Week 3 Assignment Immunization

Week 3 Assignment – Immunization

Allison Erickson

MPH 584 – Community Health

Dr. Kimberly Brodie

March 23, 2014 2

Entering the collegiate environment is an exciting and anxious time for tens of thousands of young adults in the United States yearly. This new chapter often brings preparation for leaving home, making new friends, and discovering a taste of independence. Also, this time poses health risks that can often be lessened through appropriate health education and practices. One such practice is receiving the recommended vaccination to prevent against communicable disease.

Although there are no consistent requirements across the United States, many colleges and universities, as directed by the state, have requirements of immunization prior to beginning one’s freshmen year. There are four recommended vaccines that are consistent across the board from the school itself to the Centers for Disease Control (CDC) recommendation. These four vaccines include the meningococcal, Human Papilloma Virus (HPV), tetanus, diphtheria, and pertussis

(Tdap), and the seasonal influenza vaccine.

To begin, the meningococcal disease has 13 different subtypes (Immunization Action

Coalition, n.d.). Meningococcal disease is spread from person-to-person through respiratory and throat secretion exchange, but it is not spread as easily as the common cold or flu. The disease can make an individual extremely ill, causing high fever, chills, rash, and lethargy, as well as progressing rapidly. “In overwhelming meningococcal infections, shock, coma, and death can follow within several hours, even with appropriate medical treatment” (Immunization Action

Coalition, n.d.). In regards to the importance of college freshmen receiving the vaccination, the

Immunization Action Coalition (n.d.) reports, “Studies have also shown that college freshmen who live in a dormitory are at an increased risk of meningococcal disease compared with others their age.” These freshmen housing environments often include close quarters with diseases spreading easily from person to person. Because of the dangerous nature of meningococcal disease, requiring this vaccination not only prevents the individual from receiving the vaccine, 3 but it protects the floor of freshmen, as well as protecting the college or university as an institution. An example of such outbreak occurred at both Princeton University and The

University of California in 2013 (CDC, 2014). Although both institutions reported less than ten cases, as aforementioned, the rapid spreading and extreme possibilities of the disease is not something that should be taken lightly.

Continuing, the HPV vaccination is recommended for both men and women from teenage years to 26 years old (CDC, 2012). This vaccination is recommended for college age individuals because HPV is the main cause for cervical cancer among women (CDC, 2012). Men are recommended to receive the vaccination because, “about 7,000 HPV-associated cancers in the

United States that may be prevented by vaccine each year in men” (CDC, 2012). McKenzie,

Pinger, and Kotecki (2012) share that college students often put themselves at risk for sexually transmitted diseases (STDs) and pregnancy through unprotected sexual activity. “Approximately

60% of all gonorrhea cases and nearly three-fourths of all chlamydia cases occur among persons under 25 years of age” (McKenzie et al., 2012, pp. 227-228). Any kind of sexual activity increases the risk for HPV to spread from one person to another, with the carrier often unaware of carrying the disease and spreading to a partner. Thus, receiving the HPV vaccination will assist in protecting the individual and others from receiving the virus, preventing the risk of cervical and other cancers.

With any type of medical intervention or prevention, there are risks. Individuals who have particular allergies or known risk-factors after receiving a vaccination should always contact a physician to determine if the vaccination is appropriate or necessary. Oftentimes, pregnancy or chances of being pregnant will interfere with receiving a vaccination. With the described vaccinations above, the benefits outweigh the risks for all involved including the 4 individual, the community they are a part of, and the institution as a whole. Nonetheless, the

CDC, as well as multiple government organizations supports the recommendation, requirement in certain instances, of receiving the four vaccines aforementioned for individual and community protection from serious diseases. Also, during the collegiate years for a student, there are opportunities to travel abroad and study overseas. Many times, schools will require certain vaccinations to be received by the student months leading up to the trip. Often times, students are compliant with such requirements to avoid becoming seriously ill while in another country.

Thus, the same mentality should be applied when a student travels from home to a school setting to live, eat, sleep, and study in. It can be helpful to think that the student is “traveling abroad” to an environment and community different than home. Receiving the recommended vaccinations protect from getting seriously ill which can impact the overall college experience for many college students across the United States.

