public health essay

public health essay

The Importance of Vaccinations in Public Health

1. Introduction

During the last century, improvements in sanitation and medical care vastly improved health in the developed world. This made vaccine-preventable diseases seem less threatening, but the risk of disease outbreaks and epidemics loomed large in the absence of immunisation as demonstrated by the re-emergence of pertussis in the 1970s. Today we have reached a turning point as cost, safety, and lack of perceived need have slowed the development and use of new vaccines. This has occurred at a time when there have been major international commitments to disease control, e.g., the Global Polio Eradication Initiative, and massive funding through organizations like the GAVI alliance. Understanding the full impact and value of vaccines on disease incidence can help ensure that the gains are not lost. This requires a shift in the perception of vaccines so that their true benefits are recognized and they are not just seen as a ‘magic bullet’ for infectious diseases.

In New Zealand, as in other developed nations, the importance and value of immunisation is being questioned by a population which has become complacent due to the success of earlier immunisation programmes. This review attempts to illustrate why the ‘immunisation is not needed’ argument is a dangerous one, and how far we still have to go to eradicate the threats to public health which are vaccine-preventable diseases. Simulation models from the pre-vaccine and vaccine eras, such as the one presented here, can provide valuable context for decision making about new vaccines.

Immunisations have had an undeniably profound effect on people’s health, enhancing life expectancy and quality of life. This has been definitively verified by a considerable body of scientific research. But what is less frequently noted is the financial contribution immunisation programmes have made to fiscal health. In the developed world, and more recently in the developing world, over the last 50 years, immunisation has been a major factor in improving health for such a modest cost. Unfortunately, these laudable achievements have in recent times been somewhat overshadowed by controversy and speculation.

2. The Benefits of Vaccinations

Vaccinations have contributed to the eradication of smallpox, one of the most devastating diseases in humankind, and have significantly reduced the incidence of diseases such as polio, measles, and diphtheria. So much so that in many developed countries such as the USA, these diseases are now so rare that people in the community have never seen a case of them. Unfortunately, from time to time, these diseases do occur among non-immunized groups. An example of this is the polio outbreak in an unimmunized group in the Amish population in several U.S. communities. A disease that is not prevented by vaccination can return in full force. An outbreak of measles occurred in Ireland in 1999. This outbreak was so significant that it led to a huge demand for measles vaccine in Ireland, the most ever in a short period. Such demand is usually seen as baby-booms, which puts the event into perspective.

Vaccinations have been developed to generate an immune response in the body. They help to protect an individual from an infection. Vaccines are usually made from a small amount of the disease that is being prevented. They may be made from the bacteria which causes the disease, the toxins that the bacteria produce, or a protein from the bacteria. Vaccines have been around since 1796 when Edward Jenner used material from cowpox to create an immunity to smallpox. His smallpox vaccine was the first successful vaccine to be developed. The smallpox vaccine had come from the results of the cowpox vaccine. The smallpox vaccine was made using a virus called vaccinia, a pox virus similar to smallpox. The smallpox vaccine contained the live vaccinia virus, and the skin reaction it caused was a sign that the person was immune to smallpox.

3. Addressing Vaccine Misinformation

Maket et al. have studied what may cause vaccine refusal and concluded that a great deal of vaccine-hesitant parents have little faith in vaccine safety studies produced by the CDC and pharmaceutical companies. These parents are often swayed by anti-vaccine literature that creates a false association between vaccines and diseases like autism and SIDS. Maket et al. believe that to sway concerned parents, it is critical to show them concrete evidence on the safety of vaccines, including studies on vaccine ingredients and comparison of disease risk with vaccine risk. Concerned parents must also be educated on the widespread success of vaccines in reducing disease. Public health workers must target the right audience with a culturally sensitive message to build general consensus supporting vaccines and state laws that make getting vaccines the default choice for parents to protect their children.

Misinformation on vaccines can be convincing because it preys on the fears of parents who only want to protect their children. Louise Kuo Habakus and Mary Holland, authors of “Vaccine Epidemic,” note that “parents’ refusal generally comes from a good place – a desire to protect one’s children from harm. Unfortunately, in delaying or withholding vaccines, parents often bring about the exact harm they hoped to prevent” (Smith, 2011). Such parents are so afraid of their children having a vaccine reaction that they do not realize they are putting their children at greater risk for disease.

