Analytical Essay on Measles: Importance of the MMRV Vaccination

Rationale:

In 2006, the National Centre for Biotechnology released an abstract asserting that, ‘In in the 21st century, mass vaccination and routine immunization remains a necessary alliance for attaining both national and international goals in the control of vaccine-preventable disease’ (D, Heymann. 2006), to support the claim of ‘Mass vaccination programs are successful in the control of diseases’. For all human existence, diseases and infections have subsisted and have affected bodily functions and to the extent of death without proper treatment. Up until the 1930s where vaccines were introduced for various diseases including diphtheria, tetanus and tuberculosis (College of Physicians of Philadelphia, n.d.), these infectious diseases were extremely hazardous and fatal. Vaccines prevent these diseases infecting the body in future scenarios where the disease can issue critical damage to the vital functions of the body. In Australia and many first world countries, vaccines are heavily advised and provided for any citizen with minimal charge, mainly for infants and young children who are the focal victims of many of these diseases between 12 and 18 months. Programs are in place such as the ‘National Immunisation Program Australia’, for vaccines provided to individuals ranging from infants, to adulthood free of charge (Australian Government, 2019). Focusing on young children, specifically under 5, the main diseases concerning this age bracket include; chicken pox, measles, mumps and rubella (Health Direct, 2018). As vaccines are extremely versatile, these diseases can all be prevented with the correct vaccinations. For this specific investigation, measles is the principal disease analysed, specifically in young children. As vaccinations fight against these injurious diseases, without this form of defence, the mortality rate increases. The mortality rate is defined as the frequency of deaths in a defined group (Collin’s Dictionary, n.d.). This can be refined further to children under five, known as the child mortality rate where it is the probability of dying between birth and five years old expressed per 1000 live births (UNICEF, n.d.). By receiving these vaccines at a young age, should improve the overall child mortality rate.

This key information was refined into one question that defines the investigation:

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Do mandatory vaccinations of young children under the age of 5, against the disease measles, contain the spread of this disease and therefore decrease the child mortality rate in Australia?

Background:

Numerous vaccines are provided in contemporary times, all of which contribute to the control of diseases and contracting the virus’s numerous times. This is attained by the vaccine injecting dead or debilitated antigens in the bloodstream, where the immune system continues to produce antibodies to fight the disease; these antibodies will then breakdown leaving immune cells to prevent these diseases affecting the host in impending cases (S, Pappas. 2010). The MMRV (measles-mumps-rubella-varicella) vaccine (Australian Immunisation Handbook, 2019) is utilised for mumps, rubella, and measles alike, and two doses will provide immunity against the harmful viruses (NHS, 2018). The MMRV vaccine was introduced in Australia in 1989, however, the singular measles vaccine was introduced 20 years before MMRV in 1969 (Health Victoria, n.d.).

To provide a brief definition to familiarise the chosen disease, measles (rubeola) is a highly contagious disease transferred through the air and particles, via coughing and sneezing, and can last up to two hours in the particular contaminated space (CDC, 2018). According to CDC (Centre of Control and Disease Prevention), there is a 90% chance of catching measles if not vaccinated and are then consequently contaminated which can lead to a number of health complications and fatality. For the MMRV vaccine to work, as stated above, antibodies are produced in the immune system to fight the injected enfeebled, live measles virus found in the bloodstream, thus causing immunity to the diseases for impending cases (NHS, 2018).

Statistics and visual data will be included to support this claim and question with relevant and authenticated evidence from verified sources. It is evident with the provided evidence and graphs that the overarching trend is that vaccines decrease the mortality rate due to measles over the course of several years. Figures are also included to support this theory when discussing the data.

Evidence:

Measles is known globally as an infectious epidemic where this disease can contaminate any individual within range and that has not had the appropriate defences such as the general vaccine, MMRV. Viewing statistics, including data from the late 20th century, successfully depicts how this vaccine has decreased the number of deaths caused by measles over the years recorded. Between 2000 and 2017, an 80% decrease in deaths by measles globally was accounted for due to scheduled vaccinations (WHO, 2019). As well as, an estimated 21.1 million deaths prevented due to MMRV in recent years of the 21st century (WHO, 2019). Illustrated in figure 1 below sourced from the ‘Centres for Disease Control and Prevention’, from 1985 to 2016, death by measles rapidly decreased after vaccinations were introduced. With inevitable fluctuations in certain years such as 1987 and 1992, this illustrates outbreaks in the disease, most likely from less vaccinations causing measles to spread. The overarching trend exhibited in measles deaths globally is a steady decrease, where from 2007 and onwards, deaths are under 200,000, compared to the beginning in 1985 where deaths were 1,000,000 times greater at 1,200,000 (CDC, 2018). Thus, showing how vaccinations assisted in this rapid decline in deaths due to measles.

