About a century ago, some of the most common diseases to cause severe illness were polio, measles, and mumps. In fact, before vaccines were developed, these contagious illnesses were responsible for thousands of deaths each year, including in children. After vaccines came along, many common illnesses were preventable, curable, and some were even eradicated. That’s why it’s so surprising to see headlines like these about vaccine preventable diseases, “LA County Urges Doctors to Watch Out for Polio.”
This was hardly an isolated case. A few weeks ago, the New York State Department of Health (NYSDOH) issued a warning about finding polio virus samples in wastewater. In early September, Fox10Phoenix reported “3 measles cases confirmed in Maricopa County.” Even mumps made headlines this summer.
While vaccine hesitancy and misinformation are two reasons some illnesses are making a comeback, there’s more to the story.
Diseases Prevented by Vaccination
Health experts are worried about easily preventable diseases seemingly returning from the dead. Just to be clear, these are contagious illnesses that we have a vaccine for.
Vaccine preventable diseases: Polio
According to the CDC, “Polio is a crippling and potentially deadly infectious disease. It was eliminated in the United States with vaccination, and continued use of polio vaccine has kept this country polio-free.” So it’s understandable that when news hit last month that traces of the virus were discovered in sewage, health experts were alarmed. Those who lived through the pre-vaccine years were justifiably enraged.
In the U.S., polio is barely in the rear-view mirror. There are still many in American walking around bearing the scars of an early childhood diagnosis.
Famous violinist, Itzhak Perlman, contracted polio at the age of 4. To this day, the 77 year old wears leg braces and walks with crutches. Francis Ford Coppola, director of The Godfather trilogy, was diagnosed with the illness at age 9 and isolated in his bedroom for a year. Reminiscing about this period, the 83 year old said, “When you had polio then, nobody brought their friends around. I was kept in a room by myself.” Actress Mia Farrow, now 77 years old, also contracted polio at 9 years old. The Rosemary’s Baby actress relied on an iron lung and was hospitalized for eight months.
Last year, NPR reported on a woman who was diagnosed shortly after her fifth birthday in 1953. “Sixty-eight years later, an iron lung is still keeping [her] alive — she sleeps in it every night.”
What a preventable polio outbreak would look like
Fortunately, experts don’t expect to see a large number of polio cases, even in communities where vaccine hesitancy thrives. Yale School of Medicine determined that in a group of 10,000 unvaccinated people, roughly 8,000 will get the disease. Of those, about eight cases will develop into paralytic polio. If something like this does happen, health policy officials believe an aggressive vaccine drive will successfully contain the outbreak.
Why diseases that have vaccines make a comeback
Vaccine hesitancy and misinformation are two of the biggest reasons previously eradicated diseases are seeing the light of day again. However, it’s important to understand how vaccines work. A vaccinated person can contract certain diseases vaccines are designed to prevent. When someone who’s immunized is diagnosed with polio (usually spread by someone visiting from a country where polio still circulates), they usually have a mild case — oftentimes undetectable.
According to the CDC, inactivated poliovirus vaccine (IPV) protects against severe illness “in almost everyone (99 out of 100)” who’s received two doses. “Two doses of IPV provide at least 90% protection, and three doses provide at least 99% protection.”
Effective Vaccines Prevent Polio Outbreak
When communities adhere to suggested vaccine schedules, the chances of polio spreading are practically zero. All it takes is a group of unvaccinated individuals and a visitor from a country like Pakistan where outbreaks are still common. “From there it’s just a ricochet effect as the infection starts to spread like wildfire,” says Howard Forman, MD, a public health official from Yale. With more communities in the U.S. failing to reach the immunization threshold, a scenario like this is easier to imagine.
“The World Health Organization (WHO) in 2019 identified vaccine hesitancy or the reluctance to vaccinate as one of the top 10 threats to global health despite evidence of the important role of vaccines in improving population health outcomes.”
World Health Organization. Ten threats to global health. 2019.
Vaccine preventable diseases: Measles
Measles is a highly contagious disease. Thanks to the measles, mumps, and rubella (MMR) vaccine, in 2000, the CDC considered the virus eradicated in the U.S. However, there are still significant outbreaks in other parts of the world. In the decade before the MMR vaccine, most American kids under the age of 15 contracted measles. About 400 to 500 people died every year.
What a preventable measles outbreak would look like
The past few years, a period that coincided with a growing anti-vaccine movement, headlines have cropped up touting measles outbreaks around the country. In 2019, Texas Children’s Hospital reported the largest epidemic in nearly three decades. About 1,250 cases were reported across 31 states that year. The CDC said that the majority of cases were diagnosed in unvaccinated patients.
