Adult Immunization Program Vaccine Administration Record: Fill & Download for Free

The history of vaccines offers clear examples ofManufacturing issue reducing vaccine efficacy: AdenovirusEarly vaccine version protects better compared to later, cleaner one: Pertussis*Early vaccine versions protected less compared to later, more effective ones: RotavirusEarly vaccine versions hampered immune responses driven by a later more effective one: RubellaVaccine injected at one site induces poorer immune responses compared to injection elsewhere: Hepatitis BAdenovirusWith ~60 unique serotypes, adenoviruses can cause ARD (acute respiratory disease), pharyngitis, conjunctivitis, pneumonitis. Discovered in the 1950s as a frequent cause of respiratory illness among US military trainees, considerable cost through loss of time during training became the impetus for developing vaccines (1, 2, 3).While the vaccine worked well from the beginning, US military adenovirus vaccination from 1971 to 1973 didn't work as well. Why? An oral vaccine, the vaccine virus in the core of the tablet had become contaminated by the solvent used in the enteric coating process (4). Using new drying equipment ensured proper ventilation of solvent during this coating process and this change ensured stable vaccines were produced. Later, as is so often the case in science, accident rather than deliberate design revealed US military recruit adenovirus vaccination from then on was unmistakably phenomenally successful. Wyeth laboratories, the vaccine manufacturer, ran into a production delay from spring 1994 until Feb 1995 (5). In that time, the US military reported only one adeno-driven ARD outbreak (6).PertussisStill widely used around the world, the 1st generation whole-cell vaccine, is a suspension of killed Bordetella pertussis. Public concern over local injection site reactions and fears of complications from a whole-cell vaccine led to its replacement by acellular pertussis vaccines in the US, Canada, Australia, and some Asian and European countries. While acellular pertussis vaccines appear to protect as well over the short-term, i.e., 5 to 6 years, the immunity they induce wanes quickly. This necessitates booster shots, otherwise pertussis outbreaks reemerge (7, 8), having increased in both numbers and intensity since the 1990s in countries that switched to acellular pertussis vaccines*. Even more interesting? More often among the vaccinated than the unvaccinated, a clear sign that acellular pertussis may not only be less protective but may induce counter-productive immune responses that make the body more susceptible to pertussis. OTOH, whole-cell pertussis vaccines have a solid ~80 year record of long-term protection and decline in pertussis incidence (9, 10, 11, 12).RotavirusCauses severe dehydrating diarrhea in infants and young children. Licensed in 1998, RotaShield by Wyeth Lederle, the 1st rotavirus vaccine, was withdrawn a year later due to suspicion of a link with Intussusception (medical disorder). Currently, RotaTeq by Merck and Rotarix by GlaxoSmithKine are licensed in many countries. So far so good but the history of rotavirus vaccine development is strewn with other early failed efforts.There are several rotavirus genotypes. Specific rotavirus strains isolated from infants in the 1st month of life attracted a lot of early vaccine interest for a few reasons,High prevalence in nurseries around the world but with little gastroenteritis, i.e., milder than normal disease.Such infections also led to resistance to severe disease (13, 14).Many of these infected infants harbored rotavirus strains with a similar gene (15, 16).However, for reasons not fully understood, such strains largely failed as vaccine candidates (17, 18, 19, 20, 21).RubellaThough it usually causes a mild rash in children and young adults, if a mother's infected with rubella during pregnancy, it's a heartbreaking tragedy because it can cause congenital defects in the fetus, as Agatha Christie showed to great dramatic effect in The Mirror Crack'd from Side to Side, liberally sampling the real-life tragedy of Gene Tierney from Hollywood's Golden Age. During WW II, while pregnant with her first child, Gene became infected by an infected female fan during an appearance at the Hollywood Canteen. Born prematurely and underweight, the child, Daria, was severely developmentally disabled and spent the rest of her life institutionalized.Discontinued now, early live, attenuated rubella vaccines, HPV-77 