Figure 1 – Number of deaths caused by measles and vaccine prevention Source: (CDC, 2018)

As stated specifically in the research question, the child mortality rate in children under 5 in Australia is the focal topic to successfully answer this investigation. From the Australian Institute of Health and Welfare from 2010, measles outbreaks were recorded between 1950 and 1990 to evidently depict how the vaccine eliminated numerous deaths due to this disease. The ‘Australian Department of Health’ have also indicated that after 1994, measles cases have been progressively decreasing over the years (Australian Department of Health, n.d.). Before MMRV was introduced, and in any case, it is rather apparent that infants and young children are more susceptible to this disease due to a weaker and undeveloped immune system that is seen as an easier target for diseases, as the correct ‘defences’ are easier to overcome, as well as frequent contact with bacterial substances from other children (Ashish, 2017). It is unmistakably noticeable that deaths in children under five were remarkably high from 1950 to 1969, where the measles vaccine was not yet introduced where deaths reached nearly 4.5 per 100,000. After 1969, an abrupt regression is patent where deaths peaked and declined in one single year after the vaccine. From 1970 to 1990, deaths due to measles were on a continuous and constant decrease, although evident increases in deaths are prevalent, the overall inclination descends over time. This illustrates the child mortality rate descending rapidly where the measles vaccine effectively prevents innumerable deaths of children under five and controls the spread of this disease on a mass spectrum.

Figure 2 – Deaths caused by measles in Australia for children under 5 years Source: (AIHW, 2010)

In 2007, sourced from the ‘Department of health in Australia’, 94.1% of 2 year olds were fully immunised with MMRV, and 89.1% of 5 year olds (Department of Health, 2009). Provided in figure 3, more recent data regarding hospitalisation and deaths, focusing on the scope concerning the youth of Australia, was sourced to substantiate the principal claim and refined question. As the double dose of measles, known as MMRV, was later introduced in 1989 (Health Victoria, n.d.), hospitalisations and deaths due to measles declined even more than previously with the single dose of measles vaccine. As young children are still increasingly affected and prone to diseases rather than older children and above, hospitalisations and deaths are still greater than that of citizens five years and older, as illustrated below. Hospitalizations plummeted from 250 per million to 50 per million in one single year between 1994 and 1995, where a constant decrease is publicised up to recent years including 2016. It is also apparent in the graph to the right exemplifying deaths in younger children, where a decline is established circa 1947, and was almost eliminated after the mass vaccination program, known as NIP (National Immunisation Program), was introduced in 1975 (Australian Departments of Health, 2019). This evidence found supports the claim chosen where mass vaccination programs do in fact assist in the control and spread of diseases, as well as decreasing the overall child mortality rate in Australia.

Figure 3 – Hospitalisations and deaths in Australia for children in recent years Source: (AIHW, n.d.)

Evaluation:

Quality of Evidence:

To successfully support the specified claim and research question with the utmost accuracy, extensive research was conducted where a variety of evidence was accumulated and utilised. However, collecting evidence from unreliable sources can jeopardise the legitimacy of this task. On the other hand, all significant evidence originated and was sourced from either government based or approved websites and organisations such as ‘AIHW’, ‘Australian Department of Health’, and ‘CDC’. Thus, all evidence, graphs, and statistics have been approved by higher authorities with the correct qualifications that justify the validity of the evidence provided to further support the focal topic of the investigation. As well as, all sources implemented agreed on the pivotal claim on how vaccines do in fact control the spread of diseases and decrease mortality rates with no bias perceived. Therefore, providing reliable evidence to support this investigation.

Limitations and Improvements:

Although all data and evidence is accurate and directly cited from the Australian government, obtaining data and statistics from recent years became an increasingly challenging task with limited data from recent years. Data from the 1940s to 1990s was simplistic and easy to obtain, however, data would only cover to approximately 2010, and on the rare occasion, up to 2016. This was a limiting factor as data from earlier years could only support this claim so far, as evidence from recent years could not be sourced to further validate the claim and respective research question. Evidence was collected thoroughly and with minimal error by government bodies with surveys, censuses, reporting from health services and registrations which did not limit but rather improve this investigation by implementing authenticated data. However, data collection was not limited to a specific area as data was across Australia was processed, as well as globally.

