Vaccines: Test Your Knowledge

World experts are working to increase vaccination to protect our communities: True or False? 

TRUE.  Immunization campaigns have played an important role in helping vaccine-preventable diseases such as polio virtually disappear. The occurrence of diseases such as measles, pertussis, and diphtheria, among others were all significantly reduced after vaccination.   At the International Conference on Emerging Infectious Diseases in Atlanta, GA from March 11-14, vaccines were a hot topic. This biennial conference gathered world experts from across the nation including CDC, the Council of State and Territorial Epidemiologists (CSTE), World Health Organization (WHO), Association of Public Health Laboratories (APHL), American Society for Microbiology (ASM) and many others to discuss the latest diseases plaguing society, who they are affecting, why they are present, and what can be done to control them. These experts are continually working to promote the health of our communities through effective vaccination programs and the development of new vaccines. 

I attended ICEID 2012 as an eager student interested in the fascinating world of infectious diseases, but left with an even greater appreciation for the successes we have accomplished and the battles in infectious diseases that have yet to be won. After all this vaccine coverage, I got to thinking about how much I truly know about vaccines and the U.S. immunization efforts throughout the years. Even though I decided to focus on vaccine-related topics, ICEID covered many other important issues in the current emerging infectious disease world.  Maryn Mckenna summarized a few of the of the hot topics such as Hospital-Acquired Infections, the E. coli outbreak in summer 2011 and smuggled bush meat among others. 

Vaccines Save Lives: True or False?  

TRUE. Illness and deaths from most vaccine-preventable diseases targeted since 1980 have declined by 80% or more because of widespread vaccination.  Vaccinations — shots, or drops, that help make the body immune to specific diseases — are much like bailing out a boat with a slow leak.  When the U.S. started bailing, the boat was filled with water. But we have been bailing fast and hard, and now it is almost dry. We could say, “Good. The boat is dry now, so we can throw away the bucket and relax.” But the leak hasn’t stopped (i.e., most of these infectious diseases are still circulating somewhere in the world). Before long we’d notice a little water seeping in, and soon it might be back up to the same level as when we started. [7]

Increasing vaccination rates will protect our communities: True or False?  

TRUE. For a disease to spread it needs to have viable hosts (places to thrive and reproduce). If a critical portion of a community is immunized against a contagious disease there won’t be enough susceptible people for the disease to sustain transmission.  Even individuals not  able to receive certain vaccines such as pregnant women, infants, and immunocompromised persons get some protection from this phenomenon, known as community (or herd) immunity. Without high levels of vaccination, a disease can successfully penetrate a community.  For more information on how this works, click here. 

 Some diseases have been eradicated from human population: True or False? 

TRUE. Through vaccination campaigns and public health interventions, we have attempted to eradicate six diseases. Of these six two have been successfully eradicated–smallpox and rinderplast (a cattle disease).  Guinea worm and polio are both close to being eradicated, but we still have ground to cover.  Guinea worm eradication efforts are being targeted in the four remaining countries with active transmission. 

 Polio has been eradicated: True or False?  

FALSE. Three countries still have active transmission.  Polio has been eliminated in all other countries in the world, so eradication is in sight. 

Just recently India, a country with a continually expanding and migrating population, was declared polio free with no active transmission for the past 12 months. Reaching every child in India (and many other countries) was no easy feat! At times public health workers chased down buses on their motorcycles in order to reach every child, even those who were part of a transient population. Before vaccination, there were approximately 350,000 cases per year globally and now we are seeing the lowest number of reported cases, less than 1000 a year. [1]  

Polio eradication is a top priority for CDC. Recently Dr. Frieden stated that, “Although it may be expensive to carry out these vaccine programs, it is not as expensive to vaccinate as it would be to deal with the costs of treating these diseases.” Vaccinations have been a key contributor to the decrease of infant mortality and the increase of life expectancy over the past century. The eradication of polio will save $50 million by 2035, as well as considerably decrease the number of deaths.   

