Flu and meningitis vaccinations can
be crucial, but few heed the call

College students are becoming the most important demographic of the vaccine debate

Multimedia Reporting By Atoria D. Mills

On Jan. 5, 2015, the California Department of Health was notified about the start of an outbreak of measles. By Feb. 11, 125 cases of measles were reported across nearly 15 states. A majority of the new cases were linked to a single outbreak that occurred at the Disneyland park, usually known as one of the happiest places on Earth.

After nearly 20 years in which fewer than 200 cases were reported annually, this surge in measles cases raised questions and a debate quickly emerged.

The debate focused on whether or not parents should be required — potentially by law — to vaccinate their young children. The majority in the argument agreed that required vaccinations are necessary to guard against all highly preventable illnesses for the overall health and betterment of communities and the nation.

Most public schools and daycares suggest or require certain vaccinations of all students who wish to enroll in their programs, and most states require immunizations of health care workers.

The measles outbreak put a spotlight on vaccinations but the contentious conversations failed to touch on a large, mobile and important population: young people ages 18 to 26 — the college generation.

Newfound independence brings responsibilities some ignore

College students are among the nation’s most-susceptible groups. They spend their time in crowded communities, they travel often, which exposes them to contagious illness, and their immune systems are often under stress due to a lack of sleep, lack of good nutrition and intense pressure.

Graphics by Atoria Mills

This vibrant group of young people can often be ignored in mainstream health conversations. Busy, stressed and distracted college-age adults belong to a target audience that probably needs to hear the most about the importance of vaccinations.

One of the most common health problems among students is the flu, which can often be prevented. One of the most dangerous is meningitis, sometimes a killer of those of college age.

Parents are urged to get preventive vaccinations for most common illnesses when their children are much younger. The pursuit of vaccination for prevention fades as the children age. At college, these young people are on their own. Most health messages aimed at young adults on college campuses tend to focus on the abuse of alcohol and drugs and on awareness of sexually transmitted diseases, not on flu or meningitis prevention.

“North Carolina State law applies at universities like Elon within the state,” said Ginette Archinal, director of student health and university physician at Elon University. “The mandate is you must have previously had vaccinations for measles, mumps and German measles in order to enroll.” Flu and meningitis prevention are not part of any required set of expectations.

The common culprits: flu and meningitis

Meningitis on a bacteria level — Photo by Various Flicker Commons Authors

The flu virus can lower an individual’s immune system to the point where he or she may fall into a repeating pattern of illness.

Flu vaccinations are made available on college campuses and are also offered at pharmacies, but students must decide every year if they want to receive the vaccination. Students’ excuses for not getting vaccinated vary from a lack of interest to a disbelief in their effectiveness to the fact that they are just “too busy.”

Elon sophomore Audrey Engleman said she doubts the flu vaccine will have a positive impact on her health.

“When they formulate the flu vaccine they guess what strain it will be, and they can be wrong,” she said.

When a severe flu bug hits a campus, it can have some devastating results. Archinal said students who catch it should not attend classes and they should isolate themselves until the worst symptoms have subsided. Elon’s health services department took action over the past flu season to issue more-formal email notifications to the teachers of students who sought treatment for severe flu symptoms.

The most dangerous infection college-age students may suffer is meningitis, a viral, bacterial or fungal infection that dangerously impacts the delicate membranes that cover the spinal cord and the brain. Bacterial meningitis can be contagious among people in close contact.

In many states a meningitis vaccination is not required. In North Carolina, for instance, the law requires only that “postsecondary educational institutions with residential campuses are to provide meningococcal disease and vaccine information with student health forms.”

Levicia Jeter, a registered nurse at North Carolina A&T State University, said parents there do encourage their children to be vaccinated.

“Vaccination numbers increased over the last two or three years, more so because the parents are aware,” she said.

College students under the age of 26 are generally still covered under their parents’ health insurance, so vaccination costs may be covered.

People in Campus Communities Must Work to Protect “the Herd”

North Carolina is home to 54 universities that welcome students from across the nation and around the world every year.

