Vaccination in PalestineVaccination in Palestine

By: Mohammad Ba’ara

Ahmed SawalhaUnder the supervision of :

Dr.Sammar Musmar

ByMohammad Ba’ara :

Ahmed SawalhaUnder the supervision of :

Dr.Sammar Musmar

HistoryHistory

• history• The story of vaccines did not begin with the first vaccine–

Edward Jenner’s use of material from cowpox pustules to provide protection against smallpox. Rather, it begins with the long history of infectious disease in humans, and in particular, with early uses of smallpox material to provide immunity to that disease.

• Evidence exists that the Chinese employed smallpox inoculation (or variolation, as such use of smallpox material was called) as early as 1000 CE. It was practiced in Africa and Turkey as well, before it spread to Europe and the Americas.

• Edward Jenner’s innovations, begun with his successful 1796 use of cowpox material to create immunity to smallpox, quickly made the practice widespread. His method underwent medical and technological changes over the next 200 years, and eventually resulted in the eradication of smallpox.

• history• The story of vaccines did not begin with the first vaccine–

Edward Jenner’s use of material from cowpox pustules to provide protection against smallpox. Rather, it begins with the long history of infectious disease in humans, and in particular, with early uses of smallpox material to provide immunity to that disease.

• Evidence exists that the Chinese employed smallpox inoculation (or variolation, as such use of smallpox material was called) as early as 1000 CE. It was practiced in Africa and Turkey as well, before it spread to Europe and the Americas.

• Edward Jenner’s innovations, begun with his successful 1796 use of cowpox material to create immunity to smallpox, quickly made the practice widespread. His method underwent medical and technological changes over the next 200 years, and eventually resulted in the eradication of smallpox.

• First Generation of Vaccines (pre-1950s) • 1798 Smallpox • 1885 Rabies • 1897 Plague • 1917 Cholera • 1917 Typhoid vaccine (parenteral) • 1923 Diphtheria • 1926 Pertussis • 1927 Tuberculosis (BCG) • 1927 Tetanus • 1935 Yellow Fever • 1940s DTP • 1945 The first influenza vaccines (flu) began being used.

• First Generation of Vaccines (pre-1950s) • 1798 Smallpox • 1885 Rabies • 1897 Plague • 1917 Cholera • 1917 Typhoid vaccine (parenteral) • 1923 Diphtheria • 1926 Pertussis • 1927 Tuberculosis (BCG) • 1927 Tetanus • 1935 Yellow Fever • 1940s DTP • 1945 The first influenza vaccines (flu) began being used.

History of Anti-vaccination Movements

History of Anti-vaccination Movements

• Yet, opposition to vaccination has existed as long as vaccination itself. Critics of vaccination have taken a variety of positions, including opposition to the smallpox vaccine in England and the United States in the mid to late 1800s, and the resulting anti-vaccination leagues; as well as more recent vaccination controversies such as those surrounding the safety and efficacy of the diphtheria, tetanus, and pertussis (DTP) immunization, the measles, mumps, and rubella (MMR) vaccine, and the use of a mercury-containing preservative .

• Yet, opposition to vaccination has existed as long as vaccination itself. Critics of vaccination have taken a variety of positions, including opposition to the smallpox vaccine in England and the United States in the mid to late 1800s, and the resulting anti-vaccination leagues; as well as more recent vaccination controversies such as those surrounding the safety and efficacy of the diphtheria, tetanus, and pertussis (DTP) immunization, the measles, mumps, and rubella (MMR) vaccine, and the use of a mercury-containing preservative .

