Who invented mmr vaccine

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Public trust in vaccines has become an important global health issue, with negative attitudes due to fears over false but highly publicized side-effects and hesitancy among some doctors. Italy and Germany are making vaccination mandatory after health officials warned that a fall-off in vaccination rates had triggered a measles epidemic. In 10 European countries, cases of measles doubled in number in the first two months of compared to , as reported by the ECDC, with more than 2, cases in , almost ten times the number in Notwithstanding the astonishing success of vaccines in saving millions of lives and promoting civil societies, vaccine development, production, and implementation have many ethical issues and controversies.

These range from ideological anti-vaccinatonism, to professional jealousies and controversies, along with economic and legal disputes over cell lines for vaccine production, to allegations of vaccines causing diseases in children, slow adoption of life-saving vaccines, inadequate resource allocation in developing countries, lack of harmonization of vaccination policies, and others.

Recently, rates of parental refusals of vaccination have increased. This is due, in part, to increased public skepticism of public health professionals, policymakers, and the pharmaceutical industry.

Reduced public health awareness is also due to the successful control and near-elimination of many once dreaded infectious diseases such as smallpox and poliomyelitis. Today, most parents, health care staff and doctors have never seen the diseases prevented by vaccines and do not understand their gravity.

Public anxiety surrounding vaccinations rose in the United Kingdom in the s in response to concerns about the safety of the pertussis vaccine. This resulted in a decline of immunization coverage and the return of this once well controlled disease.

In the mid - s UK uptake of MMR vaccination fell from a peak of 92 percent at the age of two to 82 percent in , with uptake falling below 75 percent in parts of London. This has serious implications for mutual protection of the population, i.

The harm created by publication of fraudulent and unethical research activities has had an adverse impact on professional and public perception of matters such as vaccines. In , an article published in Lancet by Andrew Wakefield purported to show that the measles—mumps—rubella MMR vaccine caused autism.

This created a storm of public concern and parental refusals of the MMR vaccine. Media investigation and professional studies proved the study was fabricated, and many reliable studies have since disproved its claims. However, despite the media coverage and retraction of the article, the credibility of vaccinations—specifically MMR vaccine—in the eyes of the public was damaged substantially. The allegation, although proven to have been fabricated, continues to be widely believed and spread via the internet and social media.

Popular resistance to vaccination is both a legal and ethical question as reflected in current controversies in the United States, where opting out of mandatory vaccination has contributed to measles outbreaks, a disease that was considered eradicated many years ago. All 50 US states have legislation requiring specified vaccines for students.

However, exemptions are allowed for medical reasons, and for reasons of religious beliefs and 18 states allow philosophical exemptions for those who object to immunizations because of personal, moral, or other beliefs National Conference of State Legislatures, Pediatricians in the United States are reporting increased refusal of parents to immunize their children, prompting the American Academy of Pediatrics AAP , the American Medical Association AMA and the American College of Physicians to recommend the elimination of non-medical exemptions in state immunization laws.

Refusal of vaccination can be seen as posing a threat to other children, as well as a form of child neglect such as having a child in a car without an appropriate child car seat.

In part, this action is stimulated by concern over increasing resistance of parents to vaccination along with return of previously controlled diseases. Failure to vaccinate is a form of child neglect. Both the public and private sectors, including the pharmaceutical industry, have contributed greatly to increasing vaccine coverage rates, and public—private partnerships remain vital to vaccinology.

As a senior staff member of Merck, responsible for vaccine development at a major pharmaceutical company, Hilleman conducted industry-funded research and his contribution led directly to manufacture of the majority of vaccines created in the latter half of the 20 th century that have been, and remain, vital for public health in the US and globally.

The role of the private pharmaceutical industry needs to be recognized as crucial for advances in this field, but is equally dependant on scientists at universities and public research institutions with their contribution to the knowledge base that enabled breakthroughs in vaccine production and distribution.

The Zika virus transmitted to a pregnant woman by Anopheles mosquitoes, or by sexual relations with a Zika infected partner may produce a mild illness.

The race to develop effective vaccines must involve public—private cooperation to achieve a working vaccine within several years. The long time gap from availability and proof of vaccine success until it is adopted globally is an ethical issue for reducing global health inequities as well as a question of priorities and resource allocation in public health. Adoption and implementation of vaccination is slow to respond to important advances, especially in low-income countries where policy-makers have traditionally given health low priority in governmental financing.