and Cendehill, were rather ineffective.Re-infections occurred at rates >50% (22, 23, 24, 25, 26).These vaccines were also poor at herd immunity since all susceptible individuals among military recruits got infected during a rubella epidemic even though most had antibodies as a result of prior vaccination or infection, specifically >or= 80% of recruits vaccinated with HPV-77 got re-infected (27).In another outbreak among recruits, again rubella seemed to target susceptible individuals, i.e., poor herd immunity, even though the group as a whole had been vaccinated and had high antibody titers (28).What could be the reason these early vaccines didn't work as well as the later RA27/3? The possibilities (24, 29, 30) include RA27/3 being better at inducingHigh neutralizing antibody titers.Anti-rubella IgA antibody in the nasopharynx.Thus, when volunteers were challenged intranasally with RA27/3 vaccine virus, those seropositive after natural infection or RA27/3 vaccination were resistant while some of those vaccinated with other strains were sometimes infected (31), i.e., early vaccine version hampered later, more effective vaccine.Hepatitis BFinally, Hepatitis B (HBV) vaccine provides a clear example of inappropriate vaccine administration driving less effective immune responses. Vaccine in the deltoid (shoulder) muscle is more effective compared to the gluteal (buttocks) (32, 33, 34, 35).* Tirumalai Kamala's answer to Why is the pertussis vaccine not protecting those vaccinated for pertussis?Bibliography1. Hilleman, M. R., et al. "Appraisal of occurrence of adenovirus-caused respiratory illness in military populations." American Journal of Epidemiology 66.1 (1957): 29-41.2. Dingle, J. H., and A. D. Langmuir. "Epidemiology of acute, respiratory disease in military recruits." The American review of respiratory disease 97.6 (1968): Suppl-1.3. DUDDING, BURTON A., et al. "ACUTE RESPIRATORY DISEASE IN MILITARY TRAINEES TUE ADENOVIRUS SURVEILLANCE PROGRAM, 1966-1971." American journal of epidemiology 97.3 (1973): 187-198.4. Top Jr, Franklin H. "Control of adenovirus acute respiratory disease in US Army trainees." The Yale journal of biology and medicine 48.3 (1975): 185. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2595226/pdf/yjbm00149-0022.pdf5. Gaydos, Charlotte A., and J. C. Gaydos. "Adenovirus vaccines in the US military." Military medicine 160 (1995): 300-300. https://www.researchgate.net/profile/Joel_Gaydos/publication/15540386_Adenovirus_vaccines_in_the_U.S._military/links/546ccae90cf26e95bc3ca553.pdf6. Barraza, Evelyn M., et al. "Reemergence of adenovirus type 4 acute respiratory disease in military trainees: report of an outbreak during a lapse in vaccination." Journal of Infectious Diseases 179.6 (1999): 1531-1533. Report of an Outbreak during a Lapse in Vaccination7. Gustafsson, Lennart, et al. "Long-term follow-up of Swedish children vaccinated with acellular pertussis vaccines at 3, 5, and 12 months of age indicates the need for a booster dose at 5 to 7 years of age." Pediatrics 118.3 (2006): 978-984.8. Trollfors, Birger, et al. "Pertussis after end of a mass vaccination project—End of the “vaccination honey-moon”." Vaccine 29.13 (2011): 2444-2450.9. Kendrick, Pearl, and Grace Eldering. "Progress Report on Pertussis Immunization*." American Journal of Public Health and the Nations Health 26.1 (1936): 8-12. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1562571/pdf/amjphnation01058-0028.pdf10. Sauer, L. W. "Whooping Cough: New Phases of the Work on Immunization and Prophylaxis." Journal of the American Medical Association 112.4 (1939): 305-308.11. Mortimer, Edward A., and Paul K. Jones. "An evaluation of pertussis vaccine." Review of Infectious Diseases 1.6 (1979): 927-934.12. Baron, Sabine, et al. "Epidemiology of pertussis in French hospitals in 1993 and 1994: thirty years after a routine use of vaccination." The Pediatric infectious disease journal 17.5 (1998): 412-418.13. Bishop, Ruth F., et al. "Clinical immunity after neonatal rotavirus infection: a prospective longitudinal study in young children." New England Journal of Medicine 309.2 (1983): 72-76.14. Hoshino, Yet al, et al. "Serotypic characterization of rotaviruses derived from asymptomatic human neonatal infections." Journal of clinical microbiology 21.3 (1985): 425-430. http://jcm.asm.org/content/21/3/425.full.pdf15. Gorziglia, M. A. R. I. O., et al. "Sequence of the fourth gene of human rotaviruses recovered from asymptomatic or symptomatic