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Widespread vaccination has helped decrease or virtually eliminate many dangerous and deadly diseases in the United States. Yet because vaccines have been so effective at removing threats, it’s sometimes difficult to appreciate just how significant they have been to public health.
“We’re very bad at measuring risk,” says epidemiologist René Najera, editor of The History of Vaccines, an online resource by The College of Physicians of Philadelphia. “And so when we don’t see a lot of people dying from something, we think that it’s not a big deal.”
Here are four major diseases that you may have forgotten about (or downplayed) thanks to how effective vaccines have been at mitigating or eliminating them.
Smallpox is the only human disease that has been globally eradicated through vaccines. It’s also responsible for the first known vaccine, created by the English physician Edward Jenner in 1796. After observing that milkmaids who caught cowpox (a milder disease) seemed to gain immunity to smallpox, Jenner inoculated an eight-year-old boy using a milkmaid’s cowpox lesion. He then exposed the boy to smallpox, and when the boy didn’t develop any symptoms of the deadly disease, Jenner realized he’d developed a way to prevent it.
The experiment, while highly unethical by today’s standards, was a big deal. Smallpox could kill up to 30 percent of people who caught it, and had already killed enormous numbers of Native people in North and South America after European colonists brought smallpox and other new diseases to the continents. Shortly after Jenner developed the vaccine, Spain began using it to inoculate people across its empire. The British soon followed, and in the 1850s, Massachusetts became the first U.S. state to mandate smallpox vaccination.
“By the mid-1900s, right after World War II, countries all around the world decide…‘Why don’t we just get rid of smallpox?’” Najera says. “And so they undertake an effort like no other since or before.” This global effort led to the eradication of smallpox by 1979.
READ MORE: The Rise and Fall of Smallpox
Rabies has played a large role in American film and literature—think Old Yeller, To Kill a Mockingbird and Their Eyes Were Watching God. But the deadly disease, which causes erratic behavior, is no longer a major threat in the United States because of vaccines.
In this case, most of the vaccines that have helped save human lives aren’t used on humans—they’re used on other animals that can carry the disease and infect humans by biting them. State rabies programs have guidelines for vaccinating pets and wildlife and tracking animals that might have rabies. Any human who is bitten by an animal, regardless of whether the animal has been vaccinated, must go to a doctor or hospital to receive a rabies vaccine.
Though rabies is still a threat is some parts of the world, many countries have robust vaccination and tracking programs. “Latin America has one of the best anti-rabies programs in the world,” Najera says. “I got bitten by a rabid dog when I was six years old [in Mexico]. They caught the dog and the dog died a couple of days later from rabies, and so if I would have not gotten the vaccine I probably would have been dead.”
Polio was once one of the most feared childhood diseases in the U.S. The viral infection can cause temporary or permanent paralysis, as it did with wheelchair-user Franklin D. Roosevelt. This paralysis could stop a person’s body from breathing on its own, which is why so many infected people had to be placed in an “iron lung.” By the late 1940s, it was disabling more than 35,000 Americans each year. The number of U.S. polio cases peaked in 1952, when it caused 57,879 infections and 3,145 deaths.
During the 1954 trials for Jonas Salk’s polio vaccine, parents flocked to sign their children up to get the shot. As a result, 623,972 children received the vaccine or a placebo. The trials showed the vaccine was 80 to 90 percent effective at preventing polio. Thanks to the continued vaccination of children through today, no polio cases have originated in the United States since 1979. However, polio has not been eradicated, and remains a health threat in Afghanistan and Pakistan.
READ MORE: When Polio Triggered Fear and Panic Among Parents
4. The Flu
WATCH: The 1918 Flu Was Deadlier Than WWI
During the early spread of COVID-19, there was a lot of discussion about whether the infectious disease was serious, or “like the flu”—i.e., not a threat. However, influenza remains a deadly disease that has caused previous pandemics and has the potential to cause future ones as well (Najera speculates the next flu pandemic will happen “sooner rather than later”).
READ MORE: How the 1957 Flu Pandemic Was Stopped Early in Its Path
The Centers for Disease Control and Prevention estimates the flu caused between 12,000 and 61,000 U.S. deaths annually between 2010 and 2020. Globally, it kills between 291,000 and 646,000 people each year.
