Other Vaccine Preventable Illnesses
In addition to the 10 major infections that have been conquered or well controlled in the United States by vaccines, health experts are still working on eliminating others.
These include viruses and bacteria that either change or include multiple strains, and so current vaccines help, but haven't eliminated the diseases entirely. This includes the flu vaccine, which must be given each year, the pneumococcal, meningococcal, and rotavirus vaccines, which only target certain strains of bacteria and viruses, and the chicken pox, hepatitis B, and hepatitis A vaccines, which haven't been given to enough people to eliminate these infections.
- Flu - an average of about 92 children younger than age five died each year from the flu during the 1990s and there continue to be about 44 to 67 flu deaths among children the last few years.
- Rotavirus - worldwide, there are about 450,000 to 600,000 deaths in children each year from rotavirus, a common cause of diarrhea. In the United States, rotavirus causes about 3 million cases of diarrhea, which leads to about 80,000 hospitalizations, and 20 to 40 deaths, although this is hopefully decreasing now that we have two rotavirus vaccines - RotaTeq and Rotarix.
- Chickenpox - although many parents think chickenpox is a mild infection, before the routine use of Varivax, the chickenpox vaccine in 1995, there were about 4 million cases of chickenpox each year, with an average of 10,500 hospitalizations and 100 deaths each year.
- Hepatitis B - about 400 million in the world are chronically infected with the hepatitis B virus, including over 1 million people in the United States. Children can get hepatitis B from blood and body fluids and if they are born to a mother who has hepatitis B, which is why it is important that they get their first hepatitis B vaccine as soon as possible after they are born. This plan of universal infant vaccination has greatly reduced the cases of childhood hepatitis B infections. Since some children get hepatitis B without any risk factors, a birth dose of the hepatitis B vaccine is important, even if a mother doesn't have hepatitis B.
- Hepatitis A - unlike hepatitis B, children usually get hepatitis A from daycare and from eating contaminated food, including seafood, fresh produce, and from outbreaks in restaurants. Most children in developing countries end up getting infected with the hepatitis A virus, and although usually not fatal, it is one of the most common vaccine preventable illnesses in the United States too.
- Pneumococcus - the pneumococcus bacteria or Streptococcus pneumoniae can cause meningitis, pneumonia, bacteremia, and ear infections. Two pneumococcal vaccines, including Prevnar that is given as part of the routine childhood immunization schedule, and Pneumovax, which is given to older high risk children and adults, is helping to decrease these infections. Before the vaccines were available, S. pneumoniae would cause about 700 cases of bacterial meningitis and 200 deaths each year in children. Worldwide, it is thought to cause about 1.9 million deaths each year in children under age 2.
- Meningococcus - the meningococcus bacteria or Neisseria meningitidis leads to over 50,000 deaths each year around the world. In the United States, there are about 2,000 to 3,500 cases each year, and about 10% of affected children die. The Menactra meningococcal vaccine is recommended for all children when they are 11 to 12 years old.
And unfortunately, there are many childhood killer infections for which there are no vaccines yet, like malaria (over 850,000 deaths each year), tuberculosis (450,000 deaths each year), and HIV/AIDS (over 320,000 deaths each year).
Sources:
Plotkin: Vaccines, 4th ed.
Mandell, Bennett, & Dolin: Principles and Practice of Infectious Diseases, 6th ed.
Long: Principles and Practice of Pediatric Infectious Diseases, 2nd ed.
Gershon: Krugman's Infectious Diseases of Children, 11th ed.
Kliegman: Nelson Textbook of Pediatrics, 18th ed.
CDC. Vaccine Preventable Deaths and the Global Immunization Vision and Strategy, 2006--2015. MMWR. May 12, 2006.
CDC. Diphtheria in the Former Soviet Union: Reemergence of a Pandemic Disease. Emerging Infectious Diseases. December 1998.
Measles outbreak in Dublin, 2000. McBrien J - Pediatr Infect Dis J - 01-JUL-2003; 22(7): 580-4.
Vaccine preventable diseases: current perspectives in historical context, Part I. Weisberg SS - Dis Mon - 01-SEP-2007; 53(9): 422-66.