Delays in vaccine adoption lead to preventable infections, with high rates of illness, deaths, human misery, and slowing of economic progress. Lack of harmonization of vaccination policies is a major professional, public policy, ethical issue and a limiting factor in achieving the full potential of proven successful and safe vaccines.

Europe, and the European Union, still does not have a common harmonized immunization program, in some cases not even in the same country, which contributed to the massive measles epidemics since The benefits to society of vaccination are enormous, not only in saving lives and reducing morbidity, but also in reduced health care costs.

Vaccines are life-saving and cost-effective, and they should be supported by national governments and international donor programs alongside the buildup of public health education and infrastructure development within recipient countries. Vaccines have been crucial in reducing child illness and birth defects —e. Vaccines help men, women and especially children to have healthy lives without morbidity of many previously common childhood diseases e.

They also lessen infections among people with chronic medical and disabling conditions such as pneumococcal pneumonia and influenza vaccines. Reducing disease and high mortality rates promotes economic growth as supported by the World Bank and other economic analyses.

Successful vaccination also increases equity in society by reducing diseases that were often more common among poorer populations.

Since , the World Bank and economic analysts have accepted that the economic benefit to low- and medium-income countries LMICs of reducing child mortality—mostly resulting from reduced morbidity and mortality from infectious diseases—is vital to their economic and social advancement.

Nearly universal use of hepatitis B vaccine for newborns has helped to prevent mother-to-child transmission and subsequent prevention of liver cirrhosis and liver cancer, which is of enormous economic value to health systems. The vaccine to prevent the spread of hepatitis A is available and used in many countries, but a vaccine for the more serious disease of Hepatitis C has regrettably not yet been developed. Although effective, life-saving treatments are available, these are costly and an effective vaccine would bring greater benefits and advances.

A review of cost effectiveness and economic benefit studies of vaccines in LMICs concluded that vaccination brings important economic benefits and recommends that policy-makers should consider vaccines to be an efficient investment.

Immunization averts an estimated two to three million deaths every year from diphtheria, tetanus, pertussis whooping cough , and measles. However, an additional 1. Since its founding in , GAVI helps finance adoption of vaccines in low-income countries dependent on external support to finance vaccination. The percentage of low-income countries financing vaccines in their national budgets rose from 64 percent in to 75 percent in , with a modest increase in national government share of routine immunization rising from 35 percent to 39 percent between and A study reviewed publications from 27 countries which introduced rotavirus vaccine into their national routine immunization programs since Measles is a highly contagious and potentially fatal disease which is a leading cause of death among young children see Box Efforts to control, eliminate, and ultimately eradicate measles are part of international organizations and WHO strategy.

An economic analysis by Levin et al. In recent years, many cost-effectiveness studies of vaccines for hepatitis B, rotavirus, human papilloma virus, and influenza have shown that vaccination is an effective economic tool with significant health benefits.

Global targeting of rubella for eradication along with measles for achievement by will require new tactics in Europe, such as harmonization of immunization programs across the region, and certainly in the European Union where there is free border crossing between member states and large-scale refugee entry without evidence of past immunization.

The tools exist in outstanding vaccine combinations, especially the MMR vaccine created by Hilleman. Measles and rubella control—and ultimately eradication—are within the capacity of well-led public health policy and resources see Box The sciences of vaccinology depend on academic research and on the private sector of the limited number of vaccine producers in the world.

Long known diseases such as malaria, HIV, TB, dengue, West Nile fever and others are also part of the urgent call for new vaccines challenging the research capacity of academia and private manufacturers. The process of discovery is only part of a long and costly process of initial testing of safety and efficacy. New institutional and funding arrangements will be needed to make the most of new technology and genetics in vaccine development for these and new challenges that may be expected to arise.

Vaccine development and distribution have saved millions of lives, and have the potential to save millions more as new vaccines emerge from public and private research centers, through the pioneering achievements of the next generations of Hilleman and colleagues. Policy-makers in public health systems will continue to improve vaccine delivery and to implement vaccination programs for reduced morbidity and mortality rates across the globe. Vaccines are among the most efficient preventive measures available to both clinical medicine and public health.

