4 Striking statistics about vaccination

1. Influenza kills more people in the United States than all other vaccine-preventable diseases combined.

infographics - statistics-flu

In the U.S., we tend to underestimate flu. Perhaps it’s because it’s so common (an average of 5 to 20 percent of the population gets the flu every year), but many people don’t think the flu is that big of a deal. In actuality, the flu can be very deadly — even in previously healthy individuals.

Let’s be clear: all of these diseases can cause potentially devastating consequences. But the flu vaccine is just as important as the other vaccines included in the recommended immunization schedules, yet it is one of the least utilized. Less than half of the U.S. population over the age of 6 months get the vaccine every year.

2. More than an estimated 80 percent of U.S. adults are not up-to-date on their whooping cough vaccination. 

infographics - statistics-tdap

It’s recommended that adults over the age of 18 receive at least one dose of a pertussis-containing vaccine to continue being protected. Yet many adults have no clue whether they are up-to-date and can inadvertently transmit the bacteria to small children without even realizing it. For these infants, pertussis can be incredibly dangerous. In fact, roughly half of children under 1 year old who get pertussis will be hospitalized, and one or two out of every 100 will die.

Pregnant women in particular should talk to their medical provider about getting a dose of Tdap (tetanus, diphtheria and pertussis) vaccine during their third trimester in order to pass protection onto the child before they’re born. This early protection is crucial to protecting young infants during those first few months of life until they can be vaccinated themselves.

3. Vaccines save more lives than seat belts in the U.S.

infographics - statistics-seatbelts

Please don’t get me wrong. This statistic isn’t here to belittle the life-saving impact of seat belts. They are an important safety tool to protect ourselves and our families. But so are vaccines. And when you look at the estimated number of lives saved, vaccines prevent even more deaths than seat belts and child care seats (combined). That’s really saying something.

4. We’re missing out on an opportunity to protect thousands of young women from cancer.

infographics - statistics-hpv

Despite early results demonstrating the high effectiveness of HPV vaccine in preventing cancer-causing HPV, only about 1/3 of young women in the U.S. complete the 3-dose series. According to the Centers for Disease Control and Prevention, “For every year that increases in coverage are delayed, another 4,400 women will go on to develop cervical cancer.” That number is unacceptable. We can do better.

 

To the nurse who “bullied” me into getting the HPV vaccine: Thank you.

Stock image

Stock image

By Robyn Correll Carlyle

My first year of public health grad school, I went into the student health center for my general checkup. My blood pressure was well within range. I was a healthy weight. I exercised three times a week and ate vegetables – Not to brag or anything, but I felt like I was pretty much going to ace the checkup.

Everything was going well (and I was feeling pretty good about myself) until the nurse Betty* came into the exam room, looked over my chart and said, “I see you haven’t gotten the HPV vaccine yet, and you’re about to age out. Do you want to go ahead and get it today?”

Wait, what?

Prior to grad school, I had been in the Peace Corps, where they poked me with what I thought was every vaccine conceivable. I didn’t relish the thought of yet another. Besides, I had heard about the HPV vaccine. It was the STD vaccine.

I was engaged, thank you very much. To a guy I had been seeing for four years. I didn’t sleep around. I was pretty sure I didn’t have – nor would I ever get – genital warts. It seemed totally unnecessary. And didn’t the vaccine just come out only a few years prior? That’s a little too new for me. I didn’t want to be a guinea pig.

“Umm, is it something I have to get?” I ask. “For school, I mean?”

“No,” Betty said. “It’s not required. But it is really important. It’s to protect you from cancer.”

I didn’t really hear that last part. I just heard “not required.”

“Then no,” I said confidently. “I’d rather not.”

Betty put down my medical chart and sat across from me, giving me her full attention. “What’s got you nervous about it?” She asked gently.

And then she listened. For every concern I had, she had a response.

The vaccine wasn’t “totally unnecessary.” HPV is very common – most adults in the U.S. will get it at least once. And it doesn’t just affect those with risky sexual behaviors. Most new infections are in young people, just shortly after their first sexual experience. Because it can be transmitted skin-to-skin, condoms don’t fully protect against it either. It didn’t matter that I was about to get married, I was still at risk.

It’s not that new of a vaccine. Prior to licensing, the vaccine had been tested for several years in thousands of people. And what’s more the vaccine technology used to make the vaccine is even older. The HPV vaccine is made using the same technology as the Hepatitis B vaccine – a vaccine that not only has been around since the 80s, but also is so safe that it’s recommended for infants on the day they’re born.

It won’t give me HPV. The vaccine doesn’t contain the whole virus, just a slice of virus DNA. So it’s biologically impossible for the vaccine to give me HPV.

