Significant Role of Vaccinations

 Vaccinations are deemed as one of the most essential and practical achievements in epidemiology to date by nearly eradicating and counteracting several diseases that were once prevalent and killed hundreds of thousands in the past centuries. Despite its efficacy in substantially reducing certain diseases, the only vaccine discontinued because the disease was permanently eliminated from the public was smallpox. That is it, just one out of the dozens available. All other vaccine-preventable diseases still cause suffering and death in the United States and the rest of the world as a result of the growing amount of exemptions from vaccines due to parental ignorance and anxiety from fears of unsafe use. As a subsequent consequence, herd immunity--a form of indirect protection from infectious disease in a populace-- is narrowing. As a result, it is essential for vaccinations to be mandated as a culmination of its success in nearly eradicating several contagions and improving the human quality of life exponentially.

        Vaccines have been essential in preventing diseases that had otherwise a high mortality rate. In an effort to reduce childhood morbidity, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices issues annual recommendations and guidelines for childhood and adolescent immunizations (Ventola). They serve to provide immunity that is a byproduct of natural infection without the consequences of being afflicted. The creation of the first adaptive vaccine begun in England and paved the road for vast advancements in modern medicine. In the late 1700s, Edward Jenner, a physician in Southern England observed that milkmaids were immune to smallpox- a fatal disease that repeatedly devastated the English countryside. In testing his theory that blisters on the hands of milkmaids were similar to the blisters on the udders of a cow, Jenner extracted fluid from the blister and inoculated a young boy with the pus of both a maid and a smallpox victim. In turn, the boy was immune to the malady (Offit). Unknowingly, Jenner took advantage of a phenomenon that is known as a species barrier. Viruses and bacteria that have adapted to infecting one particular species have less of an effect on others (Offit). Although Jenner's speculations and the outcome was not necessarily correct, his legacy remains pertinent for pioneering immunology and the first known vaccine. Jenner laid the foundations for germ theory [the theory that specific germs cause certain diseases] (Heller) and the advancement of the medical field by erasing a pandemic that has caused millions of casualities for centuries.

The immune system has immense power in protecting individuals from the ravages of infection through expunging disease-causing microbes from the body. However, while it can eliminate infectious agents, if some function in the body goes wrong, it can yield disastrous effects for the host, leading to life-threatening diseases (Paul). When the immune system is functioning properly, it protects individuals from infectious diseases; however, one-way vaccines offer protection is by causing antibodies to form and by neutralizing the disease-causing microbe (Paul). The substance in the vaccine that causes an immune response is known as the antigen. Vaccinations also prepare the individual to make a secondary antibody response on infections with the organism bearing the antigen. This secondary antibody response is much higher in amount and more rapid than the response would have been had the individual not been vaccinated (Paul). Although the immune system is the body's primary defense against infectious organisms and other invaders, vaccinations offer a secondary powerful shield of defense from any possible invaders. According to a study conducted by the CDC in examining the efficacy of vaccines reducing the incidence disease, [s]ince the introduction of vaccines for rubella, diphtheria, Haemophilus influenza type b, measles, mumps, pertussis, polio, and tetanus, we have seen a drop of between 97.8 percent and 100 percent in each of the diseases (Largent). Moreover, the chickenpox vaccine was introduced in 1995. At the time, 4 million cases of chickenpox occurred every year. Within a few years, the number of cases declined to about 400,000, a 90 percent drop (Largent). This is a substantial decrease given these diseases' prevalence in the past. Vaccines, successfully paired with the immune system,  nearly eliminate several contagions. As compared to other demographics, such as impoverished countries in Africa where the occurrence of disease is high from a lack of proper healthcare, Western countries have a low incidence rate of transmittable viruses. If an unvaccinated child is exposed to an illness at a young age and survives, it can yield severe repercussions such as paralysis or brain damage.

There have been recent trends of parents in Western countries refusing to vaccinate their children due to numerous perceived fears. Over the last decade especially, questions have been raised regarding a relationship between autism and vaccines. Subsequently, this has led to a large number of parents exempting their children from receiving several mandated vaccines (Halpbern). While there has always been objection since its creation, there has been a recent surge in the opposition to vaccines in general, specifically against the MMR [measles, mumps, and rubella] vaccine (Hussain, Azhar, et al). This trend has been primarily due to Wakefield's fraudulent correlation between the MMR vaccine and the occurrence of autism. An adverse effect of the increasing number of exemptions can be noted from a case in Washington wherein 2008, public health officials singled out Washington State for its high number of unvaccinated children and identified the source of one of the largest outbreaks in recent history of measles as an unvaccinated child who spread the disease to seven other unvaccinated children in her household (Largent). Although all states have vaccination mandates for schoolchildren, in recent years they have granted a growing number of nonmedical exemptions, such as religious or philosophical. As a result, the risk of infectious disease outbreaks, especially among children whose immune systems are not fully developed, has increased. In an analysis of parents who opposed compulsory vaccination, researchers from the CDC asserted, [b]ecause many parents lack firsthand knowledge of vaccine-preventable diseases such as measles or polio, they are not likely to perceive such illnesses to be an immediate threat to the health of their children (Largent). This assertion was validated, researchers say, by a 1999 telephone survey that found parents were more likely to refuse a vaccine when they perceived the severity of the disease to be low (Largent). Vaccines are useful not only because they protect individuals who have been vaccinated but also because they enable a broader protection for communities by establishing herd immunity. When a sufficiently high proportion of a population is vaccinated against communicable diseases, the entire community can obtain protection. As the number of vaccinated people in a given population increases, the likelihood that a susceptible person will come into contact with an infected person decreases; making difficult for a disease to infect a host. Although the vaccination rate required to achieve herd immunity varies by the vaccine, it typically ranges from 80 percent to 95 percent of a given population (Stratton), as the number of exemptions grows within a population, those that were previously protected by herd immunity are now vulnerable to contracting an ailment.

