Vaccines have dramatically changed the landscape of childhood infectious diseases. Rabies, polio, tetanus, yellow fever, diphtheria and other vaccine-preventable diseases now are rarely seen in the U.S.
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In the past, these infectious diseases have caused tremendous disability and death, especially in young children. Before we had the measles vaccine, more than 8 million people died worldwide from complications of measles. In the 1960s, 20,000 U.S. infants were born blind, deaf or with other severe abnormalities from congenital rubella syndrome because of their mother’s exposure to infection during pregnancy.
Before the Hib vaccine was available in the 1980s, severe infection caused meningitis, pneumonia, joint and bone infections and epiglottitis in 20,000 young children, killing nearly 1,000 each year. Each of today’s vaccine-preventable diseases carries such a history.
Vaccines have made these diseases clinically unimportant because they occur so uncommonly. Vaccines even protect unvaccinated children through "herd" immunity, because transmission of infection is not sustained in a highly vaccinated population. There is no question vaccines have saved lives and have prevented enormous suffering and disability.
Yet we must remain vigilant.
Colorado has the sixth-highest rate of immunization exemption in the U.S. In 2012, nearly 3,000 kindergartners started school in Colorado without protection from a vaccine preventable disease. "Herd" immunity is lost when increasing numbers of children are not vaccinated. Today, more than ever, travel exposes all of us to vaccine-preventable diseases, whether we personally travel or not.
Take a look at measles and hepatitis, for example.
According to the Centers for Disease Control and Prevention, the United States is experiencing a high number of reported measles, many of which were acquired during international travel. A total of 129 measles cases have been reported in the U.S. in 2014, the highest number reported since 1996. Of these cases, 34 were imported from other countries, such as the Philippines.
The Philippines has been experiencing an explosive outbreak of measles, with approximately 20,000 confirmed or suspected cases reported during January and February, including 69 deaths. Measles is a highly contagious, acute viral illness that is transmitted by contact with an infected person through coughing and sneezing. After an infected person leaves a location, the virus remains contagious for as many as two hours on surfaces and in the air.
Measles can cause severe health complications, including pneumonia, encephalitis and death. The CDC recommends international travelers, school-age children and college students receive two MMR (measles, mumps, rubella) vaccinations. Children between ages 1 to 3 years old should receive one dose of MMR, but two doses if they are traveling internationally.
Millions of Americans have viral hepatitis and an estimated 72,000 become infected each year. Hepatitis A and B can be spread through contaminated food and water. When a person first gets viral hepatitis, he or she can develop a very mild illness with few or no symptoms or get a more serious illness lasting months. Hepatitis B and hepatitis C can progress to a “chronic” or lifelong infection, which can cause serious health problems including liver damage, cirrhosis, liver cancer and even death.
Most people with chronic hepatitis do not know they are infected and can live with the disease for decades without having symptoms or feeling sick. All ages should protect themselves from hepatitis infection by vaccinating against hepatitis A and B.
Discuss any vaccine concerns you have with your child’s doctor. When you delay vaccinating your child, you delay protecting your child against infectious diseases.
The vaccine decisions you make for your child are very important.
Northwest Colorado Visiting Nurse kicks off Immunization Week with drop-in clinics for anyone seeking vaccinations or vaccine education at Steamboat Springs High School Commons from Monday to Friday from noon to 4 p.m. each day for the general public. All ages are welcome. Insurance is accepted, but bring your insurance card to the clinic. Uninsured persons will not be charged more than $21.50 per shot; cash or checks accepted. No one will be refused a recommended vaccine due to an inability to pay a fee. For more information, call 970-879-1632.
Diana Hornung, MD, is the medical director for the Northwest Colorado Visiting Nurse Association.