Category: Dr. Casey

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Dr. Casey

Spooked by Needles? The Future of Needle-Free Vaccines Could Be a Treat!

Given we are in the Halloween season, I thought it would be fitting to talk about an aspect of vaccines that some people find “scary” but might not be in the near future. One of the most common reasons I hear why people are hesitant to get vaccines is because they are afraid of needles. That might sound childish to some, and I know people who have the attitude that getting a shot is not a big deal, that people with this fear need to “get over it.” But it is a very real thing. Did you know there is even a name for it? Trypanophobia is an intense fear of needles, and in severe cases, people with this fear can put themselves at great risk by not getting vaccines or even medical treatment when needed. To be very clear, I am not talking about a dislike of needles. I think most people dislike needles, especially being poked with them. Rather, here I am describing a true, irrational fear of needles that causes anxiety, panic attacks, even fainting, and other consequences. However, for those who have a genuine fear of needles and those who simply don’t like them, there could be good news in the pretty near future…

Another way to vaccinate

Vaccines for several diseases are currently undergoing testing — that can be delivered through a person’s nose! So far, early trials in the United States have had very promising results. For example, trials of two of these nasal spray vaccines have initiated multiple immune system responses against the virus that causes COVID. Results like these have researchers optimistic that there could be an approved COVID vaccine nasal spray available by even 2027! Some other countries, like China and India, are already using approved COVID nasal vaccines because they prioritized developing these types of vaccines during the pandemic. In the U.S. and many other wealthy countries, we chose to remain with our tried-and-true methods of arm injections. Many of the most recent efforts in nasal vaccines in the U.S. have focused on COVID-causing viruses, but nasal vaccines could also be effective against the flu, respiratory syncytial virus (RSV), and others.

Yes, a handful of nasal vaccines have already been developed in the U.S., but they have had a variety of issues. Maybe the most well-known of these is FluMist (a flu vaccine), but it never became a leading option because its effectiveness was widely debated. What is different about the ones being developed now? They use new technology that can produce stronger immune responses and is safer than the medicines used previously.

Could these vaccines be even better than traditional methods?

It is very possible. Researchers say it is possible that vaccines delivered through nasal spray or possibly inhaling through the mouth can offer stronger (and quicker) protection against respiratory viruses than our long-standing way of injecting into the arm. Why is that? When introduced to the body through inhaling (through nose or mouth), these vaccines stimulate part of the immune system that has adapted specifically for fast, comprehensive protection from airborne germs. This could help an infection from really setting in by fighting it off quickly and completely. While an injected vaccine is good at keeping a disease from spreading, it doesn’t stop the initial infection. A nasal spray, however, is much more effective at this because sprays are targeted where many viruses first enter the body — the nose and nasal tissue (called mucosa, which is a thick, multi-layered tissue that produces mucus, full of immune cells, to fight infections). So mucosal immunity gets your immune system ready to fight off infection, where it starts and offers three different types of protection, while shots provide two types.

Additionally, attacking the invading virus in the nose may prevent it from spreading to other people because it would lower the amount of virus the infected person inhales. Another positive consideration is that, by the spray limiting how far into the body the infection progresses, it is possible that it could prevent long COVID, the chronic, sometimes debilitating condition that so many individuals have faced in the aftermath of infection with COVID. Another pros of these vaccines? They should be less expensive and more convenient to transport to poor areas than the injections we use now (which require rigid, specific temperature regulations, etc.).

Regardless of how it is delivered (through a shot or a spray), developing any new vaccine is extremely complicated and challenging. Researchers have to find that perfect balance where they elicit an immune response intense enough to protect the body from future infections but not too strong so that it harms the individual. There is a delicate balance of individuals’ immune systems, exposures, various cell stimulations, and a host of other factors that will go into fine-tuning these sprays before they can be thoroughly tested and approved by the U.S. Food and Drug Administration. If you are interested in the nuts and bolts and very nitty-gritty details of immunology, I will include a couple of resources below where you can explore more thorough explanations of T cells and spike proteins and all of that good stuff related to this topic, and you can find plenty out there — it is a hot topic!