One by one, she patiently shot down each and every one of my concerns until I was fresh out of excuses. She gave me the first of three doses then and there, and then made sure I knew when I needed to come back to finish the series.

I didn’t really appreciate it at the time (in fact, I thought she was bit of a bully), but now I’m grateful to Betty for taking the time to talk to me. It wasn’t until a few years later that I truly understood how grateful I should be.

One day a good friend of mine called me in tears. She had just been into her doctor for her annual checkup when she got the news: she had what is known as high-grade cervical dysplasia. The step right before full-blown, rock-your-life cervical cancer.

She wasn’t even 30.

The thing is she had requested the HPV vaccine from her OB/GYN years before, when she was still eligible to receive it (the vaccine’s approved up to age 26). But her doctor actively discouraged her.  There were potentially serious side effects, her doctor said (not adding that these side effects are very rare). She should really think about it and then come back if she still wanted it.

My friend didn’t push it. After all, she was just the patient. Of course, time slipped by, and it was annoying to make an appointment. So my friend never got the vaccine. And her doctor (as well as every other medical professional she encountered thereafter) never mentioned it to her again.

Now, she was facing the reality that she could be developing cancer – cancer that probably could have been avoided had she been vaccinated. Her doctor told her they would wait six months and check again. “These things can clear up on their own sometimes.” Otherwise, they would need to remove the pre-cancerous cells, an often painful and uncomfortable process.

Much to everyone’s relief, her body did clear the precancerous cells. But it was a terrifying six months. And throughout that time (and in the time since), she wondered what would have happened had she been vaccinated.

Hearing about her experience made me want to chase Betty down and hug her. My friend wanted the vaccine and was discouraged from getting it. But I actively rejected the vaccine, and Betty didn’t give up on me. She pushed me to really understand what made me so nervous and responded to my concerns in a way that I understood. She took the time to talk it through with me. Even though she was busy. Even though she had other patients to see, other things to do. She didn’t have to do that. But she knew how important the vaccine was, and she didn’t want me to miss the opportunity to protect myself simply because I was ill-informed.

I might have felt (slightly) bullied at the time, but it wasn’t because Betty was rude or dismissive. She was simply being assertive. Standing up for what her education and training assured her was the right thing to do for me and my health. I was taken aback by her confidence, and uncomfortable because she challenged my (I now realize, totally unfounded) beliefs. I thought I was fairly well-educated on the topic — after all, I was in graduate school studying public health — but I didn’t realize how limited my understanding of the vaccine truly was. Betty wasn’t afraid to share — and assert — her expertise as a medical professional. And she did it in a way that was patient and kind to my misunderstanding of the topic.

To Betty – and to all those nurses and doctors like her – thank you for standing up for (and to) me. It might have saved my life.

 

*Not her real name.


Robyn Correll Carlyle, MPH, is a project manager for educational programming at The Immunization Partnership

Measles Control Made Easy: Stronger Laws Equal Less Disease

This post originally appeared on The Network for Public Health Law on February 4, 2015. 

Virtually no other set of public health laws have had as direct an effect on health as immunization laws. Sbaby-with-rashtrong laws lead to high immunization rates, which in turn lead to lower incidences of disease. Some diseases have been nearly eradicated such as polio, rubella, and until recently, measles. However, keeping immunization rates high takes constant vigilance. Unfortunately over the past two decades there has been a weakening of immunization laws in many states. When immunization laws are weak, it puts the public’s health at risk.  For instance, while all states allow medical exemptions to vaccines, and many allow religious exemptions, there are 20 states that also allow non-medical exemptions, meaning that parents may opt-out of vaccines for any reason and their children may still attend public schools. For years, the public health community has been watching the increase in the number of children not fully immunized, and have warned of a resurgence of dangerous diseases. Sadly, that time has come. Measles is back, and it hit Disneyland, “happiest place on earth.”

It’s not surprising that California, a state that has seen dramatically rising exemption rates, was the setting for the most recent outbreak of measles.  In response to the rising exemption rates, California lawmakers recently passed a law requiring parents opting out of vaccines to obtain the signature of a provider stating that they have been counseled on the risks and benefits of vaccines.  This was an excellent step in the right direction to protect Californians, but considering the extent of the outbreak, it may have been too little too late. The measles outbreak that originated at Disneyland has so far affected 102 people from 14 states and Mexico. Unfortunately, this is not an isolated occurrence. There have been an additional 23 outbreaks over the past year, with cases reported in 27 states and affecting 644 people, the most cases since measles was declared eliminated from the US in 2000.

