Descriptive analysis of vaccine-preventable diseases in the Dominican Republic: is public media counteracting the public health efforts?

Abstract

The Anti-vaccination movement has dominated media; meanwhile public health policies are being conducted to counteract declining vaccination rates. Despite the efforts made, in recent years there has been an increase in vaccine preventable diseases, especially in tropical and sub-tropical regions. These diseases have caused outbreaks in the Caribbean and low-income countries. The aim of this study is to characterize vaccine preventable diseases in the Dominican Republic from 2012-2018. Data of cases of Vaccine Preventable Diseases included in the Governmental Immunization Program and their demographic characteristics were extracted from the Ministry of Health Weekly Reports (digepi.com.do) in order to establish prevalence and describe demographic patterns. A total of 777 cases were analyzed, of which B. pertussis, represented a total of 411 cases, 48% females, and a, mean age of 128 days (3 days – 16 years); C. tetani, a total of 329 cases, 88% males with a, mean age of 41 yo. On the neurological related preventive illnesses, those caused by S. pneumoniae, a total of 27 cases, 59% males and 41% females, with a mean age of 8 years (73 days - 76 years). Mortality rates related to those illnesses accounted for 41% related to meningitis, 27% for tetanus, and 5% related to pertussis. In animal-transmitted preventable vaccination Rabies accounted for a total of 10 cases, in the majority affecting males (70%), and a mortality rate of a 100% in mid-age individuals (mean age 12 yo). Vaccine preventable diseases seem to have a major impact in public health, especially B. pertussis. Mortality by vaccine preventable diseases constitutes an important part of reported cases. Counteracting measures to increase intake of vaccines and reinforcement of vaccine coverage are still needed, many questions remain from the local perspective, are this lower coverage induced by lack of education, or the negative impact of media, case-control and infectious disease modeling are needed to estimate the real impact of communicable diseases prevented by current interventions in the DR.