Vaccine-preventable diseases, or VPDs, are illnesses that can be prevented by vaccination. They are caused by viruses or bacteria and can be spread easily from person to person. These diseases can cause serious health problems, and in some cases, they can be life-threatening. Vaccines are the most effective way to prevent these diseases. Vaccines use an antigen; the antigen is put into the body to copy an infection and prepare the immune system to respond against a future occurrence.¹ Every vaccine is tested thoroughly before becoming available to the communities. 

There are many vaccine-preventable diseases. In the United States, there are recommended vaccine schedules based on age. Getting vaccines on time can help fight against death in childhood. Infectious diseases are the leading cause of morbidity and mortality in childhood, especially in low or middle-income countries, most of which are VPDs.² The question is, if vaccines are available, why aren't they fully utilized? Multiple factors are at play here, including vaccine hesitancies, lack of access to the vaccine, and the price of the vaccine. False accusations about the vaccines and fear typically cause vaccine hesitancy. It became a huge ordeal during the Covid-19 pandemic. Healthcare providers and the media must provide all the information on vaccinations.²

Vaccinations are recommended in all countries; many politicians, academics, and public health professionals use the phrase “Disease knows no borders.”³ This phrase shows how we cannot control where the diseases spread; we can only control what we can. Vaccines are what can control the spread of diseases. This is why herd immunity is so essential. Herd immunity is when a large part of a population is immune to a disease. Herd immunity is the result of vaccinations. 

Multiple vaccinations for infectious diseases are readily available to the public. The Centers for Disease Control and Prevention (CDC) put out recommendations for vaccinations. Vaccinations in early childhood can help prevent serious illnesses when the child does not have a strong immune system. Giving the child antibodies through the vaccine to create fighter cells against that disease will help with prevention. The diseases that are recommended to be vaccinated against by the CDC include Hepatitis B, Diphtheria, tetanus, and whooping cough (pertussis) (DTaP), Haemophilus influenzae type b (Hib), Polio (IPV), Pneumococcal (PCV), Rotavirus (RV), Influenza (flu), Chickenpox (Varicella), Measles, mumps, rubella (MMR), Hepatitis A (HepA), Meningococcal conjugate vaccine, Human papillomavirus (HPV) vaccine, Tetanus, diphtheria, and pertussis (Tdap),  Pneumococcal, and Zoster vaccines.^4,5 

The CDC separates diseases into three different categories, each labeled based on their specific goal for said disease.  The first is to Eradicate. As of June 15th, 2023⁶, Polio is the only one in this category; the vaccine was first created in 1955 by Dr Jonas Salk.⁷ There are two different types of vaccines: Inactivated poliovirus vaccine (IPV) is an injection in the leg or arm; this vaccine is inactivated, meaning it has no active polio strains. This vaccine is the only polio vaccine used in the US since 2000.⁷ Oral poliovirus vaccine (OPV) is an oral vaccine that is a weakened polio virus; this vaccine is used regularly in other countries. The first dose of the polio vaccine is recommended between 1 and 2 months of age, then booster doses at 4 and 6 months of age, and the final booster at 4 years old.⁴ 

The second category is to eliminate; this category is divided into two subsections with the goal of eliminating the transmission of diseases.

The first subsection targets disease, which includes Measles and Rubella.⁶ The original measles vaccine was created in 1963, and the rubella vaccine was created in 1969.8 By 1971, Dr. Maurice Hilleman made the MMR vaccine, which combines measles, mumps, and rubella.⁸ The first dose of MMR is recommended between 12 and 15 months, and the final dose is recommended between 4 and 6 years of age.⁴

The second subsection aimed to eliminate public health problems; the diseases in this category include Hepatitis B, Bacterial Meningitis, and Human Papillomavirus⁶. The Hepatitis B vaccine first became available in 1981 but was not added to the recommended vaccine schedule until 1989, and it was officially on the schedule in 1994⁸. The first dose of HepB is recommended at birth, then again between 1 and 2 months; the final dose is given between 6 and 18 months of age.⁴ The first Bacterial Meningitis vaccine became available in the 1970s but was more widely used starting in 1999⁹. There are multiple different vaccines, but the vaccines that are most commonly used in the United States are: MenACWY was first introduced in 2005; the first dose of MenACWY is recommended between 11 and 12 years old, and the second/final dose at 16 years old.¹⁰ MenB was first introduced in 2014. After speaking with their provider, the first dose of MenB is recommended for children between 16 and 18 years old.¹⁰ The first vaccine for HPV was available in 2006¹¹; the first dose is recommended between the ages 11 and 12, with the final dose being 6 to 12 months after the initial dose.

The third category is to control, which is divided into 3 different subsections.

The first is control targets, which include influenza, Japanese encephalitis, tuberculosis, and yellow fever.⁶ 3 of 4 of these are only recommended for those traveling to countries where those diseases are prevalent. The Influenza vaccine was first made available in 1945 after being tested on the US Military by Thomas Francis and Jonas Salk at the University of Michigan.¹² The initial dose of influenza is recommended at 6 months of age, and the second dose is at least 4 weeks after the initial dose, then yearly afterward. 

