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Background

Discuss the arguments for and against the use of vaccination for the prevention of spread of an infectious virus or disease.

The immunity of a person is guaranteed partly by maintenance of personal hygiene and partly by diseases. Thus, the occurrences of diseases contribute a specific part in the building up of immunity of a person. Firstly, there is a need to understand that diseases are a deviation from the otherwise normal healthy condition of an individual. Thus, the occurrences of diseases are attributable to a number of infectious agents such as bacteria, viruses, fungus, being some of the few. The diseases can be further grouped into communicable and non-communicable diseases. The communicable or the contagious diseases are the ones, which spread easily from a sick person to a healthy person.  Some of these diseases are malaria, chicken pox, measles, influenza etc. The non-communicable diseases, on the other hand, are spread either due to metabolic disorders or due to hereditary influence.

The vaccination plays a crucial role over here by providing the body immunity against the occurrence of some of the contagious diseases. The vaccines protect an individual through direct immunization and contribute greatly towards the maintenance of a global health. Thus, putting in a basic amount of investment in vaccine technologies can help reduce the health costs manifold times. In the present chapter, the implication of vaccine in ascertaining an overall good health of the community has been discussed.  Moreover, the chapter also takes into consideration both the advantages and the disadvantages of the vaccine. 

Studies have shown that vaccinations have prevented nearly 103 million cases of childhood infection since 1924. This represents approximately 95% of the infections that could have occurred otherwise. As per the reports published by World Health Organisation (WHO), the administration of vaccines prevents almost 2.5 million lives each year from some of the communicable diseases such as tuberculosis, diphtheria, whooping cough among the few (Tomczyk et al. 2014, p.5). In 2010, almost 109 million children were immunized by MMR vaccine, which protected them against mumps, measles and German measles.  As commented by Moore et al.  (2015, p.305), the lack of immunization could prevent the occurrence of some of the life threatening diseases. Thus, failure in being immunized may lead to some serious consequences such as disability.


In order to provide maximum rates of immunization, more money should be vested upon vaccination program. Thus, sufficient support needs to be provided by the government as well as the local and states non-governmental organizations for maximizing the rates of prevention through the administration of the vaccine. Figures and reports estimate that on time administration of vaccine and adherence to the recommendations stated by the US centre for Disease Control and Prevention can reduce the morbidity and mortality rates manifold times.  However, as argued by Markowitz et al. (2014,p.25), the invention of new inventive technologies would require additional money to be spent.

Mode of Action of Vaccines

In the recent work produced by a US based public health school, they have estimated that for increasing the production of vaccines for the control and prevention of pneumococcal bronchitis, meningitis and rotavirus and an additional amount of $63 billion dollars need to be spent. Thus, in order to cover the health costs of the estimated 3.7 million at risk in the developing countries $115 billion dollars would be required. However, the costs seem huge compared to the vast majority population that they have to cover. As reported in the year 2010, California had alone had 9000 cases of measles leading to the death of 10 infants. Estimates have shown that immunization program done on a routine basis would prevent almost 42,000 early deaths and 20 million cases of the disease. Globally vaccination may save a lot of amount vested in the recurrent long term and short-term treatment, which accounts to almost $61 billion dollars (Rahier et al. 2014, p.445).Reports have shown that vaccines contribute a considerable amount in the prevention of the spread of the diseases. As commented by Henao-Restrepo et al. (2017, p.25), such vaccination measures prevent the situation of an epidemic. Thus, additional quarantine measures can be taken for the prevention of highly contagious diseases such as measles and chicken pox.

The vaccines provide an added line of defense in the prevention of infectious diseases.  An infection usually occurs when a pathogen gains entry into the body of a person through innumerable channels. This further initiates a defense reaction by stimulating the synthesis of a protein substance such as antibodies. The microbes can enter the body through a number of routes such as the oral routes, through food and water, through contaminated articles. In this context the first line of defense is provided by the skin. Once the microbe invades past the skin and gains entry into the deeper system an immune response is triggered. In this respect, the foreign pathogen attacking the body releases toxic chemical messengers in the blood of an individual. These are mostly proteins and are known as antigens, which stimulate an immune response in the body.  The substances produced in response to the antigens are known are antibodies. Thus, the antigen-antibody reaction initiates an immune reaction in the body. This is known as the natural defense line of the body. As commented by Koff et al. (2013, p.122), a recurrent attack by the same pathogen in the future can elicit the entire antigen-antibody cycle again.

