They are talking about an article from 2001, The Role of Public Health Improvements in Health Advances: The 20th Century United States, by David Cutler, which found that “clean water was responsible for nearly half of the total mortality reduction in major cities, three-quarters of the infant mortality reduction, and nearly two-thirds of the child mortality reduction.”
Did the Measles Vaccine Have Only a Meager Effect on Deaths?
What are they missing?
“In the early 20th Century, mortality in the United States declined dramatically. Mortality rates fell by 40% from 1900 to 1940, an average decline of about 1% per year”
Cutler on The Role of Public Health Improvements in Health Advances: The 20th Century United States
Most of the decline the article talks about came at the beginning of the 20th Century, before these vaccines were developed.
What about the vaccines for whooping cough, diphtheria, and tetanus, which were developed in the earlier part of the 20th Century? They weren’t routinely used until much later. Remember, the individual diphtheria, tetanus, and pertussis vaccines didn’t even become combined into a single DTP vaccine until 1948.
But, all of these diseases that are now vaccine preventable were still very deadly in the 1940s and 1950s, even with clean water and sanitation.
At least they were until the measles vaccine was discovered and more and more people started getting vaccinated and protected.
You can even ask the author of the article in question…
“Dear Lord. The fact that vaccines aren’t the only reason why mortality declines in no way means that vaccines are not an important reason why mortality declines.”
David M Cutler, Harvard College Professor, Otto Eckstein Professor of Applied Economics
The idea that the measles vaccine had only a relatively meager effect on deaths due to measles infections is silly. It’s also dangerous if you believe it and leave your kids unvaccinated and at risk to get measles, which is clearly a deadly disease.
Benjamin Franklin later wrote in his autobiography that:
“In 1736 I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way. I long regretted bitterly, and still regret that I had not given it to him by inoculation. This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it; my example showing that the regret may be the same either way, and that, therefore, the safer should be chosen.”
Fortunately, not all of the stories are quite so tragic.
“The doctors told my parents that little could be done for me, so my father prepared for my funeral. Fortunately, I recovered, except for the use of my right hand.”
Archbishop Desmond Tutu on Vaccination’s Lifetime of Blessings
John Salamone – probably the only real pro-safe vaccine advocate there has been, as he fought to replace the OPV vaccine with the IPV vaccine, to prevent further cases of VAPP, like had happened to his son
And there are other fathers to recognize on Father’s Day.
As we wish a Happy Father’s Day to all dads, please take some time to take some time to learn why getting your kids vaccinated and protected is the best choice, because the overwhelming evidence shows that vaccines are safe and necessary.
“Well, here are the numbers. And the numbers change every year. I think in 2012, there were 185 million doses of flu doses manufactured in this country. And I think fewer than 10 million were thimerosal-free. Over 90 percent had huge, huge doses of mercury.”
An interview with Robert Kennedy Jr. on vaccines
Huge, huge doses of mercury?
Although it was never actually linked to any significant side effects, as a “precautionary measure,” the AAP recommended that thimerosal (mercury) be removed from childhood vaccines in 1999.
Thimerosal was removed from the hepatitis B, DTaP, and Hib vaccines, the only routinely used, non-flu vaccines that ever had thimerosal, in 2001. It is important to note that thimerosal-free versions of the DTaP and Hib vaccines were already available in the late 1990s though.
By January 2003, remaining stocks of vaccines with thimerosal expired.
Also in 2003, thimerosal-free flu vaccines became available, including thimerosal-free flu shots and FluMist, the nasal spray flu vaccine.
Is he right about the number of thimerosal-free flu vaccines in 2012?
Let’s do the math.
Ever since thimerosal-free flu vaccines became available in 2003, the supply has increased each year.
2007-08: 112 million doses, with 10-12 million doses of thimerosal-free flu vaccine from Sanofi Pasteur, 7 million doses of thimerosal free FluMist, plus Afluria was thimerosal-free, and flu vaccines with trace thimerosal from Novartis and GSK
2008-09: 110 million doses, with 50 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine and only 25% infants and toddlers are fully vaccinated against flu
2009-10: 114 million doses, with 50 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine
2010-11: 155 million doses, with 74 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine
2011-12: 132 million doses, with 79 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine
2012-13: 134 million doses, with 62 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine, including 13 to 14 million doses of FluMist. While 76% of infants and toddlers were vaccinated, only 50% of pregnant women got a flu shot.
