Vaccination Program on Measles

Posted: September 9th, 2013

Vaccination Program on Measles

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Introduction

                        Measles is an airborne disease that is fatal mostly among many children in the world. Over the past years before vaccination programs, the spread of measles led to the death of many people. Vaccination of measles involves administration of a solution containing measles. The natural hosts of the measles virus are human beings only. The introduction of the measles vaccination was a responsive measure on the case of myriads of measles deaths among susceptible people living in places of poor environmental conditions. The vaccination program of measles is a worldwide strategy of eliminating the disease, and its implementation has resulted to improvement in the public health care system. It ensures effective control of measles by boosting the immunity of multitudes of children.

The Live Attenuated measles Vaccine (LAV) and the Measles Initiative are instrumental programs that have attempted to curb the spread of the disease through routine immunization and eventually global elimination of measles. A greater degree of population immunity has been established by the vaccination campaigns and programs. According to Ndhlovu (2009), reports on measles associated deaths in Africa and all parts of the world reduced notably by 91% and 68% respectively due to the Measles Initiative program. Over 500 million children in more than 50 countries have immunized against measles. More and improved vaccination strategies are underway to meet the core objective of global measles elimination (Nixon, 2000). Most developing countries have experienced the decline of measles having been the main premises of measles prevalence in the earlier years.

Background

            Dating back to 7^th Century A.D, a larger fraction of child mortality was associated with measles. The disease was a serious threat that claimed so many lives. Rhazes, an Arabic physician, recorded the initial instances of measles after the discovery of its adverse effects. It was mistaken by Arabic and Latin physicians to be a milder version of small pox hence the name morbili. However, in the London epidemic, Sydenham, an English doctor classified measles as an independent disease different from smallpox towards the end of the 17^th century. Ndhlovu (2009) further explains that the contagiousness of measles, incubation period of the measles virus (MV) and the clinical presentation of the disease were first documented by a Danish physician known as Peter Panum in 1846.

Hektoen delved into a discovery in 1905 when he realized the transmission of the measles virus through blood transfusion if infected people in the acute phase are involved. In 1908, Von Pirquet discovered the immunosuppressive element of measles that showed the possibility of measles vaccination. John Enders and Thomas Peebles were the first to identify the measles virus, which they isolated from the body tissue of a human being and replicated it in monkeys (Ndhlovu, 2009). This instance created an excellent opportunity for the development of measles vaccines. The alum-adjuvanted and tween-inactivated whole virus vaccines were the first vaccines to be developed. However, their weakness and tendency of atypical measles called for further development of multiple vaccines. In 1960, Live Attenuated Vaccine (LAV) was first introduced alongside inactivated vaccines. United States licensed attenuated Edmonston B virus in 1963 as the first vaccine against measles.

Current Key Considerations

            As a viral disease, the eradication of measles needs sufficient investments and efforts. In addition, it is essential to develop an economical, safe and effective vaccine to control measles in a community. According to the Institute of Medicine (U.S) Forum on Emerging Infections (2002), a mass vaccination program depends on biological factors that influence virus transmission, the behavior of human beings, varying interaction between the agent of infection and the human host, and demographics of the latter. Before measles control immunization in the United States, a substantial number of susceptible people were infected by those who were already exposed to primary infection. Therefore, a mass vaccination program must put into account both primary and secondary infections in order to facilitate effective elimination of measles in a community (IMFE (U.S), 2002). A vaccination program on measles should be based on a serological approach that encapsulates the process of determining the dynamics of virus transmission accurately. Proper epidemiological surveillance will define the most suitable vaccination age and time according to the prevalence of measles in a community.

The combination of theory and practical observation of highly transmissible diseases such as measles also help in the designing of an effective vaccination program that blocks transmission. The financial aspect should also be considered in the preparation of the vaccination program. Mass vaccination is extensive, and the costs should well calculate beforehand for a smooth flow in the immunization process, in schools and health facilities. The cost-benefit analyses of health agencies should not undermine the quality of vaccines. Extensive vaccination programs decrease the tendency of transmission among unvaccinated people. Vaccines should be administered in a balanced manner to all the regions that might have susceptible people (World Health Organization, 2005). It is also necessary to consider the migration of people from different regions who can carry the measles virus in them. Epidemiological surveillance should also focus on evolutionary changes that may result viral mutants resisting the current vaccines.

