This article basically states that whooping cough, considered a disease of the past, is starting to rise again starting in California. If the right preventive measures are not taken, this disease could spread nationally and with an infection rate greater than smallpox, has potential to be a very serious public health issue. Whooping cough is also a cyclical disease, meaning that it has its highs and lows in terms of infection rates. It is a very dangerous disease because of its high infection rate and various characteristics that differ from most other diseases. The bacteria that causes whooping cough, Bordetella pertussis, initially only causes minor symptoms in its host and once it is detected, the disease is usually too late to treat. The article gives an example of a woman's child who died because he was detected with this disease too late.
Herd immunity is a theory that states that if a portion of the population is vaccinated against a particular disease, this will provide protection for the unvaccinated portion of the population from that disease. The logic behind this is that if a large portion of the population is vaccinated and since infectious diseases are passed from person to person, this chain of infection is going to be less significant. Normally, those who do not receive vaccinations will experience some sort of negative side effect upon vaccination. Therefore, the public health importance here is that if most of the population who can be vaccinated are vaccinated, the rest of the population who, for whatever reason, cannot take the vaccination will be protected because it is harder for the infectious disease to get to them since the majority of the population will be immune to the disease.
The revival of whooping cough especially in California is due to numerous reasons. First, it is legal and easy for parents in California to refuse vaccinations for their children. Vaccination laws differ among different states and California is lenient in terms of an individual choosing whether or not to get vaccinated. The reason they opt to not be vaccinated is that there was a rumor that vaccinations cause autism, brain damage, and other negative side effects. Parents also believe in herd immunity, thinking that if their children's peers all get vaccinated, their children will be protected against the disease as well. Also, these days, physicians give children acellular vaccines instead of whole-cell vaccines because acellular vaccines are considered safer. However, they are not as effective in curing whooping cough than whole-cell vaccines are. Also, the Pertussis bacteria (the bacteria that causes whooping cough) has evolved and mutated and is more resistant to vaccines nowadays. Therefore, the vaccines used earlier up to the mid 1990s are not as effective as the newly developed vaccines. Furthermore, this bacteria is very good at hiding and is hard to detect even with advanced biological tools used by researchers. The whooping cough vaccination, unlike other vaccinations, does not 100% prevent someone from getting the disease, so one can get infected even after being vaccinated.
Public Health policymakers should educate the general population about whooping cough and inform them of its various unique characteristics. Therefore, people will be more cautious and parents will be more willing to let their children get vaccinated. Policymakers should provide evidence that states that there are no negative side effects in getting vaccinated for this disease. Also, parents should be informed that herd immunity will only work up to a certain point (herd immunity threshold). That is, a certain level of the community needs to be vaccinated in order for herd immunity to operate. Therefore, all children who don't experience negative side effects should be vaccinated. Also, biomedical researchers should continue doing ongoing research on this disease and not just reject it as a "disease of the past." This bacteria has shown that it can mutate and evolve various mechanisms to continue to infect even those who are vaccinated. Also, researchers should be informed that this bacteria is very hard to detect even with the most advanced scientific tools so they should perform numerous trials and scrutinize their results carefully.
Unfortunately it looks like you didn't answer all the questions. Question 3 asked for 2 examples from each of three categories: reasons stemming from parents, from physicians, and from the healthcare system (so a total of 6 examples). You gave 2 parental reasons, but only 1 physician (which is actually a system reason), and no system reasons. So physicians don't have any control over the efficacy of a vaccine, right? They can only give what they have available. So decreased vaccine efficacy is an example of a health system reason. Another system reason is that insurance companies don't make any effort to ensure that required vaccinations are actually given. Some physician reasons for lack of vaccination might be a failure to check a patient's medical record to see if their vaccinations are up to date, or a failure to keep an adequate supply of vaccine in their office.
ReplyDeleteOther comments: You gave a good discussion of herd immunity, but I don't understand what you mean by "Normally those who don't get vaccines will have a negative side effect when vaccinated"? There are many reasons for not getting vaccinated, and one of them is an allergy to egg-based vaccines, but especially these days many people have non-health related reasons for not getting vaccinated and probably won't suffer a serious side effect.
Also, your discussion about vaccine efficacy is confusing. First you say that the newer acellular vaccine may be less effective (true), then you say that vaccines administered before the mid-1990s were not as effective as the newer one (its the other way around). I'd also like to point out that most vaccines do not offer 100% protection (in fact, I don't think any do); some are more effective than others, but no vaccine is perfect. Finally, the difficulty in detecting pertussis is a clinical problem, not a research one, and is also a weakness in the testing technique itself and cannot be improved by increased scrutiny of results.