From the first weeks following a child’s birth, all the way to their teenage years, children in the Cayman Islands are gradually immunised against 11 serious diseases.
The Initial Immunisations
In the Cayman Islands, immunisations start from birth, explains Alice Jane Ebanks, the epidemiology manager at the Public Health Department.
‘When the babies are still in the hospital they receive the first Hepatitis B vaccine,’ she says.
The Hepatitis B germ lives in the blood and bodily fluids of the infected person and attacks their liver.
‘It’s like AIDS actually, because you can carry this virus and not even know its’ says Ms Ebanks.
Three doses of the Hepatitis B vaccine are delivered over the course of several months: the first occurs soon after birth, the second at six weeks of age, and the third at nine months of age.
Also at six weeks, babies receive the Bacillus Calmette-Guerin vaccine.
‘The BCG is the vaccine that protects against Tuberculosis, which is a bacterial disease that commonly starts in the lungs, though it can affect other organs,’ says Ms Ebanks.
At two months of age, babies receive the first in three doses of a vaccine that guards against Diphtheria, tetanus, acellular pertussis, polio, and Haemophilus Influenzae Type b.
Ms Ebanks explains that Diphtheria is a bacterial disease that attacks the airway and the heart, causing major swelling that can lead to death.
Tetanus is also a life-threatening disease that can enter the body through a break in the skin.
Acellular pertussis is commonly known as whooping cough, an illness that is still relatively common and that affects children most severely.
‘People don’t understand Haemophilus Influenzae Type b too well. Sometimes they think it is the flu because of the name, but that is just the name of the organism,’ says Ms Ebanks, explaining that the disease can cause brain damage, lung infections, deafness, blindness, and blood and bone infection.
This vaccine is an example of a combination, or simultaneous, vaccine.
These immunisations guard against multiple diseases by combining two or more vaccines into a single liquid.
Though combination vaccines often seem intimidating to parents, Ms Ebanks explains that combination vaccines have been in use for over 50 years in the United States.
‘So this is not a new deal, we are just getting better at it and are putting more and more things together,’ she says.
‘It’s practical: you protect children with more antigens earlier, and it cuts down on your visits.’
In particular, this vaccine has been highly successful in combating polio.
‘The polio vaccine works so well that the whole western hemisphere is now free of polio,’ Ms Ebanks says, adding that, until polio is eradicated world-wide, there is no excuse for inadequate protection.
The second and third doses of this combination vaccine are administered when infants are four and six months old.
After a Year
At 12 months, babies are then administered the Varicella vaccine which protects against chicken pox.
Despite a reputation as a relatively harmless childhood illness, chicken pox can cause particular harm to adults and the unborn children of pregnant women.
Ms Ebanks explains that this vaccine is the newest addition to the official immunisation schedule of the Cayman Islands, having been added in 2000.
At 15 months of age, infants then receive booster shots to guard against Diphtheria, Tetanus, acellular Pertussis and Haemophilus Influenzae Type b.
MMR: Myths and Realities
Also at 15 months, children are given the first in two doses of a combination vaccine to protect them against Measles, Mumps, and Rubella.
Ms Ebanks explains that, although measles, mumps and rubella are life-threatening diseases, a few parents are unnerved by myths that the vaccine has been linked as a cause of autism.
The journal that first published the study that publicised this claim has since rescinded the story and the theory was discredited.
‘Most people don’t even know what these diseases are and the younger doctors have never seen these diseases because they have become so rare,’ says Ms Ebanks, ‘and while that is good, parents don’t realise how serious these diseases really are because they have never seen them … So, what they are focusing on are the possible side-effects of the vaccine.’
Ms Ebanks explains that measles is a highly contagious disease that can lead to brain damage and death. Mumps can also cause serious problems in children.
Rubella, however, takes its most serious toll when contracted by pregnant women.
‘If a woman contracts Rubella, especially during the first 12 weeks of pregnancy, her baby can be very severely affected or killed by the virus … if the baby survives it can have a lot of abnormalities,’ Ms Ebanks says.
‘All of our people at child-bearing age should have had this vaccine.’
From Toddler to Teen
Between the ages of four and six, children are given booster to protect against diphtheria, tetanus, acellular pertussis, and polio.
At this age they are also given the final dose of the vaccine against measles, mumps, and rubella.
The final vaccine on the childhood immunisation schedule occurs ten years after the previously mentioned vaccine against diphtheria, tetanus, acellular pertussis and polio. ‘When they are 14 to 16, depending on when they got the previous shots, at the ten year interval they will receive the adult vaccine which consists of Tetanus and a modified form of Diphtheria,’ says Ms Ebanks.
Immunisation rates in the Cayman Islands are usually quite high, according to Ms Ebanks.
‘We go up into the 90 per cents of coverage,’ she says.
‘The coverage should be 95 per cent and above … to keep the disease away because if your coverage drops too low then you will see children being infected with these diseases again.’
Ms Ebanks explains that other countries have seen resurges of diseases like diphtheria and polio when immunisation rates dropped too low.
‘It has happened before and it can happen again,’ she says, ‘so we have to have a high coverage to keep these diseases at bay.’
Though parents are not legally required to have their children vaccinated, Ms Ebanks reminds parents that immunisation is the best way to keep children safe from life-threatening diseases and infections.
‘While you are here you might feel safe, but when you travel, until the world has eradicated these diseases you are not safe,’ she says.
According to Ms Ebanks, the Public Health Department are also hoping to add new vaccines to the childhood immunisation schedule this year in an effort to better protect children in the Cayman Islands, namely: the Human papillomavirus virus vaccine, the pneumococcal conjugate vaccine, commonly known as prevnar, and the Rotavirus vaccine.