The news just keeps on coming. One disease after another. What should I do? What are my risks and what is my plan of action? Everyone has an opinion. Are they correct? Certainly, the information about Covid-19 vaccines has been inaccurate and incomplete from the beginning.
I belong to the generation that was required to have vaccinations to attend public schools. There was no debate. You were vaccinated, or you were not admitted. Our children faced the same requirements. There were no options nor discussions. The landscape today is not the same. We will not debate our history, but we do need to review where we are in terms of what we did as children or what we did for our children.
Our major patient populations fall into one of these three categories. They are the Silent Generation, the Baby Boomers, or the beginning of the Generation X group. How are they fixed for vaccinations? As a healthcare worker, do I need to be concerned about their vaccination status against the pandemics, present or future?
Two major concerns at the current time in 2022 are monkeypox and polio.
FACT Check: Can your childhood smallpox vaccine protect against monkeypox?
The short answer is yes. If you are in the Silent Generation or a Baby Boomer and were vaccinated against smallpox as a kid, that dates your vaccination to before 1972. Routine smallpox vaccinations stopped in 1972. Generation X could be included in the early date range of classification. Smallpox was eradicated through a massive public health effort built upon outbreak detection plus the use of the vaccine.
Both the CDC and WHO are publishing data showing that smallpox vaccine is 85% effective in preventing monkeypox also. As we know, human immune systems age, and immunity from a smallpox vaccine also decrease in protection. It is possible that a childhood vaccine will not be effective against monkeypox.
There was a United States monkeypox outbreak in 2003, originating in Texas and spreading through the Midwest from infected rodents imported from Africa. The rodents were shipped to locations in Illinois where they were housed with prairie dogs, which became infected. All known human cases of the 2003 monkeypox outbreak were attributed to the handling of the prairie dogs, and no known human to human transmission happened.
Monkeypox vaccination is effective if the vaccine is given after exposure and within a 4-day window from the date of the exposure. There are 2 kinds of vaccines. The most preferable is JYNNEOS, which is newer and mostly side-effect free. The other vaccine, ACAM2000, is a live virus preparation inoculated into the skin by pricking the skin surface. After successful inoculation, a lesion will develop at the site of the vaccination. This can spread to other parts of the body or to other people. Caution must be taken to maintain the lesion for the next 28 days.
The CDC Advisory Committee on Immunization Practices (ACIP) recommends that people whose jobs may expose them to orthopoxviruses, such as monkeypox, get vaccinated with one of the two vaccines, including those who use PCR assays for diagnosis. Others, including laboratory personnel, are advised to consult with biosafety officers or supervisors before taking the vaccine. It is not recommended for laboratory workers unless the work they are doing requires it.
FACT Check: Did I get the polio vaccine? Do I need a booster?
Polio virus was recently discovered in the waste water in New York and has hit the news. This has everyone scurrying to check their vaccination status. The first case of polio in nearly a decade is an Orthodox Jewish man in Rockland County just north of New York City. This patient has experienced paralysis and left the hospital in a wheelchair.
This area in the county is historically a low vaccination population and was the center for the measles outbreak in 2018-2019. The rate of completion of childhood vaccination in this community is 42%, the lowest in the state. Nationally, more than 92% are fully vaccinated by the age of two. Polio vaccine is given in 3 to 4 doses beginning at 2 months old, 4 months old, and 6 through 18 months old. An additional dose is usually given between 4 to 6 years old. Children under 5 years old are most susceptible to the polio virus caused by placing contaminated objects into their mouths.
Outbreaks of polio could be deadly before the first polio vaccine was introduced in 1955. I contracted the virus before the vaccine was available and had what was considered then to be a “light” case. I spent the summer in the hospital and on an army cot in the back yard listening to the radio and reading. My left leg is still weak from the disease. I was fortunate; some in my neighborhood were crippled, and some were in an iron lung for months. Polio is very contagious, and a person can spread the virus even if they are not sick or experiencing symptoms.
Most adults do not need a vaccine if they were vaccinated as children. Healthcare workers could be at risk if they have never been vaccinated, or if they are traveling to a part of the world where polio is active. If you are unvaccinated, it is wise to get an update to prevent your danger of contraction of the virus. You should do so quickly, especially if you are traveling.
Pandemics are slow to start, but it is better to err on the side of safety than to be exposed to a disease that could change your life.