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The new National Immunisation Programme 2012

by Dr. Luis Gonçalves [email protected]

Dr Luis Gonçalves is a Specialist Paediatrician in Neonatal Intensive Care and Coordinator of the Paediatric Unit at the Hospital Particular do Algarve in Gambelas, Faro.

Vaccines save more lives and prevent more cases of disease than any other medical treatment.

The National Immunisation Programme (NIP) is universal, free and accessible to all people residing in Portugal. The vaccination schedules advised are based on universal guidelines.

In the years following the beginning of the NIP on 1965, there was a noticeable reduction in morbidity as well as mortality due to infectious diseases targeted by vaccination.

The new NIP came into effect on January 1 and replaced the NIP of 2006.

This year’s programme includes vaccination against tuberculosis, hepatitis B, diphtheria, tetanus, whooping cough, polio, Homophiles influenza, serotype b invasive disease, measles, mumps, rubella, Neisseria meningitidis sero group C invasive disease, and infection by the human papilloma virus.

The main changes to the previous NIP are:

1. Change to the administration schedule of the vaccine against the invasive disease caused by meningitis group C (MenC), from three doses (vaccination at three, and five to 15 months) to a single dose at 12 months of age.

2. A high coverage was achieved rapidly through routine immunisation and various advertising campaigns, which have been maintained over the years, yielding a significant decrease in morbidity and mortality due to meningococcal C disease. These epidemiological data and scientific evidence available to date indicate that a single dose administered before 12 months of age is sufficient. Later a reinforcement might be needed.

3. Anticipation of the first dose of immunisation against measles, mumps and rubella (MMR) from 15 to 12 months of age. It is estimated that, currently, most children are born to mothers vaccinated against measles, reducing interference from maternal antibodies with vaccination antibodies, therefore an earlier date for the first dose of the vaccine is more effective. The object of this amendment is to obtain immunity as early as possible.

4. Updating the strategy of vaccination against the Hepatitis B Virus (HBV).

Immunisation against hepatitis B is made only once in a lifetime, with a series of three doses of the vaccine. Since 2000, HBV has been administered to two different groups: newborns and young people aged between 10 and 13.

Children currently between the ages of 10 and 13 were vaccinated at birth and therefore no longer require routine vaccination at this age as the majority are already immune.

5. Termination of the vaccination campaign against infection by the human papilloma virus (HPV) to the cohort of girls from 17 years of age.

Since 2008, the HPV vaccine has been administered routinely to girls 13 years of age and under with campaigns for the last three years (2009, 2010, and 2011) up to the age of 17. From 2012, vaccinations are carried out routinely at 13 years of age.

The NIP applies to individuals residing in the country under the age of 18 years and throughout their lifetime for tetanus and diphtheria (Td) vaccines.

Vaccination schemes started before the age of 18 may be completed after this age, except where maximum age limits are established.

The NIP does not exclude other recommendations in the field of a national vaccination policy, so other immunisation strategies will, in time, if and when necessary, be disclosed should an epidemiological situation or other factors warrant.