There are many ways that laws can be strengthened to protect the public from the measles. However, as with most law aimed at protecting the public’s health, individual rights must be balanced against the risk of harm to the community. For example, the risk of harm to individuals and to property is high if a person drives while intoxicated, therefore we prohibit it.  In the context of immunizations, if there are many unvaccinated people in the community, the risk of an outbreak of disease is very high. With the threat of measles returning to the U.S. as a widespread disease, it’s time to have a national dialogue about our social contract with each other and the risk of harm to the general community if immunization rates continue to drop. The risk of harm from immunization to the individual is low. The Measles, Mumps, Rubella (MMR) vaccine has been used for decades and has an excellent track record for safety (despite the misinformation that the anti-vaccine community would like people to believe).  However, the risk to the public is very high if there is an outbreak. According to the CDC, measles is so contagious that if one person has it, 90 percent of the people close to that person who are not immune will also become infected. And it’s not just the children who are unimmunized who pay the price. The very young (under 12 months of age) and those with a weakened immune system and cannot be immunized are at the highest risk. If a person becomes infected with the measles there are severe consequences including pneumonia, brain damage and death.

With the outbreak that originated in Disneyland continuing to spread, states clearly have a compelling interest in strengthening immunization laws to protect those among us who are too sick or too weak to be immunized. The time has come to develop more aggressive strategies for protecting the public’s health. Some strategies that could be considered:

Reduce or eliminate non-medical exemptions: In the U.S., all states have requirements for kindergarten entry and many have also added adolescent vaccines to the school requirements. School entry requirements are highly effective in achieving and sustaining high immunization rates, yet the allowance of non-medical exemptions and the ease in obtaining these exemptions have slowly chipped away at the protections these requirements provided. And now the rate of disease is climbing. We must eliminate or significantly reform the laws allowing non-medical exemptions. While non-medical exemptions are permitted in 20 states, there is no constitutional requirement that these exemptions be permitted. In fact, the majority of states (30) do not permit non-medical exemptions. Some states have or are currently taking steps toward limiting or eliminating non-medical exemptions. For example, a 2012 bill in the Vermont Senate proposed the removal of philosophical exemptions from the state’s school vaccination requirements. Also, several states including Washington (Wash. Rev. Code § 28A.210.090) and Oregon (Or. Rev. Stat. § 433.267), now require parents who request a non-medical exemption to provide evidence that they were advised by a health care provider about the risks and benefits of immunization.

Pursue Tort Claims: Some legal scholars have suggested examining the viability of bringing a cause of action against parents who refuse to immunize, and whose decision results in the spread of a vaccine-preventable disease. Much has been written about the potential for such a cause of action to be successful, how the case might be built, who might have standing to bring a cause of action and the likely outcomes in different scenarios. In the face of the current measles epidemic the viability of this type of legal action could be tested in an effort to compel parents to take responsibility for immunizing their children and for protecting others.

Actively engage in foreign relations: As concerning as the measles cases are in the U.S., there is an even scarier scenario playing out in Europe and other parts of the world. Unlike the U.S., most countries do not require any vaccines for school entry. Children in other countries get their immunizations on a recommended schedule, usually determined by the country’s public health officials. If they have not received a vaccine by the time they start school, there is no mechanism to compel their parents to get them up to date.  Last year there were 4,151 cases of measles in Europe, compared with 644 in the U.S. Since measles was declared eradicated in the U.S. in 2000, every outbreak has been tied to someone who traveled overseas and brought the disease home with them. Vaccine-preventable diseases are high in many countries in Europe and across the developing world. With infectious diseases, what happens in one country has far reaching effects in the U.S. This is why we have put so many resources into eradicating polio.  Until there are no more cases, we are all at risk because diseases can and do reemerge.

In order to truly impact the diseases coming into this country, we need to take an active role in helping other countries overcome their challenges in the fight against vaccine-preventable diseases. Access to care, affordability, logistics and education are all factors that contribute to low immunization rates in other countries. Additionally, with the rise of Neglected Tropical Diseases(NTDs) in the U.S., new opportunities for international collaborative research and vaccine development are possible. In order to protect Americans there needs to be increased efforts to address all of these challenges through vaccine diplomacy, vaccine development partnerships, increased support for immunization programs abroad and encouragement to implement strong laws and policies in other countries.

Note: The Network and the CDC Public Health Law Program will present a webinar on February 19 to examine the current measles outbreak in the U.S. and associated legal issues. Speakers will describe current vaccination recommendations, provide an overview of vaccination laws and exemptions, explore state temporary exclusion laws related to unvaccinated students, and highlight lessons learned by LA County in implementing legal disease control measures. More details here.