2013-14: 134 million doses, with 62 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine. 13 million doses of FluMist.
2014-15: 147 million doses, with 98 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine. 14 to 15 million doses of FluMist.
2015-16: 146 million doses, with 116-118 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine
2016-17: 145 million doses, with 120 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine
2017-18: 155 million doses, with 130 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine
So Kennedy was wildly wrong about the number of thimerosal-free flu vaccines that were available in 2012. And he is certainly wrong about the number of thimerosal-free flu vaccines that are available today.
“Over 90 percent had huge, huge doses of mercury. Not trace amounts as the industry likes to claim. Trace amounts means less than 1 microgram. They contain 25 micrograms, which is 25 times trace amount and over 100 times what EPA’s safe exposure levels are. … So today, in the last three or four years, that number has been reduced to 48 million.” Which number has been reduced to 48 million?
“I believe this year there were 150, around 150 million flu doses manufactured and 48 million of those, or a third, were loaded with mercury.”
An interview with Robert Kennedy Jr. on vaccines
What about his theory about the way the “industry” uses the term trace amounts?
There has never been a conspiracy to hide the thimerosal content of flu shots or any other vaccines. Those with trace amounts of thimerosal clearly have less than or equal to 1mcg per dose. Others were either thimerosal free or contained a standard amount of thimerosal, 25mcg.
Not surprisingly, this isn’t the first time Kennedy has tried to mislead people about vaccines.
“There is no question that meningococcal meningitis is a serious disease that can cause death and disability, but we need to ensure that the solution is not worse than the problem. There is every reason to believe that mandatory meningococcal B vaccines for every college student could kill more students than the disease they protect against. Before we relinquish our rights, pay millions and sicken students, we should do the math.”
Robert F. Kennedy, Jr.: Doing the math on meningitis vaccinations
A few years ago, Kennedy responded to a resolution that had been passed by the University of Colorado-Boulder student government about new meningococcal B vaccines.
For some reason, he devoted a good deal of time talking about the “hefty mercury load” that kids could get from Menomune, a vaccine that doesn’t cover the meningococcal B strain and which has largely been replaced by the newer Menactra (2006) and Menveo (2010) vaccines. In fact, Menomune was discontinued last year.
What to Know About Robert F Kennedy, Jr
Kennedy seems to mislead people about thimerosal and vaccines at every opportunity he can.
We have come a long way since the development of the first measles vaccines in the early 1960s…
Pre-Vaccine Era Measles Outbreaks
In the pre-vaccine era, measles was a very common childhood disease.
As it is now, it was also a deadly disease.
In the 1950s, there were 5,487,332 cases (just under 550,000 a year) and 4,950 deaths (about 500 each year).
In 1962, there were 469,924 cases of measles in the United States and 432 deaths.
Post-Vaccine Era Measles Outbreaks
The first measles vaccines were licensed between 1963 and 1965, but it was the first national measles eradication campaign in 1966 that got people vaccinated and measles rates down.
In 1970, there were only 47,351 cases and 89 deaths.
Rates continued to drop until the large outbreaks between 1989 to 1991, when there were 55,622 cases and 123 deaths. The addition of a measles booster shot got measles outbreaks under control again. By 2000, when measles was declared eliminated in the United States, there were just 86 cases and one death.
Post-Elimination Era Measles Outbreaks
Declaring measles eliminated in the United States didn’t mean that we didn’t have any more measles, after all, it hasn’t been eradicated yet. It just that we are no longer seeing the endemic spread of measles. Since 2000, all of the latest measles outbreaks have been imported from outside the country, or at least they are started by cases that are imported.
We have seen more than a few records in the post-elimination era, including:
the year with the historic low number of measles cases – 37 cases in 2004
the year with the largest number of cases since 1994 – 667 cases in 2014
the largest single outbreak since the endemic spread of measles was eliminated – 377 cases in Ohio in 2014
In 2015, we got a reminder of how deadly measles can be. Although there have been other measles deaths and SSPE deaths in the past ten years, unlike the 2015 death, they are usually buried in CDC reports and aren’t published in the newspaper.
