Vaccine Heroes

Dr Lucy Jessop, Director National Immunisation Office

As a current public health doctor, ex-paediatrician and a mother I believe that vaccines are the best gift we can give our children and even better the health service gives them to us for free, something we may take for granted but people in many other countries aren’t so fortunate. If my sons first birthday hadn’t been on a Sunday he would have had his 12 month vaccines on that day, because you never know when they will be exposed to infections so it is really important to get them vaccinated as soon as they are due for them.

I also firmly support breast feeding and healthy eating, but they can’t protect your baby effectively against potentially fatal infectious diseases, like vaccines can.

I still remember the anguish of young parents when their only child died aged 2 years from Hib meningitis in the hospital I was working in as a junior doctor. She had been vaccinated as a baby, but this was before it was known that a booster dose at 1 year was necessary, so her immunity had waned and she died very quickly when the disease took hold of her. Her death contributed to the introduction of a booster dose of the vaccine at 1 year, which means that Hib disease is virtually never seen now, but it could come back if immunisation rates drop.

I also remember the extreme care of a father for his son aged about 10 who had SSPE, a rare complication of measles. They were from Eastern Europe originally so probably couldn’t have accessed the vaccine for him and so he had contracted measles some years before I met them. His son was very slowly dying because SSPE causes progressive deterioration of the brain and there is no cure.

These children losing their lives to potentially preventable infectious diseases and the devastation that the death of a child leaves on the families left behind made me want to dedicate my medical career to trying to ensure vaccine rates were as high as possible so this wouldn’t happen needlessly to other families.

Dr Chantal Migone, Specialist in Public Health Medicine, National Immunisation Office

When I was a medical student our professor of medicine introduced us to one of his patients; a young woman who was dying from a rare but serious complication of measles, a condition called sub-acute sclerosing pan-encephalitis (SSPE). This young woman had measles as a young child, and years later developed SSPE, a chronic neurological condition that is almost always fatal.

I’ll always remember this young woman, she was just five years younger than me at the time, but was now confined to a wheelchair, was getting frequent seizures, and would soon die.

By introducing us to her, the professor of medicine was trying to stress to us the importance of immunisation against measles.

We have a really good vaccine to protect against measles, the MMR vaccine. After two doses of MMR vaccine 99% of people are protected against measles. If 95% of our community are protected then the virus can’t spread, which means that nobody should be at risk from SSPE.

Sometimes I hear people say that natural immunity against conditions like measles is better than being vaccinated. But “natural” immunity can come at a really terrible price, as it did for this young woman. That’s why we vaccinate against measles, to prevent SSPE and other serious complications of measles like pneumonia and encephalitis.

Dr Kenneth Beatty, Specialist Registrar in Public Health Medicine, National Immunisation Office

In late September 2020, my wife gave birth to our first child, a baby girl named Sadhbh. As all new parents, we were hit with a mix of overwhelming joy and serious anxiety as to how we would be able to care for this little bundle. This was complicated even further by COVID-19.

The re-introduction of Level 4 lockdowns in Ireland occurred one month after Sadhbh’s birth which meant that family supports we had relied on to help us during this time were removed. Thankfully, after countless nights of midnight feeds and nappy changes we got through the first few months of parenthood. This meant that Sadhbh was then due to start her childhood vaccines.

Although I have used and promoted vaccines throughout my career and know how important they are, when it came to Sadhbh’s first vaccines even I had to acknowledge a feeling of apprehension knowing she was going to have to feel some pain. This surprised me as although I knew all the evidence about the safety, efficacy and importance of childhood vaccines I still had to fight the instinct any parent would have of ensuring our children didn’t feel pain.

However, it couldn’t have gone smoother. The COVID-19 restrictions made it a bit unusual (trying to make funny faces while wearing face coverings is hard!) but Sadhbh took them in her stride. It’s so important not to let fears around COVID-19 stop us from vaccinating our children.

These vaccines prevent against diseases that have previously caused very high numbers of illness and death in children in particular and it’s vital we ensure our children continue to be protected against them.

Dr. Rachel McLoughlin

Louise

My story really starts when I wanted to become a social care worker. I needed to have all of my vaccinations up to date and also get a Hepatitis vaccination as required by my employer, I am not the best when it comes to needles so I needed my mom to support me for these visits, even though I was in my 20's!

From there my life with regular injections continued and will do; yearly Flu vaccines are a must in my line of work and I have also had two pregnancies in 2018 and 2019 for these I got my Pertussis vaccines as well as my Flu vaccine. Both of my babies have had their required vaccines as I am a firm believer that protecting them from as many preventable diseases as possible is key to their health and development just as much as a balanced diet. I have never suffered any negative side effects from any vaccination and neither have my two babies. I will continue to vaccinate myself and my children in the future as I think it would be very silly not to.