This guest post was prepared by Anna C. Dragsbaek, J.D., President/CEO of the Immunization Partnership, a nonprofit organization that educates individuals, parents and providers about the importance of immunizations, and advocates for evidence-based public policy and fosters collaborative efforts among immunization partners.

The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.

Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF

What you need to know about measles in 9 simple infographics

1. Measles still exists in many parts of the world.

Measlesmap

Map of measles outbreak, 2008-2015; Source: Council on Foreign Relations

2. … And while we might not often see it anymore, with modern travel, measles is just a plane ride away.

Source: Centers for Disease Control and Prevention

Source: Centers for Disease Control and Prevention

3. When it arrives in our community, anyone who is not immunized could be at risk of getting sick.

Source: ECDC

Source: ECDC

4. It’s easy to spot (pun intended).

Source: GMA News

Source: GMA News

5. But it’s no joke.

Source: The Immunization Partnership

Source: The Immunization Partnership

6. The best way to prevent measles is by getting vaccinated.

Source: Centers for Disease Control and Prevention

Source: Centers for Disease Control and Prevention

7. The vaccine is safe …

You have a greater chance of being struck by lightning than having a severe reaction to the MMR (measles, mumps and rubella) vaccine. Source: VacciNews.net

You have a greater chance of being struck by lightning than having a severe reaction to the MMR (measles, mumps and rubella) vaccine. Source: VacciNews.net

8. … and effective.

Source: Centers for Disease Control and Prevention

Source: Centers for Disease Control and Prevention

9. Talk to your doctor about whether you and your family are up to date with your vaccinations. 

Ivy-Bean-Vs-measles ivy-and-bean-vs-measles2ivy-bean-vs-measles3

4 Great Animations Showing How Vaccines Work

Ever wonder how vaccines work? These videos explain:

1. Kid reporter: How vaccinations prevent outbreaks

Video source: The Atlanta Journal-Constitution

Why we love it: This Kid Reporter gives a great overview of how getting vaccinated get help protect the entire community from disease.

 

2. Immunize For Good – How Vaccines Work

Video source: Immunize For Good

Why we love it: Using adorable animations and easy-to-understand language, this animated video explains how vaccines build up the immune system.

 

3. NOVA | Immunity and Vaccines Explained | PBS

Video source: NOVA

Why we love it: Animated white blood cells have never looked so cool.

 

4. How do vaccines work? – Kelwalin Dhanasarnsombut

Video source: TED-Ed

Why we love it: In addition to outlining how vaccines prime the immune system, it also describes the different types of vaccines and how they are made.

Know of an animated video that belongs in this list? Let us know! Write a comment below.

Switching Sides: From Anti-Vaccine to Pro

by Nicolevaccine books

I was an “antivaxxer.” Today, that surprises many people as I’m an outspoken advocate for vaccination. But it’s true. Once upon a time, I was just as outspoken against vaccination, particularly mandatory vaccination. It rankled my inner Libertarian, this notion that “They” could tell us what to put in our bodies. Polluting our children’s precious bodily fluids with mercury and aluminum. How dare they.

When the Wakefield study (now thoroughly debunked, discredited and stinking up the compost pile) was released, I read it from beginning to end. That was the moment when I became not only anti mandatory vaccination, but anti-vaccination. When I spoke with people around me, also opposed to vaccines, they had much to tell me. They told me that vaccine immunity is inferior to natural immunity. They told me that sanitation, not vaccination, was responsible for the decline of vaccine preventable illness. They told me that the decline in the natural life cycle of polio simply coincided with the rise in vaccination. They told me that Big Pharma made huge profits off of vaccines. They told me that breastfeeding provides immunity against all illnesses, and that a healthy mother’s milk was better than any vaccine. They told me that most of the sick people in an outbreak of vaccine-preventable illness are vaccinated, so clearly vaccines didn’t even work. I listened to these people. They had magazine articles and books and websites, and I devoured them all.

My son had already been mostly vaccinated, as he was about 6 when all this happened. I was horrified that I’d let doctors put mercury and aluminum into his little body. I felt guilty and outraged at the medical establishment for leading me astray. I vowed never to get him another vaccine, because now, I knew better. I was lauded by my anti-vaccine friends for my regret, and my newfound awareness.

The year I began my prerequisites for nursing school, I took a class in Microbiology, which I devoured as eagerly as the anti-vaccination propaganda I’d consumed before. I discovered some unsettling information there…I discovered how immunity actually works. I discovered how vaccines actually work. And suddenly there were cracks in the firmament.