infections." Journal of virology 62.8 (1988): 2978-2984. http://jvi.asm.org/content/62/8/2978.full.pdf16. Hoshino, Yet al, et al. "Serotypic characterization of rotaviruses derived from asymptomatic human neonatal infections." Journal of clinical microbiology 21.3 (1985): 425-430. http://jcm.asm.org/content/21/3/425.full.pdf17. Midthun, K. A. R. E. N., et al. "Reassortant rotaviruses as potential live rotavirus vaccine candidates." Journal of virology 53.3 (1985): 949-954. http://jvi.asm.org/content/53/3/949.full.pdf18. Flores, J., et al. "Comparison of reactogenicity and antigenicity of M37 rotavirus vaccine and rhesus-rotavirus-based quadrivalent vaccine." The Lancet 336.8711 (1990): 330-334.19. Vesikari, T. I. M. O., et al. "Evaluation of the M37 human rotavirus vaccine in 2-to 6-month-old infants." The Pediatric infectious disease journal 10.12 (1991): 912-917.20. Midthun, Karen, et al. "Safety and immunogenicity of human rotavirus vaccine strain M37 in adults, children, and infants." Journal of Infectious Diseases 164.4 (1991): 792-796. http://arch.neicon.ru/xmlui/bitstream/handle/123456789/4209669/JournalofInfectiousDiseasesjinfdis_164_4_164-4-792.pdf?sequence=121. Barnes, Graeme L., et al. "Early phase II trial of human rotavirus vaccine candidate RV3." Vaccine 20.23 (2002): 2950-2956.22. Wilkins, Jeanette, et al. "Reinfection with rubella virus despite live vaccine induced immunity: Trials of HPV-77 and HPV-80 live rubella virus vaccines and subsequent artificial and natural challenge studies." American Journal of Diseases of Children 118.2 (1969): 275-294.23. Fogel, A., et al. "Response to experimental challenge in persons immunized with different rubella vaccines." The Journal of pediatrics 92.1 (1978): 26-29.24. Harcourt, Gillian C., Jennifer M. Best, and J. E. Banatvala. "Rubella-specific serum and nasopharyngeal antibodies in volunteers with naturally acquired and vaccine-induced immunity after intranasal challenge." Journal of Infectious Diseases 142.2 (1980): 145-155.25. Schiff, Gilbert M., Rudolf Donath, and Thomas Rotte. "Experimental rubella studies: I. Clinical and laboratory features of infection caused by the Brown strain rubella virus: II. Artificial challenge studies of adult rubella vaccinees." American Journal of Diseases of Children 118.2 (1969): 269-274.26. Naficy, Kiarash, et al. "Artificial Challenge Studies in Rubella: Utilization of RA 27/3 Rubella Vaccinees, Rubella Naturally Acquired Seropositives, and Rubella Susceptible Children." American Journal of Diseases of Children 120.6 (1970): 520-523.27. Horstmann, Dorothy M., et al. "Rubella: reinfection of vaccinated and naturally immune persons exposed in an epidemic." New England journal of medicine 283.15 (1970): 771-778.28. Lehane, Daniel E., Neil R. Newberg, and Walter E. Beam. "Evaluation of rubella herd immunity during an epidemic." JAMA 213.13 (1970): 2236-2239.29. Ogra, Pearay L., et al. "Antibody response in serum and nasopharynx after naturally acquired and vaccine-induced infection with rubella virus." New England Journal of Medicine 285.24 (1971): 1333-1339.30. Plotkin, Stanley A. "Correlates of protection induced by vaccination." Clinical and Vaccine Immunology 17.7 (2010): 1055-1065. Correlates of Protection Induced by Vaccination31. O'Shea, Siobhan, Jennifer M. Best, and J. E. Banatvala. "Viremia, virus excretion, and antibody responses after challenge in volunteers with low levels of antibody to rubella virus." Journal of Infectious Diseases 148.4 (1983): 639-647.32. Centers for Disease Control (CDC. "Suboptimal response to hepatitis B vaccine given by injection into the buttock." MMWR. Morbidity and mortality weekly report 34.8 (1985): 105. Epidemiologic Notes and Reports Suboptimal Response to Hepatitis B Vaccine Given by Injection into the Buttock33. Lindsay, Karen L., David A. Herbert, and Gary L. Gitnick. "Hepatitis B vaccine: low postvaccination immunity in hospital personnel given gluteal injections." Hepatology 5.6 (1985): 1088-1090.34. Lemon, Stanely M., and Davis J. Weber. "Immunogenicity of plasma-derived hepatitis B vaccine." Journal of general internal medicine 1.3 (1986): 199-201.35. Shaw, F. E., et al. "Effect of anatomic injection site, age and smoking on the immune response to hepatitis B vaccination." Vaccine 7.5 (1989): 425-430. https://www.researchgate.net/profile/Stephen_Hadler/publication/20624868_Effect_of_anatomic_injection_site_age_and_smoking_on_the_immune_response_to_hepatitis_B_vaccination/links/5490a9cc0cf2d1800d87c087.pdf

