Value of Vaccines Can’t Be Overstated

Fifteen years ago, the U.S. declared measles eliminated from this country because of an effective vaccine, high immunization rates, and a strong public-health system. Yet, over the last five years, more cases have occurred. The latest outbreak, beginning at Disneyland in December and likely caused by an unvaccinated traveler, led to more than 150 cases in 17 states by March 1.

The outbreak has intensified because of the spread of misinformation about vaccines, the refusal of some parents to immunize their children, and complacency developed over the years that has created a lack of understanding about the severity of the disease. Because our immunization efforts have kept measles and other vaccine-preventable diseases so well under control over the last several decades, many people, especially young parents, have not seen these illnesses and do not understand how serious they can be.

Measles is a highly contagious virus that is spread easily through coughing and sneezing. The virus can live up to two hours on a surface or in air where the infected person coughed or sneezed. The disease is often brought into the U.S. by travelers from other counties, and the contagious nature of the illness means that, if a case comes in from outside the U.S., it is likely people will become infected. Thus, an outbreak can be just one plane ride away.

Worldwide deaths and the probabilities of hospitalization and complications from infection testify to the severity of the illness. The World Health Organization (WHO), which still regards measles as a global threat with outbreaks occurring around the globe, estimates that more than 100,000 children in the world die each year from measles — about 400 deaths every day. And the U.S. Centers for Disease Control (CDC) notes that one out of four people who get measles will be hospitalized, one of every 1,000 will develop encephalitis (a swelling of the brain due to infection that could lead to brain damage), and one to two of every 1,000 will die.

Physicians and public-health officials frame the protection against infectious diseases with a concept called ‘herd immunity.’ As more and more people are vaccinated, a barrier is built that prevents the spread of disease, even to those who may not be able to be vaccinated due to weakened immune systems or other medical issues such as HIV or cancer. The target to attain this immunity is 90{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of a population; below that number, the risk of infection and spread of disease increases.

One of the most critical things to remember about measles (and most other vaccine-preventable illnesses) is that it cannot be treated. This fact makes vaccination all the more important. Indeed, the health risks of not getting vaccinated are high, as the complications from a disease — encephalitis from measles or pneumonia from flu, as examples — can be dangerous and even deadly.

While the current focus on measles spotlights childhood immunization, physicians urge all patients to remember that vaccines are as important for adults as they are for children. Vaccines now exist for such conditions as pneumonia, shingles, and even some types of cancers. For example, a vaccine for the human papillomavirus (the most common sexually-transmitted infection) prevents cervical cancer in women, and a vaccine for hepatitis A and hepatitis B can prevent liver disease and cancer. Current efforts in vaccine development target diseases like ebola and AIDS.

Physicians must respect the perspective of their patients and their parents, but our message to those who may have reservations about immunization is simple: vaccines have earned their place on the CDC’s list as one of the top 10 greatest public-health achievements of the 20th century.

Vaccines are studied in millions of patients before they are introduced and are studied for decades afterwards. We know more about vaccines that we know about any other medication. They are safe, prevent disease and suffering, and are one of the most important steps a person can take for personal and public health. And we urge all patients of all ages to make immunization an indispensable part of their continuing healthcare. –

Dr. George Abraham is a board-certified infectious-disease specialist, associate chief of Medicine at Saint Vincent Hospital in Worcester, a professor of Medicine at UMass Medical School, and governor of the state chapter of the American College of Physicians. Dr. Sean Palfrey is a board-certified pediatrician at Boston Medical Center, clinical professor of Pediatrics and Public Health at Boston University School of Medicine, and the founder and director of the Immunization Initiative of the state chapter of the American Academy of Pediatrics. This article is a public service of the Mass. Medical Society.