It took some time, and no small amount of courage, but I slowly began to do more research. I discovered that shingles is what happens when your immunity to chickenpox begins to wear off and the virus reactivates – so much for natural immunity being inherently superior or lifelong. I found out that even breastfed babies can get whooping cough – so much for breastfeeding replacing vaccines and herd immunity. I realized that people had modern sanitation – even indoor plumbing and soap – during the height of the polio and measles crises – so much for sanitation being a cure all. I learned that there is no natural decline of polio – only deaths caused by it. And yes, deaths from polio did indeed decline before the polio vaccine was introduced… but it was because they’d invented the iron lung. Polio cases didn’t decrease, only polio deaths, because of better medical treatment.

On and on it went. Everything crumbled around me in layers of logical fallacy and misrepresented statistics. “Big Pharma” makes less than 0.9% of their profits (1.82% of their revenue) from vaccines. Hardly worth it, and many pharmaceutical companies are getting out of the vaccine production business as a result.

The last one to fall, the hardest brick in the wall, was the fact that often most victims in an outbreak have been vaccinated. That one is, surprisingly, quite true. But it’s not true because vaccines don’t work. It’s true because vaccines are very popular. If a vaccine protects 90% of the people who get it, and 95% of a group of 1,000 people get it, then 950 people will be vaccinated, 95 of them will get the disease in our hypothetical outbreak, and the 50 unvaccinated people will get it. Nearly twice as many of the sick people are vaccinated, but the vaccine still prevented illness in 855 people! It wasn’t the vaccine effectiveness that was lacking, it was my understanding of math.

During this time, Andrew Wakefield’s study was being torn apart in scientific circles as well as the popular press. These were the final blows. I was no longer afraid of vaccines. Now I was very, very angry. I was livid that this man, in his greed to promote his own MMR vaccine, had falsified data and performed unethical experiments on children. But mostly I was enraged that he had fooled me. Not only was my son now behind on his boosters, but I’d had a micropreemie daughter, and refused her early vaccines. While we were very lucky that neither of them caught a vaccine-preventable illness, the fact that he tricked me into putting my children at risk can never be forgiven.

People will sometimes ask me, “Do you think that antivaxxers’ minds will ever be changed?” I honestly don’t know. I think there is a cohort which is indeed intractable. These are the people who didn’t reason themselves into their position, so they cannot be reasoned out. They are acting out of fear and stubbornness, and I don’t know if that can be fixed. But I do know there’s another group. There are some who did reason themselves, educated themselves, into their anti-vaccination stance. Most of my friends are brilliant, educated people. They are afraid, but they’re also well-read…they’re just reading the wrong things. And for that group, for my group, I beg you… don’t give up on us. We can be reasoned out of it again with better information. It’s not easy, but it’s worth saving lives by trying.

5 things you probably didn’t know about vaccines

This post originally appeared on HealthMap’s Disease Daily on September 9, 2014. It has been reposted here with permission from the authors.

This image depicts a number of what were “suspected” smallpox scab fragments, from the archives of the Virginia Historical Society (VHS) by James Gathany

This image depicts a number of what were “suspected” smallpox scab fragments, from the archives of the Virginia Historical Society (VHS) by James Gathany

By Jane Huston and Robyn Correll Carlyle

1. More than half of all routinely recommended vaccines given to children were all developed by the same guy.

Musicians have Mozart. Physicists might have Einstein. But VacciNerds have Maurice Hilleman.

Hilleman worked to develop eight of the 14 routinely recommended vaccines on the childhood immunization schedule, and 36 vaccines in total. He is credited for likely saving more lives than any other scientist in the 20th century.

But despite his contributions to the world of vaccinology, few people know his story.

2. The first attempt at immunization actually involved snorting smallpox scabs.

Long before Edward Jenner developed the first-ever vaccine, there was a technique known as variolation. People in Asia, Africa and the Ottoman Empire would take scabs from a smallpox patient and blow them into people’s noses to purposely infect them with smallpox. The induced illness was often milder, and the result was lifelong immunity from the disease.

Given the rigorous testing we now use to ensure vaccine safety, the technique seems haphazard and irresponsible by today’s standards. But compared to a naturally acquired infection, it was a much better option. Only one to two percent of individuals undergoing variolation died, compared to the roughly 30 percent who died after contracting smallpox on their own.

3. Despite more vaccines, kids actually receive fewer antigens now than they did 100 years ago.

Antigens, you’ll recall, are the part of the pathogen — a disease-causing agent, such as a virus or a bacterium — that the immune system learns to recognize and fight. When our body encounters these antigens (whether by vaccination or natural infection),, we develop antibodies matched to a particular antigen. This allows the  body to identify and destroy future invasions from the same pathogen, preventing you from getting sick.