Smallpox and the Anti-vaccination Leagues in EnglandEdward Jenner’s showed that he could protect a child from smallpox if he infected him or her with lymph from a cowpox blister

• Beginning with early vaccination in the nineteenth century, these policies led to resistance from a variety of groups, collectively called anti-vaccinationists, who objected on ethical, political, medical safety, religious, and other grounds. Common objections are that compulsory vaccination represents excessive government intervention in personal matters, or that the proposed vaccinations are not sufficiently safe

• Beginning with early vaccination in the nineteenth century, these policies led to resistance from a variety of groups, collectively called anti-vaccinationists, who objected on ethical, political, medical safety, religious, and other grounds. Common objections are that compulsory vaccination represents excessive government intervention in personal matters, or that the proposed vaccinations are not sufficiently safe

Brazil 1904Brazil 1904

Vaccination policyVaccination policy

•Vaccination policy refers to the policy a government adopts in relation to

vaccination Vaccinations are voluntary in . some countries and mandatory in some countries. Some governments pay all or

part of the costs of vaccinations for vaccines in a national vaccination

schedule.

•Vaccination policy refers to the policy a government adopts in relation to

vaccination. Vaccinations are voluntary in some countries and mandatory in some countries. Some governments pay all or

part of the costs of vaccinations for vaccines in a national vaccination

schedule.

*Compulsory vaccination*Compulsory vaccination• In an attempt to eliminate the risk of outbreaks of

some diseases, at various times several governments and other institutions have instituted policies requiring vaccination for all people. For example:

• 1853 law required universal vaccination against smallpox in England and Wales, with fines levied on people who did not comply.

• In the United States, the Supreme Court ruled in the 1905 that vaccination policies require that children receive common vaccinations before entering school.

• In an attempt to eliminate the risk of outbreaks of some diseases, at various times several governments and other institutions have instituted policies requiring vaccination for all people. For example:

• 1853 law required universal vaccination against smallpox in England and Wales, with fines levied on people who did not comply.

• In the United States, the Supreme Court ruled in the 1905 that vaccination policies require that children receive common vaccinations before entering school.

• In Malaysia, mass vaccination is practised in public schools. The vaccines may be administered by a school nurse or a team of other medical staff from outside the school. All the children in a given school year are vaccinated as a cohort. For example, children may receive the oral polio vaccine in Year One of primary school (about six or seven years of age), the BCG in Year Six, and the MMR in Form Three of secondary school. Therefore, most people have received their core vaccines by the time they finish secondary school.

• In Malaysia, mass vaccination is practised in public schools. The vaccines may be administered by a school nurse or a team of other medical staff from outside the school. All the children in a given school year are vaccinated as a cohort. For example, children may receive the oral polio vaccine in Year One of primary school (about six or seven years of age), the BCG in Year Six, and the MMR in Form Three of secondary school. Therefore, most people have received their core vaccines by the time they finish secondary school.

*Basic vaccination*Basic vaccination

•Hep B•IPV•DTP•PCV

•Hib•MMR

•Varicella

•Hep B•IPV•DTP•PCV

•Hib•MMR

•Varicella

Vaccination scheduleVaccination schedule

• Avaccination schedule is a series of vaccinations ,including the timing of all doses ,

which may be either recommended or compulsory, depending on the country of

residence.• Many vaccines require multiple doses for

maximum effectiveness, either to produce sufficient initial immune response or to boost ,response that fades over time. For example tetanus vaccine boosters are often

recommended every 10 years.

•A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence.

•Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time. For example, tetanus vaccine boosters are often recommended every 10 years.

• Vaccine schedules are developed by governmental agencies or physicians groups to achieve maximum effectiveness using required and recommended vaccines for a locality while minimizing the number of health care system interactions. Over the past two decades, the recommended vaccination schedule has grown rapidly and become more complicated as many

new vaccines have been developed.

•Vaccine schedules are developed by governmental agencies or physicians groups to achieve maximum effectiveness using required and recommended vaccines for a locality while minimizing the number of health care system interactions. Over the past two decades, the recommended vaccination schedule has grown rapidly and become more complicated as many new vaccines have been developed.

• Some vaccines are recommended only in certain areas (countries, subnational areas or at-risk populations) where a disease is common. For ,instanceyellow fever vaccination is on the

routine vaccine schedule of French Guiana, is recommended in certain regions of Brazil but in the United States is only given to travelers heading to countries with a history of the

disease.