Guide to the Answer:A. History of VaccinationB. Major Arguments Against VaccinationThe history of vaccination is long - very long. I think in order to understand our current resistance to vaccination you need to understand the history a little. Throughout the story you will see a pattern -“We don’t like what we don’t understand, in fact it scares us, and this monster is mysterious at least!”Historians noted that people began observing the protective effect of acquiring some diseases, such as smallpox as early as 430 BC.[1] Records from the 10th century indicate Chinese physicians were inoculating through a process called “variolation” - deliberate infection with disease by blowing scabs up a healthy person’s nose. Variolation worked, too - cutting mortality from around 30% down to 1–2%.[2]Why would it take so many centuries? There were several problems. First, the early inoculation attempts worked — sort of. Often the person would get a lesser form of the disease. Sometimes they wouldn't. Sometimes they’d contract another disease. Because the physicians had no clue about other blood-borne diseases, sterile technique, secondary infections and the like, they often caused unexpected problems that were rather difficult to understand.Above everything else — no one really understood why people got sick in the first place, much less why this method of making a person sick — just less sick — worked. Germ theory of disease was proposed in 1546, and improved in 1762 — but largely ignored in favor the more plausible miasma (bad air) theory, which went back to antiquity (note to scientists — beware of “settled science”!) So the physicians by and large believed that smallpox was caused by “bad air”, and for whatever reason, exposing people to the lesions and giving them the disease this way protected them against the disease contracted through the “bad air” — particularly if a worse case of “bad air” came along.The physicians were pragmatic — they observed it worked, so they wanted to do it, but let’s be real here, the treatment is a bit gross. A lot gross. The physicians were cutting open scabs from the following types of lesions:People were terrified of this disease, and rightfully so. It killed between 30% to 100% of the people who got it, depending on the strain. Many people who survived were scarred for life. They might go blind, or become completely crippled from the disease attacking their bones and joints.Physicians were asking people to let them take fluid or powder from those pustules, and blow it up their nose or inject it right into them. Think about how frightening that must have been! They didn't even want to be near someone with the disease, or near someone who had been near a person with it because they all knew it was contagious. This was a terrible invasion of privacy.So people did what people always do — they invented a million reasons the physician should NOT do this terrifying thing to them.In 1721 a tremendous smallpox epidemic broke out in Boston. The Rev. Cotton Mather initiated a highly controversial inoculation program. Yes, that Cotton Mather, of the Salem Witch Trials — he wasn’t all bad.mezzotint portrait of Cotton Mather (Feb. 12, 1663 - Feb. 13, 1728), American Puritan clergyman.Peter Pelham, artist - http://www.columbia.edu/itc/law/witt/images/lect3/Cotton Mather was inspired by a slave named Onesimus, who told him about his inoculation in Africa, and by a letter published to the Royal Society of London in 1721 by Emanuale Timoni describing the procedure and its efficacy. He was backed by exactly one physician — Zabdiel Boylston. He faced opposition that was religious and scientific.Why do you fight God’s will? (doesn’t this sound familiar)There’s not enough evidence to use that method (not a bad science argument).Cotton Mather and Zabdiel Boylston decided to argue against the religious people with a fairly succinct message — this is no different than any other invasive medical procedure.And the scientific argument? Well — that meant collecting data. So they began inoculating people — not as many as they could have if they had had the support of the town’s physicians as a whole, but they managed to inoculate 287, and only 2% died, compared to nearly 15% of those in the city at large.