Vaccines Seek to Offer Cradle-to-Grave Protection

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Vaccines Seek to Offer Cradle-to-Grave Protection

By Dennis , HealthDay Reporter

Friday, August 29, 2008; 12:00 AM

FRIDAY, Aug. 29 (HealthDay News) -- Immunization shots used to be the

realm of the young.

Babies would go through series after series of vaccinations. And

toddlers would take their shots before entering preschool.

And they still do. But vaccines are now expanding to include all age

ranges, in an attempt to ward off disease from the cradle to the grave.

What's more, immunization rates continue to gradually improve in the

United States, although not as quickly as public health officials

would like.

About 77 percent of children 19 months to 35 months had received all

their recommended vaccinations in 2007, according to the U.S. Centers

for Disease Control and Prevention. It falls short of the federal goal

of 80 percent but is a small improvement over the 76 percent rate

found in 2005.

" We may have a little way to go, but that's not bad, " said Dr.

Weida, professor of family and community medicine at Penn State's

Hershey Medical Center. The government's next goal is 90 percent of

kids in that age range immunized by 2010.

Public health officials see these regular vaccinations as a wall

holding back terrible diseases that have plagued mankind for

centuries: measles, whooping cough, rubella, diphtheria, tetanus and

mumps, among others.

" Vaccines are probably one of the top two or three public health

interventions of all time, " said Dr. Doug Campos-Outcalt, associate

chairman of the Department of Family and Community Medicine at the

University of Arizona College of Medicine, Phoenix Campus. " They now

have been so successful, they suffer from their success, because

people don't see the diseases and the horrors associated with them. "

The immunization goals are part of an effort to ensure that even those

who don't receive vaccinations will be protected from disease by those

who do, Weida said.

" You get something called herd immunity, although I wish there were a

better name for it, " he said. " If you get enough people vaccinated,

even people who aren't vaccinated are protected, because the disease

can't transmit. The virus can't get past the wall of vaccinated people

we've created. "

Most of the biggest changes in the immunization schedule have targeted

preteens ages 11 to 12, Campos-Outcalt said.

There are new immunizations available for meningitis, human

papillomavirus (HPV), and tetanus/diphtheria/pertussis in that age

range, he said.

" It's kind of a coincidence, " Campos-Outcalt said. " Several vaccines

for that age group just kind of came up. "

The HPV immunization is unique in that it is the first vaccine that

can prevent a form of cancer. Girls are provided the vaccine to

prevent the spread of HPV, a sexually transmitted disease that can

result in cervical cancer.

The HPV vaccine has been somewhat controversial, with some religious

and conservative groups arguing that it promotes promiscuity.

" The issue is explaining the vaccine at a time when neither the child

nor the parent want to think about this, when the girl is still

preteen, " Weida said. " I say, 'This is to prevent cervical cancer, and

you have to receive it before you're infected.' "

Unfortunately, some vaccinations have been lagging in teenagers.

Researchers have found that immunization goals for children 13 to 17

have fallen short in all the recommended vaccines.

The problem is that most children enter public elementary schools,

where there are strict immunization requirements, Weida said. Not as

many go on to college, however, where they would face the same

requirements.

" There's not the same push if you're not going to college, so they

don't think about it, " Weida said.

Influenza is another disease receiving a huge immunization push from

public health officials. The flu vaccine soon will be recommended for

children through age 18, Campos-Outcalt said.

" I think eventually it will be universally recommended for everyone,

every year, " Campos-Outcalt said. " This is just an incremental step in

that direction. "

Weida agreed. " We need to do a better job at immunizing people against

flu, " he said. " Everyone over 50 should get one, and so should kids,

because we're discovering they're the reservoir for flu. They're in a

closed container called school, so they transmit it easily between

themselves, and then they bring that little present home. "

New vaccines also have been springing up for the elderly, specifically

immunization that provides protection against pneumonia and shingles.

To keep track of all these changes, Weida recommends that families

choose a doctor and stick with him or her.

" If my patients come in for a routine visit or a sick visit, I'll look

at their immunization record, " he said. " You're not going to get that

so much if you're bouncing around from provider to provider, because

they're not going to have the record. "

A more promising means of making vaccination easier is the movement

toward creating nasal or oral vaccines, Campos-Outcalt said. A nasal

flu vaccine already has been produced, and others are on the way.

A widespread belief that some childhood vaccines are linked to autism

has hampered improvement of the vaccination rate, despite numerous

studies that have disproved the claim.

It has become a great source of frustration among public health

experts, Campos-Outcalt said.

" To me, it's kind of puzzling, " he said. " The evidence is becoming

clearer every day that vaccines do not cause autism. But there are

some very stubborn groups out there who still make that claim. "

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