•Some vaccines are recommended only in certain areas (countries, subnational areas or at-risk populations) where a disease is common. For instance, yellow fever vaccination is on the routine vaccine schedule of French Guiana, is recommended in certain regions of Brazil but in the United States is only given to travelers heading to countries with a history of the disease.

Vaccination schedulesVaccination schedules

السلطة • قبل•UAE Israel

• BCGHepatitis B•polio DTP+eIPV

•DPT TOPV•MeasleseIPV •MMR MMR

• HbCV b• B.C.G

•MOH UNRWA•VARIOLAOPV

• POLIOMYELITISTT•DTP DT

•B.C.G MMR• B.C.G

السلطة • قبل•UAE Israel

•BCG Hepatitis B•polio DTP+eIPV

•DPT TOPV•Measles eIPV•MMR MMR

• HbCV b• B.C.G

•MOH UNRWA•VARIOLA OPV

•POLIOMYELITIS TT•DTP DT

•B.C.G MMR• B.C.G

السلطة السلطة بعد بعد•UAE Israel

• BCG HEP B HBV +•Hep B IPV•IPV Hib

•PCVDTaP •DPT + Hib + Hep B OPV•DPT + Hib MMR

• MMRVARICELLA ZOSTER• HEP A + HAV

• PNEUMOCOCCAL VACCINE

•MOH UNRWA•MMR MMR•DPT DTP

• DPT + HibMEASLES•OPV OPV

•IPV IPV•HEP. B HEP B

•BCG BCG• Hib

• Vit A

•UAE Israel•BCG HEP B + HBV

•Hep B IPV•IPV Hib

•PCV DTaP•DPT + Hib + Hep B OPV•DPT + Hib MMR

•MMR VARICELLA ZOSTER• HEP A + HAV

• PNEUMOCOCCAL VACCINE

•MOH UNRWA•MMR MMR•DPT DTP

•DPT + Hib MEASLES•OPV OPV

•IPV IPV•HEP. B HEP B

•BCG BCG• Hib

• Vit A

Global Immunization DataOctober 2010

Global Immunization DataOctober 2010

Summary: Global immunization coverage in 2008• Based on the latest World Health Organization

UNICEF global estimates for 2009, trends/(WHO) related to global vaccination coverage continue to be

positive.• Immunization currently averts an estimated 2.5

million deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and

measles.

Summary: Global immunization coverage in 2008• Based on the latest World Health Organization

(WHO)/UNICEF global estimates for 2009, trends related to global vaccination coverage continue to be positive.

• Immunization currently averts an estimated 2.5 million deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles.

The unprotected childrenThe unprotected children

Deaths due to vaccine-preventable diseasesDeaths due to vaccine-preventable diseases

Total number of children who died from diseases preventable by vaccines

currently recommended by WHO: 1.7 million.• Hib: 260 000• Pertussis: 195 000• Measles: 118 000• Neonatal tetanus: 59 000• Tetanus (non-neonatal): 2 000

Estimated number of all deaths in children under five in 2008: 8.8 million.

Nearly 20% of all deaths in children under 5 is vaccine preventable

Total number of children who died from diseases preventable by vaccines

currently recommended by WHO: 1.7 million.• Hib: 260 000• Pertussis: 195 000• Measles: 118 000• Neonatal tetanus: 59 000• Tetanus (non-neonatal): 2 000

Estimated number of all deaths in children under five in 2008: 8.8 million.

