Health Officer Letter to the Editor: Why is Public Health Obsessed with Vaccinations?

Few things have been as divisive in our community as the case for COVID immunization. People line up on both sides fence. Some believe vaccination is the responsible thing to do, while others shudder at being “forced” to receive a vaccine. Most recent arguments primarily focus on the individual health benefits or consequences of vaccination. The discussion about a personal decision to be vaccinated should primarily occur between you and your health care provider. Public health agencies, including the Garrett County Health Department, are not typically “health care providers,” although they provide some interventions and treatments. But, the health department is not your doctor!

So why is the Health Department promoting vaccination if it is not to improve the health of individuals? It’s for population health. The Institute of Medicine states, “public health is what we, as a society, do collectively to assure the conditions in which people can be healthy.” Examples include: eating food from stores and restaurants, swimming at a public beach or pool, and drinking tap water without being afraid of getting sick. Because of public health interventions we never hear of anyone in the world getting small pox, or in the U.S. getting polio. And, we rarely hear of persons in the U.S. getting cholera, Ebola, botulism, legionella, malaria, etc. Assuring the population’s health includes safely gathering in public, children attending school, and being able to visit those in the hospital or nursing home without the fear of spreading disease. This is where COVID vaccination enters the equation.

Public health interventions help keep communities healthy and immunizations have played a huge role in this. When most people are immune to an infectious disease, it provides indirect protection, also called “population” or “herd” immunity, to those not immune to the disease. In the 1960s, children often got measles, mumps and chicken pox, and unfortunately, some died or had long term health consequences because the viruses were circulating periodically. Now, children rarely contract these diseases because over 90% of all children are vaccinated against them by their second birthday. This level of vaccination provides protection for everyone, even the unvaccinated, by decreasing the viruses in circulation. If a person with measles enters a community, nine out every 10 people are immune, making it difficult for measles to spread. While occasional outbreaks occur in the U.S., those outbreaks generally die down without starting a nationwide epidemic. This principal works for all infectious disease, including COVID. Our hope is that the population will develop a high enough level of immunity to keep the spread low just like measles.

Can we still get there? Maybe, but it will take some time. We are having a harder time getting people vaccinated for COVID than for childhood diseases, and until recently, young children were not eligible for the vaccine. COVID has also been hard to address because some vaccinated people can still become infected, and others who have had COVID-19 can get it again. This means we need even higher levels of vaccination to achieve herd immunity. So, we will probably see some COVID cases for years to come. However, as more people acquire immunity the risk of severe illness decreases in the population, and hopefully we will return to some sense of normalcy.

When will that occur? Unfortunately for our region, it will take longer than other locations because our vaccination rates are much lower. As of November 16th, 41% of all our residents are vaccinated and we have a case rate of 66 per 100,000. By contrast, 73% of all Howard County residents are vaccinated and their case rate is 10 per 100,000. If this continues, things will be back to normal a lot sooner there than here.

The answer to the question of why public health advocates community vaccination is that it is the best way to protect our community and make sure we have a healthier tomorrow. This can be accomplished if most of us do our part.

Bob Stephens
Garrett County Health Officer