Academic journal article International Public Health Journal

Perspectives on Immunizations

Academic journal article International Public Health Journal

Perspectives on Immunizations

Article excerpt

Introduction

Proper immunizations of all children, adolescents, and adults should be a mission of all clinicians (1,2). Global travel allows easy dispersal of dangerous organisms that can infect and injury the person who has not been exposed to these microbes and thus, has no immunity against them. Fortunately, some of these disorders are preventable because there are vaccines that have been developed to allow the vaccinated person to avoid the growing list of these vaccine preventable diseases (VPDs).

After millions of years without protection against these microbes, much progress has been made after the historic work of Dr. Edward Jenner (1749-1823) in 1796 against the smallpox virus, one of the deadliest epidemics haunting humans, killing over one-third of those infected for thousands of years. One hundred and eighty one years after Jenner inoculated 8 year old James Phipps with cowpow vaccine in 1796 using what was then called the "Turkish" method, smallpox was eliminated from the world except for stockpiles of this virus in some countries (3). This monumental achievement in medicine was started in the 800s in India with oral snake venom, continued in China in the 1100s, stimulated by Jenner in 1796, sparked by the Spanish government for the world's first immunization campaign from 1803 to 1813 (4), and improved greatly with scientific progress in immunology and microbiology in the 20th and now 21st centuries.

As a result of such progress, many diseases have been reduced or even eliminated in some parts of the world. For example, infectious poliomyelitis has been eliminated from the Western Hemisphere and in the United States, diphtheria and congenital rubella syndrome are rarely seen. In the United States inactivated polio vaccine (IPV) is given at 2,4,6-18 months, and 4-6 years; it is not routinely given at or after age 18 years in the U.S. Oral polio vaccine (OPV) is used in some developing countries.

Unfortunately, controversy arose against vaccines as soon as vaccinology began, with a number of people in the 19th century mounting an antivaccine campaign, as is noted today even in the 21st century (4,5). Such controversy has reduced the number of people in the globe who have received immunization against vaccine preventable diseases (VPDs).

Other issues with regard to providing comprehensive coverage of VPDs to the public have continued. Some people do not have access to immunizations because of poverty, have limited access to clinicians, or have clinicians who do not emphasize vaccinations in health care. Despite World Health Organization's (WHO, Geneva, Switzerland) and the Centers for Disease Control and Prevention's (CDC, Atlanta, Georgia, US) guidelines, immunizations schedule and recommendations can be vary from country to country. Some people do not receive comprehensive health care, were vaccinated at the wrong time or given a wrong schedule because of clinician error.

Estimates in the United States note that over 35 million American adolescents are missing one or more recommended vaccinations (6,7) Some may have been vaccinated at the wrong time or with a wrong schedule because of error by the busy health care system (8). Sometimes an opportunity to vaccine an individual is missed because the health care system uses incorrect contraindications for vaccinations. Some vaccines (such as for hepatitis B and varicella) were not part of the recommended vaccine schedule when some youth or college students were children.

Some of the VPDs considered in this discussion are listed in Table 1. More vaccines are being developed and their safety is important to provide to a sometimes skeptical public that may receive the wrong information from the media (5,9) (www.cdc.gov/od/science.iso/). In this discussion, the immunization schedule used in the United States is considered (10,11). The exact recommendations and schedule will vary from country to country depending on the issues within that country and the precise recommendations of the experts in that particular country-as for example, in Argentina (12). …

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