Commentary —

Vaccinations Prevent Diseases And Epidemics

By Conrado Bárzaga, MD

Vaccines are one of public health’s greatest triumphs. With the exception of safe water, no other health strategy, not even antibiotics, has had such a tremendous effect on reducing disease and improving health. Vaccines protect the immunized person from disease, and prevent it from being passed from one person to another. They have reduced and, in some cases, eliminated many diseases that routinely killed or harmed tens of thousands of infants, children, and adults

But diseases like diphtheria, tetanus, whooping cough, polio, measles, mumps, rubella, varicella, haemophilus influenzae type B, and hepatitis B remain a threat. They can be held in check only as long as people become vaccinated. If the rate of vaccinations drops, the incidence of the disease they fight will increase. For this reason, in an effort to call attention to this problem, August has been designated National Immunization Awareness Month.

Despite the availability of safe and effective vaccines, thousands of cases of infectious diseases continue to occur in the United States annually — diseases that could be prevented by immunization. The viruses and bacteria that cause diseases such as diphtheria, whooping cough, measles, chickenpox, and influenza still exist and can infect people who are not protected by vaccines.

Consider the following:

Pneumococcal disease, which includes pneumonia and other complications, results in thousands of deaths and 175,000 hospitalizations each year in the United States. This bacterium is the most common cause of bacterial invasive infection in children younger than 2 years of age. Pneumoccocal infection is the seventh leading cause of death in the United States, and the sixth leading cause of death among people 65 years of age and older. It is considered the first leading cause of death in the world.

Disease outbreaks occur when immunization rates decline. For example, from 1989 through 1991, low rates of measles, mumps, and rubella immunization among preschool-age children resulted in a measles epidemic that caused more than 55,000 cases and 120 deaths.

Chickenpox is widespread in the United States. Virtually everyone who is not vaccinated is at increased risk for contracting chickenpox in adulthood. The risk of complications and death from chickenpox can be up to 10 to 20 times greater for adults than children.

Each year in the United States, there is an average of 200,000 influenza-related hospitalizations and 36,000 influenza-related deaths. Approximately 340,000 children and adolescents have chronic illnesses placing them at increased risk for influenza disease and its complications.

Nearly one-third of the 12,000 annual cases of meningococcal disease, meningococcemia (blood infection) and meningitis (an infection of the membranes surrounding the brain and spinal cord), in the United States result in fatalities or severe disabilities. Both forms of the disease can come on suddenly and progress rapidly to serious complications and death. In 2002, an estimated 150 deaths due to meningococcal disease occurred in the United States. Infants under 12 months of age have the highest rates of disease. The proportion of cases among adolescents and young adults has increased in recent years.

What is amazing is that so many people, especially young children, are not getting immunized. Children under 19 can be immunized free under the Social Security Act. The problem seems to be getting this information to parents, so they can act.

Beyond this, it is imperative that adults become immunized as well. Their health has a direct bearing on their ability to provide for their children, and on others who are not or cannot be immunized. The consequences of contracting these diseases far outweigh the cost of the vaccination.

With school season upon us and flu season just around the corner, August, National Immunization Awareness Month, is appropriate month to start focusing renewed attention this problem. By making sure they and their families are vaccinated against diphtheria, tetanus, whooping cough, polio, measles, mumps, rubella, varicella, haemophilus influenzae type B, and hepatitis B, adults can protect the lives of their children, their friends, relatives and neighbors, and themselves.

(Conrado Bárzaga is associate director of the Southwestern Area Health Education Center at Sacred Heart University, College of Education and Health Professsions.)