The effects of vaccination on public health

Screenshot 2014-01-23 06.52.43I saw a link that’s been making the rounds via Twitter and Facebook lately, from the Council on Foreign Relations. They have put together an interactive map that allows you to focus on any geographic region and visualize reported outbreaks of a variety of infectious diseases that are currently highly preventable by vaccination. The map quickly shows some obvious trends–various diseases show regions where they are more prevalent, but the regions follow political lines, not naturally occurring geographical lines. For instance as seen in this graphic, diphtheria (whooping cough) and mumps outbreaks are prevalent in the United States, but are not significantly reported elsewhere in North America. Measles outbreaks occur with extreme regularity in Western Europe, but very little in Eastern Europe. Rubella (German measles) occurs in Eastern Europe and Japan.

A disclaimer on the Intro page of the website states its purpose; to promote awareness of a preventable global health issue. The site also allows you to download and view the dataset used to compile the maps. Interestingly, outbreak reports are not only taken from governmental public health agencies, but also from media reports, and indeed a spot on the webpage allows visitors to submit links to outbreaks that they might have come across. I suspect this practice leads to maps that might be useful from a broad educational standpoint, much as the site disclaimer suggests, however it is probably not appropriate for a true epidemiological estimate of the diseases in question from a global standpoint. For instance, according to this summary at the World Health Organization, the incidence of measles in the Russian Federation appears to be at a rate similar to that found in Spain, and furthermore measles, pertussis, and rubella have been increasing there each year over the past 4 years. Official numbers from the Russian government suggests that vaccination coverage is very good for many diseases, with the reported rate for measles vaccine coverage over 98% of the population. The United States in contrast has around 92% coverage. The rate of disease in Russia suggests several alternative possibilities; the rate of actual vaccine coverage does not accurately reflect the “official” numbers, or that the vaccine is not entirely effective in preventing the disease. The CDC indicates that the current two-dose vaccine regimen is essentially 100% effective in preventing disease due to all virus types.

Measles on its own is an annoying, but not particularly dangerous disease in most individuals. It is among one of the most contagious infectious diseases known however, and can be very easily spread through an immunologically naive population. Furthermore, complications arise in up to 20% of the cases, with a fatality rate in about one in 1000 cases. This fatality rate does not seem very large, however in the context of the number of cases in regions where it is still endemic, many deaths still occur. Because of the high infective potential, and the large numbers of cases worldwide, vaccination remains the best public health choice in this country.

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About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on January 23, 2014, in Danger danger danger!. Bookmark the permalink. 13 Comments.

  1. As an “outsider” (to the York community), but as a member of the microbiology community, I believe this blog post is “preaching to the choir.” I hope that none of your students find nothing novel in this information! The problem — as I see it — is the readers who believe all of this “stuff” is wrong, or even worse part of some kind of conspiracy to hide all the “real” dangers. That’s my $0.10 (ADI) worth!.

    • I’m fascinated actually by the whole conspiracy idea with vaccines. I understand at a basic level how the Big Pharma and corporate greed concept might arise, which follows from a fundamental misunderstanding of basic economics. There isn’t really any real money to be made in any medication that is given nice and you are done. That’s why as a society we are in such dire straits with antibiotic resistance. Viagra, Lipitor, AiDS drugs–those are money makers for Big Pharma.

      No, the conspiracies that I find really interesting are the ones that attempt to rewrite the historical record, such as the ones that purport that vaccinia administration did nothing to eradicate smallpox. I need to find out more about those arguments.

    • This week, I encountered a biology major in York who has never been vaccinated due to her parents’ beliefs. Someone with vast knowledge in science didn’t think to question her parents’ science-based decisions. That is just plain scary.

      • Yes, it’s scary, but there are still some folks who believe the world is flat or the planet isn’t warming! Go figure.

  2. http://www.safeminds.org/blog/2014/01/23/new-disclosures-vaccine-safety-datalink-vsd/

    Have you seen anything lately about this^? Curious about this whole “vaccines cause neuro deficits” in kids. I have an acquaintance (who shall remain anonymous) who refuses to vaccinate against ANYTHING- and loves to rant on Facebook about it. It’s kind of scary because I feel like the newest generation could increase the number of preventable diseases we see due to this fear… It already scares me the number of VRE, CDIFF, MRSA, etc. cases I see at my job!

    • That’s scary! The article that you posted references the CDC but when you click on the link it directs to mercury.org. If the general public had a stronger baseline in critical thinking, anyone could realize that article is bogus fear-mongering BS. #rant

      PS unfriending the anti-vaxxers on FB is really the best strategy, in my personal opinion.

  3. When I first went to the “Council on Foreign Relations” site I did not pay attention to its interactive aspects. Today, I spent more than a ½ hour wandering down a “rabbit hole” tracing the flourishing of various diseases, in the US, from 2008 – 2014. What a
    great
    computer game; now on to the rest of the world!

  4. It’s a shame that CDC say the vaccine is 100% effective in preventing ALL disease cause by viruses; when there is an outbreak of viral infection every year which affect close to 1/2 of the population. And every year CDC will proudly defend themselves that the disease is cause be a new strain and they are working on developing a new vaccine for it. If they vaccine is that highly effective then why the swine flu is back and with vengeance. God help us all!!!

    • The CDC does not assert 100% effectiveness for the seasonal influenza vaccine. Analysis halfway through the 2012-13 seasonal influenza outbreak indicated approximately 60% effectiveness in preventing disease. The problem with influenza (as we will see in lecture) is that influenza virus is undergoing an extremely high rate of mutation, consequently the protection afforded by last year’s vaccine does nothing for this year’s flu strains.

  5. I’m puzzled by the way people are using magical thinking to dismiss a health current viruses grow new strains as a way of evolving and or adapting . I understand the public has the freedom of choice to vaccinate or not but with CDC not producing a update vaccine the selected few that choose not to get vaccinated , will not have the pleasure to enjoy an herd immunity. My major concern is a possible epidemic if this virus has a high mutation rate and a high mortality rate

    • Influenza, due to its high rate of mutation and its sneaky ability to jump from animal reservoirs into human populations, is the type of disease that keeps me up at night worrying about things that could potentially decimate human populations if we aren’t vigilant.

  6. From an ecological perspective, it’s interesting to think about sherrell’s comment in terms of human mobility and its effect on virulence in different diseases. The current theory is that for the pathogen, there is a trade-off between how rapidly it reproduces (and therefore increases it’s transmission rate because there’s more of it present in the host) and the negative effects of the pathogen on the host (i.e., once the host is dead it’s hard to get transmitted to another host and/or keep reproducing). [See: http://www.nature.com/scitable/knowledge/library/disease-ecology-15947677 and skip to the section on Host-pathogen Evolution]. Since humans have become vastly more mobile (planes trains and automobiles), pathogen virulence may be subject to less selection pressure against faster-reproducing strains that cause more host harm. Maybe we should just all stay home?

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