The second group is control targets that are recommended in all countries. This includes Diphtheria, Tetanus, Pertussis, Haemophilus influenzae type b, Pneumococcal, and Rotavirus (RV).  Diphtheria, Tetanus, and Pertussis are typically put into a combination vaccine, either Dtap or Tdap.⁶ Dtap first became available in 1991¹³; the first dose of the Dtap vaccine is recommended at 2 months, with the second dose at 4 months, the third dose at 6 months, the fourth dose between 15 and 18 months, a final dose between 4 and 6 years old.⁴ Tdap first became available in 2005.⁸ The first dose of Tdap is recommended for children between 11 and 12 years old, with a booster every 10 years and /or during each pregnancy.¹⁴ The vaccine for Haemophilus influenzae type b is commonly known as the HIB vaccine; the original vaccine was for children 18 months and older and was available in 1985, but in 1987, a Hib conjugate vaccine became available for infants and children.¹⁵ The first dose of Hib is recommended at two months, then a second dose at 4 months, and the third and final dose between 12 and 15 months.  The first pneumococcal vaccine was available in 1977, but in 2000, a conjugate pneumococcal vaccine was licensed and started to be used.¹⁵ Multiple different Pneumococcal vaccines are commonly used currently: PCV13, PCV15, PCV20, and PCV23. PCV13, PCV15, and PCV20 can be given to infants, whereas PCV23 can only be given to adults aged 65 or older. The first recommended dose of pneumococcal vaccine is recommended at 2 months, the second dose at 4, the third dose at 6, and the final dose between 12 and 15 months.⁴ Then, if clinically necessary, a booster dose at 65 years.¹⁴ The last disease that is in this category is Rotavirus. The first rotavirus vaccine was available in 1998 but was withdrawn in 1999 due to an adverse event.¹⁷ However, in 2006, a new live oral vaccine used today was introduced and used.¹⁷ The first recommended rotavirus vaccine is recommended at 2 months old, then the second/final dose at 4 months. Some rotavirus vaccine brands require one more dosage at 6 months.⁴

The final group is a control group based on a disease burden, which includes Hepatitis A, Mumps, Varicella, and Zoster vaccine.⁶ The Hepatitis A vaccine was first available for use in 1995^18. The first recommended dose of Hepatitis A is recommended at 12 months, and the second dose between 18 and 23 months. The Mumps vaccine is put together with the vaccine for measles and rubella. The Varicella vaccine was first available in 1995¹⁹. The first recommended Varicella dose is between 12 and 15 months, and the second/final dose is between 4 and 6 years old.⁴ The Zoster Vaccine was first available in 2006²⁰; this vaccine is only recommended for elders who are at a higher risk or if they never received their initial doses of Varicella.¹⁴

VPDs were and still are valuable developments in history. These vaccines can and have saved millions of lives and livelihoods from debilitating and life-threatening diseases. As we all know, we just lived through a worldwide pandemic; researchers, doctors, and chemists all worked on finding and making a vaccine that could fight against COVID-19, and now we have a vaccine that is there for those who want it.

References

1. Pfizer Inc (2023, June 26). How Vaccines Work: Immune Response and the Body's Reaction. Pfizer. Retrieved November 29, 2023, from https://www.pfizer.com/news/articles/how_vaccines_work_immune_response_and_the_body_s_reaction
2. Allergy and asthma proceedings (2021, September 1). The global burden of vaccine-preventable infectious diseases in children less than 5 years of age: Implications for COVID-19 vaccination. How can we do better? National Library of Medicine. Retrieved November 28, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677503/
3. Pandemics, Publics, and Politics: Staging Responses to Public Health Crises (2018, November 4). “Disease Knows No Borders”: Pandemics and the Politics of Global Health Security. National Library of Medicine. Retrieved November 28, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7122625/
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7. Global Polio Eradication Initiative (n.d.). IPV. Polio Eradication. Retrieved November 28, 2023, from https://polioeradication.org/polio-today/polio-prevention/the-vaccines/ipv/
8. Children’s Hospital of Philadelphia (2014, November 20). Developments by Year. CHOP. Retrieved November 30, 2023, from https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-history/developments-by-year
9. Pan American Health Organization (n.d.). Meningococcus. Paho. Retrieved November 30, 2023, from https://www.paho.org/en/topics/meningococcus
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11. KFF (2021, July 12). The HPV Vaccine: Access and Use in the U.S. Retrieved November 30, 2023, from https://www.kff.org/womens-health-policy/fact-sheet/the-hpv-vaccine-access-and-use-in-the-u-s/
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13. Mayo Foundation for Medical Education and Research (MFMER) (n.d.). Whooping cough. Mayo Clinic. Retrieved November 30, 2023, from https://www.mayoclinic.org/diseases-conditions/history-disease-outbreaks-vaccine-timeline/whooping-cough
14. Centers of Disease Control and Prevention (n.d.). 2023 Recommended Adult Immunization Schedule. CDC. Retrieved November 30, 2023, from https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf
15. Immunization Action Coalition (n.d.). Haemophilus influenzae type b (Hib): Questions and Answers. Immunize. Retrieved December 1, 2023, from https://www.immunize.org/wp-content/uploads/catg.d/p4206.pdf
16. Centers of Disease Control and Prevention (2021, August 18). Pneumococcal Disease. CDC. Retrieved December 1, 2023, from https://www.cdc.gov/vaccines/pubs/pinkbook/pneumo.html
17. National Library of Medicine (2021, October 1). The Rotavirus Vaccine Story: From Discovery to the Eventual Control of Rotavirus Disease. NIH. Retrieved December 1, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482027/
18. Centers for Disease Control and Prevention (2021, August 18). Epidemiology and Prevention of Vaccine-Preventable Diseases: Hepatitis A. CDC. Retrieved December 3, 2023, from https://www.cdc.gov/vaccines/pubs/pinkbook/hepa.html
19. Centers for Disease Control and Prevention (2021, April 28). Chickenpox Vaccination: What Everyone Should Know. CDC. Retrieved December 3, 2023, from https://www.cdc.gov/vaccines/vpd/varicella/public/index.html
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