As with polio, those countries that still have active cases can easily be transmitted to other countries and wreck havoc on the public health infrastructure.  Just another piece of evidence that vaccines do matter! Outbreaks take away time and resources from other public health interventions such as ensuring clean water and protecting the nation’s health security.  The more people left unvaccinated, the quicker a highly infectious disease can spread throughout a community.  Many countries have held national vaccine days to encourage and enable easy access to immunizations. The United States has held a National Infant Immunization Week since 1994 to ensure that all infants are vaccinated against the 14 vaccine-preventable diseases.  CDC also initiated a National Immunization Awareness month in August 2007 to provide education for caregivers and healthcare providers about the necessary vaccinations for teens. 

Vaccination rates in the United States continue to rise: True or False? 

TRUE.  Well…somewhat true.   The United States has been slowly, but surely improving vaccine uptake for most diseases.  The percentage of individuals receiving the seasonal flu vaccine has increased 3.5% from 2010. [5]  However, this is not the case for all vaccines.  

Although a majority of children (90% coverage for most long-standing vaccines) are obtaining the recommended vaccinations, there is still a slow uptake of new vaccinations, such as HPV (only 32% coverage with 3 doses for girls in 2010) and the 2009 H1N1 vaccine (from October 2009 to January 2010 only 20% of the US population received 2009 H1N1 vaccine).  According to award-winning author Seth Mnookin, a professor of science writing at MIT who also spoke at ICEID, says there are ways we can increase overall vaccine coverage:  

• Have schools showcase their vaccine rates as a selling point. Since we all know that even the common cold will spread quickly through schools, a highly infectious disease can rapidly debilitate the entire school (sometimes even in those children that were vaccinated). 
• Use a One Health  approach, where practitioners talk to the parents and grandparents at the same time to discuss appropriate vaccinations for all three generations.  [6] 

Once you become an adult, you no longer need to receive vaccines: True or False? 

FALSE.  People of all ages require timely immunization to protect their health.  There are some vaccines you only need as an adult such as the Zoster vaccine.  However, vaccine protection often fades with time requiring boosters for diseases such as tetanus, diphtheria, pertussis, measles, mumps, rubella  in order to maintain immunity over time.   As science advances, new vaccines continue to become available and adults are often recommended to receive some of these vaccines as well.  

For more information you can watch this short video that highlights the need for adult vaccination against serious diseases. 

A healthier America begins with preventing communicable diseases: True or False? 

TRUE. National Public Health Week was April 2-8, with this year’s theme of “A Healthier America Begins Today.”  One of the sub-themes is preventing communicable diseases of which vaccines play a large role in modern day, preventative medicine.  Their fact sheet reminds us that one in nine people who contract meningococcal disease, such as meningitis, will die from it, even if they are diagnosed and treated quickly.  The Advisory Committee on Immunization Practices (ACIP) constantly updates their recommendations to best protect the public.  They recently updated the meningococcal recommendations in order to prevent the most disease. 

Parents, if you are unsure about vaccines, talk to your healthcare provider or visit a reputable website such as CDC or ACIP that will provide scientific background on each and every vaccine.  CDC also has a great, interactive website to teach kids about what happens when they get a vaccine using the “Immune Platoon”.  Practitioners, make sure to take the time to talk to your patients about each vaccine, the potential side effects and benefits of each. 

Citations: 

1. Aylward, B. 8th International Conference on Emerging Infectious Diseases, Atlanta, GA March 11, 2012
2. Kemble, SK. Evaluation of School-Related Exposures as Potential Risk Factors for Pertussis Infection in Children Aged 7 to 12 Years in Minnesota, 2010. 8th International Conference on Emerging Infectious Diseases, Atlanta, GA March 12, 2012.
3. Reingold, A. “No Shots, No School,” No Longer Enough: Childhood Immunizations for 2012 and Beyond.  8th International Conference on Emerging Infectious Diseases, Atlanta, GA March 12, 2012.
4. Link-Gelles, R. Forecasting Invasive Pneumococcal Disease Trends after the Introduction of 13-Valent Pneumococcal Conjugate Vaccine in the United States 2010-2020. 8th International Conference on Emerging Infectious Diseases, Atlanta, GA March 13, 2012
5. Press Briefing Transcript National influenza vaccination week telebriefing Monday, December 5, 2011 – 12:00pm ET
6. Mnookin, S. Public Confidence in Vaccines. 8th International Conference on Emerging Infectious Diseases, Atlanta, GA March 11, 2012
7. “Why Immunize?” Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Vaccines and Vaccine-Preventable Diseases.  http://www.cdc.gov/vaccines/vac-gen/why.htm