2017 Measles Outbreaks
The first new case of 2017 was an unvaccinated adult in San Luis Obispo County, California who was exposed to international travelers over the holidays. The person exposed others to measles at the Twin Cities Community Hospital emergency department in Templeton while contagious in early January.
The second case of 2017 was related to an LA county outbreak that started at the end of 2016 – a resident of Ventura County.
And it went on, with other measles cases in 2017 including:
at least 122 cases
cases in 16 states, including California, Florida, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Utah, and Washington
an infant in San Luis Obispo County that was too young to be vaccinated and who had contact with an unvaccinated adult with measles
one new case in the Los Angeles County outbreak, which is now up to 20 confirmed measles cases (including 18 in LA County), all unvaccinated
four new cases in Ventura County, California that are linked to another Ventura County measles case and the LA County outbreak, which is now up to 24 cases
a case in Jersey City, New Jersey following international travel who exposed people at multiple places, including a hospital, pharmacy, mall, and on a commuter train
an unvaccinated 7-month-old baby from Passaic County, New Jersey who had been traveling out of the country and may have exposed others at area hospitals (a good reminder that infants who are at least 6 months old should get an MMR vaccine before leaving the country)
two cases in Salt Lake County, Utah – which began in a resident who had “received all appropriate vaccinations” and developed measles after traveling outside the US and then spread to another person “who had contact with the first case.” According to the SLCoHD, “One of the two individuals with measles had received one MMR vaccine.”
two cases in King County, Washington – a man and his 6-month-old infant, both unvaccinated, developed measles after traveling to Asia, and exposed many others around Seattle, including at a Whole Foods, a sandwich shop, their apartment building, and two Amazon buildings.
a confirmed case in Omaha, Nebraska, who exposed people on a Delta flight and multiple places in Douglas and Sarpy counties, including the Bergan Mercy Hospital Emergency Room.
two children in Minnesota without a known source of infection
another child in Minnesota – among the three Somali Minnesotans in this outbreak are two children who are just two years old – all of the cases were unvaccinated and two required hospitalization, although the common source is still not known. Vaccine hesitancy has been a problem among the Somali Minnesotans because of Wakefield‘s MMR study.
five more unvaccinated children in Minnesota, as the outbreak grows to 8.
a confirmed case in North Platte, Nebraska who may have exposed others at a middle school, church youth group, the Great Plains Health Emergency Room, a medical office, and a lab.
a resident of Livingston County, Michigan who exposed others at area restaurants and St. Joseph Mercy Brighton Hospital after getting measles on a plane ride with an unvaccinated child
another case in Minnesota, bringing the outbreak count to 9 unvaccinated children.
three more cases in Minnesota, bringing this outbreak case count to 12, with at least 200 people in quarantine.
eight more cases in Minnesota, bringing this outbreak case count to 20 young children under age 5 years, and now including an infant under age 12 months.
four more cases in Minnesota, bringing this outbreak case count to 24 young children under age 5 years and surpassing the size of the 2011 measles outbreak in the Somali community in the same area, which was also mostly among intentionally unvaccinated children.
five more cases in Minnesota, including the first outside of Hennepin County – spreading to nearby Stearns County, bringing this outbreak case count to 29 young children under age 5 years, with only one that was vaccinated.
three more cases in Minnesota, as the outbreak spreads to the third county – Ramsey County.
more measles (2 new cases) in Minnesota (Hennepin County, Ramsey County, Crow Wing County, and now Le Sueur County), where the ongoing outbreak is up to 66 cases, almost all unvaccinated children and where there has been a call to accelerate the two dose MMR schedule for kids over age 12 months.
a child in Maryland who was admitted to Children’s National Medical Center in Washington, D.C.
more measles (3 new cases) in Minnesota (Hennepin County, Ramsey County, Crow Wing County, and Le Sueur County), where the ongoing outbreak that has been confirmed to be from the wild type B3 strain is up to 68 cases, almost all unvaccinated children.
a case in Pennsylvania who exposed others at a visitor center
someone who visited the MIT Museum in Cambridge, Massachusetts.
two new cases in Minnesota, ending speculation that the outbreak, now up to 70 cases, was over…
one new case in Minnesota, raising the number of cases in this ongoing outbreak to 78 cases.
a healthcare worker in New York who is employed by Hudson Headwaters Health Network and also works at a Warren County medical practice.
someone in Franklin County, Maine (their first case in Maine in 20 years!) who traveled out of the country and caught measles, returning home and possibly exposing others at a movie theater, restaurant, farmers market, and hospital.