The deadliest outbreak ever recorded was in 1918 and 1919. That flu pandemic killed roughly 675,000 people in the United States and up to 50 million people worldwide. It also may have infected a third of the world’s population, or about 500 million people. Since then, there have been several other flu pandemics.
READ MORE: See full pandemics coverage here.
A short history of vaccination campaigns in Australia and what we might expect with COVID-19
Of the many things we take for granted about our modern lives — hot showers, supermarkets, video streaming services — perhaps none has had as much impact on our longevity as vaccines.
Back at the turn of the 20th century, the average life expectancy of an Australian baby boy was about 55. About one in 10 children died before their first birthday, many from diseases that are now controlled with vaccination.
Now, as a virus spreads around the globe that we have no existing immunity to, we've been forced to return to the same methods of reducing disease transmission — social distancing and masks — used more than 100 years ago.
And, just like in generations gone by, now we're hoping for a vaccine to help will bring us out of the pandemic we're living through.
So what did some of the previous vaccination campaigns look like in Australia? And what can we learn from them for how a COVID-19 vaccine might be rolled out here, if or when one proves safe and effective?
Hepatitis A and B
These are two viruses that infect your liver. Between 2,000 and 3,000 people get hepatitis A each year. About the same number get hepatitis B. The vaccine will protect adults for at least 25 years.
Who should get it: Anyone can get hepatitis A or B, but you’re most at risk if you:
- Travel outside the country
- Are a man who has sex with other men
- Use illegal drugs
- Have a clotting-factor disorder, like hemophilia
- Come into regular, close contact with someone with hepatitis A
- Have a chronic liver disease
Who shouldn’t get it: If you have allergies to anything in the hepatitis A or B vaccine, talk to your doctor. If you’re sick when you’re scheduled to get either shot, move the appointment to when you’re well. If you’re pregnant, ask your doctor before getting the hepatitis A shot.
How you get it: The hepatitis A vaccine comes in two doses, 6 months apart. The hepatitis B vaccine takes three shots. There is also a combination vaccine that protects against hepatitis A and B. It comes in three doses.
This stands for human papillomavirus. The infection it causes can lead to cervical, vulvar, and vaginal cancers in women, and penile cancer in men. It can also cause anal cancer, throat cancer, and genital warts.
Who should get it: The HPV vaccine is recommended for boys and girls at age 11 or 12 so they're protected before ever being exposed to the virus. However, women younger than 26 and men who aren’t yet 21 can still get it. Men who are in sexual relationships with other men can get the vaccine until age 26.
Who shouldn’t get it: People who are allergic to it or are pregnant.
How you get it: The HPV vaccine comes in three doses. Your doctor will give you the second shot a month or two after the first. You’ll get the third dose 6 months after the opener.
Measles: Why it’s so deadly, and why vaccination is so vital
On the darkest day of 2018, the winter solstice, we at the Center for Vaccine Research at the University of Pittsburgh tweeted, with despair, a report in the Guardian that measles cases in Europe reached the highest number in 20 years.
Why was this a cause for concern? Europe is far away from the United States, and as some people apparently believe measles is a benign, childhood disease that causes a bit of a rash, a dribbling nose and a few spots, right? What was all the fuss about?
Well as George Santayana said, “Those who cannot remember the past are condemned to repeat it.” Collective amnesia about the virulence of this disease has driven us to forget that the measles virus has killed tens of millions of infants throughout history. Now, with several ongoing outbreaks across our own country, this unnecessary threat is back.
Measles is a highly contagious and sometimes deadly disease that spreads like wildfire in naive populations. The virus played its part in decimating Native American populations during the age of discovery. Since these people groups had no natural immunity to the diseases brought to the New World by Europeans, some estimates suggest up to 95 percent of the Native American population died due to smallpox, measles and other infectious diseases.
In the 1960s, measles infected about 3 million to 4 million people in the United States each year. More than 48,000 people were hospitalized, and about 4,000 developed acute encephalitis, a life-threatening condition in which brain tissues become inflamed. Up to 500 people died, mainly from complications such as pneumonia and encephalitis. This was why vaccine pioneers John Enders and Thomas Peebles were motivated to isolate, weaken and develop a vaccine against measles that is truly transformative for human health. Parents who knew the reality of the disease were quick to vaccinate their children. Uptake skyrocketed and the number of cases, and associated deaths, plummeted in the developed world.
