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Vaccination in Public Health, Then and Now

By Emmanuel Opada MD, MPH


Many years ago, efforts in ensuring a healthy community received a boost following the development of various vaccines that help to prevent the transmission of infectious diseases or sometimes mitigate the impact of infectious diseases such as smallpox, rabies, tetanus, yellow fever, measles, tuberculosis and most recently COVID-19. Following the discovery of early vaccines in the 18th century, there were no substantial reasons to doubt their effectiveness even though there were cases of resistance as time went by. Additionally, it appeared that most of the community appreciated the impact of vaccines, the potential benefits and the likely outcomes of non-vaccination. More so, it might also appear that scientists were not perceived to be biased or partisan. 


When preventative measures are disproportionate to the costs of treatment for preventable diseases, informed policies to support prevention would be beneficial; hence the need for vaccine requirements in some aspects of life such as across various educational and employment levels. Observing the attitude and beliefs of people in contemporary times, we might then ask ourselves, what changed? When we forget the discoveries in the health sector, the tremendous works of scientists in vaccine development and HIV/AIDS research in the 20th century, we may also be forgetting how the world appreciated scientific efforts in research works leading to the development of various vaccines and the understanding of the pathogenesis of diseases.


To some, it may seem worrisome that scientists still have not developed a vaccine against some conditions including HIV/AIDS, whereas, some might wonder why Influenza vaccines are administered every year. Note that at the molecular level different viruses may have different structures evidenced by their envelopes and some segments. This makes the influenza virus unique because transfer of genetic materials occur across the segments leading to genetic shift, hence, the need for the yearly vaccination to cover for the recurrent mutation in the gene.

Furthermore, previous vaccines against COVID-19 do not seem to confer the expected protection against the newly emerging variants, evidenced by seasonal and increasing rates of COVID-19 transmission even among previously vaccinated. Vaccines such as Johnson & Johnson, Moderna and Pfizer approved by the FDA were administered to the public in an effort to prevent the COVID-19 transmission. Scientists and public health experts worked in a concerted effort to educate the public on the benefits and the need to comply with vaccination schedules. Upon recommendation by public health officials during the COVID-19 pandemic, some states collaborated with various stakeholders to establish vaccine and mask mandates. Considering these efforts, one would expect that case control would be at least proportionate to the effort on prevention, but to the majority, including the public and healthcare workers, there has been a disproportionate seasonal increase in the transmission of COVID-19 with respect to the various interventions already put in place.


Going forward, scientists might want to take more time to adequately understand the pathogenesis of novel disease conditions and arriving at definitive interventions before disseminating advisories that would inform policies to the constituted authorities in order to ensure commensurate expectations to maintain public trust especially in a time where politics has been perceived to influence public health policies. Likewise, there may be a need to emphasize the importance of vaccination at all levels; leaving the decision to the public to accept or reject vaccination based on scientific evidence in an effort to achieve a healthy community.


Emmanuel Opada, MD,MPH  is the Epidemiologist at the Victoria County Public Health Department. He has been with the health department since 2021.