[3] That largely put the matter to rest in the mind of the scientific community, and the practice was adopted to the great health benefit of the Boston community. (See graph below)The Fight Over Inoculation During the 1721 Boston Smallpox Epidemic - Science in the NewsNow, keep in mind, people still had no idea why this worked. Only that it did.Twenty years later, in 1774, a farmer in England named Benjamin Jetsay contracted cowpox. All the dairy farmers and milkmaids knew if you got cowpox, you could safely nurse people with smallpox and you wouldn't get the disease. Cowpox was much milder than any form of smallpox, so this was very good. Jetsay had heard about inoculating people with smallpox, and even though he wasn't a doctor, he decided to deliberately inoculate his wife and sons with cowpox.[4]It worked.It was another twenty years before Edward Jenner caught wind of this wonderful phenomenon, and decided to stake his career as a physician on it. In 1796, Jenner gave his first trial, inoculating a child with material he gathered from a milkmaid’s pustule. He continued his inoculations, and two years later published “An Inquiry into the Causes and Effects of the Variolae Vacciniae.”[5] The book was pretty much a hit — people read it — and debated it widely — but it wasn't really accepted by the scientific community immediately. Jenner had to do a lot of work to get this idea accepted. However, he was tireless, and vaccination spread through England, and ultimately to America as well.That’s not to say it didn't have people up in arms!James Gillray's The Cow-Pock—or—the Wonderful Effects of the New Inoculation!, Library of Congress, Prints & Photographs Division, LC-USZC4-3147As you can see from the image abov,e there were those who thought that cowpox inoculation might turn you into a cow. Does this really seem much different than modern-day fears?All this — and people still thought disease was transmitted by “bad air”. Although several physicians working with microscopes had described microorganisms and implicated them in the bubonic plague (black death), smallpox, measles, rabies, and others, their work by and large just wasn’t accepted by physicians or the public.This work was probably set back in no small part due to the understandable fear of Antonie van Leeuwenhoek[6], “the father of Microbiology”, who developed a unique method of grinding lenses in the 1650s that enabled him to create microscopes of spectacular resolution. Due to a lack of patent law protection, he guarded his secrets and took them to his grave, and similar caliber instruments weren't developed for almost 200 years. This set back microbiology by about the same amount.The Geographer - by Johannes Vermeer - historians believe painting is of Antonie van Leeuwenhoek[7]It wasn’t until 1854 when a physician named John Snow, working to stem a cholera outbreak, realized that the disease must be transmitted by an agent present in water [8]— and that it was coming from feces of infected individuals. He meticulously detailed the contamination of water used for drinking and cooking with waste from infected individuals in a number of cases. Only after removing a single pump he believed infected with cholera did the epidemic in London subside.After another outbreak, he argued strenuously for filtration of water. He was convinced that people’s poop was contaminating water, and in drinking water with poop from sick individuals, everyone was getting sick and dying. Unfortunately for the citizens of London, and the world elsewhere, his ideas were slow to catch on. Why?It was too disgusting to accept.[9]How slow? Well, in 1854 the Italian scientist Filippo Pacini published a full description of the virus[10] that caused cholera, and in subsequent years further described how to properly treat the disease as well as how the disease became so deadly[11]. Somewhat later, and independently of him, scientific literature not being quite so easy to share in the 19th century, Robert Koch published his work describing the same bacterium[12] (1884).Now you would think the matter of cholera settled, right? It is, after all, 2019. We've understood how to combat this disease now for over 150 years.WHO Cholera Kit inforgaphic. [13]From the infographic: “Researchers estimate there are as many as 4 million cases each year and up to 143,000 deaths annually (2017).”OK, but what does this have to do with worldwide anti-vaccination sentiment?A lot, I’m afraid. You see, the persistence of cholera is only one symptom of the anti-vaccination sentiment that’s been around since the beginning of vaccination. The first cholera vaccination was available in the 1880s.