Health Profile Table

Disease (Ages 18-24) Morbidity/Mortality Risk Factors  No vaccination  Living in crowded spaces  Attending a new school 1.8 cases per 100,000 (2003- with students from a variety 2012) (CDC, 2013). of areas Meningococcal Disease 10-15% of cases are fatal (National Meningitis Association (NMA),  Irregular sleeping patterns 2014)  Exposure to someone with the disease (National Meningitis Association (NMA), 2014  No vaccination 3.2 cases per 100,000 (2004-  Unprotect sexual activity  Being younger than 25 Human Papilloma Virus 2008) (CDC, 2012) (Associated Cancers) 3,939 women died of cervical  Having multiple sexual partners cancer in 2010 (CDC, 2012)  Un-Circumcision (American Cancer Society (ACS), 2014) Tetanus, Diphtheria, Tetanus:  No vaccination Pertussis .04-.07 cases per 1 million  Contact with infected 2001-2008 (CDC, 2011) individuals 5

No mortality data from 2001-  Living in crowded, 2008 reported unsanitary conditions Diphtheria:  Traveling to areas where 8 cases reported between infection rates are high 1980-2004 (CDC, n.d.)  Penetrating injury of a nail Overall case fatality rate is or other rusty, metal object between 5-10% (CDC, n.d.) Pertussis: 2.2 cases per 100,000 (CDC, 2014) 0 deaths in 2013 (CDC, 2014) (Mayo Clinic, 2014)  No vaccination 11.6 cases per 100,000 (2012-  Having one or more 2013 season) (CDC, 2013) chronic disease Influenza Little to no specific data  Not washing hands regarding mortality of  Contact or in vicinity of an influenza between 2012-2013 infected individual

As seen above, the morbidity and mortality rates among this population of individuals may be seen as relatively low. However, disease like meningitis, HPV, and influenza spread rapidly. It takes only a few people to contract the disease to become a serious concern for health officials and college or university leadership. Therefore, all four diseases require vaccination to prevent outbreak across the United States and on college campuses. 6

References

American Cancer Society. (2013). What are the risk factors for genital HPV? Retrieved from: http://www.cancer.org/cancer/cancercauses/othercarcinogens/infectiousagents/hpv/huma npapillomavirusandhpvvaccinesfaq/hpv-faq-hpv-risk-factors

Centers for Disease Control and Prevention. (2012). Cervical cancer statistics. Retrieved from: http://www.cdc.gov/cancer/cervical/statistics/.

Centers for Disease Control and Prevention. (n.d.). Diphtheria. Retrieved from: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/dip.pdf.

Centers for Disease Control and Prevention. (2012). Human papilloma virus-associated cancers – United States, 2004-2008. Morbidity and Mortality Weekly Report, 61(15), 258-261.

Centers for Disease Control and Prevention. (2013). Meningococcal disease: Surveillance. Retrieved from: http://www.cdc.gov/meningococcal/surveillance/index.html.

Centers for Disease Control and Prevention. (2014). Princeton university meningococcal disease outbreak. Retrieved from: http://www.cdc.gov/meningococcal/outbreaks/princeton.html.

Centers for Disease Control and Prevention. (2014). 2013 Provisional pertussis surveillance report. Morbidity and Mortality Weekly Report, 62(52).

Centers for Disease Control and Prevention. (2011). Tetanus surveillance --- United States, 2008-2011. Morbidity and Mortality Weekly Report, 60(12), 365-369.

Centers for Disease Control and Prevention. (2013). Update: Influenza activity – United States, September 30, 2012-February 9, 2013. Morbidity and Mortality Weekly Report, 62(07), 124-130.

Immunization Action Coalition. (n.d.). Meningococcal questions and answers: Information about the disease and vaccines. Retrieved from: http://www.immunize.org/catg.d/p4210.pdf.

Mayo Clinic. (2014). Diphtheria, tetanus, and acellular pertussis. Retrieved from: http://www.mayoclinic.org/drugs-supplements/diphtheria-tetanus-acellular-pertussis- polio-vaccine-intramuscular-route/precautions/drg-20071983.

National Meningitis Association. (2014). Who is at risk? Retrieved from: http://www.nmaus.org/disease-prevention-information/who-is-at-risk/

McKenzie, J.F., Pinger, R.R., & Kotecki, J.E. (2012). An introduction to community health (7th ed.). Sudbury, MA: Jones and Bartlett Learning.