Category: Vaccine Preventable Diseases

Vaccine-Preventable Diseases

The latest immunization schedule from the CDC and AAP.
The latest immunization schedule from the CDC and AAP.

Today, in the United States, children typically get:

  • 36 doses of 10 vaccines (HepB, DTaP, Hib, Prevnar, IPV, Rota, MMR, Varivax, HepA, Flu) before starting kindergarten that protect them against 14 vaccine-preventable diseases
  • at least three or four more vaccines as a preteen and teen, including a Tdap booster and vaccines to protect against HPV and meningococcal disease, plus they continue to get a yearly flu vaccine

So by age 18, that equals about 57 dosages of 14 different vaccines to protect them against 16 different vaccine-preventable diseases.

While that sounds like a lot, keep in mind that 33% of those immunizations are just from your child’s yearly flu vaccine.

Vaccine-Preventable Diseases

Of course, kids in the United States don’t get all available vaccines and aren’t protected against all possible vaccine preventable diseases. Some vaccines are just given if traveling to a high risk area or in other special situations.

Vaccine-preventable diseases (in the United States, children and teens are routinely protected against the diseases highlighted in bold) include:

  1. adenovirus – a military vaccine
  2. anthrax – vaccine only given if high risk
  3. chicken pox – (Varivax, MMRV)
  4. cholera – vaccine only given if high risk
  5. dengue – vaccine not available in the United States
  6. diphtheria – (DTaP/Tdap)
  7. hepatitis A – (HepA)
  8. hepatitis B – (HepB)
  9. hepatitis E – vaccine not available in the United States
  10. Hib – (Hib)
  11. HPV – (Gardasil)
  12. Haemophilus influenzae type b – (Hib)
  13. measles – (MMR, MMRV)
  14. meningococcal disease – (MCV4 and MenB and MenC)
  15. mumps
  16. pneumococcal disease – (Prevnar13 and PneumoVax23)
  17. pertussis – (DTaP/Tdap)
  18. polio – (bOPV and IPV)
  19. Q-fever – vaccine not available in the United States
  20. rabies – vaccine only given if high risk
  21. rotavirus – (RV1, RV5)
  22. rubella – (MMR, MMRV)
  23. shingles – vaccine only given to seniors
  24. smallpox – eradicated
  25. tetanus – (DTaP/Tdap)
  26. tick-borne encephalitis – vaccine not available in the United States
  27. tuberculosis – (BCG) – vaccine only given if high risk
  28. typhoid fever – vaccine only given if high risk
  29. yellow fever – vaccine only given if high risk

Discontinued vaccines also once protected people against Rocky mountain spotted fever, plague, and typhus.

These vaccine-preventable diseases can be contrasted with infectious diseases for which no vaccines yet exist, like RSV, malaria, norovirus, and HIV, etc., although vaccines are in the pipeline for many of these diseases.

What To Know About Vaccine Preventable Diseases

Available vaccines are helping to eliminate or control a number of vaccine-preventable diseases, like polio, measles, and diphtheria, but a lot of work is left to be done.

More About Vaccine Preventable Diseases

Obstetric Tetanus Is Still a Thing in the United States

Yes, even though we have had a tetanus vaccine for over 80 years, obstetric tetanus is still a thing in the United States.

Obstetric Tetanus in Kentucky

According to a report from the CDC, in July 2016, an unvaccinated Amish woman in Kentucky developed “facial numbness and neck pain, which progressed over 24 hours to stiff neck and jaw and difficulty swallowing and breathing” about nine days after “she delivered a child at home, assisted by an unlicensed community childbirth assistant.”

She  was hospitalized for a month, during which time she had seizures and was on a mechanical ventilator to help her breath for a “prolonged” amount of time.

Fortunately, her baby didn’t also develop tetanus, even though the family refused a recommended dose of tetanus immunoglobulin that could prevent neonatal tetanus from developing.

Surprisingly, after this incident, only 12% of community members agreed to be vaccinated with a tetanus vaccine. One pregnant woman even refused to get vaccinated. This is even less than the response to the Ohio measles outbreak in 2014, when up to 28% of unvaccinated Amish members got vaccinated with an MMR vaccine.

Neonatal Tetanus

An 8-day old baby with neonatal tetanus born to an unvaccinated mother.
An 8-day old baby with neonatal tetanus born to an unvaccinated mother. (CC BY 3.0)

In addition to obstetric tetanus, getting tetanus during or right after a pregnancy, neonatal tetanus is a big concern for unvaccinated mothers. Just like if their mothers don’t get a flu or pertussis containing vaccine, without a tetanus vaccine, newborn babies don’t get any passive immunity and protection against tetanus.

In 2015, 34,019 newborns died from neonatal tetanus worldwide. Amazingly, that is down from 787,000 newborns in 1988 “through immunization of children, mothers, other women of reproductive age (WRA) and promotion of more hygienic deliveries and cord care practices.”

