1. Vaccination in Palestine By: Mohammad Ba’ara Ahmed Sawalha Under the supervision of : Dr.Sammar Musmar By: Mohammad Ba’ara Ahmed Sawalha Under the supervision of : Dr.Sammar Musmar

2. History

3. history The story of vaccines did not begin with the first vaccine– Edward Jenner’s use of material from cowpox pustules to provide protection against smallpox. Rather, it begins with the long history of infectious disease in humans, and in particular, with early uses of smallpox material to provide immunity to that disease. Evidence exists that the Chinese employed smallpox inoculation (or variolation, as such use of smallpox material was called) as early as 1000 CE. It was practiced in Africa and Turkey as well, before it spread to Europe and the Americas. Edward Jenner’s innovations, begun with his successful 1796 use of cowpox material to create immunity to smallpox, quickly made the practice widespread. His method underwent medical and technological changes over the next 200 years, and eventually resulted in the eradication of smallpox. history The story of vaccines did not begin with the first vaccine– Edward Jenner’s use of material from cowpox pustules to provide protection against smallpox. Rather, it begins with the long history of infectious disease in humans, and in particular, with early uses of smallpox material to provide immunity to that disease. Evidence exists that the Chinese employed smallpox inoculation (or variolation, as such use of smallpox material was called) as early as 1000 CE. It was practiced in Africa and Turkey as well, before it spread to Europe and the Americas. Edward Jenner’s innovations, begun with his successful 1796 use of cowpox material to create immunity to smallpox, quickly made the practice widespread. His method underwent medical and technological changes over the next 200 years, and eventually resulted in the eradication of smallpox.

5. First Generation of Vaccines (pre-1950s) 1798 Smallpox 1885 Rabies 1897 Plague 1917 Cholera 1917 Typhoid vaccine (parenteral) 1923 Diphtheria 1926 Pertussis 1927 Tuberculosis (BCG) 1927 Tetanus 1935 Yellow Fever 1940s DTP 1945 The first influenza vaccines (flu) began being used. First Generation of Vaccines (pre-1950s) 1798 Smallpox 1885 Rabies 1897 Plague 1917 Cholera 1917 Typhoid vaccine (parenteral) 1923 Diphtheria 1926 Pertussis 1927 Tuberculosis (BCG) 1927 Tetanus 1935 Yellow Fever 1940s DTP 1945 The first influenza vaccines (flu) began being used.

7. History of Anti-vaccination Movements Yet, opposition to vaccination has existed as long as vaccination itself. Critics of vaccination have taken a variety of positions, including opposition to the smallpox vaccine in England and the United States in the mid to late 1800s, and the resulting anti- vaccination leagues; as well as more recent vaccination controversies such as those surrounding the safety and efficacy of the diphtheria, tetanus, and pertussis (DTP) immunization, the measles, mumps, and rubella (MMR) vaccine, and the use of a mercury- containing preservative.

8. Smallpox and the Anti-vaccination Leagues in England cowpox Edward Jenner’s showed that he could protect a child from smallpox if he infected him or her with lymph from a cowpox blister

9. Beginning with early vaccination in the nineteenth century, these policies led to resistance from a variety of groups, collectively called anti-vaccinationists, who objected on ethical, political, medical safety, religious, and other grounds. Common objections are that compulsory vaccination represents excessive government intervention in personal matters, or that the proposed vaccinations are not sufficiently safe

10. Brazil 1904

11. Vaccination policy Vaccination policy refers to the policy a government adopts in relation to vaccination. Vaccinations are voluntary in some countries and mandatory in some countries. Some governments pay all or part of the costs of vaccinations for vaccines in a national vaccination schedule. vaccination Vaccination policy refers to the policy a government adopts in relation to vaccination. Vaccinations are voluntary in some countries and mandatory in some countries. Some governments pay all or part of the costs of vaccinations for vaccines in a national vaccination schedule. vaccination

12. *Compulsory vaccination In an attempt to eliminate the risk of outbreaks of some diseases, at various times several governments and other institutions have instituted policies requiring vaccination for all people. For example: fines1853 law required universal vaccination against smallpox in England and Wales, with fines levied on people who did not comply.EnglandWales In the United States, the Supreme Court ruled in the 1905 that vaccination policies require that children receive common vaccinations before entering school.Supreme Court In an attempt to eliminate the risk of outbreaks of some diseases, at various times several governments and other institutions have instituted policies requiring vaccination for all people. For example: fines1853 law required universal vaccination against smallpox in England and Wales, with fines levied on people who did not comply.EnglandWales In the United States, the Supreme Court ruled in the 1905 that vaccination policies require that children receive common vaccinations before entering school.Supreme Court