A case in Butler County, Kansas. Many remember that one of the largest outbreaks of 2014 was in Kansas.
an unvaccinated man who lives in Hennepin County, raising the number of cases in this ongoing outbreak (an outbreak that has already cost over $500,000 to contain and which many hoped would soon be over) that started in March to at least 79 cases. With the new case, the clock starts ticking again and Minnesota will have to wait to see if new cases appear over the next 3 weeks.
passengers from 13 states on an American Airlines flight from New York to Chicago were exposed to a person with measles in early July, including a 12-week-old infant who required preventative treatment with immune globulin (IG), as she was too young to be vaccinated.
a fully vaccinated resident of Onondaga County, New York who was exposed on a domestic flight, only developed mild symptoms, but did expose others.
someone who exposed others at the Penn State University Hetzel Union Building Bookstore and other places in State College, Pennsylvania.
a second case in the Wichita, Kansas area, this time in Sedgwick County, with exposures at a church, dental office, elementary school, and multiple stores over at least 3 days.
a possible case in Sedgwick County, Kansas, a child too young to be vaccinated who may have been exposed at a church. Three other exposed infants who were too young to be vaccinated and who were considered at risk to get measles in this outbreak received immunoglobulin treatment.
a traveler who spent time in Hampton Beach in New Hampshire, exposing others.
a 46-year-old male in Ohio that got the disease while traveling internationally.
2017 would have been a mild year for measles, except for the really big outbreak in Minnesota… 79 people got measles, 71 were unvaccinated, more than 500 people were quarantines, and the outbreak cost over $1.3 million to contain.
2016 Measles Outbreaks
Starting slow, 2016 ended as a fairly average year for measles:
cases in 17 states, including Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, Tennessee, Texas, and Utah
a large outbreak in Arizona, 23 cases, linked to a private detention center
a large outbreak in Shelby County, Tennessee, at least seven cases, including six unvaccinated and one partially vaccinated child
a case in Colorado in which an unvaccinated adult traveled internationally and ended up exposing many people “from Dec. 21 to 29, 2016, who was at a wide variety of locations in the Denver-Boulder area,” including an Urgent Care center and the Parker Adventist Hospital Emergency Department
As in other years, many of these outbreaks involved unvaccinated children and adults. One case involved a child at the Yuba River Charter School in California, a Waldorf School with very high rates of unvaccinated children.
2015 Measles Outbreaks
With a large outbreak in California, 2015 got off to a very strong start.
Most concerning, more and more, cases don’t seem to have an source that is easy to find, which could mean that the endemic spread of measles has returned in the United States. So instead of having to travel out of the country or be exposed to someone who got measles with a link to international travel, you could get measles just by going to a ball game, a movie theater, or to Disneyland. That makes it more important than ever to learn how to avoid measles.
Among the 189 measles cases and outbreaks in 2015 were:
113 cases that were associated with a multi-state outbreak that was linked to Disneyland in California. Before it was declared over on April 17, a few unvaccinated travelers also help spread measles from this outbreak to large outbreak in Quebec, Canada. All in all, the outbreak was linked to at least 113 cases in California and an additional 169 cases in Arizona (5), Nebraska (1), Utah (3), Colorado (1), Washington (2), Oregon (1), Mexico (1), and Canada (155).
13 cases, including an adult worker and 12 infants too young to be vaccinated at the KinderCare Learning Center in Illinois.
At least 13 cases, all intentionally unvaccinated, in a South Dakota outbreak that started with an unvaccinated adult traveling to India.
Five cases in Clallam County, Washington, including four who were not vaccinated, which cost at least $36,000 to contain and led to the death of an immunosuppressed woman.
In addition to these large outbreaks, 2015 also saw a number of quarantines for unvaccinated students, closing of daycare centers, and a recommendation from a California Department of Health state epidemiologist that people who are not vaccinated against measles “avoid visiting Disney” and “crowded places with a high concentration of international travelers, such as airports.”