But for now, I hope some people might be a little less “spooked” knowing that the future of vaccination may be one free of needles…

Other Questions?

I am always interested to hear from you, to answer your questions and even have just interesting conversation! I love the engagement from readers, and all of you are fantastic. Also, feel free to send in topic suggestions if there is anything related to vaccines or similar that you’d like me to take a deeper dive into. I would love to hear what you are interested in reading more about!

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

For a fairly brief discussion about the potential future of COVID-19 nasal vaccines, here is a pretty concise overview: https://abcnews.go.com/Health/clinical-trial-begins-generation-nasal-covid-19-vaccine/story?id=111605093

The National Institutes of Health (NIH) began trials of a nasal COVID-19 vaccine back in July of this year. This link will take you to a press release from when those trials first started and gives some information about the trials themselves: https://www.nih.gov/news-events/news-releases/nih-sponsored-trial-nasal-covid-19-vaccine-opens

This is a lengthier article from Scientific American, but contains a lot of detailed information and is great for anyone who wants to read about the in-depth mechanisms related to immunology and other technical details (particularly later in the article): https://www.scientificamerican.com/article/new-nasal-vaccines-offer-stronger-protection-from-covid-flu-and-more-no-needle-needed/

You can find another article (and briefer, if you are looking for more of a quick read) that discusses the potential greater effectiveness that nasal vaccine may have in stopping COVID-19 transmission compared to traditional injections by individuals from the Washington University School of Medicine here: https://scitechdaily.com/better-than-traditional-shots-new-nasal-vaccine-halts-covid-19-transmission/

If you are interested in learning more about what I described quite briefly, above regarding nasal immunity, etc., this article is fantastic. It is all about the immune cells of the nose, specifically, and how their effectiveness could be a great advantage to protecting us: https://www.nature.com/articles/d41586-024-02503-5

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Dr. Casey

A “Miracle Worker”: Honoring Dr. Jonas Salk

October 28th marks the 110th anniversary of Dr. Jonas Salk’s birth. Jonas Edward Salk was an American virologist, physician, and medical researcher who became known as a “miracle worker” after developing the first safe and effective vaccine for polio in 1955. This vaccine, known as inactivated poliovirus vaccine (IPV), contained killed virus. Since its development, polio vaccination has helped to eliminate wild poliovirus in the United States.

Polio: Before the vaccine

Before the development of Salk’s vaccine, polio was a highly feared disease. One reason it caused so much concern is because it was–and still is–so highly contagious. It paralyzed and killed thousands of people every year. There were frequent polio epidemics, making it one of the most dreaded diseases in the world. Little was known about the virus, and attempted treatments (such as lumbar punctures) were rarely successful. Children infected with polio often survived by depending on an iron lung to help them breathe because the virus can paralyze the muscles used for breathing. Even for those who recovered from the initial polio infection, 25 to 40 people out of 100 were affected by post-polio syndrome which caused many painful, debilitating symptoms. Polio killed millions of people worldwide, particularly during the 1940s and 1950s, before the vaccine was developed. It was a leading cause of death and paralysis internationally. At its peak, polio killed close to half a million people every year, killing thousands of people at a time in individual outbreaks in a single city in the U.S.

Developing the vaccine

Widespread fear of polio led to many researchers working toward a vaccine in the mid-1900s. Different methods were used, but Salk remained focused on developing a vaccine using a “killed” virus (rather than using a vaccine containing live poliovirus). Although this went against common beliefs in the scientific community then, Salk believed the killed virus vaccine could immunize without the risk of infecting the patient. In the early 1950s, Salk found success with his vaccine in laboratory testing. He then tested the vaccine on himself, his family, and a small group of volunteers. After that continued success, he launched an international vaccine trial in 1954 in the United States, Canada, and Finland, testing the vaccine on 1.6 million child volunteers, ages 6–9 years old, who had not had polio, known as the “polio pioneers.” The patients in these trials developed anti-polio antibodies and did not experience adverse reactions to the vaccine. In April 1955, the vaccine was announced as safe and effective and became immediately available for widespread use.

