You need to know about vaccinations ahead of your Medicine interview – and how this relates to the NHS. Some of the hot topics you’ll need to know about include how vaccinations work, why people aren’t getting vaccinated, and what the MMR scandal is.

How Do Vaccinations Work?

Vaccinations work by giving small amounts of a weakened or dead form of a pathogen.

When a vaccine is given, the immune system will produce antigens from the pathogens. This triggers a range of responses, such as the production of antibodies. This means that if a person is exposed to the same pathogen again, the body will recognise the antigens and fight the infection before symptoms occur.

Read more about vaccinations here.

Why are vaccinations used?

There are a number of reasons why vaccinations are used, including:

  • Herd immunity. If enough people become immune to a particular infection or disease through vaccination, those who can’t be vaccinated are protected such as the young, old or immunocompromised.
  • Mass protection. Currently, vaccinations prevent 2-3 million deaths a year. With the improvement of global coverage, it could save a further 1.5 million lives per year.
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Vaccinations In The UK

The NHS offers a schedule of free vaccines in the UK. The majority of the vaccines on the routine schedule are the 13 childhood vaccines.

Here’s what you should know about vaccinations:

  • Uptake of all 13 vaccines fell between 2018 and 2019.
  • Some conditions (e.g. mumps and rubella) require children to be given multiple vaccine doses over time.
  • Vaccines are also offered in schools. The HPV vaccine is offered to 12 and 13-year-olds to protect against some cancers that are commonly caused by high-risk types of HPV, such as cervical cancer.
  • Most vaccines provide long-term immunity. However, the flu vaccine only provides immunity for a short amount of time as the virus mutates each year. This means the strains in last year’s vaccines may not circulate in next year’s vaccines.
  • Those 65 and older can receive flu vaccines on the NHS, whilst primary school children can receive the vaccine in the form of a nasal spray.

COVID-19 Vaccine

The first person to get the Pfizer/BioNTech COVID-19 vaccine in the UK received it the morning of December 8, 2020. Up to four million people were expected to get the Pfizer/BioNTech vaccine by the end of the month – but the reality was that just 786,000 people were given the first dose by December 31, 2020. On January 4, 2021, the first doses of the Oxford/AstraZeneca vaccine were administered in hospitals.

Both vaccines are designed to be given as two injections, 21 days apart – but the government instead decided to give the first dose to as many people as possible and follow this up with the booster 12 weeks later. Some experts questioned this immediately.

Learn more about how effective a single dose of the COVID-19 vaccine is, in this BBC long-form read – and see what the BMJ says here.

As of October 2021, almost 49 million people in the UK have received at least one dose of a COVID-19 vaccine. A booster programme began in September 2021, offering booster jabs to people who had their second dose over six months ago.

Keep up to date on the progress of other COVID-19 vaccines with these resources:

Key Issue: Anti-Vaccination Groups

Anti-vaccination groups claim that vaccines are unnatural and toxic, with an emphasis on the alleged risks of vaccines. It’s an issue that dates back to the 1880s when ‘anti-vaxxers’ protested in Leicester about the smallpox vaccine.

Anti-vaccination social media pages have had an increase of 7.7 million followers from the UK and US during the COVID-19 pandemic. An investigation revealed that hundreds of NHS staff were members of an anti-vaxxer Facebook group that compared the COVID-19 vaccination to poison and are opposed to wearing masks.

It’s become such a big issue that Labour proposed a new law to tackle the spread of fake anti-vaccination news during the pandemic.

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Key Issue: Wakefield And The MMR Scandal

In 1998, a controversial paper linking the MMR vaccine to autism was published in the Lancet, authored by Andrew Wakefield and 12 others. The paper proposed a new syndrome called autistic enterocolitis that raised the possible link between a novel bowel disease, autism and the MMR vaccine.

The paper got widespread publicity despite the fact that the sample size was small, it couldn’t be replicated and the design was uncontrolled. It later emerged that the team behind the paper had engaged in ethical misconduct.

What was the impact of this paper?

  • The claims have been proven to be false, but the drop in the MMR vaccine uptake has continued.
  • Childhood vaccinations began to fall in 1998, coinciding with the publication of Wakefield’s paper. They continued to fall until 2003/4, reaching a low of 79.9%.
  • Andrew Wakefield was struck off the UK medical register in 2010 but has since become a prominent figure in the American anti-vaxxer movement.

Key Issue: Measles Increase

In 2017, the WHO declared the UK had eliminated measles after the country reached a high enough level of immunity to stop endemic transmission. However, in August 2019 the UK lost its measle-free status.

It’s thought that this can be traced back to the falling levels of MMR vaccinations between 1998 and 2004 – because these children are now at university, and that’s where the high level of measles and mumps are being reported.

In 2019 there were 890 cases of measles reported in England. The year before there were almost 1,000 measles cases and 5,500 cases of mumps.

Why Are Vaccinations Falling?

A study by the Royal Society of Public Health shows that two in five parents have been exposed to negative messages online about vaccines.

Another reason for falling vaccinations could be that because it’s been generations since the mumps and measles were endemic in the UK, perhaps many parents have forgotten how serious the illness was and therefore do not feel an urgency to vaccinate their child.

The timing and availability of appointments is also an issue, according to a survey conducted by the Royal Society of Public Health in 2018.

How Does The NHS Plan to Tackle This?

The NHS Long Term Plan includes various measures that will be used to increase the uptake of both MMR doses. This includes improving local coordination and support to improve immunisation conversation in low uptake areas. They’re also adding an MMR check for children aged 10 and 11 with GPs, and trying to ‘catch up’ young adults who missed the MMR vaccinations as children.

Vaccination Questions

Some of your interview questions may focus on vaccinations in order to test your understanding of ethics and current affairs. Some example questions include:

  • Should the vaccination of children become mandatory?
  • If a country develops a vaccine against COVID-19, should it be able to prevent export until all its citizens are immunised?

Check our Interview Question Bank for more questions and thorough answer guides.

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