Current Public Health Management of these Issues

            The current public health service has a crucial role to play in the campaign of global measles eradication. Therefore, the key areas of consideration mentioned above are managed by the public health service (Buchbinder & Shanks, 2011). The efforts of public health officials to curb the spread of measles worldwide and eliminate it eventually began in the 1980s. They embarked on new strategies of measles control for effectiveness. Health-oriented entities such as the World Health Organization (WHO), CDC and Pan American Health Organization (PAHO) convened among other public health officials discussed the feasibility of global measles eradication through the evaluation of successful vaccination programs on measles (CDC, 1997). The discussion took place 9-10 July 1996 in a meeting held in Atlanta. Vaccination strategies were also examined to determine better and more effective ones.

To counter the resurgence of measles due to evolutionary changes or a high population growth of susceptible adults, the major strategy of the public health officials is to perform routine measles vaccinations programs (Cochi & Dowdle, 2011). Government health agencies should develop strategies that will increase the beneficial function of vaccination programs, despite the fact that cost effective measures must be met. Long-term benefits should be considered in the calculation of vaccination program costs. Public health services offer catch-up immunization as a strategy of blocking transmission of the measles virus (Immunize Australia Program., & Australia, 2000). This is, in addition to the cohort immunization (MMR) that is offered on a routine basis to two-year-old babies. The catch-up immunization strategy has been evident in most developing countries among all children of a certain age range having put into account both the primary and secondary infections. The public health services manage the key factors of the measles virus through the epidemiological surveillance that analyses serological experiments and evolutionary changes to determine ways of improving current elimination strategies to be more effective (Neustaedter, 2002). The measles vaccination programs have been successful in South American countries such as Latin America and English-speaking Caribbean. More research in the public health service is being conducted to determine powerful ways of measles elimination (Jacobsen, 2012).

Improving the Health of the Community

            The improvement of a community’s health is a valuable measure in its healthcare systems. If public health issues such as prevalent epidemics are addressed and controlled, both short-term and long-term benefits will be experienced by the public health service and the people in the community (World Health Organization, 2005). A community’s output in any given field largely depends on the health conditions of the individuals. Public health agencies should use effective communication strategies to create awareness of issues associated with health. The health care of a community should be equitable, efficient and effective so that people are able to perform their tasks as required and for a level of quality to be achieved. Better healthcare results to a decrease in costs because there are fewer hospital admissions. It also reduces the mortality rate of people in the community or country and therefore, raises economic productivity. Reduction of healthcare rates ensures that the system is affordable to every individual in the community. Health campaigns and programs enlighten the people of the community on important issues to healthcare, hence preventing further infections.

Conclusion

            A vaccination program on measles requires adequate scientific research on the probabilities of the measles virus transmission. It would be difficult to eradicate the epidemic if past programs have not been evaluated and if their weaknesses have not been redressed. Earlier vaccination programs on measles were successful in reducing the rate of children mortality especially in the developing countries. The success of earlier campaigns and programs is evidence to the feasibility of a vaccination program on measles. However, due to the evolutionary changes and other factors that might lead to immunization resistance in the coming years, other vaccination strategies apart from the routine one-dose should be developed and implemented to test their effect on the measles virus. The strategies should involve the current key considerations on the eradication of the measles virus from the community

References

Buchbinder, S. & Shanks, N. (2011) Introduction to Healthcare Management. Jones & Bartlett Publishers.

Centers for Disease Control and Prevention (CDC) Measles Eradication. Morbidity and Mortality Weekly Report Vol. 46, 1997: pp 1-19.

Cochi, S. L., & Dowdle, W. R. (2011). Disease eradication in the 21st century: Implications for global health. Cambridge, Mass: MIT Press.

Immunize Australia Program., & Australia. (2000). Let’s work together to beat measles: A report on Australia’s measles control campaign. Canberra, ACT: Commonwealth Department of Health and Aged Care.

Institute of Medicine (U.S). Forum on Emerging Infections (2002). Considerations for Viral Disease Eradication: Lessons Learned and Future Strategies. National Academies Press.

Jacobsen, K. H. (2012). Introduction to health research methods: A practical guide. Sudbury, Mass: Jones & Bartlett Learning.

Ndhlovu, M. Z. (2009). Cellular Immune Responses to Measles Virus-Infection and Vaccination. The Johns Hopkins University.

Neustaedter, R. (2002). The vaccine guide: Risks and benefits for children and adults. Berkeley, Calif: North Atlantic Books.

Nixon, R. G. (2000). Communicable diseases and infection control for EMS. Upper Saddle River, N.J: Prentice Hall.

World Health Organization. (2005). Eliminating measles and rubella and preventing congenital rubella infection: WHO European Region strategic plan, 2005-2010. Copenhagen, Denmark: World Health Organization, Europe.