As of late, the rise in vaccine hesitancy and refusal has reached an all-time high. This has caused an increase in outbreaks and spread of vaccine-preventable diseases, which poses a serious risk to public health. Much of vaccine refusal is based on falsehoods that have been debunked repeatedly, but persist in troubling the minds of concerned parents. It is necessary to understand why misinformation regarding vaccines is so powerful and to take steps to educate the public on the safety and efficacy of vaccines.

4. Enhancing Vaccine Access and Coverage

Barriers to vaccination in the United States can translate into disparities in the health of various ethnic and socioeconomic groups. Healthy People 2020 initiatives, including the development of more effective strategies for providing accessible vaccination services, can decrease these disparities. Improving access to vaccines for vulnerable and underserved populations is one of the principal goals in public health. This was evidenced in the document, “Reaching the Healthy People Goals for Immunization,” which provided a comprehensive guideline for increasing vaccination rates in the United States to achieve the year 2000 objectives. The National Vaccine Advisory Committee and the CDC were instrumental in its development and its plan focused not only on recommendations for disease and vaccines, but the needs of specific populations and eliminating disparities in vaccination across the nation. One of the 9 principles set forth was to ensure the purchase and delivery of vaccines to all areas of the country at an affordable price. A special emphasis was placed on vaccines for children and providing an infrastructure to ensure their access for children who are uninsured or Medicaid-eligible. Incentives and mandates for vaccines were to be discussed at the federal and state level to determine their roles in increasing vaccination rates. Another example illustrating access to vaccines is the “Vaccines for Children” program. Initiated in 1994, the VFC program provides vaccines at no cost to children who are uninsured or Medicaid-eligible, as well as to American Indian or Alaska Native. The program provides vaccines for the 9 vaccine-preventable diseases at ½ of average private sector costs, and through public and private provider sites, has increased the national vaccination coverage levels for eligible children to that of insured children (ACIP). The success of the VFC program in providing access to vaccines to vulnerable children has minimized disparities in vaccination coverage between children of differing socioeconomic status. Unfortunately, the VFC program does not cover underinsured children whose insurance plans lack vaccine benefits. With the economic downturn, this has become a significant concern as many children are now underinsured (or without insurance altogether) due to their parents’ unemployment or employment in small businesses that do not offer health insurance. Reauthorization of the VFC program to expand coverage of underinsured children could prevent gaps in vaccination coverage.

5. Conclusion

Vaccines are one of the greatest public health achievements. Vaccines save millions of lives and help reduce the burden of infectious diseases. They help in eradicating various diseases and prevent illness which can be caused due to many diseases. In recent times, people have arguments regarding the side effects caused due to vaccinations. They think that vaccines can result in serious health problems or sometimes cause death. But it should be known that vaccines have side effects, but they are rare and not fatal. Formerly, vaccination was used to prevent smallpox and now it is eradicated from the world. So vaccination can prevent the killing of diseases in the future. Also, a review from CDC estimates that childhood vaccines have prevented 322 million illnesses, 21 million hospitalizations, and 732,000 deaths in the United States during the past 20 years. Nowadays, many children are affected by hepatitis B, which can cause liver cancer and chronic liver disease. But this could have been prevented if the child was vaccinated against hepatitis B. Vaccines not only help in preventing disease, but they also help in reducing the cost of healthcare. They reduce doctor visits, treatments, prescriptions, and hospitalizations which are caused due to diseases. In the case of comparison, the cost of treatment and vaccine cost is far less, so it is better to prevent disease rather than treating it. If people get vaccinated, disease-causing microbes are not spread in the country, causing illness and also damaging the immune-compromised people who can’t be vaccinated. For example, if many people get vaccinated against polio, the polio-causing virus will no longer be present to cause paralysis and death of children in the future. So it will create a healthy and happy environment to live. The United States is the best example of knowing the importance of vaccination. After the eradication of smallpox, the US stopped vaccination and now it has reintroduced the smallpox vaccination among the people in order to prevent bioterrorism. Vaccines are the safest way to create immunity against disease. The success of any vaccine is known through its ability to create immunity against disease and the adverse effects caused by it should be less. Now there is technology to know the genetic sequence of the microbe and make a vaccine to best match it. So there is always research and development in the vaccine field to prevent emerging new diseases and diseases.