As a physician, I have witnessed firsthand the devastating effects when infections are not properly prevented. This is why I am such a vocal advocate of vaccinations, especially against meningococcal disease. My commitment to this purpose is not only to prevent disease, but also to ensure that the health care system does not put patients at risk. Recent discussions about changes to established meningococcal disease vaccination schedules are deeply concerning to me, as they may unnecessarily put young people at risk.
See care and gaps
Growing up in Mumbai, India, I often saw health workers traveling to communities to administer vaccines to protect as many people as possible. My father, a trained pharmacist, knows that despite these efforts, the system often leaves behind economically disadvantaged people who cannot afford to take time off from work to get vaccinated. Ta. He took it upon himself to fill that gap by allowing his apartment workers to gather in their living rooms to get vaccinated. This vivid memory remained with me throughout my medical training.
The importance of reaching patients
These experiences fueled my passion for preventive medicine, which eventually became my specialty. My career has allowed me to observe other health systems, such as the Sultanate of Oman, where the national pediatric immunization rate has reached approximately 99%. The success of this country’s public health system lies in its proactive approach. That meant medical workers traveled by helicopter to remote areas to ensure no one was left behind.
When I moved to the US, I was shocked to find gaps in care similar to what I saw in India. Despite being one of the most developed countries in the world, quality care is not always available to disadvantaged populations.
Successful meningococcal vaccination
Given these experiences, I am very concerned that the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) is considering some changes to the current meningococcal vaccination schedule. . Since the introduction of the meningococcal vaccine in 2005, meningococcal infection rates among adolescents have decreased by 90%. This is a huge success story. Current ACIP recommendations include administering the MenACWY vaccine at age 11 to 12 years, followed by a booster at age 16 years.
This schedule is widely implemented and supported by admission requirements to ensure high vaccination rates, especially among young adolescents. The proposed phase-out of the MenACWY dose at 11-12 years of age could have far-reaching implications and undo the progress made to date. At age 11, most children still receive regular medical care, but by age 16, many children no longer receive it. One factor that may be contributing to this decline in welfare care is that adolescents in rural areas and those from socio-economically disadvantaged backgrounds are unable to receive regular medical care and are less likely to attend health facilities. It’s about not having the resources or time to go. This may be reflected in the large difference in vaccination rates between young (89%) and older (61%) adolescents.
keep the gap closed
Removing vaccination recommendations for 11- to 12-year-olds or moving to shared clinical decision-making (SCDM) recommendations would widen existing disparities and put more families at risk of meningococcal disease. may be exposed to. The disease progresses rapidly and can become life-threatening within hours. Invasive meningococcal disease (IMD) is rare but devastating, with a case fatality rate of 10-15%. Additionally, one in five survivors will suffer long-term effects such as loss of limbs, hearing loss, or neurological damage.
If disparities in the health care system are left unchecked, it will always be the most vulnerable who suffer the most. Our current health care system already places an undue burden on patients seeking treatment. ACIP should maintain successful vaccination recommendations to protect vulnerable patients and prevent widening of already significant disparities in public health.
By maintaining this proven strategy, we can continue to protect our children and youth. They are literally our future. That’s why we must act now to ensure no one is left behind in the fight against preventable diseases.
Photo: Wild Pixel, Getty Images
Dr. Paritosh Kaur is a board-certified pediatrician and adolescent medicine specialist at Children’s Hospital Colorado and an associate professor at the University of Colorado School of Medicine. He earned his medical degree from the Seth Gordandas Sunderdas College of Medicine in Mumbai and completed a fellowship in adolescent medicine at the Albert Einstein College of Medicine.
Dr. Kaul specializes in adolescent health, with an emphasis on mental health, substance abuse, sexually transmitted diseases, and adolescent gynecology. He is Co-Director of the Culture, Health, Equity, and Society Thread and Associate Director of Pediatric Education Across the Curriculum (EPAC) at the University of Colorado. Additionally, he consults with Denver Public Schools and the Youth Championship Model. His contributions include numerous publications and active involvement in professional organizations such as the American Academy of Pediatrics and the Medical Association for Adolescent Health.
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