Quest for life-long protection by vaccination.

Abstract

Life-long protection from disease through immunization can be accomplished through individual or community protection. Individual protection is the goal for vaccination against diseases that have inanimate or animal reservoirs or that pose risks for certain populations. Community protection is the goal for vaccination against diseases that are transmitted only from human to human. Community protection afforded by childhood vaccines has been highly successful against measles, rubella, mumps, and polio. However, outbreaks of measles, rubella, and mumps continue to occur, primarily because of inadequate immunization of children under age 2. Simplification of vaccination regimens, provision of incentives to care providers and parents, and increased access to care should improve vaccination rates in the United States. Better protection requires better use of available vaccines. Eradication of disease through vaccination is the ultimate goal of community protection. Elimination of the infectious agent is the most effective means of achieving life-long protection. The World Health Organization's (WHO) smallpox eradication campaign eliminated a serious disease as well as the need for a vaccine with frequent and severe adverse reactions. The discontinuation of smallpox vaccination in the United States has produced a savings of over $3 billion. Polio has been targeted by WHO for eradication by the year 2000. The eradication of polio and the elimination of the need for polio vaccination in the United States should result in a savings of $110 million per year in vaccine costs alone. Strong United States support is crucial for WHO to reach its goal. Any of the vaccine-preventable childhood virus diseases could be eradicated with sufficient national and international will. Measles and hepatitis B should be high priorities. The ultimate goal of vaccination is life-long protection of all individuals. Any disease of sufficient public health importance to warrant routine vaccination is of sufficient importance to warrant eradication wherever judged to be possible.