Average life expectancy in the U.S. has increased exponentially over the last century. The earliest settlers were lucky to celebrate their 30th birthday. Their most common cause of death? Infection. An inability to prevent or treat disease resulted in pandemics — times when up to hundreds of thousands of people became infected simultaneously and died. Even with diseases that never sparked huge outbreaks, infection remained a common cause of death.
As the medical community learned more about the immune system, they uncovered major tools to prevent disease. The most significant advancement? Vaccines.
The first successful vaccine was discovered and refined by Edward Jenner in 1796 to fight and eventually eradicate smallpox, a deadly scourge that left many survivors disfigured. Intense research brought many more vaccines, effectively wiping out other diseases, such as diphtheria. In fact, vaccines have proved so effective that many of us would not even recognize the symptoms of these diseases if a family member were to come down with them today. The medical community regards vaccines as one of the greatest boons to human health that research has delivered to date, and scientists are still working feverishly to develop new vaccines to fight the emerging diseases of our times, including Ebola and HIV.
Recently, however, the use of vaccination as a disease prevention strategy has been called into question. The latest measles outbreak around the country has sparked a national debate about required vaccinations. The concept of personal choice has been invoked by parents regarding the decision to vaccinate. On the other side of the aisle are those in the field of public health, who know all too well the threat that vaccine-preventable diseases can pose to society when they are allowed to re-enter our communities.
Perhaps the greatest benefit of vaccinations is their power to confer herd immunity. When enough of a population receives and reacts to a vaccine by making antibodies that block the germ from taking hold and causing illness, the disease activity in a community slows way down, minimizing opportunities for outbreak. This is especially important in protecting our people who cannot have a vaccine or do not react to a vaccine. Young babies, the elderly and people whose immune systems do not work well often are susceptible to diseases for which they have not been vaccinated. When the rest of the community stays current on vaccinations, we can cocoon the vulnerable and keep them healthy.
So far, the current measles outbreak has sickened more than 160 people in 19 states and the District of Columbia. The majority of these infections, around 70 percent, have been directly linked to the first case at Disneyland, meaning that someone who encountered that case then spread it to those they came in contact with; those folks then spread it to anyone they met who was unvaccinated and so forth until many people were ill.
The reasons for rapid spread are numerous. Measles is highly contagious. Each person who has the disease could easily infect 90 percent of the people they encounter who are not vaccinated. Because measles can mimic many other viral illnesses, it can spread before diagnosis is clear. Even when patients seek help, many health care providers today have never seen a case of measles, which could delay diagnosis, resulting in even more spread. Treatment, as is true with most viral illnesses, is only supportive — rest, hydration, fever control. The virus has to run its course and can be contagious as long as the patient shows symptoms.
So, measles is a virus and will run its course. No problem, right? Not necessarily without significant risks. One-quarter of patients with measles will be hospitalized, and even now, with state-of-the-art medical facilities and care, about 0.2 percent of patients will have serious complications such as brain inflammation or encephalitis, deafness or death.
Before the vaccine was introduced in 1963, measles infected around a half million people annually. In 1989, a second booster dose was added to the immunization schedule, making the vaccine 99 percent effective. In 2000, measles was declared eliminated from the U.S. That meant it would not be seen regularly but only occasionally when it was contracted from other areas of the world. All was quiet on the measles front until a spike of 644 cases in 2014 and the current outbreak.
So why the spike? Global travel has certainly increased, which does result in cases being brought in from areas where measles has not yet been eliminated. However, it’s when those isolated cases are allowed to spread to others who have not been vaccinated or properly vaccinated that larger outbreaks occur.
Across the country, estimated percentages of unvaccinated or undervaccinated children range from about 3 to 40 percent depending on the community. A few areas cite religious mandates as the reason for no vaccination but the greatest numbers come from personal choice exemptions. Parents cite concerns over vaccine side effects. Much of this was started by a 1998 report linking autism to measles vaccination. Not only was this report later refuted, but it was retracted, yet anxiety still persists. Other parents are committed to natural and organic lifestyles and do not want chemicals used — even for disease prevention.
As states continue to clarify laws around exemptions and consider both sides of the vaccine debate, we need as a society to remember:
— There is no debate surrounding the effectiveness and safety of the immunizations used today.
— There is no debate that vaccinations have changed the face of infectious disease and improved the health of society as a whole.
— There is no debate that the diseases we’ve successfully eradicated with vaccines, such as smallpox, can make deadly resurgences if we aren’t careful to prevent them.
— There is no debate that these illnesses pose a public health threat, especially evident as a disease we were voluntarily estranged from — measles — makes its way around the country.
— There is no debate that we may know nothing about the health and immune status of those sitting next to us in school, restaurants or on public transportation, who may be susceptible not through their personal choice.
If we look at the needs of society as a whole, then there really is no debate at all.
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Vaccines: Why There Is Really No Debate At All originally appeared on usnews.com