Other measles cases in 2015 include:
A student at UC Berkeley who may have exposed others to measles on a public bus.
A confirmed case in Fairbanks, Alaska – their first case in 15 years, who flew in from Seattle (and is probably the King County case discussed below) and may have exposed others at an area Walmart, Home Depot, Walgreens, several supermarkets, the airport, and hospital, etc.
A confirmed case in King County, Washington, who may have exposed others in Seattle, including at an area McDonalds, the Baroness Hotel, a drug store, and the Sea-Tac Airport.
A confirmed case in Branson, Missouri, a traveler from Asia, who was contagious when visiting the ER, three local businesses, and perhaps his flight to town.
A confirmed case in the Washington D.C. area.
Another case of measles in Spokane County, Washington – an unvaccinated person that was exposed to the other case in the area.
An unvaccinated student from Europe in Boston, Massachusetts who also traveled to Maine and New Hampshire.
Another unvaccinated child in St. Lucie County, Florida – bringing the total to five cases in central Florida in what so far looks like two separate outbreaks.
Another case in Indian River County, Florida – an unvaccinated child.
An unvaccinated adult in Spokane, Washington – the first case in the area since 1994.
Two unvaccinated adults in Indian River County, Florida, one of whom contracted measles while traveling out of the country.
An unvaccinated 6-year-old in St. Lucie County, Florida who attended Fairlawn Elementary School in Fort Pierce – leading to five unvaccinated students being kept out of school until early May.
The first case in Oklahoma since 1997, a case in Stillwater.
A case in Florida, a traveler who was contagious while attending a conference at the Gaylord Palms Resort and Convention Center and also in Maimi-Dade, Orange, and Sarasota counties.
A new case in Illinois, the 15th – and so far not linked to the other two outbreaks in the state.
A student at Princeton University in New Jersey.
Another case of measles in the Washington D.C. area, a case without a known source.
A case in a student at Elgin Community College in Kane County, Illinois.
A hospitalized infant in Atlanta, Georgia.
An unvaccinated 1 year old in Jersey City, New Jersey.
A traveler in King County, Washington that may have exposed others in Seattle. The unvaccinated visitor is from Brazil, where there was a large outbreak of measles last year (almost 400 cases).
At least one more case in Clark County, Nevada and four more possible cases in Southern and Northern Nevada, which led to the quarantine of at least 11 students at the Spanish Springs Elementary School.
A case in Franklin County, Pennsylvania.
Four cases of measles in travelers, including two international travelers, who visited Florida.
A case in Washington D.C.
A student at Bard College in Dutchess County, New York, who exposed many people while traveling on an Amtrak train to Penn Station in New York City.
An unvaccinated woman in New Castle County, Delaware who had recently traveled out of the country.
A case on the University of Minnesota Twin Cities campus in a student that had recently returned from out of the country. Although others were exposed, it is considered to be a “highly immunized” population, so hopefully the outbreak won’t spread.
Two more cases in Arizona that are tied to the Disneyland outbreak, including a woman in Phoenix who may have exposed others up to 195 children at the Phoenix Children’s East Valley Center, including a 3-year-old getting chemotherapy for leukemia.
An adult in Cook County, Illinois which in not linked to Disneyland.
A student at Valley High School in Las Vegas which led to the quarantine of 36 unvaccinated students until early February.
Four cases among an unvaccinated family in Kearny, Arizona that is directly linked to the Disneyland outbreak.
A child in Sioux Falls, South Dakota that is unrelated to 13 recent cases in the area and which has no link to travel out of the area.
A new case in Oakland County, Michigan that is likely linked to the Disneyland measles outbreak, meaning that the outbreak has now spread to include 7 states and 2 countries.
A case in Maricopa County, Arizona has been linked to the Disneyland outbreak.
A person in Nebraska who could have exposed others in Omaha and Blair, including at the Omaha Children’s Museum.
A case in Lane County, Oregon that has been linked to the Disneyland measles outbreak.
A resident of Tarrant County in North Texas who developed measles after a trip to India.
Another unvaccinated person in Utah with links to the Disneyland outbreak has tested positive for measles, bringing the total in that state to 3 cases.