However gains from successful immunization campaigns are being rolled back as rates of vaccine refusal increase. Public support can be won or eroded by pro- and contra-advocacy groups. Public concerns over vaccine safety can become wildly exaggerated and has the effect of reducing vaccine acceptance. The support of medical practitioners and the media is vital to promote adoption and acceptance of newer vaccines by an often skeptical public.

Neither the science, nor the application of its advances, occur automatically. Hilleman believed and demonstrated that academic and industry-based scientists could work in a complementary fashion in support of global public health goals for disease control and eradication, as vaccine development and distribution have a crucial role in population health.

The prospects look favorable for scientific advances leading to new vaccines and to the potential for further disease control and eradication. This process requires long and expensive periods of basic sciences research and vaccine testing, and when proven effective and safe, the implementation of immunization programs. In many countries, adoption of new vaccines in routine immunization programs has proven to be slow.

Disease control depends on monitoring case reports including quantity, common factors such as time, location, risk factors, and available intervention that can be applied to control epidemic or endemic diseases. It is essential to reach out to especially vulnerable groups living in urban poverty areas as well as remote villages and those with particular risk factors for diseases. This is the context in which vaccines are of enormous social and economic benefit, as well as being critical to improve health, prevent disease, and avoidable mortality.

A well-trained public workforce is required to meet these challenges. Ultimately, ensuring the development of these key preventive measures to reduce—and in some cases, eradicate—infectious diseases requires public health and governmental leadership.

The public health system is responsible for total population health and must take the lead to finance, organize, monitor, and deliver needed services such as child vaccination.

Public health widely suffers from low priority in national government budgets. Harmonization of immunization policies and public support are needed, as are resources. Strong support by national government policy and funding are key to the reduction in incidence, prevalence, and control of diseases which can be ameliorated by known, as well as yet-to-be discovered, vaccines.

Hilleman was undoubtedly the leading vaccinologist of the 20 th century, and perhaps of all time. In , he was awarded the National Medal of Science, the highest scientific honor in the United States, and although he received many professional honors he never achieved the popular recognition or fame of other pioneers in vaccine development and implementation such as the developers and leaders in poliomyelitis vaccine, Jonas Salk and Albert Sabin.

Over the course of his career, Maurice and his colleagues developed more than forty vaccines. Of the fourteen vaccines currently recommended in the United States, Maurice developed eight. Although largely unknown among the general public and even among public health practitioners and teachers, Maurice Hilleman was the outstanding scientist in the field of vaccinology in the 20 th century who brought dynamism and creativity to develop vaccines saving countless lives and bringing the means and the hope for eradication of important diseases such as measles, congenital rubella syndrome, and hepatitis B.

He introduced new approaches to vaccinology which others following his path can use help to control—or eliminate—important diseases now, and others that in the future may face humanity. Progress in vaccinology application relies on funding, prioritizing, monitoring, surveillance, routine immunization programs, and outbreak control as cornerstones of public health goals in disease control or its eradication.

Public health must improve its leadership responsibility and realize its important role in reaching out to at-risk, vulnerable segments of the population in outlying rural areas and urban dwellers.

Harmonization of vaccination policies is urgently needed in Europe and low-income countries to halt resurgence and achieve eradication of still significant diseases including measles, rubella, and other targeted vaccine-preventable disease in the coming years. Public health should increase advocacy efforts in health promotion to extend vaccine development and to assure public support for measles control and eradication, as well as other vaccine-preventable diseases.

Resources for science advancement and for service delivery are equally important and must be accepted as a governmental responsibility in LMICs as well as in high-income countries. Training of public health and community health workers is vital to meet old and new vaccine challenges of premature death, disease, and disability in aging populations, with severe climate and social inequality challenges. Governments, academic research centers, vaccine manufacturers, and public health authorities require well-designed plans to respond to pandemic illnesses, especially in recognizing the global importance and urgency of the need for quicker development and distribution of the influenza vaccine, as well as for newly emerging infectious disease such as Ebola and Zika, among others.

Why is it slow and costly to develop new vaccines and to adopt them in public health practice? Which infectious diseases would you place on a priority list for vaccine development to save the maximum feasible number of people from disease and avoidable death? Why has measles rebounded after being considered eliminated in Europe and the Americas? Discuss factors that affect progress toward the eradication of infectious diseases such as measles? What methods of public health are available to control diseases for which there is no vaccine?

