The vaccination of children helps to prevent many diseases that were once common and are, at worst, life threatening. The youngest children are at the greatest risk of getting these diseases.
Finland started vaccinations in the early 1800s with vaccinations against smallpox, but the country continued to have a high rate of child mortality for a long time.
“In the early 1900s, a large proportion of children’s deaths were still caused by infectious diseases, and Finnish children had a lot of serious diseases. When vaccines started to be developed then, there was a real need for them,” says Professor of Pediatric Infectious Diseases Ville Peltola from the University of Turku.
“Child health clinics played an important role in helping to launch widespread vaccinations. At the end of the 1950s, child health clinics started vaccinating children against diphtheria, whooping cough, tetanus and polio, and child health clinics still have an important role in ensuring that vaccine coverage remains high,” says Peltola.
Vaccines protect children under school-age
In Finland, all children under school-age are entitled to vaccinations against 12 different infectious diseases. In non-vaccinated children, these diseases may, at worst, be life-threatening. They also cause unpleasant sequelae and permanent disabilities.
“Because the youngest children are at greatest risk of getting ill, it is important that the vaccinations are given at a sufficiently young age,” Peltola underlines.
The rotavirus vaccine, which is administered to babies who are two months old, prevents a disease characterised by severe vomiting and diarrhoea. Before the vaccinations started in 2009, many infants required hospital care due to the disease.
“Every year in early spring, our pediatric ward at the Turku University Hospital was full of tiny patients needing IV fluids, who were at risk of dehydration,” says Peltola.
Protection against serious illnesses
“The 5-in-1 vaccine administered at the age of three months is a combination vaccine, which protects against diphtheria, tetanus, whooping cough and polio and the diseases caused by the Haemophilus influenzae type b (Hib) bacteria, which include meningitis, epiglottitis and sepsis. All these are life-threatening diseases which, thanks to vaccination, have virtually been eliminated today. Vaccination has also eliminated the Hib diseases in Finland,” says Peltola.
The pneumococcal vaccine administered to babies at the age of three months provides protection against meningitis, pneumonia, sepsis and otitis media (ear infection). Since the vaccine started being administered in 2010, severe pneumococcal diseases caused by the pneumococcal serotypes included in the vaccine have been almost entirely eradicated in young children.
The chickenpox vaccine, administered at the age of 18 months, prevents chickenpox. It is a highly infectious disease and without the vaccine almost everyone would catch it. The varicella virus that causes chickenpox remains in the body after the disease and may cause shingles, a disease with painful blisters, in middle age. The second dose of the vaccine is given to six-year-olds in the MMRV vaccine.
“The MMR vaccine, given at the age of one year prevents measles, mumps and rubella, all of which are highly infectious. Before the MMR vaccines were started, more than 90 per cent of the population were affected with these diseases, which have since been eradicated from Finland. The MMR vaccine, which was introduced to the national vaccination programme for children in 1982, is celebrating its 40th anniversary this year,” says Peltola.
Choosing not to vaccinate can risk lives
Parents today may not necessarily know how serious many of the infectious diseases that are nowadays prevented by vaccination can be.
For example, 5–10 per cent of those who contract diphtheria die of suffocation caused by swelling of the throat. About one in ten of those infected with tetanus die, and in young children the serious coughing fits caused by whooping cough can result in loss of oxygen to the brain or brain damage and lead to death. The most serious forms of polio may cause muscle paralysis in the limbs and paralysis of the respiratory muscles leading to death.
“Measles and its sequelae can also be fatal. In Finland most cases of measles come from abroad, but the disease is widespread in other parts of the world and without vaccination it is easy to be infected when travelling abroad. The disease will easily find those who are not vaccinated,” says Peltola.
Polio was still widespread in the 1950s. Finland’s most recent polio epidemic in the 1980s was brought to an end with an immunisation method that used a version of the live polio virus administered through a drop on a sugar cube to the entire population in 1985.
Child mortality is very low in Finland today. While vaccinations have had an impact on this, improvements in hygiene and living conditions have also reduced the number of child deaths.
Not all infectious diseases have disappeared from Finland
Whooping cough is still common among school children, and infants are at risk of contracting the life-threatening form of the disease. That is why vaccination is necessary.
“The rotavirus is still common among older children, so vaccination coverage is still needed among younger children. The influenza virus also circulates in Finland every year. Younger children suffering from a severe infection may need to be hospitalised, and sequelae are also common. More severe infections are prevented with annual vaccinations given to children over six months of age.”
Tetanus is also still present in the population. It is possible to catch it from the environment, for example from the soil or a dirty wound, but it does not spread from one person to another. Vaccination is the only protection against tetanus.
Vaccination of children produces savings in treatment costs
“According to a study by the Finnish Institute for Health and Welfare (THL), prior to the introduction of the rotavirus vaccine in 2009, more than 11,000 children under the age of five every year required healthcare services, i.e. a visit to the doctor or hospital treatment due to the rotavirus disease. However, since the vaccine was introduced, the number of rotavirus cases requiring hospitalisation in children under five years of age has decreased by 93 per cent,” says Peltola.
Peltola believes that the national vaccination programme for children is a very beneficial investment financially and socially. It produces significant savings of tens of millions of euros in treatment costs. In addition, vaccinations reduce parents’ absences from work due to children’s illnesses.
National vaccination programme
The national vaccination programme is developed continuously as necessary. A lot has happened in the 2000s alone. The most recent addition to the programme was in 2020 with the HPV vaccine administered to boys aged 10–12 years. The chickenpox vaccine was added in 2017. These were preceded by the pneumococcal vaccine in 2010 and the rotavirus vaccine in 2009.
“The vaccines must be safe, so they are studied very thoroughly. They are given to healthy children in a preventive manner. They can cause known reactions but these are not dangerous,” says Peltola.
Parents usually want to talk openly about the benefits and risks of vaccines and Peltola believes that the support and advice provided by a professional at a familiar child health clinic is very valuable.
Text by: Leena Koskenlaakso