Cuba and USA Vaccination Programs - Essay Example

Name Class Unit The medical establishment has a number of tools to deal with contagious diseases; one of the most efficient instruments to address these diseases such as measles and others are chart of vaccination. Vaccination is among the strategies that modern medicine has to deal with. It is one of the tools that health care system use to curb the spread of diseases in vulnerable population particularly children and aged. Almost 5.9 million deaths are avoided annually through immunisation programmes globally. A polio vaccine was the first vaccine to be introduced by 1950s, and many others have been introduced since then. Despite the success of these programmes, there are objection to vaccination by stakeholders based on complications in isolated cases which have led to falling rates of vaccination in developed and developing countries. The objections have been based on association of vaccines with diseases such as Asthmas and Autisms, and isolated cases of their vaccines have enhanced rather than prevented disease. This essay will examine the success rates of childhood vaccination of measles, mumps and rubella (MMR) in USA and Cuba, and will consider the objections based on complications in isolated cases. It will also argue that although it’s a highly successful preventative measure, vaccination should not be made compulsory worldwide to steer clear of interconnected ethical problems. It will also show that vaccination must be highly encouraged globally to prevent communicable diseases through increased public awareness and financial incentives. There are a number of developing countries managing to eliminate preventable infectious diseases (McDonald, Halperin, Chaple, Scott and Kirk 2006). Cuba is a small and poor country that has been able to achieve great success in their health sector. Cuba immunisation program has been a success compared to the developed countries. The country has lower infant mortality rates than United States, which uses a large budget on health. Cuba success is an experience that has showed that use of a lot of money in health care will not always result to better health. USA has been experiencing high rates of objections to vaccination compared to Cuba. McDonald et al. (2006), asserts that over 95% of the Cuban children are immunised against 13 preventable diseases which is a significant rate than in most developed countries. There has been a disappearance of measles, rubella and mumps due to comprehensive immunisation program. The elimination of the three diseases has been a remarkable feat for Cuba as it has limited resources. According to McDonald et al. (2006), the country won the Gates Award in 2001 due to their National Immunisation Program. On the whole, vaccination has been a great success in Cuba. There is increased elimination of immunisation preventable disease by vaccination in developed countries. The successful elimination of these illnesses in United States has led to some of the parents to lack personal experience of having vaccine prevention conditions which have resulted in them objecting their children from vaccination (Walter et al. 2004). Objections have led to challenges as the immunisation rates have been reducing over the years. Challenges faced are based on objections that are cases of vaccine enhancing rather than preventing disease and association with vaccines with illnesses such as Asthma and autism. These complaints have led to an increase in request for exemption from vaccination (Sanford, Ilene, Robert & Richard 2007, S64). Some of the states in US have very high exemption rates. These exemptions exist despite the success that US have enjoyed over the years in their vaccination program. The increase in calls for an exemption is a threat to success of immunization program in US. Data shows that in 1964-65, United States had 12.5 million cases of rubella. These figures have reduced significantly with the immunisation program and in 2004, cases of rubella were nine. From 1997, the country has reported an annual incidence of rubella less than one case per million people. Measles is no longer an epidemic in USA. The case of USA is a proof that immunisation has the capability to eliminate vaccination preventable diseases (Walter et al, 2004). There are many objections to vaccination in USA and Cuba based on complications in isolated cases. Largent (2012) cites that objections exist despite the success level of immunisation programs in both countries. The falling rate of vaccination in countries such as USA in the recent past is due to these objections. Isolated cases have been exaggerated by anti-vaccine activists worldwide. The campaigns have been able to spread far and wide through use of internet. There have been creations of anti-vaccine movements online which have waged the campaign against vaccination. The best example is measles vaccine as it contains a weakened virus, it have been proved to cause rash and inflammation in 5% of the injection cases. Though this eventually leads to measles if, not treated the percentage is small hence not justifiable since vaccination saves more than 90% of children against measles. This case though isolated led to an increase in anti-vaccination campaigns worldwide. William, Peter & Gilbert, (2009) claims that anti-vaccine campaigns have been very active in highlighting the isolated case and gaining support among some parents and religious groups. The support for anti-vaccine campaigns is a worrying occurrence since it has acted to undermine the support for vaccination and led to calls for exemptions. Lack of immunization leads to suffering for the child and also leads to high costs economically. During an outbreak, the hospital can spend up to $ 800,000 for only seven patients while immunisation costs about $78. The exemption from vaccination increases risk of infections for the unvaccinated. For this reason, objections are an important cause of falling rates of vaccination in countries (Largent, 2012). There