Group 2. Diseases preventable by vaccination

Disease tools: 7. Acute respiratory infections preventable by vaccine: diphtheria, mumps, rubella, chickenpox, whooping cough 8. Measles 9. Meningococcal meningitis 10. Polio 11. Yellow fever

A range of diseases can be prevented and controlled by vaccination. Each is different and spreads in a different way. For volunteers, the important thing is to know how to prevent epidemics of such diseases from occurring and how to assist with vaccination campaigns.

Diseases that are prevented by vaccines include polio, whooping cough (or pertussis), diphtheria, pneumonia, tetanus, viral hepatitis A and B (liver infection), measles, mumps, rubella, chickenpox, typhoid fever, yellow fever, dengue, meningitis (HIb and meningococcal meningitis), cholera and some other diseases.

How are these diseases transmitted?

Diseases in this group are transmitted in different ways. Polio, cholera, hepatitis A and typhoid fever are transmitted by contact with hands and objects that are dirty, or by consuming water or food that is contaminated by infected stools in a similar way to diarrhoeal diseases. Yellow fever and dengue are transmitted by vectors (mosquitoes). Hepatitis B is transmitted by sexual intercourse or contact with blood, including blood passed from mother to child. Other diseases are transmitted by droplets emitted by coughing or sneezing.

What symptoms do they cause?

The symptoms can also be different because they are disease specific. In each case, nevertheless, it is critical to prevent them by helping to bring children to health workers who will vaccinate them. All these diseases can cause death in young children and in adults.

How do we prevent epidemics of these diseases?

Epidemics of these diseases can be prevented by some simple actions: 

• Specific vaccines will prevent many people from being infected by the diseases in this group.
• If enough people in a community are vaccinated against these diseases, epidemics of these diseases will not occur. 
• Yellow fever and dengue epidemics can also be prevented by controlling mosquitoes and protecting people from being bitten.
• Improving living conditions, hygiene and sanitation and reducing overcrowding help to prevent polio, typhoid, hepatitis A, measles and meningitis. Action in this area is especially important in refugee and displaced persons’ camps.

About vaccines

The vaccines for diseases in this group are usually very effective. Some (in particular, polio, measles, mumps, rubella, diphtheria, tetanus and whooping cough) should be given to every child as part of a routine vaccination schedule. As volunteers, you should tell people in your local community to always take their children to health centres for vaccinations that are due.

These are the vaccines for the different diseases in this group:

• Measles, mumps and rubella (MMR). The vaccine is given in two doses. In countries where measles causes many deaths, the first dose is given at nine months and the second at between 15 and 18 months. In countries where few children die from measles, the first dose is given at 12 months and the second usually at school entry. 
• Polio. The vaccine is given by drops in the mouth or by injection. It should be given to children three to four times in their first year, followed up with one or two booster doses during childhood. 
• Diphtheria, tetanus and pertussis. Vaccines are usually given in a combined form together with an anti-tetanus vaccine (called DTP) and sometimes with a vaccine against hepatitis B and HIb (called pentavalent). It is recommended to give children three doses during the first year of life.
• Meningococcal meningitis. The vaccine should be given to persons between one and 29 years of age who live in 26 African countries where this form of meningitis is prevalent. In other countries the vaccine schedule differs. 
• Hepatitis A. vaccine can be given to children as part of regular childhood immunization programmes, and to travellers with other vaccines.
• Typhoid fever. Vaccination is recommended to control endemic typhoid, for outbreak control, and in the context of other efforts to control the disease.

How to deal with cases of these diseases?

When people are sick with one of the above-mentioned diseases, there is little that volunteers can do to cure them. These diseases are dangerous and require prompt medical treatment. The best way to help is to recognize when a child is sick (which you will learn to do with the help of the toolkit) and refer him or her to the nearest hospital or health facility.

How to detect an epidemic? 

1. Polio. An epidemic is suspected when children suffer from paralysis. 
2. Measles. An epidemic is suspected when many children have fever with a rash on the skin, a runny nose, and sometimes eye infections. 
3. Meningitis. An epidemic is suspected when many people have fever with a bad headache and stiff neck.

How to deal with an epidemic?

If an epidemic of a vaccine-preventable disease occurs in your community, several actions need to be taken:

• Build trust with members of the community. 
• Involve members of the community in efforts to control the epidemic.
• Familiarize yourself with the community’s culture.
• Promote mass vaccination to bring the epidemic under control. 
• Improve water, sanitation and hygiene where required, to reduce the spread of polio, typhoid and hepatitis (and some other diseases). 
• Improve living conditions and reduce overcrowding to reduce the spread of measles and meningitis.
• Detect new cases in the community and refer them to health facilities for treatment.

What can volunteers do?

Volunteers do not usually give vaccines, either during routine vaccination programmes or vaccination campaigns. However, you can do many other things to support the health authorities during vaccination. They include:

• Monitoring. It is important to ensure that vaccination campaigns cover all the people who needs to be vaccinated. In particular, make sure that people who are especially vulnerable or stigmatized are reached by the campaign.
• Community-based surveillance. Help members of the community identify cases of infection. Tell them how to deal with them. 
• Social mobilization and community engagement. Talk to members of the community to understand their ideas and concerns about vaccination. Find out whether they trust the health authorities and the information they provide. Listen for rumours or misinformation about vaccinations. Social mobilization is one of the most valuable things volunteers can do. Because volunteers belong to the community, they can address its concerns, encourage families to get their children vaccinated, and follow up children who are missed. 
• Psychosocial support. Give sick people and their families support. 
• Screening for malnutrition in children less than five years of age. Vaccination campaigns are a good opportunity to screen for severe or acute malnutrition in children under five years old, who can be at high risk of getting very sick.

Participate

Discuss in your group a possible epidemic of a vaccine preventable disease in your community. Look at the disease tools for vaccine preventable diseases and select the appropriate action and message tools for each disease. Discuss with your facilitator the similarities and differences between the tools for each disease in this category.

It is important to recognize that regular vaccination and mass vaccination campaigns are the most effective way to end epidemics in this category of diseases. Discuss how you would support a mass vaccination campaign in your community. What difficulties would arise if you decided to vaccinate all the vulnerable people in your community?