Vaccination for the Prevention of Measles

The vaccines are dead and weakened microbes, which are entered into the blood stream of an individual. The mode of delivery of the vaccine can be both oral and through injections. The dead or weakened microbes, which enter into the blood stream of an individual, trigger an immune response in the body. This results in the production of antibodies in the body. The antibodies are synthesized by the plasma or β cells of the Lymphocytes and are known as the memory cells (Schrag et al. 2013, p.25).  The mode of immunity offered through the synthesis of β cells is known as humoral mediated immunity. This is because an attack by a similar pathogen any time later can cause the memory cells to recognize the pathogens. This will further initiate an immune response thus neutralizing the effect of the pathogen.

The immunity can be further broken down into active immunity and passive immunity. The active immunity is mainly offered by the immunoglobulin present in the blood of an individual such immunoglobulin A (IgA) and immunoglobulin B (IgB). These are produced as a response to an immune reaction. However, as argued by Demicheli et al.(2014, p.20), active immunity provides much long-term immunity to an individual. On the contrary, vaccine mediated passive immunity is often effective for a shorter duration of time.

The Mumps Measles Rubella Vaccine (MMR) though administered to children within 12-15 months does not guarantee 100 % affectivity in the control of the disease. The active immunity is offered only after the Rubella virus has caused an infection. However, as argued by Carlin et al. (2013, p.1430), immunization through vaccines can reduce the severity of a disease, through not eradicating the same completely.

In this context, the active immunity provides much long term prevention against the disease compared to the passive or vaccine mediated immunity. Moreover, as commented by Carlin et al. (2013, p.1429), the vaccines have to be repeated in frequent booster doses. This results in additional cost being vested every time that a dose is repeated.  As mentioned by Lee and Nguyen (2015, p.52), parents of infants lacking sufficient knowledge regarding the vaccine doses often miss to follow up the exact doses. Thus, such lost doses often result in possessing higher chances of infection from the microorganims or pathogens.

 In this context, vaccination can  reduce the severity  of a disease by inducing the production of the memory cells . Therefore, a second bout of infection from the Rubella virus is often easily preventable. As supported by Li et al. (2014, p.558), the MMR vaccine acts by providing triple fold protection against mumps, measles rubella (German measles). It has been noted only in rare cases that a second dose has been repeated in the children. This happens only after the first dose has failed to provide the required immunity. Thus, the invention of vaccination for the prevention of such diseases could be a boon in disguise. However, as argued by Tyler et al. (2014, p.125), for an active follow up huge medical costs and expenditures need to be borne. Moreover, the lack in sufficient knowledge regarding the affectivity of such vaccination programs can act as deterrence.

 Thus, vaccination can act as a much dependent mode of prevention of diseases and can prevent any future lethal condition from occurring. Thus, some of the diseases as in the case of poliomyelitis the virus synthesize potent neurotoxins. The neurotoxin further affects the cerebellum or the motor control of the body. Thus, the World Health Organization (WHO) has designed a common framework indicating the age wise vaccine doses. This is provided to all hospitals, pediatric wards for maintaining the required dose of the vaccines. The vaccines are a way of completely eradicating a disease, which could have otherwise changed into an epidemic. As reported by Javed (2016, p.752), by the year 2002, small pox had been completely eliminated from India. This was made possible by repeated and constant vaccination. Further examples can be cited where in the year 1976, there were 13,000 cases of an epidemic due to a whooping cough in Japan. This was only after the news spread that Japan had gained full control over whooping cough disease and did not need any more vaccination program.

Figure 1: Vaccination chart for children

(Source:  Drolet et al. 2015, p.20)

Thus, a roster chart needs to be followed by the pediatrics for prevention or recurrent occurrence of a disease. Moreover, such vaccination rosters are prescribed by the World Health Organizations (WHO), which helps in maintaining the transparency of the care process. It has been noticed that a newborn child generally has a good immunity for a period of six months or more. Thus from birth until six months of age a child is dependent on the breast milk fed by the mother.  Reports and studies have shown that the mother’s milk is a rich source of antibodies. As suggested by Demicheli et al. (2014, p.89), most of the antibodies have been either actively or passively acquired by the mother. Thus, the availability of such antibodies in prepared form provides the child with a natural line of defense.

However, as argued by Carlin et al. (2013, p.1429), the neonatal immunity persistently drops with age. Thus, the vaccination programs can help in addressing the loopholes in the immune system of the body. For the purpose of which the WHO has organized a vaccination or immunization charter for maintaining the age wise requirements of the vaccine doses.