[14] People are still afraid to get vaccinated even when they know they run a high risk of contracting and dying from cholera, a disease that has mortality between 10–90%, and can kill within 2 hours[15].2 hours.Did I mention there are vaccines for this? Now you’d think people would be MORE afraid of cholera than of vaccines, but — no. In fact, they’re not even afraid enough of cholera to wash their hands or drink bottled water consistently.[16] People are weird like that.Throughout history, and worldwide, people invoke the same reasons over and over and over for why vaccination is bad, or at least just isn't right for them.[17][18][19] [20][21] [22] [23] [24]Moral/Religious FoundationInvulnerabilityCost/Benefit Ratio isn't worthwhile* (this is complex)Fear of Bad EffectsNone of these are irrational — per se — not even the moral/religious foundation argument.Moral/Religious FoundationThis argument hasn't changed much. There aren’t that many groups [25]that claim a religious exemption to vaccination, and those that do aren’t under significant expansion in numbers. You’ve got the Christian Scientists, and some members of the Dutch Reformed church. For major religions, that’s it.InvulnerabilityCalvin of Calvin and Hobbes - being selective about accepting realityPeople are very good at this — feeling invincible. Invulnerable. That’s why 15% of Americans don’t use seat belts[26] and 43% of drivers admit to texting and driving[27] (seriously, people STOP IT!). When it comes to vaccines, a fair number of people don’t believe they or their child will actually become ill, so they forgo vaccines. This is a major factor in why people routinely travel without proper vaccinations.Cost/Benefit Ratio isn’t worthwhile* (this is complex)Costs of vaccination vary widely. Many people receive free or low-cost vaccination for children — but the money cost isn't the only cost involved. There’s time spent traveling to and from the provider. This may be fairly trivial in much of the Western world, where vaccinations can be received at any grocery store pharmacy as well as community clinic or hospital, but in developing nations it can present a huge roadblock. A parent may not want to deal with a child being feverish or cranky after vaccination after a tough night on a previous course. They may perceive vaccines as not being effective enough to justify the cost or inconvenience (this is especially true with influenza vaccines). A lot goes into the decision to actually get up and go get a vaccination — and people acting in rational self-interest don’t always weigh the factors the way those invested in public health would hope they should.Fear of Bad EffectsBy far and away, the current anti-vaccine sentiment roared to a new momentum with the 1998 study led by Andrew Wakefield that seemed to link autism to the combined measles mumps & rubella (MMR) vaccine.[28]Andrew Wakefield, Certified FraudThat study was a disaster from the moment of publication — and honestly, it wreaked havoc in far more than just vaccine science. In that same paper, now retracted, which cost Wakefield his medical license, [29]Wakefield et al. proposed the now terribly popular “leaky gut” theory that you can find all over the place — that GI disturbances from food cause a “leaky gut” which in turn leads to “bad blood” and every ailment known to mankind. All of it is modern quackery nonsense, and all of it widely embraced by far more than just those afraid of vaccines.The study was a disaster — with a selected sample size of 12, no control, and terrible statistics, The Lancet never should have published it. Publish it they did, and the damage was done. His co-authors ultimately retracted the paper, but Wakefield went on a martyr tour, selling his “leaky gut” hypothesis. After that, as they say, the horse was out of the barn, and hysterics piled on.“Thiomersal!” became the new rallying cry. As with the MMR issue, there was little scientific evidence for that hypothesis, and a lot against it.