Nearly 20% of all deaths in children under 5 is vaccine preventable

Global coverage of infantsGlobal coverage of infants

Global coverage of infants

1990 2009 Notes

DTP3 75% 82% #vaccinated2009/107 million

Polio-3 doses 75% 83% 1988/350 0002009/1783 polio cases

polio-endemic countries: 1988-125 /// 2009-4

Measles- 2 birthday -one dose

73% 82% Measles deaths in 2008: 164 000

MNT: # cont. not eliminate

2000/58 42

Hepatitis B 1% 70%

*Special vaccination*Special vaccination• Data for quantifying the risk of medical problems related to

religious pilgrimages are limited; the best documented, in terms of health risk, is the Hajj

• In Hajj, more than 2 million Muslims from all over the world .• The potential for spread of infectious diseases associated

with this pilgrimage has long been recognized

• Data for quantifying the risk of medical problems related to religious pilgrimages are limited; the best documented, in terms of health risk, is the Hajj

• In Hajj, more than 2 million Muslims from all over the world .• The potential for spread of infectious diseases associated

with this pilgrimage has long been recognized

The Ministry of Health of Saudi Arabia has issued the following

requirements and recommendationsfor entry visas for the year 1431H

(2010) Hajj andUmra seasons

The Ministry of Health of Saudi Arabia has issued the following

requirements and recommendationsfor entry visas for the year 1431H

(2010) Hajj andUmra seasons

… Yellow fever :

travellers from countries at risk of yellow fever transmission . e.g :Somalia, Sudan

… Poliomyelitis :

Countries infected with poliomyelitis (e.g: Niger, Sudan,) should be vaccinated against poliomyelitis with the oral polio vaccine

… Yellow fever :

travellers from countries at risk of yellow fever transmission . e.g :Somalia, Sudan

… Poliomyelitis :

Countries infected with poliomyelitis (e.g: Niger, Sudan,) should be vaccinated against poliomyelitis with the oral polio vaccine

• … Meningococcal meningitis• For all arrivals: Visitors from all over the world

arriving for the purpose of ‘‘Umra’’ or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) .

• Interior pilgrims and Hajj workers : vaccine is required for:

• — all citizens and residents of Madina and Makkah

who have not been vaccinated during the past 3 years;• — all citizens and residents undertaking the Hajj;• —all Hajj workers & who work at entry points or in

direct contact with pilgrims in Saudi Arabia.

• … Meningococcal meningitis• For all arrivals: Visitors from all over the world

arriving for the purpose of ‘‘Umra’’ or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135) .

• Interior pilgrims and Hajj workers : vaccine is required for:

• — all citizens and residents of Madina and Makkah

who have not been vaccinated during the past 3 years;• — all citizens and residents undertaking the Hajj;• —all Hajj workers & who work at entry points or in

direct contact with pilgrims in Saudi Arabia.

WHO//The view from the futureWHO//The view from the future

By the 2020s:

• child deaths from infectious diseases are expected to be

at an all-time low;

• polio should be eradicated, and measles eliminated in all

countries;

• hopes remain high that new vaccines will be available to

combat malaria, tuberculosis, AIDS, and other diseases.

By the 2020s:

• child deaths from infectious diseases are expected to be

at an all-time low;

• polio should be eradicated, and measles eliminated in all

countries;

• hopes remain high that new vaccines will be available to

combat malaria, tuberculosis, AIDS, and other diseases.

Sources : Palestinian Ministry of health. Israel Ministry of health . UAE ministry of health . WHO. International Travel and Health — 2010

(www.who.int/ith). State of the world’s vaccines and immunization -3rd

edition/WHO Health conditions for travelers to Saudi Arabia for

(Hajj) for the year 1431H/2010 \\\ Journal of Infection and Public Health (2010) 3, 92—94

CDC website http://www.historyofvaccines.org/content/timelines/all http://www.historyofvaccines.org/content/articles/history-

anti-vaccination-movements

Sources : Palestinian Ministry of health. Israel Ministry of health . UAE ministry of health . WHO. International Travel and Health — 2010

(www.who.int/ith). State of the world’s vaccines and immunization -3rd

edition/WHO Health conditions for travelers to Saudi Arabia for

(Hajj) for the year 1431H/2010 \\\ Journal of Infection and Public Health (2010) 3, 92—94

CDC website http://www.historyofvaccines.org/content/timelines/all http://www.historyofvaccines.org/content/articles/history-

anti-vaccination-movements