It’s reasonable to assume that the more vaccines are added to the schedule, the more antigens are introduced into a child’s immune system. But we’ve come a long way in vaccine technology. And while children today might receive more vaccines than their parents (14 to their parents’ seven for example), they actually receive fewer antigens than the generations before them.

In 1900, the only vaccine that was routinely given to children was the smallpox vaccine, which contained roughly 200 antigens. In 1960, kids routinely received five vaccines, totaling 3,217 antigens. In 1980, the seven vaccines administered contained 3,041 antigens.

In 2000? The 11 routine vaccines contained fewer than 150.

4. Pregnant women can (and should!) be vaccinated.

There are a lot of “Do’s and Don’ts” in pregnancy. But while it’s a good idea to steer clear of alcohol and poorly cooked meats, there are a few vaccines that pregnant women should receive to protect their own health and the health of their child.

Diseases like flu can be incredibly dangerous for pregnant women. In fact, women in their second or third trimester are more than four times more likely than nonpregnant women to be hospitalized because of influenza-related complications. That’s why the Centers for Disease Control and Prevention (CDC) recommend a flu shot for women pregnant during flu season. It’s the best defense we have against this deadly disease.

Another important vaccine for pregnant women is the Tdap (tetanus, diphtheria and pertussis) vaccine. When given in the third trimester, Tdap can help not only protect the mom from getting pertussis (or “whooping cough”), but it also passes on that protection to the baby. This is important because pertussis is highly contagious and is much more serious for small children than adults.

Not all vaccines are recommended or safe during pregnancy, however. It’s important for pregnant women to talk with their provider about what vaccines they might need.

5. The first vaccine against cancer was licensed in the 1980s.

You’ve probably heard about the HPV vaccine and its ability to protect against cancer. Given that HPV is responsible for 5 percent of all cancers worldwide, the arrival of this vaccine in doctors’ offices in 2006 was a huge victory for public health.

But the HPV vaccine wasn’t the first cancer vaccine available. That title goes to the very first Hepatitis B vaccine, licensed in 1981.

More than 1,000 people are estimated to die every year because of Hepatitis B-related liver cancer — some of whom were infected as infants. The first vaccine (created by none other than our personal hero Maurice Hilleman) was created using purified plasma. It was safe and effective at preventing Hepatitis B– but it arrived just as people were becoming terrified of HIV and tainted blood products, and was not well received.

But Hilleman was nothing if not tenacious, and a new Hepatitis B vaccine using recombinant DNA technology was licensed in 1986.

The vaccine is so safe that its given to infants the day they’re born.


Jane manages the Vaccine Finder project at Health Map, the host site of the Disease Daily. Robyn is a contributing writer for the Disease Daily and works as a project manager for a non-profit focused on vaccine education. Both are fully up-to-date on their immunizations.

Mumps in the Era of Vaccination

In case you missed it, there’s a mumps outbreak in the NHL that’s causing quite the stir.

HealthMap’s Disease Daily explains how these kinds of outbreaks can happen — even if most people are vaccinated.


This post originally appeared on HealthMap’s Disease Daily on May 8, 2014. It has been reposted here with permission from the authors.

Eastern Chipmunk with cheeks filled of food supply, Cap Tourmente National Wildlife Area, Quebec, Canada by Cephas

Eastern Chipmunk with cheeks filled of food supply, Cap Tourmente National Wildlife Area, Quebec, Canada by Cephas

By Jane Huston and Robyn Correll Carlyle

When we hear the word mumps, we picture a young boy wearing wool trousers and suspenders with comically swollen cheeks, left behind while his family takes the brand new Model T to town to see the latest Charlie Chaplin flick. Maybe we’re too imaginative but nonetheless, it sounds like a disease from the past.

So, imagine our surprise when we started hearing reports of a mumps outbreak at Ohio State University (OSU) in early January. What started as a few cases has now spread to more than 300 people throughout the state. And news of other mumps outbreaks have cropped up at Fordham University in New York and the University of Illinois.

The kicker? Most of those affected have been vaccinated.

How is this possible? If these people were vaccinated, how did they still get mumps? Wasn’t the vaccine effective?

The answer is complicated, and there are a few things you need to consider:

1. The majority of people getting sick with the mumps are vaccinated — but that’s because almost everyone is. The percent of small children in the United States with at least one dose of the MMR vaccine has been at or above 90 percent for nearly two decades now.

2. No vaccine is 100 percent effective. But then again, no surgical procedure or medication is either. Even Google goes down occasionally.