In addition to the 36 measles cases that have been associated with the Disneyland outbreak, California already has 5 additional measles cases this year with no link to Disney, including cases in Alameda, Orange, and Ventura Counties.
Typhus and typhoid have both been in the news recently.
Texas officials issue alert about typhus threat
Typhoid: Two children die‚ 60 ill after drinking from contaminated stream in South Africa
Should you start panicking?
Of course not.
While neither is usually a threat to most people in developed countries, instead of panicking, get educated and learn how you can prevent these still common infections.
Epidemic typhus fever is spread by human body lice (not head lice!) that are infected with the Rickettsia prowazekii bacteria.
Symptoms of typhus fever can include the sudden onset of:
muscle aches (myalgias)
not feeling well (malaise)
Some patients develop a characteristic rash made up of small red spots (macules) that start on the upper trunk. It then spreads to the rest of the body, but spares the face, palms, and soles. The rash can eventually become petechial.
Untreated, the fever may last up to two weeks, followed by a slow recovery of two to three months for all of the other symptoms. Typhus fever can be fatal.
Fortunately, treatment is available – the antibiotic doxycycline.
How do you prevent epidemic typhus fever? You avoid body lice. And avoid flying squirrels, which can be infected with Rickettsia prowazekii bacteria.
Is typhus fever vaccine-preventable? No, although a typhus vaccine was once available, it was discontinued in 1979.
Keep in mind that in addition to epidemic typhus, which is now very rare, typhus can also be spread by fleas (murine typhus) and chiggers (scrub typhus).
Murine or endemic typhus is common in tropical and subtropical climates, where it is spread by rats and fleas. In the United States, it is mainly found in California, Hawaii, and Texas, where it has also been associated with cat fleas found on cats and opossums.
Scrub typhus is associated with chiggers in rural areas of Southeast Asia, Indonesia, China, Japan, India, and northern Australia.
Although typhus and typhoid some very similar, there are some big differences between these two diseases.
What are they?
Unlike typhus, typhoid fever is:
caused by the Salmonellatyphi bacteria
spread by ingesting contaminated food and water
characteristic by symptoms that include a gradual onset of fever, with stomach aches, headache, loss of appetite, and sometimes a rash.
But few likely now that we have had rabies vaccines since 1885, a flu vaccine since 1945, or that the last case of wild polio in the United States was in 1979.
“It is hard to fully appreciate how vaccines have revolutionized modern medicine. The long schedule of vaccines may seem like a hassle, and rumors about harmful effects unnerve parents. But, the fact is, vaccines have helped save millions and millions of lives. Just a few generations ago, people lived under the constant threat of deadly infectious diseases, like smallpox, polio, and hepatitis.
Let’s look at the greatest infectious scourges of the past 1,000 years and how vaccines have mitigated or even eradicated the danger.”
Public Health Understanding Vaccines
From historical safety concerns, like the Cutter Incident in 1955 or the withdrawal of the first rotavirus vaccine in 1999, to improvements in vaccine safety and the control, elimination, and eradication of vaccine-preventable diseases, understanding the history of vaccines can help you get educated and understand that vaccines work and that they are safe and necessary.
Early History of Vaccination
In the early history of vaccination we had the the smallpox vaccine and the beginning of the pre-vaccine era – the first vaccines.
Lady Mary Wortley Montagu brings variolation to England to prevent smallpox
George Washington mandated that every soldier in the Continental Army had to be inoculated against smallpox
Edward Jenner conducts experiments in 1796 that led to the creation of the first smallpox vaccine a few years later and replaces variolation as a preventative for smallpox
*Dr. Luigi Sacco becomes the Jenner of Italy
James Madison, one of the Founding Fathers, signed the Vaccine Act of 1813 – An Act to encourage Vaccination.
a vaccine for rabies is developed by Louis Pasteur in 1885
vaccines for cholera and typhoid were developed in 1896 and a plague vaccine in 1887
the first diphtheria vaccine is developed in about 1913 through the work of Emil Adolf Behring, William Hallock Park, and others
the first whole-cell pertussis vaccines is developed in 1914, although it will take several decades before they are more widely used
a tetanus vaccine is developed in 1927
12 children die when a multi-use bottle of diphtheria vaccine that didn’t contain a preservative became contaminated with bacteria in the Queensland Disaster in 1928
Max Theiler develops the first yellow fever vaccine in 1936
the AAP formally approves the use of a pertussis vaccine created by Pearl Kendrick and Grace Eldering in 1943
the first flu vaccine is licensed for use in the US in 1945
End of the Pre-Vaccine Era
In the mid-20th century, we started to get vaccines to control diseases that many of us have never seen, like polio, measles, and rubella.
