Imunisations Given at the clinic
I'm certainly not opposed to immunisation. Indeed my children have all received the MMR for instance. As a parent however I recognise that I have a different view of immunisation from the advisors to the DHSS. There is also a professional difference between a paediatrician who is to a large extent a primary care provider to one who advises government on populations.
The notes contained below are a reflection of that difference and also the freedom of being self employed.
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MMR
I believe that giving the measles, mumps and rubella immunisation separately provides an acceptable way of immunising against these three conditions. There is, however, little evidence in the literature that they are safer when given singly. It has been suggested that they are marginally less effective when given singly because the immune response obtained is not so great. However, it is just the sheer volume of the immune response when all are given at the same time which has given cause for concern. The single measles, rubella and mumps immunisations do not have a UK product licence but do in France, France and USA respectively. They are the same attenuated viruses as in the MMR.
MMR fact sheet

Tuberculosis
The vaccine currently used against Tuberculosis the BCG Bacille Calmette Gurein named after the two French who developed it works by inducing a delayed white cell immunity. It is by no means 100% effective at preventing TB-which is on reason why it is not used in the USA another is that TB is less common there. It is however particularly good at preventing generalised TB which children are particularly prone. In London where in some boroughs the TB incidence is greater than in Sao Paulo-Brazil, there is little doubt that it should be freely available. The group of Londoners most at risk from developing generalised TB are children who should ideally be immunised in the first 3 month of life when it is not necessary to perform a skin sensitivity (Heaf) test before. Children older than 3 months of age can easily be immunised but need a skin sensitivity test first to make sure that they have not already been exposed.
Tuberculosis fact sheet

The new 5 in 1 Primary Vaccines
In many ways the new 5 in 1 vaccines routinely offered now by your NHS GP are a step forward when all that was available before were live polio virus-capable of rarely producing polio in the recipient, cellular pertussis ( wooping cough) more likely to produce reactions than acellular product in a mercury containing base ( thiomerysl).
The new vaccine has been around for less long although it has been in use in Canada for a few years.

The Influenza Vaccine
The DHSS advice is that this vaccine should be given to children with underlying illness ( including asthma) each September to cover the winter. Each September I recall patients on my data base requiring protection. As children as a group are at greater risk from the complications influenza it can be argued that it should be given to all children at this time( as is the case in America)
Influenza Vaccine fact sheet

Hepatitis B immunisation
This is an example of another safe vaccine that is given to all children in the USA before they attend school and which arguably can be given to British children -it should certainly be given to children a increased risk of instance those regularly travelling to at risk areas Pakistan and SA.
3 injections given at time zero, 1 and 6 month gives protection.

Hepatitis A immunisation.
This vaccine is often not given to children because it is argued that the infection in childhood can be less severe than in adulthood. This is certainly true but the infection in child hood can be cause problems. I recommend joint vaccination with Hepatitis A and B for at risk children.

Prevanar Immunisation
This is another immunisation which is routinely given to children in USA. Like MenC ( Meningitis C) it protects against an organism that causes meningitis and ear infection in children - The Pneumococcus. It is highly effective and very safe and can either be given with primary immunisation or at one as a single injection.

Chicken Pox immunisation
Another immunisation which is given routinely in the USA where this illness has been eradicated because of the immunisation policy. This disease can cause an initial encephalitis and cerebellitis chest and ear infection. In the longer term the illness tends to worse with age and children who have had chickenpox are at lifelong risk of shingles which can be extremely debilitating. If a mother has not had chickenpox in the first 3 month of her pregnancy then her child is at risk of developing congenital infection. For this reason I recommend vaccinating against chickenpox if not at one year which is the practice in the States then certainly in non immune children at 5 years.