The mumps component of the MMR (measles, mumps, rubella) vaccine is between 75- 91 percent effective, and effectiveness is higher with two doses. As a result, up to 10-15 percent of those who get a mumps vaccine won’t actually develop sufficient antibodies to provide immunity, especially during an outbreak.

This can be for a few different reasons: First, the MMR is a live vaccine, which means that it needs to be kept alive to work. If a vaccine is not stored or handled properly, that vaccine can lose its potency and become less effective at helping your body produce antibodies. This is a particularly large challenge in developing countries, where the electricity and infrastructure needed to keep the vaccine at optimal temperatures is sometimes infrequently available. But power outages can happen in the United States, too, and if vaccines aren’t handled properly en route from the manufacturer to the provider’s office or pharmacy, there’s a chance they won’t be as effective.

Second, as much as we want to believe there can be a one-size-fits-all approach in medicine, human bodies aren’t all the same, and not all immune systems will react in the exact same way to vaccines. As a result, there are individuals who, for one reason or another, do not develop an immune response after vaccination, or who do develop some protection against a disease, but that protection is incomplete or temporary.

Fortunately, even if a vaccine fails in an individual, that person has something to fall back on: herd immunity. We’ve written about herd immunity before, and explained its role in protecting those who can’t get vaccinated for age or medical reasons. But herd immunity also protects those who are vaccinated and (unknowingly) do not generate the appropriate immune response.

3. Protection from a disease is not an all-or-nothing thing. Here’s an example: Say you are someone who got one dose of the vaccine and developed a weak, but present, immune response. Those antibodies will probably protect you if you come into contact with one infected individual in passing, but multiple infected individuals in close quarters? Probably not. Your immune system can handle a small amount of exposure to mumps, but not a full-on assault, which is what happens when you get those infected with the mumps in close proximity with a lot of other people — in a college dormitory, for example, or a crowded lecture hall.

4. Even with “breakthrough” cases, vaccination is still our best defense against the mumps. Before vaccination campaigns began in 1967, there were about 186,000 cases every year. In 2013, there were 438. Vaccination has resulted in a roughly 99 percent decrease in the number of mumps cases. So think of how much worse these outbreaks would be if vaccination rates weren’t already high.

Even if you do get the disease after getting vaccinated, chances are it will be a much milder illness. And while mumps might look like nothing more than a case of chipmunk cheeks, it can cause some pretty severe complications like pancreatitis or deafness. Prior to routine vaccination against mumps, 15 percent of cases suffered meningitis, two to five percent pancreatitis, and on rare occasions (about 1 in 20,000), patients could go deaf as a result of mumps infection.

Of the 309 cases of mumps in Ohio so far, there have been only three hospitalizations. If we applied pre-vaccination era hospitalization rates to the same number of cases, that number would be roughly five times higher.

So if anything, these mumps outbreaks demonstrate why vaccines are so important, and why everyone who can be immunized should be.

Unless, of course, you’re into chipmunk cheeks.


Jane manages the Vaccine Finder project at Health Map, the host site of the Disease Daily. Robyn is a contributing writer for the Disease Daily and works as a project manager for a non-profit focused on vaccine education. Both are fully up-to-date on their immunizations.

What We Didn’t Miss, Thanks to the Flu Vaccine

This post originally appeared on Voices for Vaccines. It has been re-posted here with permission from the author. 


In recognition of National Influenza Vaccination Week (NIVW) Voices for Vaccines is participating in a blog relay as part of a countdown to the first day of NIVW. Each day, a different Flu Vaccination Digital Ambassador will post about the importance of flu vaccination as it relates to their readers. You can follow the NIVW conversation on Twitter using hashtag #NIVW2014 and stay tuned as each Digital Ambassador shares who will be posting next. 

Countdown to NIVW blog relay schedule:

What We Didn’t Miss

Last season, influenza took the lives of 109 children. And 90% of those children had not received their flu vaccine.

Despite these statistics, many parents will not get their children vaccinated against the flu. In 2013-2014, less than 60% of children received their flu vaccines, an uptake rate only marginally better than the 42% of adults getting their vaccines.

I get it. Finding a flu vaccine can be a hassle, and if you have kids of different ages, you might have to schlep different kids to different places for different flu vaccines. And you have to go back every year to get them at a time of year when the school year is beginning and soccer practices, lawn work, and after school activities are all competing for your time and attention.

But I also get how terrible the flu is. It’s not just about the deaths. Influenza results in up to 200,000 people being hospitalized and can cost the US economy $87 billion each year. Even if your child is healthy and emerges at the other end of influenza infection unscathed, the flu is an awful illness.