Leah

My second baby was premature. The fear I had bringing her home during a measles outbreak in North Dublin was horrendous. Knowing I could not vaccinate her for another year.

She's nearly 2 now and is brilliant. Both my daughters are up to date on the schedule, additionally they both have their flu shot ever year and chicken pox.

Being a parent I am responsible for my children, and our herd immunity.

Catherine

Elyce

A few years ago I was working as a Junior Doctor in paediatrics and was involved in the care of several very young babies who were unwell with whooping cough. Unfortunately some of them became seriously unwell and had long hospital stays.

Years later when I became pregnant with my first little boy, I was so happy that I could do something to protect him from whooping cough. While I was pregnant I got the whooping cough (pertussis) vaccine from my GP and am happy he was protected.

I got pregnant again in 2018 and got my pertussis and flu vaccine. It is really good knowing that taking a few minutes to get a simple vaccine will help protect my baby and me from these serious illnesses.

Sue

Jean

Michael

My name is Michael and my son had a liver transplant when he was a young child some years ago. Luckily he had got all the recommended vaccines before he had the transplant. But, these vaccines may no longer work because of the medicines that he has to take for the rest of his life. He can have more doses (boosters) of certain vaccines but not others which are live vaccines.

Live vaccines prevent diseases like Measles, Mumps and Rubella. These diseases can affect people of all ages but especially those in schools or colleges. Complications from these diseases are more common in people like my son. He wants to be able to go to school, meet up with his friends and join in normal everyday activities for a boy his age. He needs those around him to have the MMR vaccine to protect themselves and those at risk like himself.

“Ar scáth a chéile a maireann na daoine”. (People depend on each other).

Eoin

42 year old Eoin Roche from Co. Kildare talks about his experience of undergoing treatment for a HPV-related cancer – which for Eoin is now thankfully in remission. Eoin is a strong advocate for the HPV vaccine and he hopes his story will encourage parents to get their daughters and sons vaccinated.

Theresa

I am a Practice Nurse and a strong advocate for the HPV Vaccine.

There is currently no specific treatment for HPV infection and vaccination is paramount in the prevention of HPV related illnesses. Most HPV infections cause no symptoms and resolve spontaneously however sometimes the infection can give rise to cancer.

Most HPV infections are low risk and don't lead to cancer, however, there are at least 12 high risk strains of which two cause the majority of HPV related cancers. HPV types 16 and 18 can cause cancer of the cervix, vagina, vulva, anus, penis and oropharynx. These infections are often transmitted sexually or through other skin-to-skin contact. HPV types 6 and 11 cause more than 90% of genital warts. Vaccines can help protect against the strains of HPV most likely to cause genital warts or cervical cancer.

Globally, HPV is the most common sexually transmitted infection. In 2018, an estimated 569,000 new cases and 311,000 deaths occurred from cervical cancer worldwide. Nearly all cervical cancers are caused by HPV infections, but can take 20 years or longer to develop after an HPV infection. Vaccination against HPV infection is the best protection from cervical cancer.

The uptake of the HPV vaccination has risen to 70%, a rise of 20% in the past two years. These figures mark a welcome recovery in demand for the vaccine, which was the subject of a vigorous campaign of opposition by parents’ groups and the anti-vax movement led by misinformation and ill informed sources through negative social media. Despite the absence of any scientific basis for claims linking the vaccine to chronic illness among some girls, uptake of the vaccine fell from 87% in 2014 to just 50 per cent in 2016/’17. It is important that people are aware of the pitfalls of relying on ill-informed and unreliable sources for health care advice and receive the facts and reliable information and data about the benefits and safety of HPV vaccination from regulatory government bodies, the HSE and health care professionals. The HPV vaccine saves lives. Thanks to recent targeted campaigns including the positive use of social media by the HSE NIO, HPV Alliance, The Irish Cancer Society and HPV vaccine advocates including the late Laura Brennan, Ireland is now seeing a reversal of these negative trends, and levels of HPV vaccine uptake are once again increasing and continue to rise.

HPV vaccines have been endorsed by national and international regulatory bodies and proven to be very safe. The safety of the HPV vaccine has been strictly monitored for more than 14 years and frequently reviewed by: the European Medicines Agency (EMA); the Global Advisory Committee on Vaccine Safety of the World Health Organization and the Centers for Disease Control and Prevention in the US (CDC). The HSE is guided by the recommendations of the National Immunisation Advisory Committee (NIAC) and the World Health Organization (WHO). All vaccines used by the HSE including Gardasil® are licensed by the Health Products Regulatory Authority (HPRA) and the European Medicines Agency (EMA).