By 1985, when Enders died, over 1 million of the world’s kids were still dying because of this infection. However, now measles was a disease preventable by vaccine, and there was a huge impetus to address that tragedy by the World Health Organization.
Who Should Not Get Chickenpox Vaccine
You do not need to get the chickenpox vaccine if you have evidence of immunity against the disease.
Some people should not get chickenpox vaccine or they should wait.
- People should not get chickenpox vaccine if they have ever had a life-threatening allergic reaction to a previous dose of chickenpox vaccine or any ingredient of the vaccine, including gelatin or the antibiotic neomycin.
- People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting chickenpox vaccine.
- Pregnant women should not get chickenpox vaccine. They should wait to get chickenpox vaccine until after they have given birth. Women should not get pregnant for 1 month after getting chickenpox vaccine.
- People should check with their doctor about whether they should get chickenpox vaccine if they:
- Have HIV/AIDS or another disease that affects the immune system
- Are being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer
- Have any kind of cancer
- Are getting cancer treatment with radiation or drugs
- Recently had a transfusion or were given other blood products
Immune Conditions in Family Members
People should check with their doctor about whether they should get chickenpox vaccine if they have immune conditions in first degree relatives (parents, siblings) that can be inherited (called immunodeficiencies).
Most children who have family members with immune system problems can safely get varicella vaccine, as long as they themselves have a healthy immune system.
Generally speaking, anyone with a damaged immune system should not get live vaccines, such as chickenpox vaccine. But most immune system problems are not related to the patient&rsquos family. They come from illnesses such as cancer, or from medications such as chemotherapy drugs.
But there are some rare immune conditions that can run in the family. So children whose parents or brothers or sisters have one of these conditions should be screened before getting chickenpox vaccine to make sure they haven&rsquot inherited it. Children with a family history of these conditions can get the chickenpox vaccine if they are found not to have the conditions themselves.
This Vaccine Side Effect Could Mean You Already Had COVID, New Study Says
Research has found that this reaction is much more common in those previously infected.
Anyone who gets the COVID vaccine can experience a multitude of side effects, according to the Centers for Disease Control and Prevention (CDC). From arm swelling to fever, these reactions are just how some people's bodies respond to building immunity against COVID. But as it turns out, your specific vaccine reactions may also offer insight into your previous experience with the virus. According to new research, one vaccine side effect in particular may indicate that you have already had COVID. Read on to find out which reaction to look out for, and for more on surprising side effects, discover The Common Vaccine Side Effect That No One Is Talking About, Experts Say.
A new study has found that certain vaccine side effects are more common in people who have already had COVID. The study, which was made available April 22 as a preprint on medRxiv, analyzed 947 people who were monitored after their vaccination for side effects—265 of whom had previously been infected with COVID. The researchers found that one unusual side effect—swollen lymph nodes or lymphadenopathy—was much more common in those who had previously had COVID. According to the study, less than 1 percent of people with no history of COVID reported experiencing lymphadenopathy after vaccination, while 4 percent of those who had been infected with the virus experienced this side effect. And for more on vaccine reactions, Doing This After Your Vaccine Can Make Side Effects Worse, Doctors Say.
There were four more side effects also more common in those who had been previously infected with the coronavirus: fever, fatigue, myalgia (muscle pain), and arthralgia (joint pain). According to the study, fever was experienced by 8 percent of those who had COVID, but only 2 percent of those who had not been infected reported it. Fatigue was reported by 29 percent of those who had COVID, and 20 percent who hadn't. Myalgia was reported by 30 percent of those who had COVID and only 15 percent who had not, while arthralgia was a side effect for 17 percent of people with a COVID history and only 7 percent of those who had never been infected. And for more on life after vaccination, The CDC Says People Who Get COVID After Vaccination Have This in Common.
According to the study, people who had previous coronavirus infections were more likely to report side effects in general after getting the COVID vaccine. People who had COVID were also more likely to report at least one moderate to severe vaccine side effect. However, vaccine reactions occurring local to the vaccine injection site—like arm redness and swelling—and gastrointestinal symptoms were not more prevalent in those with prior COVID infection than those without. And for more up-to-date information, sign up for our daily newsletter.
