In a world where I constantly feel like I have to defend my advocacy of full vaccination, it is sometimes reassuring to look backward. There is nothing more profound than the history of the polio vaccine.
Thanks to vaccination, there has not been polio in the United States since 1979. Current new parents barely know what polio is; however, you need only ask someone in their 60s or 70s to be reminded. That generation lived through an era of fear of large groups, families who lost several children, mass quarantines and permanent disabilities.
In the United States, we typically administer a polio vaccine at ages 2 months, 4 months, 6 months and 4-5 years. It is a well-tolerated vaccine with very few side effects.
Worldwide polio eradication remains a goal. In 2012, there were 223 cases of polio in the world. A very powerful collaboration between The World Health Organization, UNICEF, the CDC and Rotary International has been formed with the goal of complete polio eradication by 2018.
This goal is not going to be easy to achieve. Let’s go over the obstacles.
1. Science: Oral polio vaccine (OPV) is the preferred method of mass vaccination in disadvantaged countries. It is easy to give, provides excellent immunity, is inexpensive to produce and, because it is a live virus vaccine, it can provide herd immunity. Herd immunity means that people who have recently received the vaccine are capable of transmitting the vaccine virus to people who have not had the vaccine, thus providing them with a “passive immunity.”
The downside to this is that the vaccine virus can mutate and, in very rare cases, actually cause polio. For this reason, no OPV is given in the United States anymore. However, because of the advantages listed above, OPV is still used in third-world countries. Most of the cases of polio in these countries were actually from vaccine-derived viruses. So we need to stop using OPV and start giving IPV (inactivated polio vaccine).
2. Cost: To make the transition to IPV, we need to overcome the significantly higher costs of using that vaccine. It is more expensive to produce, and requires a needle, syringe and special storage requirements. The global initiative calls for the introduction of IPV everywhere by 2015.
3.World politics: The remaining nations which struggle with polio are Nigeria, Afghanistan and Pakistan. Most people are aware that these nations have a long history of war, poverty and oppression. Currently, all three of these countries have a democracy as the foundation of their current governments, which aids in prioritizing public health initiatives like this one. However, these systems are at times plagued with corruption and fraud, which serve as a huge obstacle to vaccination. In May, two volunteers were gunned down in Pakistan while giving vaccines; this is only one example of multiple episodes of violence surrounding this movement.
There is a great deal of suspicion among certain political and religious groups that the plan to eradicate polio is a Western plot against them. It will take peacemakers before scientists to achieve this goal. Rotary International has responded to this and is playing the role of both financial backer and peace maker to meet this goal. Its members commit dollars and volunteer time around the world, including through the 418 Rotary clubs in Pakistan, Nigeria and Afghanistan.
Using smallpox as our historical marker, it will likely be recommended that we vaccinate for polio for at least 5 years after eradication. With the target goal of 2018, that could mean that by 2024 polio could be just a memory.
To quote Dr. Jonas Salk, the scientist who developed the polio vaccine: “The reward for work well done is the opportunity to do more.” The polio success story only serves to motivate our new pioneers who are currently working on vaccines for malaria, tuberculosis, HIV, cancer, diabetes, meningitis, Group A Strep and many more. It motivates most pediatricians to help parents wade their way through vaccine information and get their children safely vaccinated to prevent the diseases we can prevent now and pave the way for a healthier future.
Source: Lancaster online