We Should Celebrate the Advances Vaccine Research Is Making: But Many Aren’t

There has been plenty of great news about vaccines recently.  A new, improved vaccine against the potentially deadly meningococcal bacteria was just approved. This microorganism causes a disease called meningococcemia that is especially prevalent among young people living in crowded arrangements, like college dormitories. It can kill its victims within hours (as one of us witnessed during his pediatric internship). But a vaccine has virtually eliminated this disease and now an updated version that covers more of the meningococcal subgroups will make it even less likely to cause severe disease and death. Of course, this new vaccine was only approved after extensive study showed it to be both effective and safe.

A five-year study has also shown that the most recent vaccine for Dengue fever, TAK-00-3, is effective against all four serotypes of the virus that causes Dengue fever. Dengue fever causes a severe febrile illness that can require hospitalization. It is the most common mosquito-borne illness worldwide, occurring mostly  in tropical and subtropical regions, particularly in Asia and Latin America, but cases have been reported in  California, Texas, and Florida and it is expected to become more prevalent in the US as global warming increases the population of mosquitoes that carry diseases.

Another study published in February showed that the  influenza vaccine cuts deaths by up to four times. The research from Spain analyzed data from more than 38 countries and 6.5 million patients and found that the flu vaccine significantly reduces illness and deaths. While this is hardly surprising—we have known for a long time that the flu shot works—it is one of the largest studies to date to demonstrate just how successful influenza vaccines can be.

A new study has also shown the  remarkable success of the vaccine against human papillomavirus (HPV), the causative agent for cervical and other cancers. The study showed that between 2008 and 2022, thanks to the vaccine, the rate of cervical precancers decreased by 79 percent and the rate of higher grade precancers dropped by 80 percent.

Hold the Celebration

We could go on and on detailing the many ways in which vaccine research is advancing our understanding of how immunizations work and providing us with improved vaccines against serious diseases. Sadly, however, our celebratory mood is severely tempered by a flurry of recent announcements that challenge all this progress.

The US Centers for Disease Control and Prevention (CDC) was ordered in February to  halt its successful “Wild to Mild” flu vaccine campaign.  Reportedly, the new Secretary of Health and Human Services (HHS), Robert F. Kennedy Jr., wants advertisements that “promote the idea of ‘informed consent’ in vaccine decision-making instead.” The “Wild to Mild” campaign emphasized the ability of the flu vaccine to reduce the risk of developing serious symptoms, hospitalizations, or dying if one contracts influenza. This was seen as a major step in helping the public understand why the flu shot doesn’t always prevent us from getting the flu but is still an important preventative step. Exactly what is meant by “informed consent in vaccine decision-making” is unclear, but it sounds as if the new policy will serve to undermine people’s trust in vaccines.

A potentially even more damaging move was the  canceling of a federal vaccine advisory committee meeting that was to be held in February. That meeting of the Vaccines and Related Biological Products Committee was to be the beginning of the process that leads to the development of the annual flu vaccine. Scientists and public health experts usually gather at this time to determine what strains of the influenza virus are most likely to be active next winter and thus get the ball rolling on the specific flu vaccine most likely to be effective. Without this meeting, there is uncertainty about whether we will be able to develop a useful flu vaccine for the 2025-2026 winter in time. No reason was given by federal officials for why the meeting was cancelled.  

We are now all on the edge of our seats worrying whether the avian bird flu virus H5N1, currently infecting chickens, dairy cows, cats, and some humans, will develop into the next pandemic. It would be reassuring if we had a ready supply of vaccine and to help make that happen the Biden administration approved a $600 million contract to the drug manufacturer Moderna to develop a novel technology of producing H5N1 vaccine. Now, however, the new administration announced it is  “reevaluating” that contract, which will put on hold the research needed to push vaccine development along.

Texas Measles Outbreak Kills a Child

And of course there is the measles outbreak in Texas, striking almost entirely unvaccinated or incompletely vaccinated people. As of this writing, over 400 people have been diagnosed with measles in the Texas outbreak, 101 of whom are babies or children. One child has already died, the first measles death in the US in a decade.  An adult in New Mexico with measles has also died. HHS Secretary Kennedy Jr. reportedly stated that this outbreak is “not unusual” because “we have measles outbreaks every year.” Epidemiologists disagree. It is true that there are a few cases of measles reported every year, but the scale of the Texas outbreak and the death of a child are unusual and concerning. Measles is not just a mild rash and fever.  Before the measles vaccine became available in 1963, 48,000 people were hospitalized in the US with measles every year, 1,000 people suffered encephalitis (swelling of the brain), and 400 to 500 people died, mostly children. It is critical that vaccination rates be maintained above 95% of the population to ensure community-based immunity against measles, but vaccination rates are dropping in many places below that standard, fueled by false reports of harm from vaccines.

We Can’t Wait For Outbreaks

Fortunately, most parents still seem predisposed to vaccinate their children against preventable illnesses. Despite the persistence of the myth that the measles, mumps, and rubella (MMR) vaccine causes autism, a recent survey by the  Kaiser Family Foundation showed that a strong majority of Americans favor mandatory school vaccinations. And since the outbreak, parents in Texas who previously chose not to vaccinate their children are  “lining up” to get their children vaccinated against measles.

An often-cited reason behind the choice not to vaccinate is that many vaccine-preventable illnesses have not been seen in decades in the US. Because vaccines are so successful, most people have never seen a child with measles, diphtheria, pertussis (whooping cough), or polio. Cases of infertility or encephalitis caused by mumps, of death from meningococcemia, or pneumonia from Hemophilus influenzae infection are extremely rare these days. People have forgotten what it is we are preventing so well with vaccines.

But scaring people by telling them about the tragedies caused by these diseases that are no longer common because immunizations work does not seem to be an effective strategy. The fact that parents in Texas are rushing to get their kids vaccinated now that they are confronting an active measles outbreak is not reassuring. Vaccines are not intended to help us when there is already a disease outbreak; they are intended to prevent the disease outbreak in the first place.

We need to develop new ways of making it clear to people why we recommend vaccinations. Policies hindering research and the development of new and better vaccines are certainly not helping us do that. We should be celebrating the incredible work vaccine researchers have produced, protecting us from horrible illnesses that can kill our children. Instead, we are left scratching our heads about what “informed consent” means when applied to vaccinations and how anyone could call a deadly measles outbreak “not unusual.”

In their piece titled “To the Pandemic Czar: Are We Prepared to Talk About Bird Flu?” addressed to Gerald Parker, the new head of the White House Office of Pandemic Preparedness and Response Policy, Critica’s Sara E. Gorman and Heather Lanthorn lay out steps the federal government should be taking to improve vaccine uptake. They emphasize that building trust in public health agencies is critical. “To build trust,” they write, “public health entities must deliver and demonstrate credibility by exhibiting technical competence, building authentic connections based on compassion, and handling uncertainty with honesty and humility. And we need to be doing this now, not when a crisis is already underway.”

We urgently need to turn away this tide of vaccine mistrust and skepticism. Measles is rearing its ugly head again and an H5N1 pandemic could be looming. Scientists and public health experts have the tools at hand to protect us. Let’s celebrate what they can do and convince people that they and not the vaccine naysayers are the ones to trust.