Many experts question whether people who have had COVID actually need the second dose, as more reactions to the vaccine may mean more antibodies are formed after only one dose for those who have had prior infections. In fact, the researchers for this study conclude that their data "adds weight to the question of whether a second dose of mRNA vaccine is necessary in those with previous COVID-19, assuming effective immunity is established after the first dose."
However, the CDC still says that you should get two shots of the Pfizer or Moderna vaccines, whether or not you've had COVID already. And aside from extremely rare allergic reactions, normal vaccine side effects should not dissuade you from your second dose either. "You should get your second shot even if you have side effects after the first shot, unless a vaccination provider or your doctor tells you not to get it," the CDC says. And for more vaccine guidance, Don't Do This for 2 Days After Your COVID Vaccine, Doctors Say.
Her son died of a vaccine-preventable disease here's what one mom wants you to know
When my son Gabriel was very little, he would beg, cry and even hyperventilate when faced with getting a shot. Like many kids, he has an aversion to needles and would be upset for days if he knew he was going to the doctor.
When he was a toddler, we spoke in simple terms about why the vaccines are important: they would keep him from getting sick. When he was a little older, he understood that they protected against bad diseases. Now 8, he knows our family’s most painful truth: his brother died of a disease that is now vaccine preventable.
Our first son, the bright, joyful little boy who made me a mother, was 7 months and 4 days old when he died from Neisseria meningitidis, a bacterial meningitis so swift and deadly it killed him less than 12 hours after his first symptom.
Phoenix was fully up to date on his vaccinations, but back in 2005, there wasn’t a vaccine available in the U.S. to protect against Strain B, which is what killed him. It is the strain that most commonly affects babies, our pediatrician told us. In the past few years, it has made news because of deadly outbreaks on college campuses.
For months after Phoenix died, whenever I’d sleep, I’d dream that I was trying to save him again. Night after night, I ran through different scenarios trying desperately to make things add up to a different outcome — what Joan Didion called “magical thinking” after her husband died.
I drove myself crazy trying to piece together the puzzle to identify when and where my boy had been exposed. I was searching for the moment that changed everything.
I never found it. If I had it to do all over again, I still wouldn’t know how to save him.
I desperately hoped a vaccine would be developed that could protect children like Phoenix. I hoped it would happen in my lifetime so I could see it.
A few months ago, the FDA approved a vaccine to be used in the U.S. One had been available in Europe and Canada before, but never in the U.S. While it’s recommended for kids age 10 and up, older than Phoenix was, I believe that at some point, it’ll be approved for use in infants.
On the day I heard about the FDA’s decision, I could barely function. I was profoundly grateful for all the lives it would save, but alongside that was the knowledge it had been too late for Phoenix. In the grand history of time, it felt like a cruel near miss.
As I read about the measles outbreak spreading across the nation now, I can’t help but think that we’ve simply forgotten. We don’t see these diseases anymore they don’t seem real. I know that the parents who choose not to vaccinate their children truly believe they are doing what is best for them. They love their children as much as I do.
But what I want them to know is that I would give anything — I would trade all the rest of my life to go back in time for the chance to give Phoenix the vaccine that would have saved his life. It is real for my husband and me in a way that I never want anyone else to have to know.
We want to believe we are invincible and that nothing can touch our children. We have access to the best medical care. Many of the deadly diseases that swept through communities have now been eradicated due to vaccination. We don’t see them anymore, the way our parents and grandparents once did. We have forgotten — until now, when Disneyland is ground zero for a rapidly spreading outbreak of measles traced to unvaccinated Disneyland visitors. Or until you run into someone like me, whose child died of a disease that is now vaccine preventable.
To vaccinate your child means to admit the possible — that the bogeyman is real and diseases exist that can snatch your child away. That in itself sometimes may feel too scary to look at.
Each year around Mother’s Day I go to the historic cemetery where Phoenix is buried to wash and weed his grave. Then I go to an older part of the cemetery where children were buried so long ago that their families are no longer alive to tend their graves. I hope that someday, years from now, when I am gone, maybe another mom will do that for Phoenix.
There are dozens and dozens of small graves, some marked with lambs, others with tiny crosses, many bearing the date 1918 or 1919, when the flu epidemic was sweeping the world. There are so many that if I spent days there, I probably could not get to all of them.