In subsequent years, cases have gone down, but increased vaccination rates are only partially responsible. It turns out that the Covid pandemic was a driver for higher measles numbers in some communities, while it also helped reduce the spread in others. According to UNICEF, in the early days of the pandemic, uninsured and underinsured kids were cut off from basic health services, including appointments for well-child care and vaccines. On the other hand, fewer contagious disease outbreaks, including measles, occurred in communities that adhered to social distancing, lockdown, and masking recommendations. The way in which these two roads do converge is that areas where vaccine hesitancy thrives were also more likely to fight policies proposed to prevent the spread of Covid. Hence, higher incidence of contagious diseases.
“More than 93 percent of people who get the first dose of MMR develop immunity to measles. After the second dose, about 97 percent of people are protected.”
Mayo Clinic
Vaccine preventable diseases: Mumps
If we’re seeing an uptick in measles cases, it seems reasonable that mumps could also make a comeback since they’re both easily prevented by the MMR vaccine. But in this case, it’s not misinformation or the anti-vax movement that are solely responsible for causing new cases of mumps to circulate. Last year, NBC News reported that about 94 percent of kids who contracted mumps had been vaccinated. So what gives?
What is mumps
Mumps is known for causing swelling in the jaw and cheeks. The contagious illness also causes fever, body aches and fatigue. While diagnosed cases of the virus declined almost 100 percent after the MMR vaccine came out, public health experts started seeing a spike again in 2006. This time, waning immunity was causing an uptick in cases.
The good news is that public health experts aren’t that worried. In terms of diagnoses, the numbers are still pretty low. Researchers say the vaccine is still up to snuff when it comes to keeping outbreaks from spreading outside of localized circles.
What a preventable measles outbreak would look like
Before the MMR vaccine, nearly 200,000 mumps infections were diagnosed each year — mostly in children. In the following years, cases decreased by 99%. And since immunization loses its effectiveness over time, according to Karen McGeehan, MD, a physician at Penn Family Medicine, the vaccine now lowers the risk of getting mumps by about 88%. People who get one or both doses of the MMR vaccine can get mumps, but their symptoms tend to be mild or undetectable. But they can still spread it to others.
Mumps is extremely contagious. That’s why someone who’s not vaccinated can get the viral infections in a room two hours after an infected person leaves. And those who are vaccinated help protect those who can’t get the vaccine, including the elderly, people who are immunocompromised and pregnant women.
“High vaccination rates have made mumps much less common. When the majority of people are vaccinated, outbreaks are smaller, shorter, and less severe,” according to Penn Medicine.
Adult and Childhood Vaccines Covered by Health Insurance
Most health insurance plans cover the vaccines that public health experts recommend for infants, kids, teens and adults. A lot of vaccines are provided for free or low-cost, regardless of health insurance status. For example, most neighborhood clinics and pharmacies offer annual flu shots, the Covid vaccine and boosters. Adults over the age of 50 can get a free or low-cost shot to immunize against shingles. Many pharmacies and walk-in clinics also offer these common vaccines:
- Hepatitis A vaccine is recommended for kids under the age of 18
- Hepatitis B vaccine, for all age groups, protects against a virus that attacks the liver
- HPV vaccine, for girls and boys, protects against certain types of cancers
- MMR, for kids, protects against measles, mumps and rubella
- Meningococcal vaccine, for pre-teens, protects against meningitis, a dangerous bacterial infection
- Tdap vaccine, for kids and adults, protects against tetanus, diphtheria and pertussis (whooping cough). Td vaccine protects against diphtheria and pertussis
- Varicella, for kids over the age of 12 months, protects against chickenpox. Adults should get this vaccine if they’ve never had chickenpox
Check that you’re up to date on your vaccines
Did you get all of your childhood and adult vaccinations? If you’re not sure, don’t take your chances. The older you get, the harder it is to recover from certain diseases. Learn how track down your immunization records so you can see what vaccines you’ve had and which ones you need to get. Read, “How to Get Immunization Records.“
Health Insurance Vaccine Coverage
Most private health insurance plans are required to provide vaccines at no cost. All active-duty members and their dependents get full vaccine coverage. Medicare B covers most recommended vaccines for enrollees. Medicaid covers all vaccines recommended for children and many vaccines recommended for adults. Families that do not have health insurance can look into the Vaccines for Children Program. According to the Department of Health and Human Services, kids under the age of 19 can receive all recommended vaccines free of charge if they qualify for Medicaid, or if they’re uninsured and can’t afford out-of-pocket healthcare costs.
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Check out chapters 2 and 5 of Decoding Health Insurance and the Alternatives: Options, Issues, and Tips for Saving Money to learn more about vaccines and immunizations. Also, learn about saving money on healthcare and health insurance in the U.S.
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