Vaccine-preventable diseases must be prevented

It is hard to imagine a worse litany than that of untreated vaccine-preventable diseases. Severe illness and death are the ripple effects of diseases such as childhood paralysis (see below), meningitis and HIV. In…

Vaccine-preventable diseases must be prevented

It is hard to imagine a worse litany than that of untreated vaccine-preventable diseases. Severe illness and death are the ripple effects of diseases such as childhood paralysis (see below), meningitis and HIV. In a recent interview, Dr. Kent Brantly, the American doctor from Texas who contracted Ebola in West Africa in 2014, implored parents not to conflate preventable diseases with the bigger issues of global health and starvation. “If we stop spreading the disease, the suffering is not going to stop,” he said. “In fact, the suffering will likely grow.”

The sad truth is that only three countries have good prevention programs for people who need them: the United States, the United Kingdom and Australia. Thousands of children in most other countries are suffering from illnesses that should have been prevented.

The World Health Organization, the government agency responsible for international health policies, reported that nearly 100 million children were affected by measles in 2015. This year, as measles reached epidemic proportions in several countries, WHO said about 13,000 children died of measles and that 772,000 people were hospitalized.

Polio: A huge problem in the United States But the U.S. initiative for screening and then vaccinating children against polio is not successful everywhere. Without progress to eradicate polio entirely, there will be no way to stop a potential disease from spreading. That means that children will be in increased danger. Why? Because poliovirus cannot easily and accurately be identified in saliva. It can be identified only when the sample is taken from the child before the illness has set in. Without sufficient vaccine, children in deprived countries will become extremely vulnerable.

The World Health Organization has mobilized support to address polio, but the global fight against it has stalled. Why? Because no country that lacks effective vaccination programs can declare a major polio epidemic.

Although Senegal has succeeded in stopping polio transmission, the virus has been reintroduced into other countries in West Africa, in Africa and elsewhere. The World Health Organization reports that every day nearly 50 children receive the vaccine in Senegal and 10 in the neighboring country, Mali. These numbers are lower than they should be. Moreover, in Niger and elsewhere the WHO said, “There is no vaccine or recommended measles vaccine.” These are among some 23 countries where measles vaccine coverage is worse than in the United States.

Adolescents and adults are also at risk. Vaccination for tetanus is relatively cheap and easy to administer. But in many places, it is not possible for a baby or a toddler to receive the vaccination. Women with debilitating illnesses, including women of childbearing age, must travel great distances to receive the vaccine. If and when travel is not an option, they must remain in isolation, or be in an Ebola-affected area.

Meanwhile, the fight against measles in western Uganda has progressed only slowly and is not immune to outbreak. In September, an unvaccinated infant died of measles, and 563 children received vaccine treatment.

Why is it so hard to contain measles and prevent polio and meningitis outbreaks? Some may point to weak political will, but there are more practical reasons.

Because of where it arises, most outbreaks are small, spread through close contact. A large disease outbreak in Tanzania caused by a highly contagious strain of meningitis, Lassa fever, was averted by the immunization of nearly 300,000 children. This was possible because of extensive distribution of vaccines and good vaccination programs. Many developing countries do not have this advantage.

Parents in Cameroon’s counties of Kondugu and Meena refuse to have their children vaccinated for fear of the AIDS virus. This is true for others in Sierra Leone, Nigeria and South Africa. They are generally unable to contain large outbreaks; when they happen, adults may fear the health consequences of a return to life before vaccines.

Vaccines are inexpensive, highly effective and one of the best ways to save the lives of children and prevent chronic illness, including heart disease, tuberculosis and cancer.

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