A few years ago, I washed a grave that must have been elegant when it was new. It is made of white marble and looks like it was once the statue of a child before decades of wind, rain and snow took a toll. The base of it was overgrown with lichen so I set about scrubbing it clean. As I did, the inscription emerged: “…all the light and all the joy, we buried with our darling boy.”
Our grief when our children die is the same now as it was back then. We just don’t see it as much as we used to because, largely due to vaccination and other medical advances, children don’t die at the rates they used to.
But I can only imagine how those parents nearly a century ago would have marveled to know that now we have a flu shot. And, like me, what they would have given for the chance to get it for their child, even on years like this one where it’s only partially effective.
The truth is that as much as we wish otherwise, we can’t always fully protect our children. Lightning sometimes still strikes in ways that don’t make sense. But we can give our children all of the chances that we possibly can. And we can make promises to them that we desperately hope will come true.
After each vaccine Gabriel gets, he wants me to reassure him that the sting of the shot is worth it because he won’t ever get that disease. He wants to make sure that the people he loves have had those vaccines too. He knows what that kind of loss looks like up close.
There is a lot of anger and animosity right now around the issue of vaccination. But for me, what it really comes down to is the memory of a beautiful, sparkly little boy who was all love.
In a few years, Gabriel will be old enough to get the vaccine for Neisseria meningitidis strain B. And then I will tell him, as I do after all his other vaccinations, “You are safe.”
Linda Annette Dahlstrom Anderson is a writer and editor at Fred Hutchinson Cancer Research Center. She lives in Seattle with her husband, Mike and her son, Gabriel. Follow her on Twitter: @Linda_Dahlstrom
How medical exemptions work
The details of this whole process depend on where you live. “We don’t have a standardized way of doing things across states because they’re state laws,” Salmon says.
Some states may require a written physician’s statement detailing the contraindication while others only require a simple form to be filled out, according to a 2012 paper (coauthored by Omer) published in The Journal of Infectious Diseases.
One major variable is who is allowed to fill out these medical exemption forms (or write medical exemption statements) to replace the proof of immunization that’s usually required for school or day-care entry. States generally permit doctors with M.D.s to write these, Dr. Orenstein says, and often doctors with D.O.s as well. (If you’re wondering what the difference is, we have a whole deep dive for you right here.) Some also allow nurse practitioners, physician assistants, and other medical professionals to write them.
In general, though, whether or not there needs to be a detailed explanation of what the medical exemption is varies based on location (just like pretty much everything else about medical exemptions). In some cases, “the doctor doesn’t necessarily have to justify the medical exemption…they just have to say, ‘This child has a medical exemption,’ ” Dr. Orenstein explains.
“Then you have the issue of what happens to those exemptions,” Salmon points out. Frequently the form simply gets accepted by the school and that’s that, Diane C. Peterson, associate director for Immunization Projects at the Immunization Action Coalition, tells SELF. But in other cases the form gets sent to and reviewed by the state or local health department for approval, Peterson says. Whether or not this happens depends on both state and local laws, school procedures, and if the health department and schools have agreed to work together as part of the protocol. The steps involved in the review and approval process are not standardized and depend on the jurisdiction. They can vary based on whether or not grounds for exemption denial are coded in the law or just up to the discretion of whoever is reviewing the form, if all exemption forms get reviewed regularly or just upon request by the school or the state, and what resources (time, people, money) the involved departments can spend on reviewing medical exemption requests.
According to the CDC, some states only grant temporary exemptions that expire after a period of time, which may require regular recertification, while others offer permanent exemptions.
What should you do if you accidentally get different COVID-19 vaccines?
If you end up getting doses of two different mRNA vaccines, you don’t need additional doses of either one, the CDC says.
“Because the vaccines that are being interchanged use the exact same technology and are very close to being identical, people will have very similar immunity after they’re fully vaccinated,” Dr. Adalja says.
The CDC notes: “In situations where the same mRNA vaccine product is temporarily unavailable, it is preferable to delay the second dose (up to six weeks) to receive the same product than to receive a mixed series using a different product.”
Watch the video: 3 Deadly Diseases Youve Probably Never Heard Of (August 2022).