Careers in Disease Prevention

The field of public health emphasizes the health and wellness of various communities, both locally and internationally. This includes researching and understanding diseases and how they spread in order to prevent outbreaks and promote healthy living. As a result, vaccinations and immunizations often play a significant role in public health. The following guide takes a deeper look at vaccinations and immunizations and also includes information on how professionals in public health and other fields can leverage their expertise to help fight the spread of disease.

Understanding Vaccinations

Type of Vaccine	Description	Examples
Live, attenuated vaccines	This type is made from weakened versions of live viruses. They do not actually cause the disease, but because they are so close to the natural infection, these vaccines teach the body how to build resistance with one or two doses.	Influenza (nasal spray), measles, mumps, rubella, chickenpox, shingles, yellow fever
Inactivated vaccines	These vaccines are made when the live microbe is inactivated through radiation, heat and chemicals. These vaccines are safer than live vaccines because they cannot revert back and cause a disease. However, because these vaccines are not made from a live virus, it takes more doses for the body to build immunity.	Polio, hepatitis A, rabies
Toxoid vaccines	These vaccines are used to treat illnesses caused by a bacterial toxin. They are made from toxins that are inactivated with sterilized water and formaldehyde. Toxoid vaccines teach the body how to fight the natural equivalent of the toxin	Tetanus, diphtheria
Subunit/conjugate vaccines	Conjugate vaccines are made by different parts of bacteria, allowing the body to build a stronger resistance to the disease. These vaccines also have a carrier protein that protects the body from future infections.	Pneumococcus, meningococcus, hepatitis B, human papillomavirus, influenza (injection)
DNA vaccines	These experimental vaccines are made from a microbe’s genetic material and cause a strong antibody response in patients.	Currently, there are no DNA vaccines available for humans; however, a vaccine for West Nile virus is in Phase 1 human clinical trial.
Recombinant vector vaccines	Like DNA vaccines, recombinant vector vaccines are in the experimental stage. These vaccines combine live viruses and microbial DNA to stimulate the body’s immune system.	Measles, HIV, rabies – these vaccines, however, are still in the experimental phase and have not yet been approved.

Why Individuals and Families Get Vaccinated

Many parents believe that the decision to vaccinate their children is simply a family issue and that, just like any other aspect of parenting, it is a personal choice that people make. However, the law views vaccinations very differently.

For example, in response to a measles outbreak at the Disneyland Resort in 2015, the California legislature passed a measure that requires parents of children enrolled in day care centers and public and private schools around the state to vaccinate their children, regardless of their religious or personal beliefs about vaccines. As a result, parents are required to vaccinate their children against measles and whooping cough, among other diseases, unless they have a doctor’s note granting them permission not to.

Other states are also rethinking their vaccination laws. In Oregon, parents can no longer decline to vaccinate their children because of their religious beliefs, and Vermont has abolished the philosophical vaccine exemption. Alabama and Pennsylvania are considering legislation that will require doctors to provide vaccination education to pregnant women.

Six Reasons to Vaccinate

When it comes to public health, there are numerous benefits that vaccinations have on individuals and society as a whole. Below are some of those benefits:

Herd immunity

Herd immunity is the phenomenon where those who do not receive immunizations still receive health benefits thanks to those who do. If a significant part of a community receives a vaccination against a disease, those who have not received the vaccination—such as children too young to be vaccinated or those who have illnesses that preclude them from getting vaccinated safely—also benefit because the occurrences of the disease will decline.

Cancer prevention

When patients receive a vaccination for certain diseases, they will also be protected from cancers associated with them. For example, getting a vaccine for hepatitis B can protect people from developing liver cancer and the HPV vaccine reduces the risk of getting cervical cancer.

Extended life expectancy

Elderly people who receive influenza vaccinations reduce their mortality risk by 50 percent. Elderly patients are also 20 percent less likely to suffer from cardiovascular diseases when they receive flu vaccines.

Safer travel

In our global economy, people are travelling to foreign countries more than ever before. This makes vaccinations extremely important, as foreign travel can put people at risk for a number of different illnesses around the globe.