are a number of people objecting vaccinations associated with various diseases. Largent (2012) asserts that such conditions include Asthma and autism. The claims that vaccinations led to diseases was widespread during the introduction of MMR vaccine (Largent, 2012). Thimerosal which is found in MMR was removed from the vaccine in 1992 by many countries. Thimerosal was suspected to cause autism. Andrew Wakefield wrote and published an article which made a claim that MMR vaccine was responsible for bowel inflammatory bowel disease which led to brain being affected by harmful proteins. This article resulted in widespread fear and criticism and acted to renewal of anti-vaccine movements. The primary cause of removal of thimerosal from the vaccine was due to threats of lawsuits and fear that was generated by the public. Consequently, the objection based on association of vaccination and diseases have led to falling rates of immunization in some countries and growing mistrust (William, Peter & Gilbert, 2009). There are a number of calls for exemption from vaccinations based on isolated cases has led to an increase in number of vaccine preventable diseases (Harmsen et al, 2013). Infections can spread fast in an area where vaccination has not been carried out (William et al, 2009). In 1990, a major measles outbreak occurred in Philadelphia among unvaccinated school children. These were children whose parents had rejected their vaccination based on exemptions (Wolfe & Sharp, 2002). Despite the fact that the cases of outbreak had led to calls for vaccinations, exceptions continued to hinder the efforts. In 2008, there was measles outbreak in San Diego. The outbreak started when unvaccinated child contracted the disease and spread it. According to Krasner, (2010, p.244), the outbreak infected 11 unvaccinated children and exposed 839 people. The children affected by this outbreak had not been vaccinated before through exemptions. The cases of infection spread fast to other states especially among those who had refused the vaccination based on beliefs, association with Autism and among other reasons. Most of the outbreaks of vaccine preventable diseases occur in the unvaccinated population. There is a need to ensure that isolated occurrence of complications does not interfere with vaccination program (Harmsen et al, 2013). Accordingly, medical and public health officials should work together with parents and explain to them that unvaccinated children are at higher risk of getting vaccine-preventable diseases (Falagas & Zarkadoulia, 2008). There are existing objections to immunisation on the claims it leads to some illnesses (Mills, Jadad, Ross & Wilson 2005). The claim is invalid and malicious. A study which was carried out in 2003 by the paediatrics magazine was able to verify that thimerosal was not a cause for autism development in children. The study proved seven years after thimerosal was discontinued, cases of autism continued to increase (Largent, 2012). If thimerosal was the cause for autism, cases would have dropped after its withdrawal by the countries. More than 20 articles have been able to produce scientific evidence that MMR does not cause autism. The article written by Wakefield was retracted after his claims were proved wrong and malicious (Brumback, 2009). It was also proved that Wakefield had been bribed by lawyers who wanted the study to support their call for compensation (Brumback, 2011). The claims are associated with agents who wanted to receive compensation as well as clinics that claim to offer alternatives to MMR vaccine which are mercury free. Though the article is already retracted, the anti-vaccine propaganda based on the material still exists. The anxieties associated with allergic reactions are as a result of anti-vaccine proponents’ propaganda (Wolfe & Sharp, 2002). There are still a lot of anti-vaccine movements who have been spreading propaganda based on vaccination. As a result, clinicians should take this issue seriously and explain to the patients that there are no dangers of allergic reactions as indicated by anti-vaccine proponents (Falagas & Zarkadoulia, 2008). There is no compulsion on childhood vaccination in all countries. Making vaccination compulsory would lead to other dilemmas that include legal and ethical issues. When the process is forced, it will result in anti-vaccine sentiments. Conflict of rights is also a problem facing compulsory vaccination (Serpell & Green, 2006). According to Serpell & Green (2006), child has a right to access health care while the guardians have a right to give guidance and direction (Colgrove, 2006). Creation of policies that enhance public awareness to vaccination is a significant step that can increase vaccination rates (Diekema, 2012). It is proved that by offering financial incentives and creating public awareness can increase the rates of vaccination. Vaccination has led to declining in infectious diseases worldwide. For example, Australia was able to increase the rates of immunisation from 75% in 1997 to 94% in 2001 (Diekema, 2012). For this reason, vaccination should not be compulsory but it should be strongly encouraged because it has helped reduce infectious diseases. To sum up, Cuba has been able to succeed in vaccination programs as compared to developed countries such as USA. Developed countries such as USA have been able to eliminate measles by vaccination and cases of Rubella are almost nonexistent. Main objections faced in first world and developing countries are based on isolated cases of vaccines enhancing rather than preventing and association of vaccines with diseases such as asthma and autism. Vaccination should not be made mandatory worldwide to avoid interrelated moral problems but must be highly recommended to prevent contagious diseases. In addition, supporting vaccination through incentives and increasing public awareness can increase success rates and help in reducing outbreaks of vaccine-preventable illness. 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