the individual diphtheria, tetanus, and pertussis vaccines become combined in a single DTP vaccine in 1948
the last smallpox outbreak in the United States kills one person, Lillian Barber, in the Rio Grande Valley of South Texas in 1949
the Salk inactivated polio vaccine (IPV) is introduced in 1955
President Dwight D Eisenhower signed the Polio Vaccination Assistance Act in 1955, which gave $30 million in federal grants to states to cover the costs of planning and conducting polio vaccination programs, including purchasing polio vaccine
about 200 children develop polio in 1955 from contaminated polio vaccines in what becomes known as the Cutter Incident
the live, oral Sabin polio vaccine (OPV) replaces the Salk polio vaccine in 1962
President John F Kennedy signed the Vaccination Assistance Act in 1962 (Section 317 of the Public Health Service Act), which started as a three year program to help get kids vaccinated against polio, diphtheria, tetanus, and pertussis, but it has been continuously reauthorized ever since
the first live measles vaccine was licensed in 1963 but was replaced with a further attenuated measles virus that caused fewer side effects in 1968
President Lyndon B Johnson established a legacy of US leadership in global immunization by funding the CDC Smallpox Eradication program in 1965
the MMR vaccine becomes available in 1971, combined the vaccines for measles, mumps (licensed in 1967), and rubella (1969), and was routinely given when toddlers were about 15 months old
routine vaccination with smallpox vaccines end in the US in 1972
The Vaccination Era
The end of the 20th century brought more vaccines and protection against even more now vaccine preventable diseases.
Pneumovax, the first pneumococcal vaccine that protects kids and adults from certain types of Streptococcus pneumoniae bacteria is approved in 1971 and is given to high-risk kids
President Jimmy Carter’s National Childhood Immunization Initiative in 1977 reached its goal of immunizing 90% of children
the Thirty-Third World Health Assembly declares that smallpox is eradicated in 1979
Menomune, the first meningococcal vaccine is licensed in 1981 and is recommended for high-risk kids until it is later replaced by Menactra
a plasma-derived hepatitis B vaccine is licensed in 1981
a Haemophilus b capsular polysaccharide vaccine is licensed in 1985, but unfortunately does not provide good protection in kids younger than 18 to 24 months, who are most at risk for Haemophilus influenzae Type b disease
a recombinant hepatitis B vaccine (Recombivax HB) is approved in 1986 but is only recommended to be used in those at high risk for infection
another hepatitis B vaccine, Engerix-B, is approved in 1989
the first Haemophilus b conjugate vaccine (PRP-D) is approved in 1988 to provide protection against Haemophilus influenzae type b disease in all kids at least 18 months old, but in 1990, they are replaced with two improved Hib conjugate vaccines (PRP-HbOC and PRP-OMP) that can be given to infants as young as two months old
a booster dose of MMR is first recommended in 1989, but only for kids who live in counties that have at least 5 cases of measles. The routine 2 dose MMR schedule wasn’t put into use for all kids until 1994.
