5th Annual Advocacy Project: ImmuneWise Section on Medical Students, Residents, and Fellowship Trainees

VACCINES: A historical perspective

Vaccines Timeline 1955: Jonas Salk’s inactivated polio vaccine is licensed 1950s Monovalent  then trivalent polio vaccines introduced 1964: ACIP holds its first meeting 1960s

1971:Routine smallpox vaccination ceases 1979: Last reported case of natural polio reported in the U.S. 1970s 1982: Hepatitis B vaccine becomes available 1986: National Childhood Vaccine Injury Act  no-fault compensation system 1980s Vaccines Timeline

: Major measles resurgence, 55,000 cases reported; 2 dose vaccine recommended 1990: VAERS established, monitoring safety of vaccines 1990: Hib vaccine established 1991: Hep B vaccine recommended for all infants 1995: 1 st vaccination schedule recommended by ACIP, AAFP and AAP is published 1995: Varicella and Hep A vaccines licensed 1996: Acellular Pertussis vaccine licensed for use in infants 1998: 1 st Rotavirus vaccine licensed  withdrawn from market in 1999 due to adverse events 1999: FDA recommends removing mercury from all vaccines 1990s Vaccines Timeline

2003: Measles no longer endemic in the US 2003: 1 st live attenuated Influenza vaccine approved for use in 5-49 years of age 2004: Inactivated Influenza vaccine recommended for children 6-23 mo of age 2005: Rubella no longer endemic in US 2005: Meningococcal conjugate vaccine licensed 2006: HPV and Rotavirus vaccines licensed 2000s Vaccines Timeline

IMPACT OF VACCINES IN THE United States

Impact of Vaccines in the US Disease Baseline 20th Century Annual Cases 2006 CasesPercent Decrease Measles503, % Diphtheria175, % Mumps152,2096, % Pertussis147,27115, % Smallpox48, % Rubella47, % Haemophilus influenzae type b, invasive 20, % Polio16, % Tetanus1, % The Impact of Vaccines in the United States Credit: Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, 4/2/99, 3/21/08

A LOOK AT GLOBAL VACCINATION

Global Vaccination Coverage, 2007 VaccineNumber of countries in which vaccine is in use Estimated global coverage (if available) Hepatitis B17165% Hib11526% Rubella126-- Mumps114-- Maternal and Neonatal Tetanus (MNT) 9270% Pneumococcal20-- Rotavirus13-- HPV10-- Yellow Fever33 (out of 44 at-risk countries) -- Source: World Health Organization, “Global Immunization Data, January 2009.”

Measles

Pertussis

Global Vaccination Rates - a few examples

International Mortality Vaccine- preventable disease In 2002, WHO estimated that 1.4 million of the deaths among children < 5 years old were due to diseases that could have been prevented by routine vaccination 14% of total global mortality in children < 5 years of age

A PERSONAL EXAMPLE

Impact of Vaccine-preventable disease Heather Whitestone, named Miss America in 1994 Became deaf at 18 months of age after contracting Hib meningitis