Improvements, however, can be applied to increase how valid and reliable this analysis is. Although a specific and considered research question was developed, certain aspects can be further analysed to support the theme. Conducting further investigations into data that was collected in Australia in the last three years so the claim and question is supported with current evidence that validates how vaccines are still currently functioning correctly. As well as, a detailed analysis into all effects of vaccines on the human body for different age brackets due to differences in the functioning immune system and other vital structures. Considering the factor that some diseases are becoming immune to the vaccine can be investigated and added to justify some fluctuations in data throughout the years.

Extensions:

Extensions to further assist in justifying the topic and provide a more thorough insight into mass vaccinations and how it does in fact control diseases efficiently can be stated. Although a specific and narrow research question was advised and necessary, comparing various diseases and the child mortality rate for each can advance this investigation, such as comparing measles with polio. Observing numerous countries with measles data and comparing will also extend the investigation further and can be discussed why one country may have a higher mortality rate than another. As well as, age brackets and the corresponding mortality rates and how measles affects each age range in various manners.

Conclusion:

To conclude, the chosen claim on vaccines and infectious diseases, and the developed research question can be successfully supported and answered with maximum authenticity. From valid sites, reliable evidence and data was collected to justify the overall investigation, the considered trend in all sources supports and suggests how mass vaccination programs are in fact successful at controlling the spread of infectious diseases. As well as, reinforcing the question where vaccinating young children decreases the child mortality rate and contains the spread of measles to others. Relevant data was evident, which therefore suggests that mass vaccinations does in fact assist in controlling the spread of diseases through the use of reliable sources.

References:

1. Ashish (2017) Why do Children and the elderly get so sick easily? [online] Available at: https://www.scienceabc.com/humans/why-do-children-and-the-elderly-get-sick-so-easily.html [Accessed on 14 Aug. 2019]
2. Australian Institute of Health and Welfare (n.d.) Measles in Australia [online] Available at: https://www.aihw.gov.au/getmedia/c828baef-75d9-4295-9cc9-b3d50d7153a2/aihw-phe-236_Measles.pdf.aspx [Accessed on 12 Aug. 2019]
3. Australian Department of Health (2019) National Immunisation Program Schedule [online] Available at: https://www.health.gov.au/health-topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule [Accessed on 16 July. 2019]
4. Australian Department of Health (2019) Rubella [online] Available at: https://immunisationhandbook.health.gov.au/vaccine-preventable-diseases/rubella [Accessed on 23 July. 2019]
5. Better Health (2018) Measles [online] Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/measles [Accessed on 16 July. 2019]
6. Better Health (2018) Vaccines [online] Available at: https://www.betterhealth.vic.gov.au/health/healthyliving/vaccines [Accessed on 16 July. 2019]
7. Centre for Disease Control and prevention (2018) Measles Transmissions [online] Available at: https://www.cdc.gov/measles/transmission.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmeasles%2Fabout%2Ftransmission.html [Accessed on 18 July. 2019]
8. Centre for Disease Control and Prevention (2019) Measles statistics [online] Available at: https://www.cdc.gov/measles/downloads/measlesdataandstatsslideset.pdf [Accessed on 16 July. 2019]
9. College of Physicians of Philadelphia (n.d.) History of Vaccines [online] Available at: https://www.historyofvaccines.org/timeline/all [Accessed on 16 July. 2019]
10. Collins English Dictionary (n.d.) Mortality Rate [online] Available at: https://www.collinsdictionary.com/dictionary/english/mortality-rate [Accessed on 18 July. 2019]
11. Health Direct (2018) Measles [online] Available at: https://www.healthdirect.gov.au/childhood-illnesses [Accessed on 18 July. 2019]
12. Health Victoria (n.d.) Vaccine History Timeline [online] Available at: https://www2.health.vic.gov.au/public-health/immunisation/immunisation-schedule-vaccine-eligibility-criteria/vaccine-history-timeline [Accessed on 24 July. 2019]
13. National Health Service (2018) MMRV vaccine overview [online] Available at: https://www.nhs.uk/conditions/vaccinations/mmr-vaccine/ [Accessed on 23 July. 2019]
14. S. Pappas (2010) How do Vaccines work? [online] Available at: https://www.livescience.com/32617-how-do-vaccines-work.html [Accessed on 18 July. 2019]
15. UNICEF (n.d.) Basic Indicators [online] Available at: https://www.unicef.org/infobycountry/stats_popup1.html [Accessed on 18 July. 2019]
16. World Health Organisation (2019) Measles [online] Available at: https://www.who.int/news-room/fact-sheets/detail/measles [Accessed on 16 July. 2019]