the Vaccine Adverse Events Reporting System (VAERS) is established in 1990
the hepatitis B and Hib vaccines are recommended for all infants in 1991
after year’s of neglect under President Reagan, President George HW Bush’s immunization action plan in 1991 once again raised immunization rates following three years of measles outbreaks
the DTaP vaccine, which is supposed to have fewer side effects than DTP is licensed, and by 1997 replaces DTP for all required doses, although DTP is never actually shown to have caused seizures or brain damage, as was once claimed in Vaccine Roulette
President Bill Clinton’s Childhood Immunization Initiative in 1993 includes signing the Vaccines for Children (VFC) Act, providing free vaccines to many children
the WHO declares that polio has been eliminated from the Western Hemisphere in 1994
a vaccine to protect kids against chicken pox (Varivax) is licensed in 1995
VAQTA, the first hepatitis A vaccine is approved by the FDA in 1996 for kids who are at least two years old, but is mainly given to kids at high risk to get hepatitis A
the Salk inactivated polio vaccine (IPV) is once again recommended for kids and replaces the oral polio vaccine (OPV) in 1996 because of a small risk of vaccine-associated paralytic poliomyelitis (VAPP), beginning with a sequential IPV-OPV vaccine schedule and then going to an all IPV schedule in 2000
RotaShield, the first rotavirus vaccine is licensed in 1998 but is soon withdrawn from the market in 1999 after it is associated with an increased risk of intussusception, a form of bowel obstruction
LYMErix, a Lyme disease vaccine, is licensed in 1998
Dr. Andrew Wakefield publishes a report in the journal Lancet and attempts to link the MMR vaccine to autism
thimerosal is removed from the vast majority of vaccines in the childhood immunization schedule in 1999 and 2000
endemic measles is declared eliminated in the United States in 2000
Prevnar, a newer pneumococcal vaccine is licensed in 2000 and is added to the immunization schedule the next year
LYMErix goes off the market because of insufficient sales in 2002
Flumist, a live, intranasal flu vaccine, is approved in 2004
endemic rubella is declared eliminated in the United States in 2004
a flu shot for all healthy children between 6 and 23 months became a formal recommendation for the 2004-05 flu season.
beginning in the 2004-05 flu season, a flu shot is recommended for women who will be pregnant during flu season, in any trimester, which is different than previous recommendations for a flu vaccine if a women was going to be beyond the first trimester of pregnancy during flu season. Unfortunately, even though they are in a high-risk category, only about only 13% of pregnant women received a flu vaccine in 2003.
Havrix, another hepatitis A vaccine, is approved in 2005 and the age indication for both hepatitis A vaccines is lowered to 12 months.
Menactra, a vaccine to protect against certain types of meningococcal disease is licensed in 2005 and is added to the immunization schedule in 2006, being recommended for all at 11 to 12 years of age or when they enter high school
the Tdap vaccine (Boostrix or Adacel) is recommended for teens and adults to protect them from pertussis in 2006 and replaces the previous Td vaccine that only worked against tetanus and diphtheria
RotaTeq, another rotavirus vaccine, is licensed in 2006, and is added to the immunization schedule in 2007
the hepatitis A vaccine is added to the routine childhood immunization schedule in 2006
a 2nd booster dose of the chicken pox vaccine is added to the immunization schedule in 2007 to help prevent breakthrough infections
The Post Vaccination Era
Why call it the post-vaccination era?
It has been some time since a vaccine for a new disease has been added to the routine vaccination schedule, but we are also starting to see more and more outbreaks of old diseases, especially pertussis, mumps, and measles.
another rotavirus vaccine, RotaRix, is approved in 2008
another HPV vaccine, Cervarix, is approved in 2009
Gardasil is approved for use in males in 2009
another meningococcal vaccine, Menveo, is approved in 2010
a newer version of Prevnar, which can provide coverage against 13 strains of the pneumococcal bacteria, is approved and replaces the older version (Prevnar 7) in 2010
Fluzone Intradermal and Fluzone High-Dose are two new flu vaccine options that became available in 2011
a combination vaccine that protects against both Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y was approved by the FDA in 2013. MenHibrix is recommended for infants at high risk for meningococcal disease.
Quadrivalent flu vaccines, which protect against four strains of flu, become available for the 2013-14 flu season
Trumenba, the first vaccine to protect against serogroup B Meningococcal disease is approved by the FDA (October 2014). Previously, Bexsero, a MenB vaccine that is approved in some other countries, was given to some college students during outbreaks under the FDA’s expanded access program for investigational products. Both are now recommended by the ACIP for those at increased risk for meningococcal serogroup B infections.
Gardasil 9 is approved by the FDA (December 2014) to provide protection against five additional types of HPV.
Cervarix is discontinued in the US in 2016 because of poor sales
Vaxchora is approved to in 2016 for adults traveling to cholera-affected areas
MenHibrix is discontinued in the US in 2016 because of low demand
Menomune is discontinued in the US in 2017 as it was long ago replaced by the new meningococcal vaccines Menactra and Menveo