An unyielding defense is as critical to success as a powerful offense, in medicine as in nature, sports, or war. In health care it is essential to develop effective treatments such as antibiotics and surgical procedures that stop infections and cancers in their tracks, but it is much healthier, less painful, and more cost-effective to prevent the infection or cancer from ever taking hold in the first place.
Medicine has developed, through very sophisticated research, very simple vaccines to prevent infectious diseases and cancers -- serious, debilitating and often fatal illnesses that, once established in our bodies, current medications are powerless to cure. Only prevention works.
Examples of such untreatable but vaccine-preventable diseases are Hepatitis B, HPV (human papilloma virus), polio and measles. The first two viruses cause both miserable acute infections and common deadly cancers. We have developed safe, effective vaccines against all of these illnesses and they have saved millions, perhaps even billions of cases of these illnesses. Except for the use of clean water, vaccines have saved more lives than any other public health interventions in the history of the world.
The timing for administering each vaccine is strategic and optimal. After years of study, researchers have identified at what ages children are likely to first contract each illness, so we vaccinate before those ages. By testing both immune responses and frequency of illness, we have discovered how long the effectiveness of these vaccines lasts, so we then give boosters to rebuild immunity at those intervals. We have tested the safety of these vaccines extensively before they are allowed to be used on anyone, and we continue to follow their safety over the lifetimes of all of the millions of patients who have received them.
The concept of "herd immunity" is an essential one. It comes from the observation that animal herds use a very effective technique to protect their young from predators. The strong adults form a circle around the vulnerable members of their herd. With vaccines, we use the same technique to protect the very young and very infirm members of our families and communities. We call this creating "herd" immunity.
Fifty years ago, by immunizing almost everyone in the world against smallpox, we were able to completely eliminate this devastating disease. That virus became extinct. We are trying to do the same thing with the polio and measles viruses, but we have not succeeded yet because not enough people have been vaccinated to create worldwide herd immunity.
This failure seems tragic and frustrating. The more slowly we move toward this goal, the more difficult it will be to achieve. Every day, unvaccinated people, like those exposed in Disneyland, travel far and wide, carrying and passing on the virus to scattered vulnerable individuals. By not vaccinating a high enough percentage of our population, healthy communities can be reinvaded. We, the People, lose, and the virus wins.
No one wants to have to pass laws that force parents to vaccinate their children against their will. But we know such laws and regulations work. Fewer exemptions and tougher school entry requirements do drop the rates of preventable illness. What we hope is that physicians, scientists, legislators, teachers, religious leaders, and well-informed parents can convince their friends and relatives, patients, and students that vaccine-preventable illnesses such as measles can be devastating and even fatal, and that many are not treatable once they grip our children and loved ones. Everyone possible needs to be vaccinated.
Prevention, a tough "defense," is truly our best "offense" in the case of these terrible diseases, not the other way around, and we do have the tools to win. We just need the will.