Since HPV vaccine was first licensed in 2006, research conducted all over the world shows that the vaccine is safe and prevents cancer. The World Health Organization (2020) considers HPV vaccines to be extremely safe. There is no scientific evidence in Ireland, or any other country that the HPV vaccine causes any long term medical condition. No country has raised a safety signal for HPV vaccine Gardasil®.

Gardasil®/Gardasil9® is currently used in 115 government funded HPV immunisation programmes globally. Over 244 million doses of Gardasil® have been distributed worldwide and it is currently used in over 25 European countries, the United States, Canada, Australia and New Zealand. In Ireland 730,000 doses of Gardasil® have been distributed and more than 240,000 girls have been fully vaccinated against HPV. The introduction of the HPV Vaccine in Ireland for boys is a very welcome initiative. Since September 2019, the HSE now offers HPV9 vaccine Gardasil9® to both boys and girls in first year in second level schools on the recommendations of the National Immunisation Advisory Committee, to protect them against cancers caused by HPV virus and genital warts in adulthood. HPV9 vaccine is offered to this age group before sexual contact occurs and they are exposed to HPV and because the response to the vaccine is best at this age. Research has shown that receiving the vaccine at a young age is not linked to an earlier start of sexual activity. Once infected with HPV, the vaccine might not be as effective or might not work at all but, if given before someone is infected, the vaccine can prevent most cases of cervical cancer. Under the age of 15, two doses of the vaccine are required, but at 15 years and older three doses are necessary for full protection. HPV vaccination of boys provides direct protection against HPV-related diseases.

Each year in Ireland, over 6,500 women require hospital treatment for pre-cancerous lesions of the cervix, 300 women develop cervical cancer, and 90 women die from it. Of the 538 cancers associated with HPV diagnosed in Ireland each year, a quarter are diagnosed in men. The number of oropharyngeal cancers caused by HPV are increasing in men. Vaccinating boys now provides greater protection to everyone by preventing the spread of HPV virus which will reduce the burden of cervical and other cancers further. Vaccination protects not only vaccinated individuals against infection by the HPV types targeted by the respective vaccine. Vaccination of a significant proportion of the population also reduces the prevalence of the vaccine-targeted HPV types in the population, thereby providing some protection (herd-immunity) for individuals who are not vaccinated.

Vida

Laura

The Huestons

The Dalys

Eimear

The Brennans

Michelle

My name is Rachel Fitzpatrick I live in Co Roscommon with my partner and 3 children, I have 3 younger sisters and a younger brother. My mums name was Michelle Fitzpatrick and she sadly passed away in 2010 after a battle with cervical cancer. My youngest sister Jemma was just 2 when my mum passed away.

My mums biggest fear was not her illness or dying, her biggest fear was not being able to protect my siblings and I. She was terrified my sisters and I would experience the same fate as her. She wanted to protect us from the horrible symptoms and pain she was experiencing. While undergoing treatment and attending doctor visits she found out about the HPV vaccine and how the HPV virus causes most cervical cancer.

She headed a pressure campaign in 2009 and went public with her illness to get the government to introduce the HPV vaccine. She spoke to journalists, radio stations and politicians to raise awareness of cervical cancer and the importance of the HPV vaccine.

In 2010, Trinity College offered the vaccine to all female students at half price and then it was announced that the HPV Vaccine would be made available to all first year female students from September 2010. This made mum so happy.

Our youngest sister Jemma started 1st year this September and will be receiving the vaccine that our mum put so much work and effort ensuring that it would be made available to her.

Jemma is already living with the consequences of cervical cancer, but with regular smears and the HPV vaccine she will be protected.

My message to parents who children are eligible for the vaccine is to please think of my mum and Laura Brennan’s stories when you are making your decision to vaccinate.

We are so proud of our mum and her legacy which has saved thousands of lives and will save thousands more.

Nora

When I say Aralynn was a healthy little girl, she would have been really healthy, and very rarely sick.

In February 2018, Aralynn O’Hare caught the flu. She was four years old at the time and “a picture of health.” Within 48 hours, she was in the paediatric intensive care unit (PICU) in Crumlin Hospital.

It was a Friday when I went to pick Aralynn up from Montessori. When she came out, she started complaining saying she felt a bit cold, which was unlike her,” says Nora. “She did a tonne of activities at that stage. So I kind of went, ‘oh you’ll be grand, put on a coat’ and didn’t think anything of it.

