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06/24/13

Preventive Medicine Blog Series - Part I: Vaccines

by Rutvik Joglekar - June 24, 2013

The introduction of the vaccine in the late 18th century by Edward Jenner revolutionized public health: for the first time in history, the world witnessed a dramatic reduction in the number of infectious diseases.

Now commonly used as an instrument in preventative medicine, vaccinations provide individuals with resistance against certain diseases by stimulating immunoglobulin production. This phenomenon, generally referred to as artificial acquired immunity, occurs when harmless agents - either dead or weakened forms of the pathogen - are inserted into the body to trigger the production of antibodies; if a real form of the pathogen were to ever attack, the body would immediately fight it off. Vaccinations, in this manner, have led to the eradication of smallpox and near-elimination of polio and other illnesses.

The benefits of vaccinations extend to communities as well. When a substantial number of people within a community are vaccinated against a specific illness, individuals' immune systems can quickly respond to pathogens, thereby substantially reducing the diseases' contagion period. With people contagious for shorter lengths of time, if at all, the entire population becomes far less likely to contract the disease.

In addition to the obvious health benefits, vaccinations have proven to be extremely cost effective. In a 2001 study conducted by researchers from the Centers for Disease Control and Prevention (CDC) and U.S. Department of Health and Human Services, it was found that for every one dollar spent on common vaccinations, a society will save approximately $11. Over the six year course of the study, researchers predicted that the United States had achieved net savings of nearly $43.3 billion.

Despite the benefits of immunizations, surveys conducted by the National Center for Immunizations and Respiratory Diseases (NCIRD) indicate that coverage rates for certain vaccines are extremely low. In the United States, for example, only 9.9% of all women have received an HPV vaccine and 32.8% of high-risk individuals have received a pneumonia vaccine.

In an effort to bolster coverage rates, perhaps vital vaccines can be outsourced to individuals' local pharmacies to increase accessibility. Currently, some important vaccines can only be acquired through visiting a physician; but the general inconvenience of having to visit a doctor - lengthy wait-times, scheduling an appointment, etc. - only serve to dissuade patients. A system in which the administration of a vaccine can occur outside of the doctor's office, similar in structure to how flu vaccines are distributed, may aid in improving immunization rates.

Additionally, studies have also revealed that individuals who avoid vaccinations tend to not understand the consequences of their action. However, an experiment at Wake Forest University, simulating the spread of the flu, demonstrated that individuals were far more likely receive a vaccination when properly informed about the potential repercussions of their decision. In that regard, the education of patients may be another potential method to increase vaccine coverage rates.

While the CDC does report that some risks may accompany vaccinations, the effects are generally temporary and mild. However, both the health and economic benefits arising from vaccinations outweigh the risks - and proper strategies should be devised to increase vaccine coverage rates.

(For additional trends in Preventive Medicine see: Here)

Sources
CDC. "How the Flu Virus Can Change: "Drift" and "Shift"." CDC. Centers for Disease Control and Prevention, n.d. Web. 21 June 2013.
CDC. "Vaccination Coverage in the U.S." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, n.d. Web. 24 June 2013.
CDC. "Why Immunize?" CDC. Centers for Disease Control and Prevention, n.d. Web. 21 June 2013.
Kliff, Sarah. "Why 64.8 Percent of Americans Didn't Get a Flu Shot." Wonkblog. The Washington Post, 12 Jan. 2013. Web. 24 June 2013.
NBC. "New Study Finds No Link between 'too Many Vaccines' and Autism." NBC News Health. NBC, n.d. Web. 21 June 2013.
NIH. "Vaccines." National Institute of Allergy and Infectious Diseases. National Institutes of Health, n.d. Web. 21 June 2013.
Zhou, F. "Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001." Archives of Pediatrics and Adolescent Medicine 159.12 (2005): 1136-144. Print.