HJNO May/Jun 2021

48 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF NEW ORLEANS COLUMN INSURANCE Greatest Public Health Achievement of the 20th Century Since 1900, the average lifespan of someone living in the U.S. has lengthened by almost 30 years, with 25 years of that gain a direct result of advances in public health. According to the Centers for Dis- ease Control and Prevention (CDC), many notable public health achievements oc- curred during the 20th century. But they cite vaccinations and the control of infec- tious disease as the primary advancement. Because of vaccinations, we have erad- icated smallpox in the world and elimi- nated polio in the U.S. Along with other infectious diseases here in the U.S. and in other parts of the world, measles, rubella, tetanus, diphtheria and Haemophilus in- fluenzae type b are under “control.” But diseases vaccines prevent still pose a threat. Unvaccinated children are 23 times more likely to get whooping cough compared to fully immunized children. In some cases, measles can lead to pneu- monia, seizures, brain damage and even death, while mumps can lead to deaf- ness and meningitis. And because of the COVID-19 pandemic, Louisiana — like many parts of the country — is behind on regular childhood immunizations, creat- ing alarm and concern for the health of the children as well as for the health of the community at large. In other words, our community immunity may be at risk. How Does Community Immunity Work? Germs can travel quickly through a community, making people sick. If enough people get sick, an “outbreak”can develop. But when enough people are vaccinated against a certain disease, the germs can’t travel as easily from person to person, and the entire community is less likely to get the disease. That means even people who can’t get vaccinated will have some protection from getting sick. And if a person does get sick, there’s less chance of an out- break, because it’s harder for the disease to spread. Eventually, the disease becomes rare, and sometimes, it’s wiped out alto- gether. When 90–95% of a community is protected, it is nearly impossible for a vac- cine-preventable disease to spread. But because of both mis- and dis-information, people still question the efficacy of vac- cines. VACCINATIONS A Population Health Transformation Potentially in Peril