Vaccination programs

Preventive medicine through vaccination continues to be the most cost-effective pubHc health practice, even with the drastic advance in modern medicine. Mass vaccination programs have eradicated smallpox from the earth. The World Health Organization (WHO) has a major campaign underway to eradicate poHo by the year 2000. The development of vaccines has saved millions of Hves and prevented many more from suffering. However, there are stiU many diseases without effective vaccines, such as malaria. With the recent emergence of antibiotic-resistance strains and exotic vimses, an effective vaccine development program becomes a top priority of pubHc health poHcy. 

Rotavirus. Rotavims causes infant diarrhea, a disease which has major socio-economic impact. In developing countries it is the major cause of death in infants worldwide, causing up to 870,000 deaths per year. In the United States, diarrhea is stiU a primary cause of physician visits and hospitalization, although the mortaUty rate is relatively low. Studies have estimated a substantial cost benefit for a vaccination program in the United States (67—69). Two membrane proteins (VP4 and VP7) of the vims have been identified as protective epitopes and most vaccine development programs are based on these two proteins as antigens. Both Hve attenuated vaccines and subunit vaccines are being developed (68). 

Asia. In contrast, developed parts of the world including Australia, parts of western and northern Europe, Japan, and the United States have a lower prevalence. This is primarily due to vaccination programs, but outbreaks still can happen as evidenced by an outbreak in Pennsylvania in 2003.2,3... 

In areas without existing hepatitis A vaccination programs, catch-up vaccination of children ages 2-18 years can be considered,... 

HepA is recommended for certain other groups of children, including in areas where vaccination programs target older children. SeeMWM// 2006 55(No. RR-7) 1—23. 

The last known naturally occurring case of smallpox occurred in Somalia in 1977. In May 1980, the World Health Assembly certified that the world was free of naturally occurring smallpox. By the 1960s, because of vaccination programs and quarantine regulations, the risk for importation of smallpox into the United States had been reduced. As a result, recommendations for routine smallpox vaccination were rescinded in 1971. In 1976, the recommendation for routine smallpox vaccination of health-care workers was also discontinued. In 1982, the only active licensed producer of vaccinia vaccine in the United States discontinued production for general use, and in 1983, distribution to the civilian population was discontinued. All military personnel continued to be vaccinated, but that practice ceased in 1990. Since January 1982, smallpox vaccination has not been required for international travelers, and International Certificates of Vaccination forms no longer include a space to record smallpox vaccination. 

Scientists differed as to which method provided the better vaccine. Both Salk and Sabin agreed that more tests were needed before a mass vaccination program could begin. 

Source Center for Disease Control and Prevention. VFC Approved Vaccines and Biologjcals. www.cdc.gov/vaccines/programs/vfc/parents/apprvd-vaccs.htm [accessed September 8,2007]. 

The committee cautioned that the report offers a strategic framework and blueprint for change, not an immediate roadmap or next steps plan. The third recommendation called for a public process of stakeholder deliberations to explore the full implications of the proposal and address technical design issues. The lOM recommended that the National Vaccine Program Office (NVAC) of the U.S. Centers for Disease Control convene a series of regional and national meetings with the major stakeholders and others to rehne the recommendations and develop plans for implementation. 

Hinman, A. 2004. Institute of Medicine Report on Financing Vaccines in the 21st Century National Vaccine Advisory Committee/National Vaccine Program Office Response. AvaUable at www.hhs.gOv/nvpo/nvac/NVAC-IOM100604.htm. 

Prophylaxis against relapses of rheumatic fever (secondary prevention of rheumatic heart disease) is discussed in Section II of this chapter. In most developed countries, national vaccination programs with vaccines against diphteria and Haemophilus influenzae type b have virtually eliminated the complications of diphteria and acute epiglottitis. 

Priority, organization, and program the elevation of all vaccine development activity (including both biological warfare defense and infectious diseases) to Acquisition Category 1 priority the use of a combination of industry incentives, prime systems contractor, and COCO to achieve the production of several vaccines and the establishment of an 8-vaccine program, scaled down... 

Cohen, W., Implementation of the Anthrax Vaccination Program for the Total Force, Office of the Secretary of Defense memorandum. May 18,1998. 

Another important issue concerns the number of vaccines used for children under 2 years of age the vaccination program includes around 15 injections causing some discomfort not only to the children but also to their parents (Papaevangelou, 1998). It is therefore necessary to develop combined vaccines - live, inactivated or mixed with VLPs or other subunits - for which the allergic reactivity is minimal. 

Baylor NE (2000) Proceedings from the Workshop on aluminum in vaccines, May 11-12, 2000, San Juan, Puerto Rico. Sponsored by the National Vaccine Program Office, Centers for Disease Control and Prevention... 

Mandatory vaccine programs are A violation of the Nuremberg Code in that they force individuals to have medical treatment against their will, or to participate in the functional equivalent... 

Tetanus prophylaxis is administered to those sustaining injuries such as wounds and fractures however, there is no need for a mass vaccination program (Gree-nough, 2002). Tetanus immune globulin is administered to individuals who have never received the tetanus immunization series and who have highly contaminated wounds (Greenough, 2002). 

Smallpox is a disease that has been present for centuries. Epidemics of this viral disease, unique to humans, have been reported since ancient history. Once one of the most feared of all diseases, smallpox was declared eradicated worldwide by WHO in 1980 (WHO, 1980). The last case occurred in Somalia in 1977. A worldwide vaccination program against smallpox was responsible for the elimination of the disease. Routine vaccination of the general U.S. population against smallpox ended more... 

Centers for Disease Control and Prevention. (2003). Update Cardiac related events during the civilian smallpox vaccination program—United States, 2003. MMWR Morbidity and Mortality Weekly Report, 52, 492-496. 

Nass, M. (2002). The Anthrax Vaccine Program An analysis of the CDC s recommendations for vaccine use. American Journal of Public Health, 92, 715-721. 

Locate and review the smallpox question and answer section of this Web site (http //www.bt.cdc. gov/agent/smallpox/vaccination/vaccination-program-qa.asp). 

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