How the vaccine changed the world

After Salk’s inactivated poliovirus vaccine (IPV) was licensed, it was met with overwhelming acceptance by the public, who had suffered from so many deadly polio outbreaks and lived in constant fear. Parents, especially, were eager to vaccinate their children as quickly as possible. Programs were implemented to vaccinate children in school, if desired, to ensure as many children as possible had access to this life-saving vaccine. Programs offering vaccines at schools were extremely successful and continue to be a way to provide equitable preventive healthcare access, particularly for children in rural and medically underserved areas today. Americans were so relieved by and enthusiastic about the polio vaccine that mandatory vaccination policies were never needed. After vaccination became available in April 1955, polio cases in the United States dropped from over 45,000 a year in the 1950s to 910 in 1962. Salk chose not to patent the vaccine or to seek profit from it. His focus and goal was for the vaccine to be as widely distributed as possible, thus Salk never earned any money from his world-changing discovery. Other polio vaccines were developed later, but Salk will always be hailed as developing and implementing the first safe and effective polio vaccine.

The legacy of Salk and the polio vaccine

There have been no cases of wild poliovirus in the United States since 1979, with the disease declared eliminated from the U.S. By 1994, polio was eliminated from the Americas, and by 2000 the disease was eliminated from the Western Pacific. In the 21st century, cases have decreased by over 99% worldwide in under twenty years. However, wild poliovirus cannot be classified as “eradicated” from the world because the virus remains in Afghanistan and Pakistan. This poses a threat that individuals could contract polio in those countries, travel to another country, and an outbreak could occur. This is why it is still important for individuals in all countries to receive the polio vaccination — to protect against accidental infection or, worse, an accidental outbreak. I’ll give a prime example of this in just a minute.

The Global Polio Eradication Initiative (GPEI) is a group of partners worldwide focused on permanently stopping the spread of wild poliovirus and outbreaks of poliovirus variants. Global eradication of this disease is possible! And it was made possible by vaccines. This is another example (of many) showing how diseases, health, and prevention are connected from all parts of the world. It is so important to stay mindful of health issues in the rest of the world and to be as protected as we can be through whatever preventive measures are available to us. A person might never leave the United States or even their home state, but we live in a world without looking for diseases; sometimes, they come to us. The “prime example” I mentioned above occurred in August 2022, when there was a confirmed case of paralytic polio in an unvaccinated young adult without a relevant travel history that would have exposed them to the virus. The virus came to them through an individual who had traveled, been exposed to it, and acted as a carrier back to the community. Because the infected person was not vaccinated against polio, they were vulnerable to the disease. This is frightening and a perfect example of why we must keep ourselves protected even if we don’t think we are at a direct risk–because we never know. Just one case of polio in the U.S. represents an official public health emergency because it suggests that poliovirus could be circulating in the community. It is difficult to be sure at first glance because most poliovirus infections do not show symptoms. Below, I will link to an article about this event, the public health measures, investigation, tracing, costs, and other details associated with finding just this one case of polio.

Other Questions?

Please message my page with questions, comments, musings, or information to share. I am always learning, and it is one of the best parts of my work. I want to leave you with some powerful words from Dr. Salk:

“Our greatest responsibility is to be good ancestors.” –Jonas Salk

Be Well; Be Kind,

Dr. Casey

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Dr. Casey

August: National Immunization Awareness Month

Did you know that August has the distinction of “National Immunization Awareness Month” (NIAM) each year? You can think of it like October when you see a lot of pink everywhere as people work to raise awareness and education about breast cancer. Obviously, there are a lot of key issues out there that people should be more aware of and understand the importance of. Off the top of my head, I can think of dozens of cancers, chronic diseases (like heart disease and osteoporosis), dangers of tobacco, mental health, black history, women’s history, animal rights, and gun violence — all having dedicated awareness months. And a quick Google search turned up all kinds of things.