[30][31]In fact, there is only one serious research group pursuing this theory at this time, and they self-refer to their own studies most of the time, a hallmark of quack science. Moreover, even though the use of the preservative was phased out[32] in most of Europe and the U.S. after 1999, autism rates continue to rise — making the correlation hypothesis very difficult to support.This is the oldest, and most intractable of the problems — yet seemingly the most simple. Unfortunately, it goes hand-in-hand with distrust of authority, so reinforcement by peer networks is playing a large role in the spread of anti-vaccination sentiment.Combating this movement will require a good deal of public health work[33] — but it also is a responsibility of every parent and citizen. Talk to your friends and neighbors. Encourage vaccination with positive, fact-based information. When you see them spreading misinformation, don’t be afraid to point it out — tactfully. (OK, I admit — this can be hard!). Ultimately vaccination protects both individuals and the population.It’s a wonderful time we live in, when so many awful diseases can be prevented. Now, if only we can get everyone to fully appreciate how lucky we are!Now go check to make sure your vaccines are up-to-date.And get your flu shot!Don’t forget — immunizations are for adults, too!Relaxed. Researched. Respectful. - War ElephantFootnotes[1] http://Gross, C. P., & Sepkowitz, K. A. (1998). The myth of the medical breakthrough: smallpox, vaccination, and Jenner reconsidered. International journal of infectious diseases, 3(1), 54-60.[2] Smallpox: Variolation[3] The Fight Over Inoculation During the 1721 Boston Smallpox Epidemic - Science in the News[4] http:// Nicolau Barquet and Pere Domingo. "Smallpox: The Triumph over the Most Terrible of the Ministers of Death". Annals of Internal Medicine. Retrieved 2006-10-26.[5] http://Jenner, E. (1800). An inquiry into the causes and effects of the variolae vaccinae, a disease discovered in some of the western counties of England, particularly Gloucestershire, and known by the name of the cow pox. author.[6] Antonie van Leeuwenhoek | Biography, Discoveries, & Facts[7] The Geographer by Johannes Vermeer: Geography in Fine Art[8] http://Snow, J. (1855). On the mode of communication of cholera. John Churchill.[9] http://Chapelle, Frank (2005) Wellsprings. New Brunswick, New Jersey: Rutgers University Press. ISBN 0-8135-3614-6. p. 82[10] http://Pacini, F. (1854). Osservazioni microscopiche e deduzioni patologiche sul cholera asiatico. tip. di F. Bencini.[11] Who first discovered cholera?[12] http://Koch, R. (1884). An address on cholera and its bacillus. British medical journal, 2(1236), 453.[13] World Health Organization[14] http://Barrett, A. D., & Stanberry, L. R. (2009). Vaccines for biodefense and emerging and neglected diseases. Academic Press.[15] Cholera - Symptoms and causes[16] http://KOZICKI, MARKUS, ROBERT STEFFEN, and MEINRAD SCHÄR. "‘Boil it Cook it, Peel it or Forget it’: Does this Rule Prevent Travellers ‘Diarrhoea?." International journal of epidemiology 14.1 (1985): 169-172.[17] The Four Main Reasons People Don't Vaccinate[18] http://Gordon, D., Waller, J., & Marlow, L. A. (2011). Attitudes to HPV vaccination among mothers in the British Jewish community: reasons for accepting or declining the vaccine. Vaccine, 29(43), 7350-7356.[19] http://Canning, H. S., Phillips, J., & Stephen Allsup, M. D. (2005). Health care worker beliefs about influenza vaccine and reasons for non‐vaccination–a cross‐sectional survey. Journal of clinical nursing, 14(8), 922-925.[20] http://Kee, S. Y., Lee, J. S., Cheong, H. J., Chun, B. C., Song, J. Y., Choi, W. S., ... & Kim, W. J. (2007). Influenza vaccine coverage rates and perceptions on vaccination in South Korea. Journal of Infection, 55(3), 273-281.[21] http://Singleton, J. A., Santibanez, T. A., & Wortley, P. M. (2005). Influenza and pneumococcal vaccination of adults aged≥ 65: racial/ethnic differences. American journal of preventive medicine, 29(5), 412-420.[22] http://Constantine, N. A., & Jerman, P. (2007). Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis. Journal of Adolescent Health, 40(2), 108-115.[23] http://Darden, P. M., Thompson, D. M., Roberts, J. R., Hale, J. J., Pope, C., Naifeh, M., & Jacobson, R. M. (2013). Reasons for not vaccinating adolescents: National Immunization Survey of Teens, 2008–2010. Pediatrics, peds-2012.[24] http://Francis, M. R., Nohynek, H., Larson, H., Balraj, V., Mohan, V. R., Kang, G., & Nuorti, J. P. (2018). Factors associated with routine childhood vaccine uptake and reasons for non-vaccination in India: 1998–2008. Vaccine, 36(44), 6559-6566.[25] http://Grabenstein, J. D. (2013). What the world's religions teach, applied to vaccines and immune globulins. Vaccine, 31(16), 2011-2023.[26] Policy Impact: Seat Belts[27] Facts & Statistics About Texting & Driving (Updated for 2018)[28] http://Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M., Malik, M., ... & Valentine, A. (1998). RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children.