Abstract
Because of the anti-vaccination campaign spread in social media, more Americans refuse injections for personal reasons. In 2019, at least 20 states presented laws expanding immunization exemptions. Vaccination is mandatory only in five states – New York, Maine, California, West Virginia, and Mississippi (Lou & Griggs, 2019). The rest allow exemptions due to religious or personal beliefs. Although some Americans deny the danger of infectious diseases, in the past few years, there have been several outbreaks that took the lives of hundreds of people. It is necessary to inform the population in paediatrics rooms and in the media to change the attitude of citizens towards vaccination.
Future changes may include the introduction of mandatory vaccination throughout the US, regardless of personal or religious beliefs. For these purposes, it will be useful to establish collaboration with medical institutions, and with celebrities who care about the health of US citizens.
Immunization Campaign
Because of the spread of false formation in social media, more Americans refuse immunization. It leads to an increase in the incidence rate of preventable infectious diseases and a weakening of the nation’s immunity. Over the past few years, outbreaks of measles, mumps, hepatitis A and acute flaccid myelitis have occurred in the country. Refusal from immunization may occur because people do not recognize the severity of the symptoms and complications caused by diseases, and assume vaccination has a negative effect.
Preventable Diseases Outbreaks in the US
Since the main reason for refusing immunization is the spread of misinformation, the following is a list of preventable infectious disease outbreaks in the US in 2018-2020. The bellow news bulletin shows that the problem is urgent, as epidemics of infections lead to deaths, including among children. This information should be conveyed to opponents of immunization since the outbreaks of diseases occur due to their unreasonable decisions.
In 2019, an outbreak of measles was registered in the US. In particular, from 1 January to 5 September 2019, 1,241 cases of infection were detected in 31 states (Hauck, 2019). The most significant number of incidents happened in New York City, in the Orthodox Jewish neighborhoods; investigators and doctors assume that the infection spread from abroad. Before the measles vaccine appeared in 1963, the disease claimed 2.6 million lives annually (Hauck, 2019). According to WHO, 110,000 people worldwide died from measles in 2017 (Hauck, 2019). Thus, the above numbers provide evidence for why the immunization campaign should be held without delay.
Later in 2019, the whole country was following the news about the mumps outbreak, after 2,000 cases were recorded throughout the US in 2018. By 29 March 2019, there were 426 cases of the disease, 106 cases were among students and residents of the Temple University area, Pennsylvania (Goldschmidt, 2019a). By 26 April, this figure had risen to 736 cases in 41 states and the District of Columbia (Goldschmidt, 2019b). Further, in February 2020, an infection broke out at a ski resort in Colorado, with 26 cases recorded (“Mumps outbreak rises to 26 cases,” 2020). A vaccine called MMR against measles, mumps, and rubella successfully prevents these infectious diseases.
Furthermore, in 2018, the hepatitis A outbreak was reported among unlucky visitors of the grocery store in New Jersey. This infection is often referred to as the ‘dirty hands’ disease, as it can be prevented by washing hands. By November 2019, the number of cases had mounted to 504 people (Schumaker, 2019). Earlier, in 2016, the country was affected by the hepatitis A epidemic, with 27,634 cases of infection in 30 states (Schumaker, 2019). As a result of the outbreak, 275 people died from the disease (Schumaker, 2019). Most cases of infection came from marginalized groups such as homeless people and people who use drugs intravenously.
Finally, the saddest and most impressive was the polio-like virus epidemic, named acute flaccid myelitis. Doctors note that the virus infects the spinal cord and causes temporary or permanent paralysis in young children (Rahhal, 2018). For some reason, the infectious disease rolled in waves and receded. In 2014, 120 cases were recorded in 34 states, in 2016, 149 people were affected, and in 2018, 186 confirmed cases were reported (Rahhal, 2018). Notably, the outbreaks coincided with a viral respiratory infection, EV-D68, caused by a bug (Rahhal, 2018). Therefore, in 2020, medical practitioners are preparing for a new outbreak of the disease. The CDC has not developed a vaccine or a cure for the disease yet.
Symptoms and Complications
The problem of refusing immunization is critical since not only particular people but the whole nation is at risk. Infection can only be prevented from spreading if the majority of the population is immunized. Below, there is a list of the symptoms, complications, and epidemiology of preventable infectious diseases in which Americans refuse to vaccinate because of personal or religious beliefs. This information will later be included in booklets and posters supporting the immunization campaign.
Measles, mumps, rubella, poliomyelitis outbreaks were already registered in 2018, 2019, 2020. According to Török, Moran, and Cooke (2017), measles is “an acute, highly infectious disease of children, characterized by cough, coryza, fever, and rash, for which humans are the only natural host” (p. 384). It is endemic all over the world; without vaccination, epidemics lasting 3-4 months occur every 2-5 years (Török et al., 2017).
The infection is “airborne, spread by contact with respiratory secretions, and one of the most communicable of the infectious diseases” (Török et al., 2017, p. 385). Patients are spreading it most during the last phase of the disease, through intensive coughing. Neurologic complications may include primary measles encephalitis, acute post measles encephalitis (Patterson, 2020). Subacute sclerosing panencephalitis (SSPE), or measles inclusion body encephalitis (MIBE), which are lethal diseases, may also develop as a result of measles.
Mumps infection spreads among children and adolescents; its symptoms include swelling and tenderness of the salivary glands. If a person becomes infected and falls ill in older age, more severe manifestations are possible (Török et al., 2017). Mumps infection is common throughout the world; before vaccination, epidemics took place every 2-5 years (Török et al., 2017). It is transmitted by droplet spread or direct contact and is most infectious just before it moves to the parotitis phase. Hospitalization and severe complications due to mumps were reduced after the use of the MMR vaccine (López-Perea et al., 2017).