A large proponent and facilitator for the anti-vaccination movement was Andrew Wakefield, an ex-physician in England. In 1998, Wakefield published a paper in the journal Lancet. Wakefield hypothesized that the MMR vaccine caused a series of events that include intestinal inflammation, entrance into the bloodstream of proteins harmful to the brain, leading to the consequent development of autism (Hussain, Azhar, et al). In support of his hypothesis, Dr. Wakefield described 12 children with developmental delay, with eight having autism. All of these children had intestinal complaints and developed autism within one month of receiving MMR (Children's Hospital of Philadelphia). Despite the small sample size, the uncontrolled design, and the speculative nature of the conclusions, the paper received wide publicity (Rao and Andrade). However, a concern with this publication is that there have not been nearly enough longitudinal studies to determine the long-term consequences of a vaccine, or the effects of giving multiple vaccines to young children at one time. Wakefield's studies were controversial for several reasons. For one, multiple sources have debunked any correlation between MMR and the development of autism. About 90 percent of children in England received MMR at the time this paper was written. Since MMR is administered at a time when many children are diagnosed with autism, it would be expected that most children with autism would have received an MMR vaccine recently. The observation that some children with autism recently received MMR is, therefore, expected (Children's Hospital of Philadelphia). However, it is imperative that when studying the incidence of autism from the MMR vaccine, both vaccinated and unvaccinated children are utilized as proper control and experimental designs. This was neglected in the study. Further, Wakefield has been since discredited as a doctor. His studies were ultimately retracted; his papers are no longer part of the scientific record because it was found to be based on scientific misconduct. In this case, the studies were deemed fraudulent as data was misrepresented and falsified. However, the effect of his papers was monumental in spiking anxiety in families globally. The damage was done and parents across the world did not vaccinate their children out of fear of the risk of autism and MMR vaccination rates especially began to drop, thereby exposing their children to the risks of disease. In the UK, for example, [t]he MMR vaccination rate dropped from 92% in 1996 to 84% in 2002. In 2003, the rate was as low as 61% in some parts of London, far below the rate needed to avoid an epidemic of measles (Hussain, Azhar, et al.). Given the highly contagious nature of airborne illnesses such as measles, entire communities can be exposed to the pathogen.

Another primary concern for vaccines is that it contains harmful ingredients that are damaging to the body. Thimerosal, an organic mercury compound that is metabolized to ethylmercury and thiosalicylate, has been used since the 1930s as a preservative in some vaccines and pharmaceutical products (Stratton). Recently, fears that mercury at very low levels may be toxic to the brain have raised additional concern among many in the public. Parents have begun questioning its safety and concluded that the compound is further correlated with autism. However, what families do not realize is that there are two varieties of the organic molecule.  There are good reasons to believe that the ethylmercury used in vaccines is very different from the damaging and toxic methylmercury studied in environmental science and fish (Baker). For one, the body readily breaks down ethylmercury and eliminates it, causing no bodily or cognitive harm (Baker). Second, there are such minute amounts of mercury present in thimerosal that there is no definitive evidence to conclude its linkage to autism (Ventola). It is all merely speculative. Moreover, these preservatives are essential in killing or preventing the growth of microbes in the body. In a tragic case from Columbia, South Carolina, in 1916, a tainted batch of typhoid vaccine stored at room temperature caused 68 severe reactions and 4 deaths. A similar incident took place in 1928 in Queensland, Australia, where 12 of 21 children inoculated with contaminated diphtheria vaccine died of multiple staphylococcal abscesses and toxemia (Baker). Without mercury-containing preservatives like thimerosal in vaccines to counteract microbial growth in the rare case that the vaccine is accidentally contaminated with multi-dosages, it can produce lethal effects.

Vaccinations are vital in boosting the immune system against viral and bacterial pathogens. With the general increase in the number of parents seeking exemptions for children to receive all of the recommended schedules of inoculations, there has been a massive influx in the number of nearly eradicated diseases making a comeback. In turn, children and those that have a weakened immune system from factors such as cancer are more susceptible to being contaminated by an unvaccinated individual. The rationale that vaccines are unsafe and cause bodily or cognitive harm is severely flawed. Parents seemingly would rather risk the chance of their child contracting an illness and dying over having autism, yet being otherwise healthy. It is a selfish mentality to bear.

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