After Montessori, Aralynn went swimming and played tennis, but Nora knew something was wrong when she didn’t want to go into the play centre afterwards.

We went home that evening and she started running a temperature. She hadn’t had a cough or a cold… nothing. My mother was staying that night and she said, ‘that’s a very high temperature, you should bring her straight to the hospital.’ And I thought my mam was overreacting at the time. I gave her Calpol, and her temperature came down a bit.

But during the night, she started breathing funnily. I thought it was croup, because my other little girl had croup a few times, so I was doing all the things you do for croup.

The next morning, Aralynn got up and was looking for her breakfast – a sign that she was feeling better. However, her breathing had become irregular so Nora brought her to the GP. From there, she went straight into hospital.

By one o’clock on Sunday morning, she was being intubated because she had caught bacterial tracheitis, and her trachea was closing over,” says Nora. “We’re talking about a really, really short period of time.

But at that stage, they still didn’t know that she had the flu. They thought, ‘we’ve caught this in time, now she’ll be grand.’ But then it all happened.

‘It was like something out of a nightmare’

By Monday, Nora and her husband Adrian were told that they had a really sick child, and by Tuesday they were told she’d have to be flown to Sweden for access to an ECMO machine – a machine which provides support to people whose heart and lungs are unable to function adequately.

They said her heart was starting to shut down. It was like something out of a nightmare. Even now as I’m talking to you, I’m nearly emotional thinking back on it.

“We signed all the forms and everything. The doctors told us there was a 50% chance that she would die, even when she went on ECMO. But even if she survived that, there was a very high probability she’d be left with severe brain damage going down to moderate brain damage and all the rest of it. So the chances that she’d come out perfect were very, very slight.”

“They said she was the sickest child in ICU. I think that they were trying to let us know how sick she was. I didn’t know at the time, but we were put in this butterfly room, which is right beside the ward. Afterwards, somebody told me that usually you’re only put there if they think your child isn’t going to make it.”

Before Aralynn went to Sweden, her doctor suggested trying one more thing.

Dr Healy said we could try this filtration, like dialysis, where they take the blood out of your body and they oxygenate it and, they put it back in. And they did that. And it was a long struggle for her, but basically, she never ended up going to Sweden.

After one month in ICU on a ventilator, Aralynn recovered enough to be sent to a ward.

In the wards then, all of her limbs had sort of wasted from that month in ICU, and her muscle. So she ended up in a wheelchair for a while, and at this stage they didn’t know the extent of her brain damage. They felt that she may have been brain damaged and that would affect her ability to speak and walk and all of the normal things, so we didn’t know what to expect.

I can remember they said to us that she had sustained some brain damage, called cerebral microbleeds, these tiny little beads all over her brain. She’s just very lucky that none of them were larger.

After another month recovering in hospital and doing physiotherapy, Aralynn could go home.

The worst part for her, I think when I look at it now, was that she couldn’t do what other children could. I remember her saying about her little sister, ‘she’s faster than me now mammy, I can only walk and she can run.’ She had to learn how to do things, how to climb, how to run – all these kind of things again.

More than two years on, Aralynn is seven-years-old, in first class in school and thriving.

If you met her, you’d see that you would never ever know that there was anything wrong with her. She still has damage to her lungs and she has to take a nebuliser morning and night but other than that, she’s perfect.

If I had known that a child, a perfectly healthy child, could get that sick in 24 hours, there is no way that they would have not had the flu vaccine. I always thought, and maybe it was my own ignorance, that the flu was a long suffering process. I never thought it was like a sudden onset, that somebody could just go from being perfect and then 24 hours later be on a ventilator. I didn’t think that.

If she didn’t have the flu, she wouldn’t have gotten bacterial tracheitis.

I thought that this killed elderly people, people who were already sick, children with underlying conditions. I didn’t know that somebody who was perfectly healthy, like Aralynn could be so unwell from it. She was skiing two weeks before. She was so healthy. I wouldn’t have thought it was possible.

Today, Nora can’t stress enough the importance of vaccinating your child against the flu.

Everybody who knows me, anybody who’s close to me, they all get their kids vaccinated against the flu. They would have known Aralynn and they would have known that she wasn’t some sort of delicate child. She was hearty and healthy.

Sean

Nuala

Working in a care centre with vulnerable adults who are at risk of the flu. Increasing the staffs knowledge on the flu, the benefits, the risk to our residents and to address the misconceptions related to the flu jab.