Economic benefits

A healthy population is a strong population, and countries where vaccinations are prevalent tend to have stronger economies.

Protection against potential bioterrorism

It is important for vaccinations to be available in the event of a bioterrorist attack. For example, governments have worked to ensure that adequate supplies of smallpox and anthrax vaccines are available in response to concerns about terrorists launching attacks with these illnesses.

Understanding Vaccination Concerns

Despite the abundance of information available about the consequences of not vaccinating children, there are still many people who are against vaccines for various reasons. Below are some of the common arguments.

• Vaccines are unnecessary because major illnesses no longer exist.

  Although eradication of illnesses is the ultimate goal of medical professionals, the World Health Organization reports that the only disease that has been successfully eradicated is smallpox. In order for a disease to no longer exist, there must be population immunity around the world for long periods of time. As a result, although a disease may be uncommon, or even eliminated, in a specific community, there is still a chance of it being reintroduced.

• Vaccines cause autism.

  This belief was introduced to the medical community in 1998 when a British journal, The Lancet, published a study that claimed there is a link between autism and the measles, mumps and rubella (MMR) vaccine. Subsequently, the publication retracted the article, and its author, Andrew Wakefield, was accused of falsifying data and barred from practicing medicine. Despite the problems with this study and the fact that other researchers have debunked its claims, this myth may persist in part because autism manifests around the same time that children are scheduled to get their first vaccinations.

• The diseases that vaccinations are designed to prevent aren’t really serious.

  Many people who argue this point to the fact that they may have contracted a disease like chicken pox and it didn’t do any harm to them or that they never had any diseases at all. However, scientists point out that before vaccinations, many childhood illnesses had serious consequences. For example, whooping cough used to kill 7,000 children annually, while those who contracted chicken pox often suffered from related complications such as skin infections and pneumonia.

  Similarly, there is a popular belief that influenza vaccines are unnecessary because if you catch the flu, it’s the equivalent of a bad cold. However, according to World Health Organization statistics, influenza kills around 300,000 to 500,000 people around the world annually.

• Vaccinations contain harmful mercury.

  Vaccines have never contained methyl mercury, which is a toxic metal associated with brain damage. However, vaccinations made prior to 2001 contained the preservative thimerosal, which has the nontoxic compound ethyl mercury. Currently, the only vaccination that contains thimerosal is the flu vaccine. Although the preservative is not dangerous, people who are concerned about mercury can request thimerosal-free versions of the vaccine.

• Too many vaccinations overload a child’s immune system.

  Although there are several vaccinations that young children will receive throughout early childhood, medical experts say that vaccine combinations are safe and will not compromise the immune system.

Risks of the Unvaccinated

While some may disagree with mandatory vaccination laws, there are medical reasons that vaccination advocates point to when arguing for their necessity. There are a number of risks associated with not vaccinating a child. For example, children who are not vaccinated are at risk of contracting a number of illnesses, and because their immune systems are more vulnerable without vaccines, if they contract diseases such as mumps, whooping cough or measles, they may face serious consequences.

Similarly, those who have not been vaccinated put other children in their community at risk. If unvaccinated children get an illness, children around them are at-risk—particularly those too young to get vaccines and those with immune systems that are too compromised to get vaccinated, such as cancer patients.

Also, when parents elect not to vaccinate their children, they are assuming certain responsibilities that come with their choice. Whenever a child that is not vaccinated visits a doctor or emergency room, or rides in an ambulance, parents must inform medical practitioners so the child can receive appropriate treatment. Furthermore, when unvaccinated children become ill, parents may be required to take them out of school and, sometimes in severe cases, have them quarantined from others—including members of their own family.

Infant to Elderly: Recommended Vaccination Timeline

Vaccinations are only effective when they are delivered to patients at the optimal time. The CDC has set forth the following vaccine guidelines (up-to-date as of 2015) for when infants, children, teens and adults should receive specific vaccines.

For the most up-to-date vaccine schedule recommendations, visit the CDC’s official website.

Vaccination Exemptions

In every state, children are required to receive vaccinations before they attend preschool or public and private schools. However, in some cases, parents may be granted an exemption from their state. The following explains the types of exemptions that may be available.

