to mention that I need to win back their trust. If you notice, in the history of Nigeria, anything that the government brings in, the populace usually swallows it whole believing that government means well. But once you have an adverse effect related to such interventions you can see that that trust is likely going to be lost.
Anytime, anywhere, I will preach immunisation for babies. I think the fundamental thing is to go through the community leaders, religious leaders talk to them and let’s get back their confidence. And we will get back to where we were in the 1970s. There is no doubt about it, anytime, anywhere we would preach immunisation.
We know it saves lives and saves children. Once you save the children, the future of Nigeria is secured from preventable diseases. I will preach it anywhere, anytime.
I will try as much as possible to convince parents through community leaders, religious leaders, and personal interaction to make them see the benefits of immunisation. As a pediatrician, I will continue to preach it.