It is not all about hygiene though. Tetanus spores are everywhere. For example, in the Kentucky case, the CDC found no evidence of “birth trauma, unsterile conditions, or other complications.”

In Montana, the baby of an unvaccinated mother developed tetanus that was linked to a non-sterile clay that was given to them by a midwife for home umbilical cord care.

Fortunately, these kinds of cases are rare. There have probably been less than 40 cases of neonatal tetanus since the early 1970s, and only two since 1989, but they should still be a reminder of what could happen if we stop getting vaccinated.

Risky Umbilical Cord Practices

Adding to the risk of getting tetanus, the same moms who aren’t getting vaccinated and protected may be following unsafe umbilical cord care practices.

“…tetanus in neonates can result from umbilical cord colonization, particularly in countries with limited resources. This infection results from contamination of the umbilical separation site by Clostridium tetani acquired from a nonsterile device used to separate the umbilical cord during the peripartum period or from application of unhygienic substances to the cord stump.”

AAP – Umbilical Cord Care in the Newborn Infant – 2016

In countries that are still combating neonatal tetanus, we hear of mothers in rural areas  putting herbs, herbal pastes, chalk, powders, clay, oils, and even butter on their baby’s umbilical cord.

These natural substances are certainly not safer than more standard care, as they can be contaminated with something else that is natural – tetanus spores.

What natural things, and risky, things can you see recommended for umbilical cord care in developed countries? How about honey, goldenseal powder, Frankincense and myrrh oil, and Aztec Healing Clay?

You don’t feed honey to infants because of the risk of botulism spores, but you are supposed to put it directly on their umbilical stump?

Some midwifes even recommend ground rosemary or other dried herbs that you are actually supposed to sprinkle directly on your baby’s umbilical stump. The use of dried herbs is especially problematic. It is well known that these products are not sterile.

“Spore forming bacteria (B. cereus, C. perfringens) that are capable of causing foodborne disease when ingested in large numbers are frequently found in spices and herbs, but usually at low levels.”

Food Microbiology. Volume 26, Issue 1, February 2009, Pages 39–43

If dried herbs are also contaminated with tetanus spores (C. tetani), and you place them on an umbilical cord stump of a child whose mother wasn’t vaccinated against tetanus, then you unnecessarily increase the risk for neonatal tetanus.

Not that you would ever hear about this risk from anyone who pushes these practices or tells these moms to avoid getting vaccinated. What happened to informed consent?

And what happens as Andrew Wakefield‘s kids continue to grow up, move beyond getting measles, and begin to have kids? If they still aren’t vaccinated, they and their babies will be at risk for diseases that we thought we had gotten well controlled, like obstetric tetanus, neonatal tetanus, and congenital rubella syndrome.

Save

Hedda Get Bedda Doll and Other Measles Stories

Hedda Get Bedda originally came with a hospital bed.
The Hedda Get Bedda doll originally came with a hospital bed.

In the early 1960s, the American Character Doll Company produced a series of Whimsie dolls, including:

  • Annie the Astronut
  • Fanny the Flapper
  • Hilda the Hillbilly
  • Lena the Cleaner (baseball)
  • Samson the Strongman
  • Simon the Degree
  • Wheeler the Dealer (casino dealer)
  • Zero the Hero

Hardly politically correct for our times, the stereotyped dolls do provide a look at the history of their time.

One other doll, Hedda Get Bedda, is especially helpful in that sense.

Made in 1961, this Whimsie doll could change her face, letting you know how she was feeling when you turned the knob on her head. She could go from having a sleeping face, to a sick face (perhaps having chicken pox or measles), to a happy face (once you made her better).

Does the fact that she also came with a hospital bed mean anything?

Just like some anti-vaccine folks like to think that the simple fact that they made a doll that had measles or chicken pox could possibly mean that they looked at them as mild diseases, you could just as easily say that including the hospital bed means ‘they’ understand they were life-threatening diseases that could put land you in the hospital.

We are talking about the pre-vaccine era after all, and in 1961, and when the Hedda Get Bedda doll came out, there were about 503,282 cases of measles in the United States and 432 measles deaths.

Like the Brady Bunch measles episode, the Hedda Get Bedda doll is sometimes used to push the myth that vaccine-preventable diseases aren’t that serious, helping folks justify their decisions to intentionally skip or delay vaccines and leaving their kids unprotected.

“…for those trained in pediatrics in the 1970s, Hib (Haemophilus influenzae type b) was a horror.”

Walter Orenstein, MD

For example, if you believed that measles, chicken pox, or Hib were mild diseases, then you might feel better about not getting your child the MMR, chicken pox, or Hib vaccines.

Sure, many people get measles and do get better without any complications. On their way to getting better though, even they have high, hard to control fever for 5 to 7 days, with coughing and extreme irritability.

But while most get better, we shouldn’t forget that some people don’t survive measles without complications. Natural immunity sometimes comes with a price, from vision problems and permanent hearing loss to brain damage.

And tragically, some people don’t get to survive measles.

Get Educated. Get Vaccinated.

For More Information and Measles Stories