Medical: Medical exemptions are granted when a doctor certifies—based on guidelines put forth by the Centers for Disease Control—that a vaccination will be detrimental to a child’s health. While these exemptions are available in all 50 states, in some areas public health officials may revoke vaccination exemptions if they feel there’s not sufficient evidence to prove the vaccinations will be harmful.

Religious: The First Amendment gives parents the right to be exempt from vaccinating their children if doing so would conflict with their religious beliefs. The interpretation of this exemption varies from state to state, however. In some states, there is a loose interpretation that includes any sincerely held religious or spiritual belief. In other states, someone must be a member of a church that explicitly prohibits vaccinations. This exemption is not allowed in Mississippi, West Virginia, California or Oregon.

Philosophical: Some states allow parents to opt out of getting their children vaccinated because it goes against their philosophical beliefs. When seeking this exemption, parents must decline all vaccines, not just specific ones. Children who are at least 12 years old can object to vaccinations under this exemption.

While most states do not allow this exemption, the following do: Arizona, Arkansas, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, Missouri, North Dakota, Ohio, Oklahoma, Texas, Utah, Washington and Wisconsin.

What You Need to Know When Travelling

There has been a significant increase of international travel in recent years, and whether it is done for business or pleasure, contracting an illness can really put a damper on one’s trip. In order to avoid getting ill in a foreign country and bringing a disease back to the United States, it is imperative to get vaccinations at least four to six weeks before international travel.

The Centers for Disease Control urges international travelers to get at least a measles, mumps and rubella vaccination before their trip. Although measles has been virtually eliminated in the United States, the majority of cases that do occur are the result of someone bringing the disease into the country. Travelers may be required to obtain additional vaccinations depending on what country they’re visiting and what they plan to do when they arrive.

Traveling abroad soon? The CDC provides current travel notices and vaccine recommendations for specific countries.

Taking Action:
Public Health Degrees, Specialties and Careers

There are a number of public health specialties and careers that students can enter if they are interested in vaccinations and immunization. These academic areas will give students experience researching, developing, and delivering vaccinations, as well as educating the public about their importance.

At the graduate level, students get specialized knowledge and training that can help them land a job and make a difference in their community or abroad. Public health master’s and doctoral degree programs give students a more advanced understanding of public health and also allow students to develop expertise in a specific area, such as vaccinations and immunization. The following are examples of public health specialties that are most relevant to the topic of vaccinations, as well examples of potential careers that students can pursue after earning their public health degree.

Beyond Public Health:
Alternative Career Paths in Disease Prevention

Public health specialists play an important role in preventing diseases. However, there are many other options for those looking to go in a different direction with their education and career, including:

After Graduation: Potential Employers

Students who are interested in using their public health education to contribute to getting vaccinations to patients have a number of career options. The following are examples of places where these graduates may consider finding work.

Private Sector Employers

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  Bristol-Myers Squibb

  In addition to developing medications, Bristol-Myers Squibb works to raise awareness about the prevention of diseases like hepatitis B and C.

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  GlaxoSmithKline (GSK)

  GSK is a pharmaceutical company that manufactures a number of vaccines, including influenza, human papillomavirus bivalent, tetanus, hepatitis B, meningococcal, and rotavirus vaccines. The company distributed 800 million doses of vaccines around the world in 2014—the majority of which were disseminated in developing countries.

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  Janssen

  This pharmaceutical company has a public health division that is involved in the prevention of infectious diseases around the world. Janssen is currently working on conducting medical research, increasing access to vaccinations in emerging markets, and advising legislators on ways to improve public health policies.

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  Merck

  Merck develops pneumococcal, hepatitis B, measles, mumps and rubella, and human papillomavirus vaccines. The company has a number of clinical trials in progress in order to develop new vaccines.

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  Pfizer

  Pfizer has been involved in the development of vaccinations since the early 1900s when it created the first heat-stable, freeze-dried smallpox vaccine. The company was also the first to develop a combined diphtheria, pertussis and tetanus vaccination. In addition to research and development, Pfizer is also dedicated to providing vaccination doses to patients in developing countries.

