Friday, May 22, 2015

Why are vaccine-preventable diseases coming back?

In recent years, there have been more vaccine-preventable disease outbreaks. Why are they happening?

Why are vaccine-preventable diseases coming back?

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Today's guest blogger is Joanne Sullivan, the executive director of the Pennsylvania Immunization Coalition.

Considering it is one of the greatest marvels of medicine – the ability to inoculate human beings against deadly diseases – it’s hard to believe it’s necessary to designate any month of the year as National Immunization Awareness Month.

However, here we are, in August, recognizing and raising awareness of the importance of vaccines.

Immunizations are one of the top 10 public health accomplishments of the 20th century, according to the Centers for Disease Control & Prevention (CDC). And even though immunizations have significantly reduced the incidence of many serious infectious diseases, vaccination rates for some diseases are not meeting national public health goals, according to the National Public Health Information Coalition.

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Pennsylvania is one of 20 states to exempt school-aged children from required vaccines based on parents’ personal beliefs. According to CDC data released in early August, of the approximately 151,364 children enrolled in kindergarten for the 2012-2013 school year, only 87 percent had been vaccinated with two doses of the measles, mumps and rubella (MMR) vaccine, which makes Pennsylvania the third worst state in the country for MMR vaccinations among this age group. Pennsylvania ranks ninth worst when it comes to the diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine, with 90.7 percent having been vaccinated. A paltry 85 percent received both doses of vaccine to prevent varicella (chicken pox and shingles).

Other children in a community are put at risk if just a few are exempted from vaccinations. Herd immunity is only effective if vaccination rates are a certain level. Diphtheria only requires 85 percent of the population to be vaccinated, while pertussis and measles levels should approach 94 percent before herd immunity becomes effective. Several recent outbreaks of measles, pertussis, and varicella have been traced to pockets of unvaccinated children in states that allow personal belief exemptions, according to the Immunization Action Coalition.

Earlier this year, a measles outbreak in Brooklyn, N.Y., further highlighted the troubling trend of the resurgence of vaccine-preventable diseases. New York health officials saw a spike in measles cases in Orthodox Jewish communities. The outbreak reportedly started in a small group of families with members who refused vaccines.

After continued outbreaks of pertussis throughout North Carolina, state health officials there are encouraging people of all ages to be immunized against the disease. As of Aug. 14, according to the N.C. Department of Health and Human Services, 326 cases of pertussis, including 50 cases in infants, had been tracked. DHHS has authorized local health departments to provide vaccine at no charge to anyone, regardless of insurance status, because of high number of cases.

Why, then, are some choosing not to immunize their children? Fear is a primary culprit, and all of the fear is unfounded. In 1998, a British physician named Andrew Wakefield significantly altered the course of immunizations when a paper in which he linked vaccine to autism in children was published. He was later discredited, and his medical license was revoked. But the fear he instilled lives on.

Some parents who do vaccinate their children have opted for alternative vaccine schedules, choosing to spread out their children's immunizations over a different time frame than recommended by the Institutes of Medicine. Their concerns arise in part from the number of doses that children receive. But an alternative schedule can increase the likelihood of illness, death or hospitalization.

Vaccines are not just for children, either. Immunizations are needed throughout adult life, because immunity from childhood diseases may wear off over time, and risk for other vaccine-preventable diseases arises. CDC provides easy-to-use schedules for vaccines.

Opponents of vaccinations link them to autism and other illnesses and perpetuate fears based on little to no scientific evidence. But the ramifications of not getting vaccinated are indisputable. Vaccines are safe and effective, and recommended throughout everyone’s life.  


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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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