Vaccinations, informed decisions and facts from reliable sources

I may be in the minority on this site, however, I remember so very well when children were dying from measles. When I was 11, a friend developed rubella and was kept in a dark room for weeks. There was no treatment, only prayers that she wouldn't be blind or deaf following her illness. She did have significant hearing loss, but maintained her eyesight. She was lucky, she survived.

I had the mumps at age 9, as a result, I have kidney and reproductive organ damage.

Rubella can be very dangerous for unborn babies. If a woman gets rubella during pregnancy, especially during the early stages of pregnancy, it can lead to premature delivery or fetal death. Getting rubella during pregnancy can also result in serious birth defects, such as deafness, cataracts, heart defects, mental retardation, or liver and spleen damage. An epidemic of rubella in the U.S. in 1964–65 led to an estimated 11,250 fetal deaths, 2,100 newborn deaths, 11,600 babies born deaf, 3,580 babies born blind, and 1,800 babies born mentally retarded.*(CDC)

My mother had polio as a child. She spent months having excruciating therapy in the hopes that she would walk again after being crippled by the disease. She was lucky, she survived.

I worked for a pediatrician whom tried desperately to save children from death as a result of pertussis at County USC Medical Center because they had not been vaccinated. A child could suffocate in minutes, choking on the rope-like phlegm the disease produces.

While diphtheria has been controlled in this country because of vaccinations, it can still be brought into the country by visitors and immigrants.
The most serious complications caused by the exotoxin are inflammations of the heart muscle (myocarditis) and damage to the nervous system. The risk of serious complications is increased as the time between onset of symptoms and the administration of antitoxin increases, and as the size of the membrane formed increases. The myocarditis may cause disturbances in the heart rhythm and may culminate in heart failure. The symptoms of nervous system involvement can include seeing double (diplopia), painful or difficult swallowing, and slurred speech or loss of voice, which are all indications of the exotoxin's effect on nerve functions. The exotoxin may also cause severe swelling in the neck ("bull neck").
The signs and symptoms of diphtheria vary according to the location of the infection.

Tetanus is a serious bacterial disease caused by a toxin that leads to stiffness of your jaw muscles and other muscles. Tetanus can cause severe muscle spasms, make breathing difficult and, ultimately, threaten your life.
Spores of the tetanus bacteria, Clostridium tetani, usually are found in the soil, but can occur virtually anywhere. If deposited in a wound, the bacteria can produce a toxin that interferes with the nerves controlling your muscles.
Treatment for tetanus is available, but the process is lengthy and not uniformly effective. Tetanus may be fatal despite treatment. The best defense against tetanus is preventing it by getting a tetanus shot and by properly caring for wounds.
Whatever a parent decides in terms of vaccinations, they should have all the information available. The issue isn't black and white. *(Mayo Clinic)

Impact of Vaccines Universally Recommended for Children—United States, 1900-1998
JAMA. 1999;281:1482-1483.

MMWR. 1999;48:243-248

2 tables omitted

At the beginning of the 20th century, infectious diseases were widely prevalent in the United States and exacted an enormous toll on the population. For example, in 1900, 21,064 smallpox cases were reported, and 894 patients died.1 In 1920, 469,924 measles cases were reported, and 7575 patients died; 147,991 diphtheria cases were reported, and 13,170 patients died. In 1922, 107,473 pertussis cases were reported, and 5099 patients died.2,3

In 1900, few effective treatment and preventive measures existed to prevent infectious diseases. Although the first vaccine against smallpox was developed in 1796, >100 years later its use had not been widespread enough to fully control the disease.4 Four other vaccines—against rabies, typhoid, cholera, and plague—had been developed late in the 19th century but were not used widely by 1900.

Since 1900, vaccines have been developed or licensed against 21 other diseases.5 Ten of these vaccines have been recommended for use only in selected populations at high risk because of area of residence, age, medical condition, or risk behaviors. The other 11 have been recommended for use in all U.S. children.6

During the 20th century, substantial achievements have been made in the control of many vaccine-preventable diseases. This report documents the decline in morbidity from nine vaccine-preventable diseases and their complications—smallpox, along with the eight diseases for which vaccines had been recommended for universal use in children as of 1990. Four of these diseases are detailed: smallpox has been eradicated, poliomyelitis caused by wild-type viruses has been eliminated, and measles and Haemophilus influenzae type b (Hib) invasive disease among children aged <5 years have been reduced to record low numbers of cases.

