Vaccines are a public health good

When I was in medical school, I remember physicians talking about how difficult and dangerous epiglottis was to manage in children. Caused most often by the bacteria Haemophilus influenza, it leads to severe swelling in the throat that can lead to choking and difficulty breathing. Part of what made it such a scary thing for physicians was that just examining a child to see if they had the condition could lead to spasming and death. Severe disease affected about 20,000 kids a year and about 1000 of them died. But in 1985, the first vaccine to H. flu was introduced. Over the next few years, the use of vaccines against this bacteria became widely used. The incidence of epiglottitis dropped very quickly. And while I was taught how to recognize epiglottitis, how to diagnose it, and how to treat it, in all my time being a resident, fellow, and practicing pediatrician, I have never, ever seen a case of epiglottitis. Vaccines work. Period. Polio used to be common, but now it’s almost unknown in the developing world. Smallpox has been eradicated. Mumps is something that only happens on The Brady Bunch. Immunization regularly tops the list of the greatest public health achievements of the last century. In spite of this, vaccines are facing a continued backlash in the form of myths and misperceptions against their safety and effectiveness. Nearly everyone knows about the Lancet paper that first accused the MMR vaccine of causing autism. It’s hard to think of another study that has done such damage to so many people. That paper was, of course, was later retracted by most of its authors. Last year, another paper was published in the BMJ detailing malfeasance in the original study. The editors of that journal called the original study fraudulent. The damage has been done, though. To many, vaccines are dangerous. There are prominent celebrities who have become famous demonizing them, and political figures were tweeting even last month that vaccines cause autism. In the primaries, Rep. Bachmann accused the HPV vaccine of leading to mental retardation, an accusation for which there was no proof. Such talk has consequences. People come up with new reasons to avoid vaccines, no matter how little evidence is behind their hypotheses. And people are refusing vaccines in alarming numbers:

In 2011, CDC reported 17 outbreaks of measles and 222 measles cases, most of which were imported cases in unvaccinated persons. This was the highest number of measles cases in any year in the United States since 1996 and highlights the importance of monitoring measles vaccination coverage at the local level… Overall, among grantees in the 47 states and DC that reported 2011–12 school vaccination coverage, median MMR vaccination coverage was 94.8%, with a range of 86.8% in Colorado to 99.3% in Texas; four jurisdictions of these grantees reported <90% MMR coverage (Table 1). Median coverage with 2 doses of varicella vaccine among 33 grantees reporting was 93.2%, with a range of 84.0% in Colorado to 99.2% in Mississippi and Texas. The median coverage levels for DTaP, poliovirus, and HepB vaccines all were at or above the Healthy People 2020 target of 95%.