Patrick Turnes, MD, Valley Health Hampshire Memorial Hospital Multispecialty Clinic
Tyrannosaurus rex, the Dodo, Smallpox. What do these three entities have in common? Extinction!
T. rex was wiped out by a random meteor impact. The Dodo was carelessly
hunted into non-existence. Smallpox eradication, however, was a deliberate,
planned extinction, thanks to the intelligence and skill of medical professionals
( with first efforts dating as far back as 10th century China) and the
efforts of public health professionals, using the tool known as immunization.
Other than historical records, the only remnant that remains of the prior
existence of smallpox, is the circular scar found on the upper arm of
individuals vaccinated in the twentieth century. By 1985, smallpox was
officially declared extinct and immunization programs were discontinued
worldwide. Smallpox has not reappeared in nature in the 32 years since
those immunization efforts were halted. The complete extinction of a virus,
that on average killed more than 50% of humans that it infected, is a
remarkable achievement in preventive medicine.
Likewise, poliomyelitis, aka infantile paralysis, was a global scourge
in the early part of the twentieth century. In 1916, it caused an estimated
6000 deaths and partially or completely paralyzed 27,000 victims. Again,
through medical research and public health efforts in mass immunizations,
the last endemic case of polio in the US occurred in 1979, and the last
case discovered in the Western hemisphere was in Peru in 1991.
Many people take immunizations for granted, in large part because we receive
many of our vaccines in childhood, when this important preventative treatment
is performed at the behest of responsible parents. In recent years, vaccination
has been in the spotlight when there have been outbreaks of illnesses
due to lapses (intentional and otherwise) in vaccinations being performed.
Controversy over vaccines occurred when a 1998 study supposedly found a
link between MMR vaccines and autism. This led to many parents deferring
vaccinating their children. Six years after that study was published,
ten of the thirteen authors of the study published a statement retracting
the findings. On further investigation, it was found that 3 of the 12
children in the study did not have autism, 5 of the children had developmental
concerns well before they received any vaccines. Finally, the patients
in the study were found to have been recruited through an anti MMR vaccine
organization and the study was commissioned for planned litigation against
the vaccine manufacturers. In essence, the deck was stacked.
Today, in addition to the childhood vaccines that are well known, there
are a number of adult vaccines that can prevent or reduce the risk of
significant diseases. There are two pneumonia vaccines that can reduce
the risk of developing pneumonia by 60%. Shingles vaccine can reduce the
lifetime risk of developing shingles from 30% to 15%. Among those 15%
who subsequently get shingles after receiving the vaccine, the outbreak
tends to be milder than in unvaccinated individuals. Receiving tetanus
toxoid every ten years is recommended to avoid tetanus or lockjaw. A series
of 3 injections can prevent individuals from acquiring hepatitis B. It
is recommended that children and adults receive influenza vaccine yearly.
This frequency is necessary because the strains expected to cause the
most widespread influenza, change from year to year.
Additionally, there is a vaccine that can prevent cancer. Human papilloma
virus infection is the most frequent cause of cervical cancer. HPV vaccine
prevents the viral infection of the cervix that can lead to this cancer.
Today, researchers are working on developing additional vaccines to prevent
other serious diseases such as HIV/AIDs and Hepatitis C.
Vaccines are important. An ounce of prevention is worth more than a pound of cure.