Public Sector Employers

In addition to the employers listed below, state and local health departments also have several opportunities available for public health graduates interested in vaccinations and immunology.

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  U.S. Centers for Disease Control and Prevention (CDC)

  The CDC is a federal public health agency that works to educate the public about topics such as infectious diseases, injury prevention, environmental health and occupational safety. It disseminates a lot of information about vaccinations, in addition to offering immunization education and training to health professionals.

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  U.S. Department of Health and Human Services (HHS)

  The HHS is a cabinet-level federal agency that works to protect the good health of Americans by promoting advances in public health, social services and medicine. The agency houses the National Vaccine Program Office (NVPO), which is involved in vaccination research, development and distribution. The agency also approves licenses to companies that manufacture vaccines.

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  U.S. Food and Drug Administration (FDA)

  The FDA is a federal agency responsible for regulating a variety of drugs, including vaccines and prescription and over-the-counter medications. Vaccinations are specifically regulated by the agency’s Center for Biologics Evaluation and Research (CBER).

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  U.S. Public Health Service Commissioned Corp

  This agency works to promote and protect public health in the country.

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  World Health Organization (WHO)

  The World Health Organization is an international public health agency that is part of the United Nations. The organization is involved in research, disease monitoring, education and advocacy activities in the public health arena.

Nonprofit Employers

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  The Association of State and Territorial Health Officials (ASTHO)

  ASTHO represents the interests of public health agencies around the country, as well as their employees. In order to do this, the organization provides advice about public health policies and tracks and evaluates these rules.

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  National Foundation for Infectious Diseases (NFID)

  The NFID works to educate the public about the causes, prevention and treatment of infectious diseases. The organization also hosts the Annual Conference on Vaccine Research, where healthcare workers, public health officials and researchers share information.

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  National Vaccine Information Center (NVIC)

  This organization advocates vaccination safety, informed consent and the prevention of injuries caused by vaccinations.

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  PATH

  PATH is a global health organization that works to educate the public and legislators about vaccinations, as well as provide vaccines to children and mothers in developing countries.

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  The Public Health Foundation (PHF)

  The PHF works to improve community health outcomes by providing resources and training materials used by health organizations and government agencies, as well as individuals.

Vaccination & Immunization Resources

General Information

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  AITC Immunization and Travel Clinic

  Created by the San Francisco Department of Public Health, this site includes information on travel vaccinations and vaccine safety as well as immunization news.

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  Institute for Vaccine Safety

  This website contains information on vaccinations for specific diseases.

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  National Vaccine Information Center (NVIC)

  This site includes vaccination news and information on how vaccines are used.

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  Vaccines.gov

  Maintained by the U.S. Department of Health and Human Services, this site has information on how vaccines are used to treat a number of different diseases. There is additional information on travel vaccinations, where to receive vaccinations and who needs vaccinations.

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  Vaccinate Your Baby

  This site includes a vaccination schedule tool, research about infant vaccinations and videos that answer specific questions parents may have.

Getting Involved

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  National Vaccine Information Center

  This organization has a number of volunteer areas, including administration, fundraising, communications and research.

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  Project HOPE

  This organization has clinical volunteer opportunities around the world.

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  Shot@Life

  Supporters can host fundraisers, write letters about the importance of vaccinations and speak at community events.

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  Stop Transmission of Polio (STOP) Program

  This program, which is part of the Centers for Disease Control, has volunteer opportunities for those who want to administer polio vaccinations overseas.

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  UNICEF USA

  UNICEF has opportunities to organize or participate in fundraising events.

Trustworthy Sources for Donations

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  End Polio Now

  This organization uses donations to provide polio vaccinations and fund research.

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  Malaria Vaccine Initiative

  Donations are used to create malaria vaccinations.

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  Shot@Life

  Donations are used to protect children from illnesses such as polio, measles and pneumonia.

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  UNICEF USA

  UNICEF’s immunization programs provide measles, tuberculosis and tetanus vaccinations to children.

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  World Vision United States

  Donated funds are used to respond to polio outbreaks in several countries.