The students who arrive from afar create a convergence of different backgrounds, health systems and beliefs concerning health to navigate through. Many of the U.S. students attending colleges in North Carolina are from out of state, traveling back and forth often, exposing themselves to potential bugs as they move.

Most North Carolina universities also have active study-abroad and domestic study programs with major travel components. The constant movement of the populations on college campuses positions them at a higher risk for outbreaks just as much as the closed quarters on campus do.

Interviews about vaccination issues were conducted with registered nurses and practitioners from North Carolina state and private universities, including Davidson College (enrolled undergraduate pop. of 1,850), High Point University (enrolled undergraduate pop. of 3,999), Elon University (enrolled undergraduate pop. of 5,782), North Carolina A&T (enrolled undergraduate pop. of 8,872) and North Carolina State University (enrolled undergraduate population of 34,009).

Most of these professionals stress the importance of getting the flu vaccination every year because this simple act does more than just give the one vaccinated individual a better chance at staying health — it can stop an outbreak. The flu vaccines distributed annually can’t be formulated to prevent every strain of influenza possible but they still provide many benefits.

Alexis Perry, a junior and track athlete at North Carolina State University, says she was vaccinated for the flu in 2014 and felt ill a week later. Soon after she found out she had both the flu and strep throat. Medical professionals say her vaccination may still have been of value to her and her community.

Even a vaccinated individual might contract a different strain of the flu this person might still gain the benefit of avoiding a cold, bronchitis or sinus infection. The antibodies created to fight the flu virus can sometimes also provide added protection against related health problems.

Graphic by Atoria Mills

Medical professionals say, most importantly, each person who receives a vaccination may lower the chances for the next person to contract the flu. They help bolster and maintain the “herd immunity” of their community.

The Centers for Disease Control reported that if “a critical portion of a community is immunized against a contagious disease… there is little opportunity for an outbreak.”

When a community’s overall health undergoes stress, other illnesses begin to emerge, including bronchitis, sinus infections and severe colds.

Katie Caler wishes that the herd immunity was stronger during her frequent battles with sickness over the last two years. She suffered through bronchitis on three different occasions within a three-month span. As a result, she became so Immunosuppressed that she was not eligible to get a flu shot.

“You want to have that extra layer of defense, and I couldn’t,” said Caler. She urges those in her community to get the annual flu shots.

{In the illustration below, the top box depicts a community in which no one is immunized and an outbreak occurs. In the middle box, some of the population is immunized but not enough to confer community immunity. In the bottom box, a critical portion of the population is immunized, protecting most community members.}

Vaccines Are Evolving in Effectiveness at a Time of Need

The consensus among medical professionals concerning flu and meningitis vaccinations is that college students will protect their own health and the health of their communities if they take advantage of them. It is important to pay attention to trends, as new vaccines are emerging to treat emerging problems.

The Centers for Disease Control and the Food and Drug Association jointly recommend: “Getting a flu vaccine is the best way to prevent influenza illness and protect against its potentially deadly consequences… The CDC recognizes that currently recommended influenza antiviral drugs have limitations; however, these drugs are the only influenza-specific therapy approved by FDA with activity against circulating influenza viruses.”

The CDC reported that flu severity indicators in 2014–2015 were “among the highest seen in the past decade.”

The current formulation of the meningitis vaccine may not cover all of its potential strains. In efforts to get ahead the FDA has given advance approval to a new vaccine that will directly target the strain of the bacteria that caused recent outbreaks at Princeton University and the University of California-Santa Barbara.

Vaccines had been targeted at only four of the five major kinds of meningitis bacteria, types A, C, Y and W, up to now. The new vaccine, called Trumenba, protects against type B and has yet to be legally mandated or even widely used like its current vaccine counterparts.

About the multimedia journalist:

Atoria Mills discusses her examination of vaccinations on college campuses.

Hi there!
My name is Atoria D. and I am a multimedia journalist who has a deep love for telling the stories that shape communities and the people within it.

Atoria Mills is a broadcast journalism major at Elon University.

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