A world where polio, measles, and tuberculosis, once life-threatening illnesses, are just a distant memory is as near as it has ever been, thanks to vaccines. Vaccines are one of the greatest feats of modern medicine, preventing millions from disease, death, and devastation so that we, as humans, can lead a healthier lifestyles. They work by basically "training" the immune system to recognise and eliminate dangerous pathogens, often even before we have been in contact with the pathogens. In Bangladesh, too, people are protected throughout their lives, from infancy to adulthood, by a well-organised and structured immunisation programme, protecting communities from outbreaks of fatal diseases. 

Dr ASM Mahamuduzzanan, Assistant Professor of the Department of Pediatrics at Shaheed Suhrawardy Medical College and Hospital, states, "Now, vaccination coverage is so huge in Bangladesh that hardly anyone is at risk of vaccine preventable illnesses. Most kids are vaccinated now, very few are not and there should be even fewer. The vaccination rate in Bangladesh is very high now." Widespread vaccination has virtually eliminated these diseases, and vaccine-preventable diseases rarely cause severe illness compared to years past.

Vaccines are effective for a lifetime, starting from birth. The BCG vaccine against tuberculosis and the first dose of the oral polio vaccine (OPV) are administered to all newborns under the Expanded Programme on Immunisation (EPI). These are important interventions that foster long-term immunity. The pentavalent vaccine, which confers immunity against diphtheria, pertussis, tetanus, hepatitis B, and Haemophilus influenzae type B, is administered at six weeks. There is a pneumonia vaccine called the pneumococcal conjugate vaccine (PCV) whose follow-ups are given at 10 and 14 weeks, primarily to enhance immunity. 

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The immune system of children, while growing up, needs to be strengthened. The measles and rubella (MR) vaccine at nine months provides critical protection against these highly infectious diseases. A second dose of the measles vaccine at 15 months reinforces even greater and longer-lasting protection. Vaccines like DPT and Td provide 100 percent protection against tetanus, diphtheria, and pertussis whooping cough, with their booster shots given between one and five years. 

Although our vaccination rates are high, vaccine preventable diseases do not disappear completely. While serious diseases are rare, Dr Mahamuduzzanan says, "The absence of vaccination results in hepatitis A, smallpox, typhoid, cholera, and rotaviral diarrhea. Those who have not kept up with their required immunisations are also at risk of hepatitis B, tetanus, and mumps." This underlines the need for full immunisation and awareness programmes. 

The HPV vaccine, offered to teenage girls by the government, is a potential game changer. This is a paradigm shift in the prevention of cervical cancer, soon to be available in Bangladesh, where cervical cancer is the second most common cancer and a leading cause of death in women. This one-time vaccine leads to thousands of lives being saved by preventing cancers associated with human papillomavirus before we pass through the prime years of infection between the ages of 10 and 14. Older females should especially be encouraged to receive medical consultation for the HPV vaccine's alternative options. 

Extra protection is necessary for women of childbearing age, especially when they are pregnant. The TT vaccine protects infants against potentially fatal neonatal tetanus and is given in five doses, often at wide intervals. The seasonal influenza vaccine should also be given to pregnant women to prevent flu-related complications that are particularly dangerous during pregnancy. But when people become adults, they still need vaccines to prevent disease.

Older adults and people with chronic diseases are at higher risk of serious complications from influenza and, therefore, as we said, each year they are strongly advised to receive a yearly flu vaccine. Depending on individual risk factors, travel, and occupation, cholera, typhoid, hepatitis A, meningococcal disease, and rabies vaccines are also recommended. Extra shots are given at very specific locations to help protect more carefully where the infection is most likely to spread. But vaccination is not just a matter of protecting oneself, it is a community effort. 

Herd immunity is the result of a reduction in the spread of contagious disease when enough of a population is immune to the disease through vaccination. This is particularly important for individuals who are unable to get vaccinated due to medical conditions, so immunisation is everyone's responsibility. 

The near elimination of some diseases is an indication of how effective vaccination is, according to Dr Mahamuduzzanan. "With timely vaccination, polio and smallpox are already essentially eliminated. The incidence of diphtheria, measles, and tuberculosis with severe symptoms has declined," he points out. These success stories show how immunisation has great short-term and long-term effects on public health. 

Although lifesaving, vaccines have traditionally been greeted with scepticism due to misinformation. Misconceptions and myths can fuel vaccine hesitancy, putting individuals and communities at risk unnecessarily. It is important to be trusting of science and consult with healthcare professionals for accurate information about vaccines. 

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Maintaining up-to-date vaccinations is vital for long-term immunity and preventing disease resurgence. While Bangladesh has high vaccination rates, gaps remain, particularly in influenza and hepatitis B coverage. A study found that only 66.6 percent of healthcare workers had received the hepatitis B vaccine, with coverage as low as 38.8 percent among cleaning staff, despite over a quarter experiencing needlestick injuries. Influenza vaccination rates are also low, even though 86.2 percent of healthcare workers expressed their willingness to get vaccinated.

The COVID-19 pandemic made us realise the importance of vaccination, with Bangladesh's coverage rising from less than 4 percent in mid-2021 to over 68 percent by mid-2022, yet sustaining immunity requires adherence to booster schedules and tackling vaccine hesitancy. To ensure long-term immunity and prevent disease resurgence, continuous efforts are necessary to close these gaps, particularly among healthcare workers.

A dividend from immunisation is a future free from the diseases that rob communities of health and well-being, a future free of these unwanted ailments. One cannot overlook the wonders vaccines can do. So, embrace them, trust them, and let them help you in protecting yourself and your loved ones.

Purna is a third-year student at Shaheed M. Monsur Ali Medical College, Sirajganj. Reach her out at [email protected]