Information about disease and death during the 20th century was obtained from the MMWR annual summaries of notifiable diseases and reports by the U.S. Department of Health, Education, and Welfare. For smallpox, Hib, and congenital rubella syndrome (CRS), published studies were used.2,3,7-14

Current Delivery and Use of Vaccines

National efforts to promote vaccine use among all children began with the appropriation of federal funds for polio vaccination after introduction of the vaccine in 1955.5 Since then, federal, state, and local governments and public and private health-care providers have collaborated to develop and maintain the vaccine-delivery system in the United States.

Overall, U.S. vaccination coverage is at record high levels. In 1997, coverage among children aged 19-35 months (median age: 27 months) exceeded 90% for three or more doses of diphtheria and tetanus toxoids and pertussis vaccine (DTP), three or more doses of poliovirus vaccine, three or more doses of Hib vaccine, and one or more doses of measles-containing vaccine. Coverage with four doses of DTP was 81% and for three doses of hepatitis B vaccine was 84%. Coverage was substantially lower for the recently introduced varicella vaccine (26%) and for the combined series of four DTP/three polio/one measles-containing vaccine/three Hib (76%).15 Coverage for rotavirus vaccine, licensed in December 1998, has not yet been measured among children aged 19-35 months. Coverage among children aged 5-6 years has exceeded 95% each school year since 1980 for DTP; polio; and measles, mumps, and rubella vaccines (CDC, unpublished data, 1998).

Vaccine Impact

Dramatic declines in morbidity have been reported for the nine vaccine-preventable diseases for which vaccination was universally recommended for use in children before 1990 (excluding hepatitis B, rotavirus, and varicella). Morbidity associated with smallpox and polio caused by wild-type viruses has declined 100% and nearly 100% for each of the other seven diseases.

Smallpox.

Smallpox is the only disease that has been eradicated. During 1900-1904, an average of 48,164 cases and 1528 deaths caused by both the severe (variola major) and milder (variola minor) forms of smallpox were reported each year in the United States.1 The pattern in the decline of smallpox was sporadic. Outbreaks of variola major occurred periodically in the first quarter of the 1900s and then ceased abruptly in 1929. Outbreaks of variola minor declined in the 1940s, and the last case in the United States was reported in 1949. The eradication of smallpox in 1977 enabled the discontinuation of prevention and treatment efforts, including routine vaccination. As a result, in 1985 the United States recouped its investment in worldwide eradication every 26 days.1

Polio.

Polio vaccine was licensed in the United States in 1955. During 1951-1954, an average of 16,316 paralytic polio cases and 1879 deaths from polio were reported each year.9,10 Polio incidence declined sharply following the introduction of vaccine to <1000 cases in 1962 and remained below 100 cases after that year. In 1994, every dollar spent to administer oral poliovirus vaccine saved $3.40 in direct medical costs and $2.74 in indirect societal costs.14 The last documented indigenous transmission of wild poliovirus in the United States occurred in 1979. Since then, reported cases have been either vaccine-associated or imported. As of 1991, polio caused by wild-type viruses has been eliminated from the Western Hemisphere.16 Enhanced use of the inactivated polio vaccine is expected to reduce the number of vaccine-associated cases, which averaged eight cases per year during 1980-1994.17

Measles.

Measles vaccine was licensed in the United States in 1963. During 1958-1962, an average of 503,282 measles cases and 432 measles-associated deaths were reported each year.9-11 Measles incidence and deaths began to decline in 1965 and continued a 33-year downward trend. This trend was interrupted by epidemics in 1970-1972, 1976-1978, and 1989-1991. In 1998, measles reached a provisional record low number of 89 cases with no measles-associated deaths.13 All cases in 1998 were either documented to be associated with international importations (69 cases) or believed to be associated with international importations (CDC, unpublished data, 1998). In 1994, every dollar spent to purchase measles-containing vaccine saved $10.30 in direct medical costs and $3.20 in indirect societal costs.7

Hib.

The first Hib vaccines were polysaccharide products licensed in 1985 for use in children aged 18-24 months. Polysaccharide-protein conjugate vaccines were licensed subsequently for use in children aged 18 months (in 1987) and later for use in children aged 2 months (in 1990). Before the first vaccine was licensed, an estimated 20,000 cases of Hib invasive disease occurred each year, and Hib was the leading cause of childhood bacterial meningitis and postnatal mental retardation.8,18 The incidence of disease declined slowly after licensure of the polysaccharide vaccine; the decline accelerated after the 1987 introduction of polysaccharide-protein conjugate vaccines for toddlers and the 1990 recommendation to vaccinate infants. In 1998, 125 cases of Hib disease and Haemophilis influenzae invasive disease of unknown serotype among children aged <5 years were provisionally reported: 54 were Hib and 71 were of unknown serotype (CDC, unpublished data, 1998). In less than a decade, the use of the Hib conjugate vaccines nearly eliminated Hib invasive disease among children.