Sir, - Over the past few weeks and months you have published some articles and correspondence questioning the value of childhood immunisation. There is a perception among some of the population that the disappearance of diphtheria, tuberculosis and polio is attributable to improved social, economic and sanitary circumstances. These certainly contributed, but congratulations must go to the immunisation programme. Without vaccination, these diseases would have continued to diminish in frequency but would not have disappeared.
Diphtheria still accounts for 4,000 deaths a year in the world, measles for a million, tetanus for 500,000; tuberculosis affects up to a million children, polio paralyses 100,000 children and whooping cough has a death toll of 100,000.
The experience in parts of Eastern Europe has been that the fragmentation of the immunisation programme has allowed eliminated diseases to reappear. The reality of childhood immunisation is that when 70 to 80 per cent of children are immunised the diseases are contained or controlled; when 90 to 95 per cent of children are immunised these diseases are effectively eliminated from society; and if you achieve 100 per cent uptake you can talk about eradication.
WHO, UNICEF, the American Academy of Paediatrics, all national paediatric bodies, the Faculty of Paediatrics RCPI, having studied the scientific evidence on immunisation, are in no doubt that the balance of benefit is greatly in favour of population immunisation in terms of preventing child death, preventing childhood illness and subsequent hospitalisation, and saving society vast amounts of money by preventing chronic handicap.
I know of very few doctors who would deprive their own children of the benefits of immunisation. Those few doctors who object to immunisation are out of step with science and common sense. - Yours, etc.,
Department of Paediatrics, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2.