13. In Malaysia, mass vaccination is practised in public schools. The vaccines may be administered by a school nurse or a team of other medical staff from outside the school. All the children in a given school year are vaccinated as a cohort. For example, children may receive the oral polio vaccine in Year One of primary school (about six or seven years of age), the BCG in Year Six, and the MMR in Form Three of secondary school. Therefore, most people have received their core vaccines by the time they finish secondary school.oral polio vaccineprimary schoolBCGMMRsecondary school In Malaysia, mass vaccination is practised in public schools. The vaccines may be administered by a school nurse or a team of other medical staff from outside the school. All the children in a given school year are vaccinated as a cohort. For example, children may receive the oral polio vaccine in Year One of primary school (about six or seven years of age), the BCG in Year Six, and the MMR in Form Three of secondary school. Therefore, most people have received their core vaccines by the time they finish secondary school.oral polio vaccineprimary schoolBCGMMRsecondary school

14. *Basic vaccination Hep B IPV DTP PCV Hib MMR Varicella Hep B IPV DTP PCV Hib MMR Varicella

15. Vaccination schedule A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. vaccinations Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time. For example, tetanus vaccine boosters are often recommended every 10 years. A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. vaccinations Many vaccines require multiple doses for maximum effectiveness, either to produce sufficient initial immune response or to boost response that fades over time. For example, tetanus vaccine boosters are often recommended every 10 years.

16. Vaccine schedules are developed by governmental agencies or physicians groups to achieve maximum effectiveness using required and recommended vaccines for a locality while minimizing the number of health care system interactions. Over the past two decades, the recommended vaccination schedule has grown rapidly and become more complicated as many new vaccines have been developed.

17. Some vaccines are recommended only in certain areas (countries, subnational areas or at- risk populations) where a disease is common. For instance, yellow fever vaccination is on the routine vaccine schedule of French Guiana, is recommended in certain regions of Brazil but in the United States is only given to travelers heading to countries with a history of the disease.yellow fever Some vaccines are recommended only in certain areas (countries, subnational areas or at- risk populations) where a disease is common. For instance, yellow fever vaccination is on the routine vaccine schedule of French Guiana, is recommended in certain regions of Brazil but in the United States is only given to travelers heading to countries with a history of the disease.yellow fever

18. Vaccination schedules قبل السلطة UAE Israel BCG Hepatitis B polio DTP+eIPV DPT TOPV Measles eIPV MMR HbCV b B.C.G MOH UNRWA VARIOLA OPV POLIOMYELITIS TT DTP DT B.C.G MMR B.C.G قبل السلطة UAE Israel BCG Hepatitis B polio DTP+eIPV DPT TOPV Measles eIPV MMR HbCV b B.C.G MOH UNRWA VARIOLA OPV POLIOMYELITIS TT DTP DT B.C.G MMR B.C.G

19. بعد السلطة UAE Israel BCG HEP B + HBV Hep B IPV IPV Hib PCV DTaP DPT + Hib + Hep B OPV DPT + Hib MMR MMR VARICELLA ZOSTER HEP A + HAV PNEUMOCOCCAL VACCINE MOH UNRWA MMR DPT DTP DPT + Hib MEASLES OPV IPV HEP. B HEP B BCG Hib Vit A UAE Israel BCG HEP B + HBV Hep B IPV IPV Hib PCV DTaP DPT + Hib + Hep B OPV DPT + Hib MMR MMR VARICELLA ZOSTER HEP A + HAV PNEUMOCOCCAL VACCINE MOH UNRWA MMR DPT DTP DPT + Hib MEASLES OPV IPV HEP. B HEP B BCG Hib Vit A

20. Global Immunization Data October 2010 Summary: Global immunization coverage in 2008 Based on the latest World Health Organization (WHO)/UNICEF global estimates for 2009, trends related to global vaccination coverage continue to be positive. Immunization currently averts an estimated 2.5 million deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles. Summary: Global immunization coverage in 2008 Based on the latest World Health Organization (WHO)/UNICEF global estimates for 2009, trends related to global vaccination coverage continue to be positive. Immunization currently averts an estimated 2.5 million deaths every year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles.

