It won’t hurt a bit

Like many of us, I have vague memories of lining up to see the school nurse and being given an injection. 1 However, when I took our newborn baby for a BCG (which stands for Bacillus Calmette-Guerin, a vaccine for tuberculosis) last week, the whole experience was traumatising. The fact that there will be several more such visits over the next three years, set me on a path to finding out exactly why we do this to our children.

Although the BCG was the standard protection against tuberculosis (TB) when I was at school, it is no longer considered mandatory in the UK and the programme in schools was stopped in 2005 due to falling rates of TB. 2

Delving a little deeper. I was surprised to learn that the idea of vaccination goes back a 1,000 years or more. 3 Jenner explored the connection between the smallpox virus — one of the biggest killers of his day, particularly among children — and cowpox, which was a similar but far less serious virus affecting people who worked with cows. He noted that dairy workers who had contracted cowpox seemed to gain immunity to smallpox. 4 Then, in 1885, Louis Pasteur developed the rabies vaccine, ushering in a new era of progress, with vaccinations against a range of diseases, including cholera, plague and tuberculosis. From the middle of the 20th century, medical research focused on common childhood diseases such as measles, mumps and rubella.

Although I recognise the importance of medical pioneers like Jenner, I confess to being horrified to find out how he tested his theory. For example, it is well documented that he cut open the arm of an eight year old boy and infected the wound with the cowpox virus. 5 Fortunately for those children, and generations of others, his theories were right.

My daughter faces the prospect of up to 20 more vaccinations in the coming years to protect her against everything from polio to meningitis. With the distress of our recent experience still fresh in my mind, I wondered if there was any way to avoid the dreaded needle. It seems that one early method was to make a powder of the infected skin and blow it into the noses of the healthy, although this was limited in its effectiveness. I remembered that polio immunisation used to be given orally, on a sugar cube. Surely injections are a barbaric way of doing things?

Well, there is hope. Some vaccines can be delivered orally, and work is in progress to make others pain-free as well. There exists a nasal spray for delivering the flu vaccine, among others. 6 This system works well because the vaccine is released just under the skin where it can better trigger the immune system. Will these alternatives save my daughter from more pain? Probably not, but for the time being, let's be grateful that we have vaccinations and can live in a relatively disease-free world.