Fears of immunisation have led to the return of kids' illnesses like measles, but the risks of vaccination are relatively few

Who calls the shots? Vaccination began in 1796 with smallpox. Today, worldwide childhood vaccination programmes are one of the most cost effective means of preventing disease and the associated risks are rare.

While many parents believe immunisation is essential for their child, conflicting advice and often misreported side effects have led to a serious drop in immunisation rates, with New Zealand now behind other developed countries. The price is a measles epidemic. Measles immunisation rates are too low to prevent it. It is so infectious each case leads to 13 others swine flu only infects two.

A mother's own antibodies protect her baby but this wears off in the first year of life. Immunisation provides several small doses of vaccine over time from a very young age and this allows the child to make their own antibodies.

While not compulsory, immunisation is free for measles (English), mumps, rubella (German measles), diphtheria, tetanus, pertussis (whooping cough), haemophilus influenzae type b, polio and, more recently, pneumococcus (the most common bacterial cause of glue ear).

Four of these still occur in regular epidemics and can be life-threatening for infants. The number of immunisations has increased but they are given in combinations requiring fewer injections at six weeks, three months, five months, 15 months, four years and 11 years. (More on the childhood immunisation programme in New Zealand.) Some immunised children may still catch the disease but it is less serious.

Children with poor immune systems, or who have had an anaphylactic reaction or convulsions after previous immunisations, will not be immunised but it should not be withheld because of mild fever or the child being off-colour. Fears about MMR vaccine and autism have been refuted by experts. It isn't possible to get autism from vaccines.

Immunisation does sting and parents don't enjoy it, but children cope well. Some don't cry at all, others howl; but such discomfort does not compare to the distressed babies we nursed before the vaccines became available.

Reactions to a vaccine such as mild fever or being unsettled may last up to two days. If there is tenderness, swelling, redness at the injection site, apply a cool cloth without rubbing. Give extra fluids, paracetamol at the right dose for the child and breastfeed if possible. More serious reactions are very rare but if high temperature or persistent unusual crying occurs, call your GP. A mild rash or fever can occur one week after MMR vaccine.

The message is clear. If children are unprotected, disease can spread rapidly to the whole community, affecting the most vulnerable, such as children with cancer who cannot be immunised. In countries with high immunisation rates, few outbreaks occur.

Use your Well Child/Tamariki Ora Health Book, visit Immunisation Advisory Centre at www.immune.org.nz (0800 466 863) or ask your GP or practice nurse for advice.

(Published in the Sunday News, 16 August 2009)

More everybody MYHEALTH columns from Barbara Docherty

Barbara Docherty is a registered nurse and clinical lecturer at the University of Auckland School of Nursing, and writer for the everybody.co.nz website. The opinions contained herein are those of the author and not necessarily those of the publisher or sponsor. Copyright UBM Medica (NZ) Ltd.