Free «The Importance of MMR Vaccines Should Be Required» Essay Sample

The Importance of MMR Vaccines Should Be Required

Vaccination recommendations are frequently accompanied by disinformation and increased resistance from the representatives of the anti-vaccination movements. The case with MMR vaccines does not make any exclusion. The claims on the ineffectiveness and danger of this vaccine are similar to many other arguments used by the vaccination opponents throughout history. The protest position relies on the idea that mass immunization is inconsistent, vaccination perturbs the natural balance in the human organism and can become particularly dangerous for children. Regardless of the CDC recommendations, the anti-vaccination movement frequently captures the popular attention and finds hundreds and thousands of followers quite easily. Nevertheless, people’s refusal to get vaccinated leads to new outbreaks of dangerous diseases worldwide. The recent outbreaks of measles in countries with high vaccine uptake raise multiple concerns among world health organizations and researchers.  Although the majority of the European and Western countries declared measles and rubella elimination during the last two decades, the current statistics show that the status for the US, UK, Australia, and Canada can be altered within the closest period (Heywood 1). Referencing to people’s deepest fears, misunderstandings, and misinformation, the opponents of vaccination convince that vaccines are ineffective and even dangerous. Thus, with the increased risks of epidemic outbreaks, the government must search for new approaches to manage the attitudes of the population to vaccination. Relying on the facts and scholarly evidence, MMR vaccination must become obligatory due to its levels of safety and effectiveness in saving people from variable health complications.

Background Information

The members of the CDC and other health organizations are strongly convinced that vaccination must be obligatory. The estimated benefits of vaccination for variable conditions prove that the discovery of vaccines is a great breakthrough for humanity. Vaccination is an effective tool to enhance the immune functions of the body. Inducing the immunological memory, it adapts the lymphocytes to effectively struggle against similar pathogens (De Bree et al. 25). The studies prove the effectiveness of the vaccines for different population groups. In general, they can prevent 2-3 million deaths yearly (De Bree et al. 24). Measles, mumps, and rubella are examples of vaccine-preventable infections that are quite dangerous. Thus, the WHO has initiated the Global Measles and Rubella Strategic Plan for 2012–2020 (Orenstein et al. 25). Regardless of many achievements during this period, the healthcare experts failed to keep the targeted levels of vaccination. The analysis of the strategy outcomes reveals that the wider public fails to realize the negative outcomes associated with the discussed diseases and the positive effects of vaccination.

Measles

Measles is a viral infectious disease that is spread by the respiratory route and can lead to deadly outcomes. The symptoms of the disease usually start 10–12 days after exposure and can include high fever, malaise, cough, running nose, and conjunctivitis (DeStefano&Shimabukuro 587). Two weeks after exposure are commonly accompanied by the red rash that spreads from the head to the body and limbs during 3–4 days and disappears in a similar order after 5–6 days (DeStefano&Shimabukuro 587). Measles is commonly considered to be one of the most contagious among infectious diseases. Among those, who have contact with the infected, 90 % get ill (Singh et al. 2). Individuals can spread the infection 4 days before and 4 days after the rash has started. Besides, it is associated with such complications as diarrhea, otitis, pneumonia, vision loss, encephalitis, seizures, and death (DeStefano&Shimabukuro 587). The complications are more frequent among young children. The statistics reveal that 1-3 out of 1000 children are infected with measles (Singh et al. 1). Thus, parental attitudes to vaccination can become saving for the child’s life.

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Although the recovery from this infection leads to the formation of lifelong immunity, measles remains a serious concern throughout the world. The vaccination control has led to the elimination of measles in the US and some other countries led to the elimination of the disease at the end of the 20th- beginning of the 21st century (Singh et al. 1). During the last two decades, measles could become the cause of death and disabilities in low-income countries (DeStefano&Shimabukuro 587). However, during the last decade, new measles outbreaks in the developed countries were observed. In the US, the highest number of measles cases was 667 cases per year (Singh et al. 2). However, in 2014 - 2015, CDC has documented more than 800 cases of measles (Gilkey et al. 1). In 2018-2019, the situation in New York got worse. In 2018, measles was brought to the US by the travelers who visited the under-vaccinated subpopulations (Singh et al. 2). As a result, the number of cases in 2019 has reached 1243, which has become the largest number since 1992 (Singh et al. 2). Overall, measles is commonly considered as the most dangerous among the discussed diseases due to the highest risks to get infected.

