INTERVIEW: Nothing in medicine as cost effective as vaccination - Professor Jaime Fergie - Health - Life & Style
Speaking to Ahram Online during his visit to Cairo, Professor Fergie pointed out that many people around the world are vulnerable to viral and bacterial infections as they did not receive their routine vaccinations during the pandemic.
AhramOnline (AO): What is the purpose of your visit to Egypt, and what are the main themes you'll be discussing with Egyptian paediatricians?
Jaime Fergie: I'm here to speak with colleagues about the importance of using the newer pneumococcal conjugate vaccine (PCV) to protect children from both invasive and mucosal pneumococcal infections. The US introduced the first conjugate PCV in 2000, starting with a vaccine that covered seven strains. We've since progressed to broader vaccines covering 13, and now 20 of the most relevant pneumococcal types. The aim is to expand protection for both children and adults.
AO: Do PCV types vary between high-income and low-to middle-income countries?
JF: There are slight regional differences, but overall, the top 20 types included in the newer vaccines cover the most important strains globally.
AO: How has paediatric infectious disease evolved, especially post-pandemic?
JF: During the pandemic, infections like RSV, flu, and pneumococcus dropped due to social distancing. Post-pandemic, we've seen a sharp rebound. A major concern is the number of children who have missed routine vaccinations, leaving them vulnerable. We're still working to catch up.
AO: What are the main challenges in diagnosing infectious diseases in children compared to adults?
JF: Young children often can't describe symptoms, so we rely on caregivers. Early symptoms—such as fever, fatigue, and poor appetite—can appear similar across various infections. Differentiating between viruses and bacterial infections can be tricky. Additionally, children's conditions can deteriorate rapidly, making early intervention and prevention through vaccination crucial. Vaccination remains the most cost-effective tool in paediatrics.
AO: Why is it important to vaccinate children with cancer?
JF: Ideally, children should be vaccinated before any cancer diagnosis. But even during early treatment stages, vaccination remains vital. Cancer weakens the immune system, making infections more dangerous. Pneumococcal infections, in particular, can lead to severe outcomes such as meningitis and pneumonia. Therefore, protection is critical.
AO: What other high-risk groups face threats from infectious diseases?
JF: Children with HIV, sickle cell disease, immune deficiencies, or no spleen are at high risk. Similarly, those with cochlear implants, kidney disease, or asthma. These children are more vulnerable to severe infections. The best approach is to include vaccines like the PCV in national immunisation programmes. I've seen firsthand how vaccination has reduced the incidence of serious diseases such as meningitis and pneumonia in the US.
AO: What is the best paediatric immunisation strategy for low-and middle-income countries?
JF: The WHO recommends key vaccines for all national programmes, including those for rotavirus, polio, diphtheria, tetanus, pertussis, and measles. Pneumococcal vaccines are also essential. Recently, vaccines for RSV have been introduced, given to pregnant women to protect newborns. While some vaccines, such as meningococcal, are less common globally, they're vital in specific settings, such as during pilgrimage travel. Immunisation should ideally start at two months of age. Financial barriers can be addressed by working with the WHO and organisations like Gavi, which help low-income countries access vaccines.
AO: What would you say to people still sceptical about vaccines?
JF: It's frustrating, considering how far we've come in preventing disease. Vaccines go through rigorous testing before being approved. While mild side effects like fever or soreness are possible, vaccines prevent illnesses we no longer see thanks to immunisation. The evidence for safety and effectiveness is overwhelming.
AO: Finally, what's your message to parents, paediatricians, and policymakers?
JF: To parents: Vaccines are safe, effective, and life-saving. I vaccinated my children and want the same protection for all. To paediatricians: Use the best tools available—the latest vaccines offer broader protection. To policymakers: You hold the power to improve children's health. Prioritising vaccination saves lives and is one of the wisest investments a country can make.
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