Many people excuse themselves from their flu vaccines, claiming that they make them sick or that they don’t work. Of course, most people know that the mild malaise caused by a vaccine is nothing compared to full-blown illness and that the vaccines affords a 60% effectiveness against preventing influenza. When the vaccine does not prevent influenza, it helps reduce its severity.

45498_10151243273500698_922301626_nMy family’s experience with influenza in 2013 serves as a perfect object lesson for the importance of getting a flu vaccine. We are so grateful we all got our flu vaccines that year.

In January 2013, my husband, my 9 year old, my 4 year old, and I traveled to San Diego to attend a graduation ceremony for my stepson. The day after we arrived, we went to SeaWorld only to have our visit cut short when my 4 year old became warm and too tired to walk and announced that it hurt to breathe.

We rushed to urgent care, and my pre-schooler’s temperature continued to rise. He fell asleep in the waiting room and was coughing intermittently. He must have been achey and uncomfortable because he was moaning and restless. The urgent care doctor was alarmed when he saw him, and I guessed it was the flu because so many of his classmates had caught it in the weeks before we left for California. A lab test confirmed my hunch, and I felt grateful that SeaWorld had been almost empty and hoped that we hadn’t exposed anyone there.

We holed up in our hotel room, and by the next morning my husband had fallen ill as well. Every time my youngest child crawled into my arms only to sneeze on my face, I felt doomed. I figured it was only a matter of time before we were all sick, stuck in the hotel room, and unable to function.

But that never happened. My older child and I never got sick, and the illness was short-lived for both my husband and my pre-schooler. For half of us, the vaccine completely prevented influenza–even though we had very close, prolonged contact with the virus. For the other half of us, the vaccine seemed to mitigate the severity of the illness during a year when influenza seemed particularly virulent and claimed the lives of 171 children. By the time the graduation ceremony took place at the end of the week, we were all fever-free and well enough to attend.

Some would point to our story as a failure–we got our vaccines, and some of us still got sick! I think this interpretation is cynical. We gained so much by being vaccinated. We were spared the worst of what can be an intensely severe disease, we recovered quickly, and we were able to celebrate my stepson’s wonderful accomplishment with him.

So each year, we get our flu vaccines. We get them because influenza is a terrible illness, and any way of preventing it completely or making it less severe is worth the moment of pain (or unhappiness of sniffing) that we have to endure.

You will hear the statistics about children who lost their lives to influenza, but you won’t hear about children who are hospitalized because of the flu. You won’t hear about how miserable they are or how frightening it is to watch them battle the severest illness. You won’t hear about children like Colton, who admitted to the hospital at 15 weeks old with influenza. You won’t hear about the misery of illness or the fear of seeing your child very ill or the stress of being in the hospital, but this story is repeated far too many times every year. And you can help prevent it in your children.

I’m writing today because I don’t want your child to be a statistic or a story. I know you are busy and overwhelmed by parenting and pulled in a million different directions, but it is worth your time and energy to vaccinate your whole family against the flu.

Remember: CDC says an annual flu vaccination is the best protection against flu. Get your flu vaccine and encourage others to do the same by sharing your flu vaccine selfies on social media using the #VaxWithMe tag! Be sure to stop by the other NIVW relay participants’ blogs to learn about flu vaccination for everyone – tomorrow’s post will be hosted by Shot of Prevention.


Karen Ernst is the Parent-Leader of Voices for Vaccines. Neither she nor Voices for Vaccines received any compensation from any governmental agency for publishing this blog post or for participating in the Digital Ambassador program.

Voices for Vaccines is a parent-led nonprofit organization that helps parents advocate for on-time immunization in their communities. Join VFV at www.voicesforvaccines.org/join-us.

10 Reasons Why #GivingTuesday is the Best Day Ever

This post originally appeared on Salsa Labs’ Salsa Blog on November 25, 2014


Which day is better – #GivingTuesday or Black Friday? Well, here are 10 reasons why #GivingTuesday is so much better than Black Friday…

1. #GivingTuesday is much safer than Black Friday. You can avoid a trip to the hospital after getting trampled by people just trying to get into a store.

2. You don’t have to wake up at the crack of dawn. You can donate at any point during the day, whenever is most convenient for you.

3. You can participate from the comfort of your couch, in your PJs.

4. You can eat ice cream and watch Netflix while donating. That’s always a bonus.

5. You don’t have to break the bank to make a donation.

6. You can feel good about the money you gave, rather than regret the money you spent shopping.

… continue reading the full post here


Please support The Immunization Partnership this #GivingTuesday by going to our website: http://www.immunizeUSA.org or by clicking here.