There are a number of advantages of using vaccine such as providing long-term protection against severe infectious diseases. The vaccines help in the provision of quarantine by providing sufficient prevention against contracting a disease from a sick person or infant. The implementation of the vaccine programs has been seen to reduce deaths in young children due to severe secondary infections. Reports have shown that one out of every 20 children admitted in the hospital with measles have been seen to develop severe pneumonia. Therefore, administration of vaccines can prevent such casualties from happening. Moreover, as commented by King et al. (2014, p.22), the proper implementation of the vaccination program can help in saving any additional costs spent after unnecessary costs of medicines. Thus, the vaccines help in immunizing the infants who are the most vulnerable and prone to infection.


Similarly, there are a number of loopholes in the use of vaccines for the prevention of diseases. The vaccines trigger immune responses once they have been administered in the body of the patient. Sometimes this immune reaction causes the Major Histocompatibility Complex (MHC) present on the surface of T-cells to synthesize chemical messengers such as histamines. These histamines can further initiate secondary responses in the body leading to fever and rashes. This is particularly common in young children who are often seen to develop some or the other kind of immune responses (Ioannides, 2017, p.24).

In some cases, severe allergic reactions may develop in the child known as anaphylactic reactions. The anaphylactic reactions are rare and occur only in extremely cases.  This requires additional measures to be taken by the pediatrics for the prevention and relief against such infections.

Though there has been considerable research and analysis, there are a number of limitations of vaccinations. The vaccinations though, can reduce the chances of disease manifold times. This is because the active community is only offered in case of direct infection by the Rubella virus. However, as seen in some of the diseases such as measles and chicken pox there is no 100 % efficacy of the vaccine. That is even after administering vaccines the disease might occur again. Thus, the passive immunity offered through vaccine can never be replaced by active immunity. On the other hand, the cost of maintaining the booster doses are costly. Thus, the parents of the infant or the children receiving the booster doses need to be supported effectively by the government. Moreover, lack of education can be another hindrance in the achievement of success in the elimination of the diseases. 

Thus, there is a need for more inventive technologies such as infection from some of the pathogens such as Rubella virus or varicella sp. cannot be cured 100% effectively with the help of vaccinations.  Therefore, only constant trial and research can help in achieving success in producing effective vaccines.

Conclusion

Though vaccines have brought about a revolution in medical treatment, there are a number of downsides to using the same. Sometimes the vaccines fail to guarantee 100% protection. The vaccines in inactive form fail to initiate the desired immunity response within an individual.  Additionally, accuracy needs to be maintained during rendering the rubella virus  inactive. This is because negligence or failure in meeting the safety concerns can risk the health and safety of an individual.

In the year 2012, approximately 82 %  measles immunization rates have already been achieved across the globe. However, the success of achieving immunity through vaccination requires investment and monetary support from the government. However, in the remote areas, many people do not possess any knowledge about vaccination. Thus, they need to be aware of the same through organizing campaigns. Moreover, the lack of economic stability often prevents more and more people in remote areas from using the vaccine. Thus, sufficient programs and measures need to be organized by the government for maximum inclusion.

In spite of a global medical advancement, the affectivity of vaccines is still doubted by many. In this regards, many traditional health practitioners have argued that active immunity is the only ultimate form of immunity. Therefore, there are a number of loopholes related to treatment and intervention through a vaccine. In this regard, participation from a large number of medical channels including community participation could be helpful. Moreover, provision of free medicinal support from the government can also help in achieving the desired outcomes. Thus, awareness is required at a global level, which demands individual and community participation. Thus, further research and study need to be conducted for making vaccination an indispensable part of the health care program.

References

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Carlin, J.B., Macartney, K.K., Lee, K.J., Quinn, H.E., Buttery, J., Lopert, R., Bines, J. and McIntyre, P.B., (2013). Intussusception risk and disease prevention associated with rotavirus vaccines in Australia's National Immunization Program. Clinical Infectious Diseases, 57(10), pp.1427-1434.

Demicheli, V., Jefferson, T., Al?Ansary, L.A., Ferroni, E., Rivetti, A. and Di Pietrantonj, C., (2014). Vaccines for preventing influenza in healthy adults. The Cochrane Library.

Drolet, M., Bénard, É., Boily, M.C., Ali, H., Baandrup, L., Bauer, H., Beddows, S., Brisson, J., Brotherton, J.M., Cummings, T. and Donovan, B., (2015). Population-level impact and herd effects following human papillomavirus vaccination programmes: a systematic review and meta-analysis. The Lancet infectious diseases, 15(5), pp.565-580.

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