Schell K R
Soz Praventivmed. 1979 Oct;24(5):335-45. doi: 10.1007/BF02083602.
One of the most important and most lasting benefits of medicine to human health and health expenditure is the controlled immunological interruption of the vicious cycle of infectious disease such as smallpox, poliomyelitis, yellow fever, measles. Smallpox, with globally more than 2.5 million cases ten years ago, is gone. The incidence of infectious diseases with available immunoprophylaxis has been reduced by 90 % over the past two decades, while the incidence of diseases without vaccine has nearly tripled. By contrast, influenza, a disease against which there have been vaccines in existence for many years, demands more deaths than any other infectious disease. Reasons for this failure of influenza immunoprophylaxis are discussed and suggested to include: indiscriminate use of available vaccines of which some types are much less antigenic than others, the disappointment that influenza virus vaccines will not protect against influenza-like illnesses caused by noninfluenza virus pathogens and the concomitant indiscriminate rejection of all influenza vaccines as being of doubtful value; superficial vaccination policies which aim at narrow populations, leaving those most likely to spread the virus the full potential to do so; the unjustified fear of side reactions following vaccination which are considerably less severe than the disease this vaccination is attempting to prevent.
医学对人类健康和医疗支出最重要、最持久的益处之一，是对天花、脊髓灰质炎、黄热病、麻疹等传染病恶性循环进行可控的免疫干预。十年前全球有超过250万例的天花已不复存在。在过去二十年里，有免疫预防措施的传染病发病率降低了90%，而没有疫苗的疾病发病率几乎增加了两倍。相比之下，流感是一种多年来一直有疫苗的疾病，其造成的死亡人数比任何其他传染病都多。本文讨论了流感免疫预防失败的原因，认为包括：不加区分地使用现有疫苗，其中某些类型的抗原性比其他类型弱得多；流感病毒疫苗不能预防非流感病毒病原体引起的类似流感疾病，导致人们失望，并随之不加区分地拒绝所有流感疫苗，认为其价值存疑；表面化的疫苗接种政策，目标人群狭窄，使得最有可能传播病毒的人有充分机会这样做；毫无根据的对疫苗接种后副作用的恐惧，而这些副作用比这种疫苗试图预防的疾病要轻得多。