21. The unprotected children

22. Deaths due to vaccine-preventable diseases Total number of children who died from diseases preventable by vaccines currently recommended by WHO: 1.7 million. Hib: 260 000 Pertussis: 195 000 Measles: 118 000 Neonatal tetanus: 59 000 Tetanus (non-neonatal): 2 000 Estimated number of all deaths in children under five in 2008: 8.8 million. Nearly 20% of all deaths in children under 5 is vaccine preventable Total number of children who died from diseases preventable by vaccines currently recommended by WHO: 1.7 million. Hib: 260 000 Pertussis: 195 000 Measles: 118 000 Neonatal tetanus: 59 000 Tetanus (non-neonatal): 2 000 Estimated number of all deaths in children under five in 2008: 8.8 million. Nearly 20% of all deaths in children under 5 is vaccine preventable

26. Global coverage of infants 19902009Notes DTP375%82%# vaccinated2009/107 million Polio-3 doses75%83%1988/350 000 2009/1783 polio cases polio-endemic countries : 1988-125 /// 2009-4 Measles- 2 birthday -one dose 73%82%Measles deaths in 2008: 164 000 MNT: # cont. not eliminate 2000/5842 Hepatitis B1%70%

27. *Special vaccination Data for quantifying the risk of medical problems related to religious pilgrimages are limited; the best documented, in terms of health risk, is the Hajj In Hajj, more than 2 million Muslims from all over the world. The potential for spread of infectious diseases associated with this pilgrimage has long been recognized Data for quantifying the risk of medical problems related to religious pilgrimages are limited; the best documented, in terms of health risk, is the Hajj In Hajj, more than 2 million Muslims from all over the world. The potential for spread of infectious diseases associated with this pilgrimage has long been recognized

28. The Ministry of Health of Saudi Arabia has issued the following requirements and recommendations for entry visas for the year 1431H (2010) Hajj and Umra seasons

29. … Yellow fever : travellers from countries at risk of yellow fever transmission. e.g :Somalia, Sudan … Poliomyelitis : Countries infected with poliomyelitis (e.g: Niger, Sudan,) should be vaccinated against poliomyelitis with the oral polio vaccine … Yellow fever : travellers from countries at risk of yellow fever transmission. e.g :Somalia, Sudan … Poliomyelitis : Countries infected with poliomyelitis (e.g: Niger, Sudan,) should be vaccinated against poliomyelitis with the oral polio vaccine

30. … Meningococcal meningitis For all arrivals: Visitors from all over the world arriving for the purpose of ‘‘Umra’’ or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135). Interior pilgrims and Hajj workers : vaccine is required for: — all citizens and residents of Madina and Makkah who have not been vaccinated during the past 3 years; — all citizens and residents undertaking the Hajj; —all Hajj workers & who work at entry points or in direct contact with pilgrims in Saudi Arabia. … Meningococcal meningitis For all arrivals: Visitors from all over the world arriving for the purpose of ‘‘Umra’’ or pilgrimage or for seasonal work are required to produce a certificate of vaccination with the quadrivalent (ACYW135). Interior pilgrims and Hajj workers : vaccine is required for: — all citizens and residents of Madina and Makkah who have not been vaccinated during the past 3 years; — all citizens and residents undertaking the Hajj; —all Hajj workers & who work at entry points or in direct contact with pilgrims in Saudi Arabia.

31. WHO//The view from the future By the 2020s: child deaths from infectious diseases are expected to be at an all-time low; polio should be eradicated, and measles eliminated in all countries; hopes remain high that new vaccines will be available to combat malaria, tuberculosis, AIDS, and other diseases. By the 2020s: child deaths from infectious diseases are expected to be at an all-time low; polio should be eradicated, and measles eliminated in all countries; hopes remain high that new vaccines will be available to combat malaria, tuberculosis, AIDS, and other diseases.

32.  Sources  Sources :  Palestinian Ministry of health.  Israel Ministry of health.  UAE ministry of health.  WHO. International Travel and Health — 2010 (www.who.int/ith).www.who.int/ith  State of the world’s vaccines and immunization -3rd edition/WHO  Health conditions for travelers to Saudi Arabia for (Hajj) for the year 1431H/2010 \\\ Journal of Infection and Public Health (2010) 3, 92—94  CDC website  http://www.historyofvaccines.org/content/timelines/all http://www.historyofvaccines.org/content/timelines/all  http://www.historyofvaccines.org/content/articles/history- anti-vaccination-movements http://www.historyofvaccines.org/content/articles/history- anti-vaccination-movements  Sources  Sources :  Palestinian Ministry of health.  Israel Ministry of health.  UAE ministry of health.  WHO. International Travel and Health — 2010 (www.who.int/ith).www.who.int/ith  State of the world’s vaccines and immunization -3rd edition/WHO  Health conditions for travelers to Saudi Arabia for (Hajj) for the year 1431H/2010 \\\ Journal of Infection and Public Health (2010) 3, 92—94  CDC website  http://www.historyofvaccines.org/content/timelines/all http://www.historyofvaccines.org/content/timelines/all  http://www.historyofvaccines.org/content/articles/history- anti-vaccination-movements http://www.historyofvaccines.org/content/articles/history- anti-vaccination-movements