Mumps

Mumps is an acute viral disease that is distributed by the respiratory route. Although it can be mild for some groups of the population including young children, it can be more severe for older people. Mumps commonly develops 16–18 days after exposure. With a quarter of asymptomatic cases, it can lead to variable complications among the rest 75% of patients (DeStefano&Shimabukuro 586). For the post-pubertal males, the major threat is the inflammation of the testes. Besides, aseptic meningitis, encephalitis, pancreatitis, and deafness, frequently appear among older children and adults (DeStefano&Shimabukuro 586). Those, who have recovered after the illness generally acquire lifelong immunity.

 
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Rubella

Rubella is an acute viral infection that is spread by the respiratory route. Its symptoms usually occur 2 weeks after exposure. In the majority of the cases, the symptoms are mild and include fever, cough, sneezing, and a maculopapular rash. It is relatively contagious as only half of those who were exposed to the virus get infected. Although it is more frequently diagnosed among young children, the complications among older children and adults were documented more frequently. Among such adverse outcomes, one can find arthritis, brain infections, and problems with the liver. However, these complications are rare comparing to adverse rubella outcomes during pregnancy. In the earlier stages of pregnancy, the infection is the most threatening. In 2010, the number of babies with rubella-caused congenital syndrome has reached more than 100,000 (Orenstein et al 35). CRS can affect all organs and body systems in the developing fetus and consequently cause numerous severe defects including fetal demise, premature delivery, deafness, blindness, intellectual disability (DeStefano&Shimabukuro 587). In some cases, the effects of CRS can be delayed and progress with age. Those who were infected and recovered get lifelong immunity to the virus.

MMR Vaccine

Historical Background

The measles vaccine was initially introduced in 1967 and was combined with mumps and rubella components in 1970 (Singh et al. 1). One can find several forms of the vaccine since the 1970s. By now, four types of vaccines against measles, mumps, and rubella are offered worldwide. Among those Priorix™ by GSK Vaccines and M-M-R™ II by Merck & Co are the most widely used in the developed countries (Willame et al. 5553). Both vaccines combine three elements and are effective in generating immunity to the discusses illnesses. In the US, two types of vaccines including the combination trivalent MMR and MMRV vaccines are available. The major advantage of the MMR vaccine over monovalent or bivalent injections against measles, mumps, and rubella are requiring fewer injections and decreased risks for delays in protection and failures in immunity formation. Thus, according to CDC recommendations, the MMR vaccine is included in the US childhood immunization schedule as a series of vaccination with two doses. The first dose is injected at 12–15 months of age and the second one is provided at 4–6 years (DeStefano&Shimabukuro 588). In the UK, Canada, Australia, and other developed countries, the recommendations are similar. However, some changes are recommended for traveling infants. This population group can get the first dosage of vaccine at the age of 6 months (US, UK, and Canada) or 9 months (Australia) (Heywood 1). The health organizations recommend an injection of the next one or two doses after 12 months (Heywood 1). In lower-income countries, the combined measles-rubella vaccine is used. The results in all countries are similar and lead to eliminated transmission of the infections, a considerable decrease in measles and rubella-related complications, and deaths.

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Adverse Effects

In general, the MMR vaccine has low risks of adverse effects and is a good alternative to the risks associated with measles, mumps, and rubella. The researchers prove it is effective and well-tolerated (Seo et al. 358). However, some adverse effects can rarely occur. Fever can be present in 5–15% of cases. 5% of the vaccinated report a mild rash. 1 in 3,000–4,000 vaccinated children can report febrile seizures after the first dose (DeStefano&Shimabukuro 589). Very rarely, in 1 individual per 30,000–40,000, MMR vaccine can cause thrombocytopenia, or low platelet count (DeStefano&Shimabukuro 589). For adult women, arthralgia can become a specific reaction to MMR vaccination. Willame et al. (5551) focused on pain as one of the common children’s and parents’ concerns associated with vaccination. The researchers conducted a systematic literature review to find out that the immediate pain level can differ depending on the type of vaccine. Priorix (GSK Vaccines) was associated with lower pain levels in comparison to M-M-R II (Merck & Co., Inc.) (Willame et al. 5552). However, no interconnections between the immediate pain and possible adverse effects were found. However, it is currently known that the preparation of the injection site, needle type, and temperature of the composition can become the essential parameters that influence the pain level and must be carefully controlled (Willame et al. 5552). In addition, the researchers emphasized the additional necessity to investigate the physicochemical properties of the vaccines and the possibilities to decrease the pain levels for all MMR vaccine types. Nevertheless, considering the effects of the MMR, MR, and MMRV vaccines on the spread of infections and especially measles, the worldwide vaccination programs were considered to be effective.