Complications include meningitis in 1-10% of cases, encephalitis, and sensorineural deafness, especially in adults or babies (López-Perea et al., 2017). Such severe complications are very likely to ensure people make vaccinations.
Rubella is another infection that is spread all around the world. It is “an acute, mild viral infection of children and adults, resembling mild measles, but with the potential to cause fetal infection and birth defects” (Török et al., 2017, p. 389). Scientists note that “unlike measles, rubella is only moderately contagious; before vaccination, the incidence was highest in the spring amongst children aged 5-9 years” (Török et al., 2017, p. 389). Rubella is spread by droplets; those who are sick are most contagious when a rash appears.
Poliomyelitis is a spinal cord inflammation that causes paralysis; the term refers to gray matter, polio, and spinal cord inflammation, myelitis. Viruses from the enteroviruses group that because inflammation are spread by the fecal-oral route, and the incubation period lasts from 7 to 21 days (Wright, 2018). Clinical manifestations include “acute flaccid paralysis involving a single limb, quadriplegia, and-or respiratory failure” (Wright, 2018, p. 423). No cure for the disease has been found, so doctors mainly provide supportive therapy; complications include long-term severe neurologic effects. The solutions proposed below are aimed to support 99% immunization (Wright, 2018). It will help to mitigate the risk of infections and reduce the incidence and mortality of preventable infectious diseases among US citizens.
Information Campaign
It is proposed to develop posters for social media, online media platforms, and outdoor advertising. Moreover, it makes sense to raise the issue on national television and YouTube. In particular, videos about people who will tell their stories related to immunization will interest viewers. A Series of 15-30-minutes documentaries on the history of preventable infectious diseases will also draw the public’s attention. Besides, an information campaign will be organized on social media.
Moreover, a series of booklets will be developed with information on the spread, symptoms, and possible complications caused by infections. Leaflets will be distributed in health facilities throughout the country. It makes sense to start with the most vulnerable states, which can be negotiated by telephone with local health facilities, and then send booklets by mail. Cooperation with the relevant units of WHO, CDC, NHIL, Healthy People could also be established to help them implement the measures described as necessary in the reports of these organizations. The social media campaign will invite celebrities who support immunization to participate in the campaign.
Changes to Legislation
Immediate introduction of mandatory immunization into legislation, with exceptions solely for medical contraindications, will have the best effect. A preliminary public awareness campaign will support the changes to the legal system. Despite the recorded outbreaks of measles, mumps, hepatitis A and acute flaccid myelitis in 2018-2020 across the country, in 2019, more than 20 states have proposed new laws with more options for refusing immunization (Lou & Griggs, 2019). Thus, at the moment, in most states, the possibility of refusing vaccines for religious and personal reasons is legislatively fixed.
Costs
The cost of a public awareness campaign will be partially covered from the state budget, as 99%-immunization contributes to the health and well-being of all US citizens. Since informing implies solely intellectual contribution, the costs will not be high. Volunteers can cover part of the labor costs; the state is invited to pay for the work of journalists, as well as for advertising in city boxes and online media platforms. In the future, free vaccination in public places could be held, which will require the purchase of necessary medicines. Presumably, CDC could provide them, and volunteer medical practitioners will vaccinate all comers.
Conclusion
Thus, the latest cases of outbreaks and terrifying symptoms of preventable infectious diseases were described. The most depressing is the statistics on acute flaccid myelitis. The statistics on hepatitis A are also tragic, the infection of which can be prevented by just observing the rules of hygiene. The spread of mumps and measles, which are fraught with dangerous complications, is also impressive. Fortunately, these diseases can be prevented through timely immunization. It will be necessary to hold an information campaign in city hospitals, social networks, as well as in the media, to convince Americans to welcome immunization. The subsequent introduction of compulsory vaccination will solve the problem completely.
References
Goldschmidt, D. (2019a). Nearly 300 US mumps cases reported in March. CNN. Web.
Goldschmidt, D. (2019b). More than 700 cases of mumps in the US this year, CDC says. CNN. Web.
Hauck, G. (2019). The US in danger of losing measles-free status, a ‘mortifying’ effect of the anti-vax movement. USA TODAY. Web.
López-Perea, N., Masa-Calles, J., De Mier, M., Fernández-García, A., Echevarría, J., De Ory, F., & De Aragón, M. (2017). Shift within age-groups of mumps incidence, hospitalizations, and severe complications in a highly vaccinated population. Spain, 1998-2014. Vaccine, 35(34), 4339-4345.
Lou, M. & Griggs, B. (2019). Even with measles outbreaks across the US, at least 20 states have proposed anti-vaccination bills. CNN. Web.
Mumps outbreak rises to 26 cases at Colorado ski resort. (2020). Associated Press. Web.
Patterson, M. C. (2020). Neurological complications of measles (rubeola). Current Neurology and Neuroscience Reports, 20(2), 2.
Rahhal, N. (2018). The US set for an unprecedented outbreak of the mysterious polio-like virus in 2020: Scientists have one year to crack the mystery of the disease paralyzing America’s kids. Daily Mail. Web.
Schumaker, E. (2019). What to know about hepatitis A outbreaks in the US. ABC News. Web.
Török, E., Moran, E., & Cooke, F. (2017). Oxford handbook of infectious diseases and microbiology (2nd ed.). Oxford University Press.
Wright, W. F. (Ed.). (2018). Essentials of clinical infectious diseases (2nd ed.). Springer Publishing Company.