Shot in the Arm Why Vaccinations Are a Good Idea

Vaccines are among the 20th century’s most successful and cost-effective public-health tools available for preventing disease and death. They not only prevent a vaccinated individual from developing a potentially serious disease, but they also help protect the entire community by reducing the spread of infectious agents.

Immunization coverage among children in the U.S. is higher today than ever before for most vaccines. We have attained the goal of having 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} or more of infants receiving the most critical doses of most recommended vaccines by age 2. These very high immunization-coverage levels translate to near-record-low levels of vaccine-preventable diseases. For most of the vaccine-preventable diseases, we have had reductions in morbidity of 95{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} or more.

Vaccines not only save lives, they save money. The individual and community protection provided by vaccines help make immunization one of the most cost-effective public-health strategies. All vaccines commonly recommended for routine use are cost savings to society when direct and indirect costs are considered.

Importantly, most vaccines are cost-saving even if only direct medical costs are considered. The U.S., for example, saves $8.50 in direct medical costs for every dollar invested in diphtheria-tetanus-pertussis vaccine. When the savings associated with work loss, death, and disability are factored in, the total savings increases to about $27 per dollar invested in DTP vaccine. Every dollar our nation spends on measles-mumps-rubella vaccine generates about $13 in total savings — or about $4 billion each year.

Historic Steps

Today there are far fewer visible reminders of the unnecessary suffering, injuries, and premature deaths caused by vaccine-preventable diseases.

Polio vaccine was licensed in the U.S in 1955. From 1951 to 1954, an average of 16,316 paralytic polio cases and 1,879 deaths from polio were reported each year. As of 1991, polio caused by wild-type viruses has been eliminated from the western hemisphere.

Smallpox used to kill millions of people each year around the world. This virus no longer circulates. No one has been infected with smallpox since 1977. That is the power that vaccines provide — the ability to stop a killer.

A physician entering practice today will most likely never see a case of Hib meningitis. Before the introduction of effective vaccines, approximately one in 200 children developed invasive Hib disease before five years of age — about 20,000 cases annually. Hib was the leading cause of bacterial meningitis in children under age 5, accounting for 50{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 65{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of all cases. From 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of affected children became hearing-impaired and 2{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 5{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} died in spite of effective antibiotic therapy.

In the 1960s, many people witnessed first-hand the terrible effects of the rubella virus. During an epidemic between 1964 and 1965, about 20,000 infants were born with deafness, blindness, heart disease, mental retardation, and other birth defects because the rubella virus infected their pregnant mothers. Today, thanks to an effective vaccine, the rubella virus poses little threat to expectant mothers and their children.

Much public, media, and legislative attention has focused on vaccine safety. The public should expect safe vaccines, and is entitled to them. The Centers for Disease Control and Prevention (CDC) is committed to monitoring and ensuring vaccine safety. The agency’s key vaccine safety messages include the following:

While no vaccine is 100{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} safe, the serious adverse events that do occur as a result of vaccination are extremely rare.

The CDC is committed to monitoring the serious adverse events believed to have occurred following immunization. The agency seeks to determine whether these events are caused by the vaccines or are coincidental occurrences of rare illnesses that would have happened anyway.

The CDC strives to inform parents and the public about the risks and benefits of vaccines so that they have the proper basis for making immunization decisions.

The agency carefully evaluates allegations of harmful vaccine effects and is prepared to adjust its policies if allegations prove scientifically valid.

The CDC does not minimize the pain and suffering incurred by persons who believe they have been harmed by a vaccine, regardless of the role that vaccines may or may not have played in the illness. As a public health agency, it also advocates research that helps determine the true causes of real harms that have been suffered.

A decision to vaccinate is a decision to protect not only an individual, but the entire community as well; in other words, a decision to not vaccinate puts the community at risk.

When immunization programs achieve high levels of community immunity, the likelihood that an infected person will transmit the disease to a susceptible individual is greatly reduced. This creates indirect protection. Those indirectly protected are children who may be too young for vaccination, yet still susceptible to the disease. For example, children under 1 year old are too young to receive the measles vaccine. Also protected are children who cannot be vaccinated for medical reasons, such as children with leukemia. In addition, some of the people protected by community immunity have been vaccinated; although vaccines are effective, they are not 100{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} effective.

Except for smallpox, these viruses and bacteria are still circulating, either at low levels in the U.S. or elsewhere in the world. Those not circulating in this country are only a plane ride away. For example, each year the U.S. is hit with multiple importations of measles. Measles is no longer circulating here, but the virus is often imported from outside this country. If we let our guard down and vaccination coverage levels drop, we will see a resurgence of measles. As recently as 1989, the U.S. was hit with a measles epidemic. The result was 55,000 cases, 11,000 hospitalizations, and more than 120 deaths.

This article was prepared by the National Immunization Program of the Centers for Disease Control and Prevention.

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