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AFNS 416 > 21 - Vaccine Hesitancy > Flashcards

21 - Vaccine Hesitancy Flashcards

1
Q

What is vaccine hesitancy?

A

Refers to delay in acceptance or refusal of vaccines despite availability of vaccine services

Complex and context specific varying across time, place and vaccines

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2
Q

Vaccine preventable diseases in developed countries reduced by..

A

98-99%

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3
Q

Decline in measles mortality in developed countries

A

78% decline, 12.7 million deaths avoided

However, it has risen 30% globally

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4
Q

What diseases are eradicated?

A
  1. Small pox (20-60% death rate, 300-500 million deaths in 20th century)
  2. Rinderpest

Getting close: polio

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5
Q

What is disease elimination? E.g.

A

Local elimination
e.g. measles, mumps and rubella in NA and EU

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6
Q

What is rinderpest? Transmission? Status?

A

Cattle plague (domestic cattle, water buffalo, yaks)
Animal to animal contact, virus present in nasal secretions preclinically

Global vaccination program = last case 2001, eradication declared 2010

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7
Q

What is the MMR vaccine? Introduced when

A

Measles, mumps and rubella
Introduced in 1970
In Canada, adults born before 197o are presumed to have acquired natural immunity to MM

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8
Q

Describe measles

A

MeV
RNA virus
High R0 (12-18)
High level population immunity required

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9
Q

Describe mumps

A

MuV
RNA virus
R0 3.5-4.5
Increase in cases since 2006

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10
Q

Describe rubella

A

RuV
RNA virus
R0 3.7-7.8
Infection of pregnant women = high likelihood of birth defects

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11
Q

What is herd immunity? Diseases with high R0…

A

Reduction in disease incidence in unvaccinated individuals when sufficient proportion of pop is vaccinated

High R0 requires higher coverage to attain herd protection

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12
Q

Flu vaccination reduces risk of influenza by… Why is there variable protection?

A

Between 40 and 60%

Does the vaccine line up with the circulating influenza virus? Vaccines are made well before flu season

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13
Q

Describe polio? Incubation, serotypes of polio

A

Non-zoonotic, humans only, spread through fecal-oral route
<1% have paralytic polio

Incubation period 7-10 days

Wild poliovirus type 1 (WPV1)
Wild poliovirus type 2 (eradicated)
Wild poliovirus type 3 (eradicated)

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14
Q

What was the lubeck disaster

A

1929 Lubeck, Germany
BCG (TB) vaccine to newborns orally
251 infants inoculated
91% developed evidence of TB
77 deaths

Cause: contamination of BCG vaccine w virulent M. tuberculosis

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15
Q

Describe “The Cutter Incident”

A
  • polio vaccine in 1955
  • flaw in polio vaccine manufacturing process
  • Rushed manufacturing, Cutter laboratories produced live polio virus in “inactivated” vaccine
  • 120,000 vaccinated with it
  • 40,000 cases of polio
  • 56 paralyzed, 5 dead
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16
Q

Cutter incident led to…

A
  • regulatory changes
  • implementation of much more vigilant monitoring and regulation of the vaccine industry
17
Q

Two types of polio vaccines

A
  • inactivated polio vaccine
  • oral polio vaccine
18
Q

Describe OPV

A
  • live weakened (genetically modified) poliovirus
  • occasionally mutates to form similar to wild polio and causes paralysis
  • Canada stopped using in 1996
  • transmission in areas of poor sanitation, low vaccination rate
19
Q

After suspension of Dengvaxia, immunization rates for what diseases went down?

A

Polio, chicken pox, tetanus, others

20
Q

Describe trends in Samoa MMR vaccination rates

A
  • 2017 = 75% coverage
  • 2018 = ~40% coverage
  • July 2018: 2 deaths (children) due to improper reconstitution of vaccine (atracurium used as diluent instead of water)
  • increase in # measles deaths
21
Q

Re-emergence of measles in the US

A
  • majority of ppl who got it were unvaccinated
  • still common in many parts of world
  • travelers with measles continue to bring the disease into US
  • spread in groups of unvaccinated ppl
22
Q

Measles in Canada. Why could it be a future threat?

A

Eliminated in 1998 (transmission within country or region no longer active)

But, imported cases AND coverage below minimum needed to maintain measles elimination
(1st dose coverage = 90%, required 95% of pop)

23
Q

Describe the Montreal Vaccine Riots

A
  • March 1885: Smallpox brought to city
  • Mass vaccinations attempted, but several cases of erysipelas = suspended for 3 mo
  • Sept = 6000 cases of smallpox
  • Poor forcibly removed from housing
  • vaccinations compulsory
  • protests, riots, firing at police
  • 3234 deaths due to smallpox
24
Q

Rationales behind vaccine hesitancy (9)

A
  • Complacency (unlikely to be exposed to virus e.g. measles)
  • Mistrust of government, science
  • Religious beliefs
  • Injection of viral components/foreign substances
  • Disease disappearing for other reaons
  • Risk>benefit
  • Alternative therapies
  • Autism
  • History of distrust
25
Q

Vaccine hesitancy highest among what races? Reasons?

A

Blacks, Bangladeshi and Pakistani

Concerns about side effects/long term health impact, lack of trust

26
Q

YouTube banned any suggestions that the COVID19 vaccine would…

A
  • kill people
  • cause infertility
  • involve microchips being implanted
27
Q

Ten threats to global health in 2019 according to WHO

A
  1. Air pollution and climate change
  2. Noncommunicable disease
  3. Global influenza pandemic
  4. Dengue
  5. Ebola and other high-threat pathogens
  6. Fragile and vulnerable settings
  7. Weak healthcare
  8. AMR
  9. HIV
  10. Vaccine hesitancy
28
Q

Reasons for COVID19 vaccine hesitancy in UK

A
  • worried about unknown future effects
  • worried about side effects
  • trust
  • chances of becoming seriously unwell from COVID are low
  • chances of catching COVID are low
29
Q

Where are vaccine resistant people getting their info?

A

internet, social media

30
Q

Increase in vaccine preventable disease largely due to… (2)

A
  • health inequities (underdeveloped countries healthcare systems stretched during COVID)
  • vaccine hesitancy

AFNS 416 (22 decks)

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