Vaccine debate is about more than measles

Even defeated diseases such as polio still source of concern

A graphic depicting the concept of community,or “herd,” immunity. (NIAID/Courtesy)<br /><br /><!-- 1upcrlf2 -->


Two drops. That's all it takes to ensure that a child will grow up without knowing the pain and suffering of polio.

Many humanitarian groups refer to it as the "Two Drops of Life," and that's not far from the truth.

It's why groups like the Bill and Melinda Gates Foundation and Rotary International have teamed up to vaccinate young children worldwide. Vaccination projects like "End Polio Now" have, in 25 years, helped drop worldwide cases of polio from over 350,000 a year to just 416 in 2013. Only three countries (Afghanistan, Nigeria, and Pakistan) are considered polio-endemic now, and with a synthetic polio vaccine on the horizon, the eradication of polio is very much in sight.

In places like the United States, where polio is considered eradicated, we rely on a concept called "Community Immunity."

The vaccine is voluntary and not everyone is immunized. However, if enough people are immunized against a particular disease, the disease has nowhere to spread and eventually dies off. That's common for a myriad of other diseases we vaccinate for.

Typically, to achieve community immunity, a vaccination rate of 93-95 percent is required and, for the most part, is achieved.

What the current measles outbreak is showing health professionals is that community immunity breaks down when a significant group of the population doesn't vaccinate and, in many cases, that group is located in a specific geographic region (see Marin County in Northern California).

Diseases considered eradicated in the United States can easily and quickly make a comeback if an individual from an endemic region travels to a place where there is a lower rate of vaccination.

I was fortunate enough to go on a vaccination trip to Caborca, Mexico, over Valentine's Day weekend to participate in the project firsthand. I am part of the Route 66 Rotaract Club, a club sponsored by Rotary, and we sent two members this year to Caborca. The Route 66 Rotary Club also sent three representatives.

Vaccination day

Our bus dropped us off at Ejido Jose Maria Morelos, a neighborhood about an hour outside of Caborca. The people residing there received their land via grants from the Mexican government, and they established a small makeshift neighborhood in the middle of the desert. Utilities like running water and sewage are an issue. Many of the parents also lack the means to travel to a hospital to have their children vaccinated.

Our Kingman group teamed up with a representative from Caborca's Rotary club and a local nurse. We also had a group of high school girls who were interested in practicing their English tag along with us.

The vaccine is administered door-to-door, with us carrying the vials in a small cooler packed with ice. The nurse would call out, asking the resident if anyone younger than five was residing there. If yes, they would provide a shot record to ensure that the child didn't have the vaccine already.

This process took a few minutes at each house. The nurse would have to check her records and fill everything out. We took advantage of that time to hand out gifts to the children.

Some houses were built like tack sheds that looked like they could blow away during a storm. Many of the homes had pits where they burned their trash. We could, from time to time, smell sewage.

Yet, for the most part, the yards were well kept and their children were very clean. You could tell that many of them wore the same clothes day in and day out, but they took care of what they had. The families were incredibly friendly, letting us come into their homes and interact with their children.

Our group only vaccinated five children or so, but over the entire trip 181 children were vaccinated.

Next steps

Unlike measles, which is still prevalent in places like Asia and Europe, polio cases have been limited to a couple hundred cases.

Polio has seen a small resurgence in war zones like Afghanistan, where humanitarian immunization work has decreased. Nigeria had a significant anti-polio vaccination campaign in 2003 led by religious leaders who convinced people that the vaccine contained HIV and hormones that thwarted fertility.

The likelihood of an outbreak in the U.S. is low, but plausible if vaccinations are not conducted due to voluntarily declining the vaccination or stopping vaccinations in communities like the one near Caborca.

That's why these trips are critically important, even in countries where polio has been eradicated.