In order to encourage my staff, I am the first to get the flu jab and we support our staff to get the jab locally in working hours if they wish and it is paid for. We have in increased our uptake from 40% to 60% in 2019 and sickness rate reduced.

It about health promotion but also realising we have a responsibility and a duty of care to our residents.

Ryan

My name is Ryan Goulding. I am a Staff Nurse Eist Linn, a CAMHS inpatient service catering for young people aged 12-17.

This was my first year being a peer vaccinator, or 'flu fighter' as we like to call ourselves. Myself and my 2 colleagues Lynn Staff Nurse, and Marie Therese CNM2 spearheaded this years vaccination effort. We all organised, and conducted several onsite clinics as well as travelling to Mallow Primary Care Centre to vaccinate our colleagues in the North Cork CAMHS team.

Our DON Jennie Synnott suggested that we engage in some healthy competition with our colleagues in Linn Dara, another CAMHS inpatient unit based in Dublin. It was decided that we would have a Vaccination Challenge and whoever vaccinated the most percentage of staff would be the overall winner. A Twitter war ensued and both sides posted regular updates of their stats. It was a great way to drum up a bit of discussion around the vaccinations and get a few more people interested in getting the flu vaccine.

This year we managed to vaccinate double the amount of staff from last year. Eist Linn narrowly beat Linn Dara with a few last minute vaccinations. Linn Dara in keeping with good sportsmanship brought a box of chocolates to Eist Linn on a visit to congratulate us on this.

I think this says a great deal about the compassionate and altruistic nature of our respective teams.

I would recommend anyone to get involved in the peer vaccination programme. It has been great fun and also a great learning experience for me and my colleagues. The training was very educational and engaging and it was great to be able to utilise a skill that we don't always get to utilise in CAMHS.

I would also urge anyone who hasn't had the vaccine to get it as there's always still time. If you won't vaccinate for yourself then do it for someone in your life that can't do it for themselves or the people you work with who are at their most vulnerable.

Bernie

People like Ennis resident Bernie Tierney, who has been a Household Attendant at Ennis Hospital for the past two decades, play a vital role in keeping hospitals functioning safely for patients and staff alike.

Bernie has been a Household Attendant at Ennis Hospital for the past 20 years, and in recent years has voluntarily added to her busy daily workload by becoming a Flu Vaccine Advocate.

This decision stems from her own gruelling experience several years ago, when she was laid low by a particularly serious dose of influenza that incapacitated her and left her bed-ridden for several days.

“I was very sick with it,” Bernie explains with a shudder. “I ended up in bed for three days, and I felt so sick, with pains in every part of my body. My children had to do everything for me.”

“As soon as I recovered, I said to myself, ‘Never again! From now on, I’m going to get the flu vaccine.’ So, I’ve been getting the flu vaccine every year since, and, touch wood, I haven’t had the flu since,” she recalls.

Because Bernie’s work routine brings her into contact with many patients and staff in different parts of the hospital, she soon began to consider and appreciate the benefits of the flu vaccine for everyone – colleagues and patients, as well as her own family and the wider community.

As a Flu Vaccine Advocate, Bernie complements the efforts of management at Ennis Hospital and across the sites of UL Hospitals Group to encourage all staff to get the flu vaccine and keep hospitals safe for patients, colleagues, and their families, friends and neighbours.

Her Household Attendant duties make Bernie particularly well attuned to the importance of cleaning and hygiene.

"I’m very particular when it comes cleaning, because all day, in different parts of the hospital, I'm cleaning everything, including worktops, toilets, windows, floors, radiators and bins,” she explains.

Throughout the period of the Winter Action Plan in the Mid-West, Bernie is stepping up her efforts to encourage as many of her colleagues as possible to have the flu vaccine.

"I think it’s important for everybody in high-risk areas like hospitals to protect themselves and patients, as well as their colleagues and their families. The way I see it, the flu vaccine is the best way we have to protect ourselves and the people around us all the time," Bernie says.

"Often it's the younger people who will be saying, 'Oh, we don't need to take that.' But I think everyone should get the vaccine. And it's nice to come across people who take the vaccine for the first time because I’ve told them my story, and encouraged them to get it," she explains.

It's clear that Ennis Hospital is a big part of Bernie's life. On Christmas Day, when most people will be tucking into their turkey dinners, Bernie helped to bring Santa to the hospital to visit the wards and deliver presents to the patients.

"I love doing that, and I love the cleaning. It's what I love most about the job. It's quite challenging, balancing the different responsibilities, but very rewarding, and I see encouraging people to get the flu vaccine as an extension of that," Bernie concludes.