Health experts are recommending that children receive breakthrough vaccines for meningitis as well as for whooping cough (pertussis).
Both vaccines are safe enough to be used by 11-year-old children, providing youngsters with protection that they have not had up until this point, doctors say.
Vaccines have eradicated smallpox globally, and in the United States, they have eliminated wild polio virus and significantly reduced the number of cases of measles, diphtheria, rubella and other diseases, according to the National partnership for Immunization. However, tens of thousands of Americans still die from vaccine-preventable diseases.
More frustrating to doctors, is that 15% of adults do not believe inoculations are necessary to prevent certain diseases. And a persistent rumor linking vaccination with autism has led some parents to choose not to immunize their children.
If diseases such as measles, diphtheria and whooping cough were to resurface unchecked, thousands of American children would die.
"We are pretty complacent about vaccine preventable diseases, primarily because the vaccines are so effective we rarely see the diseases," says David Neumann, executive director of the National Partnership for Immunization. "It's kind of out-of-sight, out-of-mind."
The new meningococcal vaccine is important because it is effective over a longer period of time than the old vaccine was, says Dr. Paul Offit, chief of infectious diseases at The Children's Hospital of Philadelphia
"The problem was the earlier vaccines didn't provide long-lasting immunity," Offit says. "Frequent boosting was required."
Meningitis is a viral or bacterial infection of the membranes and cerebrospinal fluid that surround the brain and spinal cord. It is spread by coughing, sneezing, kissing or sharing drinking glasses, experts say.
Symptoms include a fever of 101"F or higher, a stiff neck, a purple rash, vomiting and headache. Meningitis can result in long-term permanent disabilities such as hearing loss and brain damage. The most serious type of meningitis is caused by the meningococcus bacteria, for which the vaccine was developed. According to the Centers for Disease Control and Prevention (CDC), approximately 3,000 cases of meningococcal disease occur in the United States every year. The overall fatality rate is approximately 10%, but it is sometimes higher in young people.
The most dangerous result from the meningococcal bacteria is sepsis, or blood infection, Offit says. "You can be fine one minute, and dead four hours later," he says.
The CDC recommends giving the new vaccine to children at age 11 or at age 15, if they have not received the vaccine before; and to college students living in the close quarters of dormitories
The new pertussis vaccine also comes as a relief to doctors, as whooping cough is the only vaccine-preventable disease that has not been quelled. In 1998, there were 7,405 reported cases in the United States. That figure rose to 9,771 in 2002.
"The problem with the original vaccine is that when it was given to kids over seven, it caused some pretty severe reactions," Offit says. So children would receive as many as five combination diphtheria-tetanus-pertussis (DTP) shots by age seven, but only receive a diphtheria-tetanus booster after age seven. Therefore, their protection from pertussis was good, but not perfect, because the vaccine's effectiveness deteriorated after five years.
This new form of the vaccine is safe for children ages 10 to 18.
"The public health community is very excited by this new booster shot," Neumann says. "We're optimistic that the incidence rates will be driven back down. The challenge will be to get those 11-year-olds back in [to the doctors' offices] for their booster shot."
Another challenge is convincing parents of the importance of vaccines. A 1998 article cited studies of 12 children who had pervasive developmental disorder, primarily autism. The parents and doctors of eight of the children said this began after they received the measles-mumpsrubella (MMR) vaccine.
A later report from the Institute of Medicine collected all of the available evidence and found no connection between vaccines and autism. However, that has made little difference to many parents, Neumann says.
"We see no evidence for the alleged effects that have been linked with vaccines," he says. "Unfortunately, people who have heard the allegations about vaccines have discounted the science, [and] the rumors persist."