What new methodologies are expected to become available to produce vaccines in less-costly and more easily-usable ways? National Center for Biotechnology Information , U. Case Studies in Public Health. Published online Mar Theodore H. Author information Copyright and License information Disclaimer. All rights reserved.

Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.

Keywords: Maurice Hilleman, Merck Company, vaccines, vaccinology, measles, mumps, hepatitis A and B, chickenpox, meningitis, pneumococcal pneumonia, disease eradication. Open in a separate window. Background Maurice R. Smallpox routine vaccination ended in The United States discontinued routine usage of Sabin vaccine in Achievements in public health, — impact of vaccines universally recommended for children—United States, — Vaccines and immunization: human papillomavirus.

The history of vaccines: vaccine development and licensing of vaccines. Last updated 17 January Figure Incidence of hepatitis B virus infection, United States, — RR-1 :1— Source: Centers for Disease Control and Prevention.

Progress in introduction of pneumococcal conjugate vaccine world-wide — Morb Mort Wkly Rep. Ethical Issues Public trust in vaccines has become an important global health issue, with negative attitudes due to fears over false but highly publicized side-effects and hesitancy among some doctors.

Economic Issues The benefits to society of vaccination are enormous, not only in saving lives and reducing morbidity, but also in reduced health care costs. Source: Mirelman A, et al. Bull World Health Organ. Box In response to growing public concerns, the United States Congress held hearings to debate the effects of thimerosal in vaccines and any possible links to autism spectrum disorders.

The Congressional reports from those hearings called for federal health agencies to determine the impact mercury-based compounds on individuals' health. However, multiple studies conducted and reviewed by the Institute of Medicine, now called the National Academy of Medicine in Washington, D. From to , there were at least nine studies conducted or funded by the CDC investigating the relationship between thimerosal in vaccines. None of those studies found any evidence to support the claim that thimerosal caused autism spectrum disorders.

Studies conducted by the Institute of Medicine in and further disconfirmed that vaccines containing thimerosal caused autism spectrum disorders. In , a CDC study concluded that there was no evidence that vaccines, in particular the MMR vaccine, caused and autism spectrum disorders.

Thorough and repeated research has demonstrated that the MMR vaccine is not only safe for use, but also highly effective in preventing against potentially deadly diseases. In , The Lancet retracted Wakefield's paper due to incorrect statements contained within.

The MMR vaccine has prevented deaths and defects caused by childhood diseases. Of the diseases that the MMR vaccine protected against, measles was the deadliest. In the early part of the twentieth century, records reported an average of 6, deaths per year in the US due to measles. In the ten years before the advent of measles vaccines in , an estimated 3.

After the introduction of the MMR vaccine in , the number of cases in the US dropped to between 22, and 75, cases per year. By the mids, the number of US measles cases had decreased to fewer than 4, cases per year. Since its licensing in , the MMR vaccine has prevented millions of cases of rubella in children as well as pregnant women, further preventing malformation in the fetuses of rubella-infected mothers due to congenital rubella syndrome.

Later, a CDC study of vaccinated children born between and estimated that the MMR vaccine prevented nearly million cases and over 57, deaths from measles, mumps, and rubella. Furthermore, the CDC estimated between and , when the World Health Organization, headquartered in Geneva, Switzerland, increased global efforts to vaccinate people against measles, they likely prevented about 1.

Worldwide, medical personnel administered more than million doses of the MMR vaccine between and In that time, the use of the MMR vaccine has improved the health of children and women by preventing measles, mumps, and rubella and preventing congenital rubella syndrome in the fetuses of pregnant women.

Sources Burton, Dan. Buynak, Eugene B. Weibel, James E. Whitman, Joseph Stokes, and Maurice R. Centers for Disease Control and Prevention. Destefano, Frank, Cristofer S.

Price, and Eric S. Dove, Alan. Hilleman, Maurice R. Weibel, Eugene B. Whitman Jr. Buynak, Robert E. Weibel, Joseph Stokes, James E. Whitman, and M. Bernice Leagus. Immunization Safety Review: Vaccines and Autism. Washington, D.