A friend asked under which circumstances would we no longer have the need for a vaccine to be given to the general population. It’s a good question, and it got me thinking. We don’t vaccinate everyone for smallpox anymore now that it’s been eradicated. (The only known virus samples live in Atlanta and Russia, and there is an ongoing discussion on whether or not to get rid of them. My thoughts on that later.)
We also don’t vaccinate against anthrax because the risk of it causing an outbreak is pretty low. The Amerithrax attacks in 2001 were deliberate, and the fact that the perpetrator told everyone what the powder was made it easy to counter it with lots and lots of Ciprofloxacin. (Penicillin would have worked too. This wasn’t a resistant strain.) The only people getting anthrax vaccine are people who work with animals that may harbor it as a spore on their hides, members of the military (because it can still be weaponized and you don’t want to bog down the troops as you give them all antibiotics), and some political leaders (for the same reason as above).
There is a hepatitis A vaccine, and it is recommended for anyone one year and over, but most of us adults never got it. It’s not a bad idea to get it, especially if you’re a person who works in preparing food. You don’t want to kick off an outbreak at a restaurant. It’s also not a bad idea to get it if you work in an institutional setting like a prison or a hospital.
So when will we be done with vaccines? Probably never, especially if you see what is going on with polio in Africa, Asia, and the Middle East. Even as polio was almost on the brink of eradication, our human propensity for violent disagreement has made vaccinating children in some parts of those continents a life or death decision for the vaccinators. They are being killed because groups of violent people are convinced that vaccines are bad or part of a plot against them. (Sound familiar?)
Ironic as it is, the very actions taken by all who refuse to be vaccinated ensure the continuing need for vaccination. Measles was eliminated (not eradicated) from North America, but the increased rates of vaccine refusal in children from misguided and misinformed parents has allowed outbreaks to return. If enough people refuse to be vaccinated against measles, outbreaks will get bigger and measles will cease to be eliminated again.
René F. Najera, DrPH
I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
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