[29] Doctor behind vaccine-autism link loses license | TIME.com[30] http://Gadad, B. S., Li, W., Yazdani, U., Grady, S., Johnson, T., Hammond, J., ... & Ferrier, C. (2015). Administration of thimerosal-containing vaccines to infant rhesus macaques does not result in autism-like behavior or neuropathology. Proceedings of the National Academy of Sciences, 112(40), 12498-12503.[31] http://Uno, Y., Uchiyama, T., Kurosawa, M., Aleksic, B., & Ozaki, N. (2015). Early exposure to the combined measles–mumps–rubella vaccine and thimerosal-containing vaccines and risk of autism spectrum disorder. Vaccine, 33(21), 2511-2516.[32] Thiomersal - Wikipedia[33] The International Roadblocks To Achieving Global Vaccination

Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998At 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, greater than 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) (Table_1). 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 (Table_2). 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 less than 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 VaccinesNational 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 ImpactDramatic 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) (Table_2). 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 less than 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 less than 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.Future DirectionVaccines are one of the greatest achievements of biomedical science and public health. Despite remarkable progress, several challenges face the U.S. vaccine-delivery system. The infrastructure of the system must be capable of successfully implementing an increasingly complex vaccination schedule. An estimated 11,000 children are born each day in the United States, each requiring 15-19 doses of vaccine by age 18 months to be protected against 11 childhood diseases (6). In addition, licensure of new vaccines is anticipated against pneumococcal and meningococcal infections, influenza, parainfluenza, respiratory syncytial virus (RSV), and against chronic diseases (e.g., gastric ulcers, cancer caused by Helicobacter pylori, cervical cancer caused by human papilloma virus, and rheumatic heart disease that occurs as a sequela of group A streptococcal infection). Clinical trials are under way for vaccines to prevent human immunodeficiency virus infection, the cause of acquired immunodeficiency syndrome.To achieve the full potential of vaccines, parents must recognize vaccines as a means of mobilizing the body's natural defenses and be better prepared to seek vaccinations for their children; health-care providers must be aware of the latest developments and recommendations; vaccine supplies and financing must be made more secure, especially for new vaccines; researchers must address increasingly complex questions about safety, efficacy, and vaccine delivery and pursue new approaches to vaccine administration more aggressively; and information technology to support timely vaccinations must be harnessed more effectively. In addition, the vaccine-delivery system must be extended to new populations of adolescents and adults. Each year, thousands of cases of potentially preventable influenza, pneumococcal disease, and hepatitis B occur in these populations. Many of the new vaccines will be targeted at these age groups. The U.S. vaccine-delivery system must routinely include these populations to optimally prevent disease, disability, and death.Despite the dramatic declines in vaccine-preventable diseases, such diseases persist, particularly in developing countries. The United States has joined many international partners, including the World Health Organization and Rotary International, in seeking to eradicate polio by the end of 2000. Efforts to accelerate control of measles, which causes approximately one million deaths each year (5), and to expand rubella vaccination programs also are under way around the world. Efforts are needed to expand the use of existing vaccines in routine childhood vaccination programs worldwide and to successfully introduce new vaccines as they are developed. Such efforts can benefit the United States and other developed countries by decreasing disease importations from developing countries.Reported by: National Immunization Program, CDC.Just imagine what we will achieve when we stop wasting billions of dollars, pounds , euros on war alone regards ian.