Positive Effects

With the weighed risks of measles for human health, the researchers prove that vaccination is a good response to the outbreaks of measles and other preventable diseases. According to scientific evidence, the first dose has 93% effectiveness in measles prevention. With the addition of the second dose, the combined effectiveness reaches 97% (Singh et al. 1). The elimination of the measles spread in 2000 can be considered as the major evidence for its effectiveness to prevent the adverse outcomes of the disease, as well as its spread. The effectiveness of the vaccine against rubella is quite high and reaches 97%. However, the effectiveness against mumps is lower and reaches 88% (Orenstein et al. 26). The immunity to mumps needs additional investigations as the positive influence on mumps outbreaks were observed among the highly vaccinated population groups. On the example of the 2019 measles outbreak management, one can see that the MMR vaccine has a high level of effectiveness to improve the public health indicators and eliminate the risks of epidemics (Singh et al. 5).  Ferrera et al. (23) provide scholarly evidence that vaccination is an effective protection against measles, mumps, rubella, and some other infections that can be associated with long-term consequences and complications. For instance, MMR is a good example of the vaccine that leads to a considerable reduction in the incidence of infectious diseases among children and a decreased number of deaths. The statistical data shows that measles vaccination has prevented at least 20 million deaths worldwide during the first 15 years of the 21st century (Ferrera et al. 23). Kowalzik et al. (5402) also emphasized the safety and effectiveness of MMR or MMRV vaccination claiming that with immunization the number of measles incidents decreases almost five times. Even though mumps outbreaks were reported, vaccination has led to a substantial decline in the number of cases. Likewise, the number of rubella and CRS cases have also declined dramatically improving the welfare of the population (DeStefano&Shimabukuro 589). Overall, the positive effects of vaccination are obvious.

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Current Concerns

During recent years, with the anti-vaccination movement progress, the hesitancy to vaccinate children and self has considerably increased leading to numerous individual, national and international concerns. Public health research shows that parents’ confidence regarding the necessity to vaccinate their children has eroded in recent years. Vaccination is frequently delayed or refused. Parents request exemptions to school entry demands for vaccination much more often than in the past (Gilkey et al.1). Among the common concerns that the parents report, one can find the beliefs that children have to get too many vaccines for their age and are every time at risk to receive serious side effects (Gilkey at al. 4). The problem raises serious risks of disease outbreaks. Nevertheless, the government does not put enough effort into the education and motivation of the population to solve the problem of vaccine refusal and delay (Gilkey et al.1). Among the unvaccinated population, children make the greatest part. In low-income countries with limited access to vaccination, infections remain the leading cause of death among children under 5 years (De Bree et al. 25). Measles is a common example of such a life-threatening infection for children. For the elderly population, infections can become a serious health threat, too. Immunosenescence is a common problem of the aging population (De Bree et al. 25). Besides, the widely spread usage of the immune-suppressive therapies increases the risks of the poor immune response to the infections, greater risks of complications, and death. Thus, concerning the risks of infecting the vulnerable groups, the outbreaks of infections raise problems for all people. groups.

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Travelers become a serious concern, With the inappropriate immunization achievements in different countries, they raise the greater risks of the diseases spread throughout the world. According to the statistical data, 1 in 10 travelers is non-immune to measles, mumps, and rubella (Heywood 2). Nearly 16 % of these people are eligible to get vaccination but received no appropriate consultation before their travels (Heywood 2). To a great extent, the younger age became one of the reasons that were associated with the lack of any intentions to search for health advice. Meanwhile, the reports reveal that the African region does not have a sufficient two-dose vaccination covering for the population (Heywood 1). As a result, the African countries can become the area of the excessive threat to get infected with measles. At the same time, it does not mean that travelers cannot get infected in other cases. Getting infected with measles was also reported among the travelers to Germany, the US, Guatemala, etc (Heywood 2). Thus, reminding that MMR is one of the primary travelers’ vaccines is critically important to promote health on the national levels (Heywood 1). Besides, the increasing number of immigrants from this region to Europe becomes another potential source of disease spread in the developed countries. The young adults make an important group of risk due to the lower levels of measles vaccination in the period of the decline of the disease levels at the end of the 20th century (Heywood 1). Thus, visiting friends or relatives from less developed countries, they can get infected very easily. The careful surveillance of these people must become an additional concern of the developed countries that are at risk of the Overall, with the gaps in the herd immunity that is caused by the population misbeliefs in the effectiveness of the vaccines, the danger of the measles outbreaks becomes stronger.

