Revised on 2/19/15; Part 2 posted on 2/20/15
I think that the continuing controversy over the safety of the MMR vaccine has distracted us from the success of immunization in general. Lots of attention in healthcare now is focused on prevention and immunization has been one of the most effective ways to prevent disease ever developed. (one note- prevention, effectiveness and safety are all relative terms medically speaking-but that will be a topic for a future post.)
The list of diseases that are “vaccine preventable” is long and continues to grow.
Target patients for each vaccine depends on age, gender, ethnic background and concurrent conditions, especially diabetes mellitus, chronic lung diseases, heart disease and immune suppressing disorders.
There are differences in the number of doses recommended, how far apart, and which vaccines can be administered at the same time.
Immunization protocols have become so complex that even physicians have difficulty keeping it straight without the use of paper or digital checklists. This is one area where the Internet and EMRs (electronic medical records) can be useful.
Today I will review some of the infections caused by bacteria for which immunization is available. Later in the week I will discuss the viral diseases. I will use the name of the disease and/or the causative organism, rather than the vaccine name, since there are different brand names and I do not want to endorse any one in particular.
So successful have these vaccines been that most young doctors have never seen a patient with these diseases (unless perhaps they specialize in infectious disease, immunology, emergency medicine or critical care). And even I, who graduated medical school in 1978, have only seen a few, and none in recent years.
Diphtheria-primarily a respiratory tract illness in young persons
Pertussis, better know as whooping cough, also a respiratory illness, which has made a comeback in recent years, apparently due to a waning of immunity
Tetanus, also called “lockjaw”– due to a toxin which may contaminate a dirty wound
Menigococcal disease, which is one of many causes of meningitis (inflammation of the brain lining), but one of the most deadly, even with treatment
Streptococcal pneumoniae disease; the vaccine is often referred to as the “pneumonia vaccine”, but the bacteria can also cause ear infections, sinusitis, meningitis and sepsis (bloodstream infection)
Haemophilus disease is similar to pneumococcal, but more of a concern in infants and children
Since this is a brief overview, I recommend you review details at