Preface
The World Health Organization (WHO) has declared that vaccines have
had a greater effect on reducing death, disability, and illness than any public
health advance except for safe water. The WHO compiles a list of medicines
that it considers essential to human health. As of 2017, there are 32 vaccine-
preventable diseases. These diseases are so devastating that vaccines against
23 of them are on the WHO essential medicine list.
Vaccines have changed the world. Smallpox once killed one of every three
people who were infected. In 1980, thanks to comprehensive vaccination, it
was declared eradicated. Gone. No more bodies buried in mass graves because
there were not enough healthy people to bury them properly. No more
scarred, disfigured survivors.
Polio, which once killed and paralyzed thousands every year, is close
to eradication. As of early 2017, the disease was found only in Nigeria,
Pakistan, and Afghanistan. The international fight to eradicate polio has been
slowed by difficulties in reaching people in the affected areas, cultural misun-
derstandings, and political opposition, but polio eradication remains an
achievable goal.
It is hard to underestimate the effect vaccines have had on the lives of ordi-
nary people. Once common diseases in the United States are now rare and
unfamiliar. In the 1920s before an effective diphtheria vaccine became avail-
able, at least 200,000 people in the United States contracted the disease each
year. Between 10,000 and 20,000 of them died. The death rate in children
under five was 20 percent. Now sometimes years go by without a single case
in the United States.
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