Safety Controversies 

Inflammatory Bowel Disease (IBD)

Among the safety controversies associated with vaccination, the potential role of the MMR vaccine in the progress of inflammatory bowel disease (IBD) deserves particular attention. The initial suspicions associated with the interconnections between the bowel disease and MMR vaccine date back to the investigations on Andrew Wakefield in 1998 (DeStefano&Shimabukuro 589). Although the initial hypothesis offered that measles instead of vaccination could cause the progress of IBD, the epidemiologic investigation led to a conclusion that MMR can increase the risks of such bowel disorders like Crohn's disease and ulcerative colitis. Nevertheless, the other studies have not confirmed any connections between the mentioned variables. Moreover, the evidence that MMR can increase the risks of IBD appeared to be quite weak. With the contradictive findings regarding the impact of measles on bowel disorders, Wakefield emphasized that the combined MMR vaccine increases the risks of the investigated disorders. Instead, the monovalent measles vaccine is not associated with bowel problems (DeStefano&Shimabukuro 589). Regardless of this claim, no further studies that were aimed to investigate the interconnections between MMR, IBD, Crohn's disease, and ulcerative colitis proved any meaningful effect of vaccination on the chosen conditions. As a result, the IBD- related fears to get vaccinated lack solid scientific evidence and cannot be considered as a well-grounded reason to refuse or postpone the vaccination.

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MMR and Autism

The potential impact of the MMR vaccine on autism development remains a serious concern reported among the parents. Being probably the most popular modern fear related to vaccination, such belief lacks scientific proof. A report published in 1998, suggested that the MMR vaccine can cause autism (DeStefano&Shimabukuro 585). This work was written by Andrew Wakefield, the same researcher, who has previously failed to prove the impact of the MMR on IBD progress and relied on the description of 12 children’s conditions and experiences. Throughout the analisys, Wakefield offered a hypothesis that the intestinal and neurological disorders of the vaccinated children were caused by MMR vaccination (DeStefano &Shimabukuro 588). Regardless of the numerous limitations of this study, it has initiated the development of the speculative hypothesis that the combined MMR vaccine can cause autism (DeStefano &Shimabukuro 588). Numerous scientific trials have refuted this hypothesis. Nevertheless, many parents became hesitant to accept MMR vaccination for their children and became fearful about the safety of the other vaccines.

Solution

Rapid surveillance efforts of the travelers’ vaccination must be accompanied by the increased vaccination levels in the developing countries. To ensure effective control, the full immunization of adult travelers is an essential component of the healthcare plan aimed to decrease the risks of infections outbreak. The enhanced vaccine coverage and expansion of the immunization programs for the developing countries is an essential part of the new effective strategy that must ensure control of the infection spread worldwide (De Bree et al. 25). To ensure the discussed improvements, several system transformations can be required. DeStefano &Shimabukuro (589) offer the implementation of active surveillance, spontaneous reporting systems, and additional governmental policies related to licensing and vaccination safety trials. Concerning the popularity of traveling and the risks to bring diseases from the other non-developed countries, such a solution must become helpful. Ensuring the obligatory vaccination for the high-risk groups and those who have no medical counterindications can also become helpful. People must realize that either vaccine refusal or delay can become an additional barrier to overcome the outbreaks of the preventable infections

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Struggling against the erroneous beliefs on vaccination and convincing the public about the importance to make the injections is an essential component of the effective company aimed to manage the overall social perception of MMR vaccination. Relying on the investigations, one should pay specific attention to the role of the parental trust to the healthcare professionals taking care of their children (Gilkey at al. 4). The providers must be trained to convince the parents about the importance of vaccination and about the fact that the healthcare system is concerned about the interests of the population. In addition to increased awareness of the problem for both parties, the possibility to provide a friendly and caring atmosphere at the healthcare establishments must become helpful to convince the public. According to DeStefano &Shimabukuro (590), communication can become a key to changing the attitudes of the parents. Clear explanations, transparent safety monitoring, the involvement of the independent expert groups to solve variable dilemmas, and open dialogues are the essential components of the policies aimed at the aware acceptance of vaccination among the population.

Conclusion

Regardless of the considerable progress in the decreased number of measles, mumps, and rubella cases, humanity has not reached the elimination of the mentioned illnesses. Although the researchers prove the safety and effectiveness of MMR vaccination, many people hesitate to believe it. For the parents, vaccination of children is a significant cause for anxiety and distress. In other cases, lack of vaccines in the undeveloped countries, low immunization levels of the young traveling population raise concerns that the gaps in herd immunity can increase. In contrast to the safety and few adverse effects that MMR vaccines can evoke, the population gets at risk to experience numerous complications of measles, mumps, and rubella that can be especially dangerous for children, pregnant females, and aging people. More effective immunization programs and transparent investigation of the side effects is highly demanded to solve this problem. Nevertheless, communication with the providers and increased trust towards the healthcare system must become the basic essential steps towards improves attitudes to MMR vaccination.

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