Did you know there is a Blood Clot Awareness Month (March)? As it happens, July is National Vehicle Theft Awareness Month, and on the island of Hawai’i, January is Volcano Awareness Month! I think it is fair to say that some of these awareness months are better known than others. But when you start searching for “August awareness month,” the topic that seems to dominate is immunization awareness, showing how important this issue is all across the U.S.

What is National Immunization Awareness Month?

National Immunization Awareness Month (NIAM) is observed every year in August in the U.S. The purpose of NIAM is to promote how important vaccination (immunization) is for people of all ages. The American Public Health Association and the Centers for Disease Control and Prevention (CDC) emphasize that NIAM is an ideal opportunity to encourage others to talk to a healthcare provider about vaccinations and ensure they are up to date on the necessary vaccines.

What is new about NIAM in 2024?

NIAM might be at its most important in 2024, as public health and healthcare professionals work harder than ever to get accurate information out to the public and stop the flood of misinformation and disinformation that seems to be increasing daily. Doubt about vaccines continues to increase with these inaccuracies, and we have seen childhood vaccination rates decline in the U.S. As many children start back to school this month, we must do whatever we can to stop preventable diseases before they start and keep our children and communities safe and healthy. For NIAM 2024, we are working to stop the decline in childhood vaccinations and to get these rates back up.

Not Just for Kids

The mis- and disinformation about vaccines is not just directed towards childhood vaccines, unfortunately. Some people who promote inaccuracies about vaccines and are very passionate about it target vaccines that save lives among adults and elderly individuals by protecting them from infectious diseases. Vaccine hesitancy refers to a person delaying the acceptance or refusing to receive a safe vaccine even though it is available. In recent years, particularly post-COVID-19 pandemic, we have seen vaccine hesitancy skyrocket in groups of all types of people, frequently resulting in lower vaccination rates. Lower vaccination rates have led to higher rates of preventable, infectious diseases like flu, COVID, and even measles outbreaks. Higher rates of illness have meant more people missing school and work because they are sick, spending more money on health care services, less time spent engaging in socializing and entertainment activities, and in extreme cases, worse mental health outcomes and negative economic impacts. It is definitely a ripple effect. The importance of vaccination should be promoted for individuals of all ages as we work to dispel myths and inaccuracies about vaccinations and to reduce vaccine hesitancy.

Other Questions?

Vaccination has become a very polarizing and even political topic in the U.S., which is both unfortunate and…well, dangerous. Individuals must remember that viruses, diseases, death, etc., do not acknowledge party lines, social status or wealth. Vaccination is important for everyone to protect themselves and their loved ones and contribute to their communities’ safety and health. There is a lot of information out there about vaccines, and some of it is trustworthy; some of it is not. If I were bitten by a snake I could not identify, I probably would not just trust what I found on a Google search about whether it was venomous…even if I found a result that supported my “hunch.” If you are unsure, then do not take a chance with your (and others’) health. Talk to a healthcare provider or message an expert. Ask questions.

As always, message me anytime with questions or thoughts. Take initiative in your health and if you are unsure, then find the answers you seek. If I do not know them, I will find them for you. I am a resource in whatever way I can be, and it is a privilege to be one.

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

The CDC has more information on NIAM as well as resources you can use to promote vaccines for all different age groups here: https://www.cdc.gov/vaccines/events/niam/index.html

At the link above, you can also find short quizzes to help you determine which vaccines you need!

If you are looking for more information about vaccines and immunizations in general, this website from the CDC has a lot of helpful resources, including vaccine schedules, so you and your family can be sure you stay up to date on what vaccines you need as you get older. It also has links to vaccine recommendations for children and recommendations for adults: https://www.cdc.gov/vaccines/index.html

Here is a great page that breaks down the basics of vaccines, including ingredients found in some vaccines, ones found in specific vaccines, and information for you and your family: https://www.cdc.gov/vaccines/basics/index.html

To read more about the decrease in childhood vaccinations in the U.S., check out this article: https://www.cdc.gov/mmwr/volumes/72/wr/mm7245a2.htm

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Dr. Casey

Global Public Health Emergency: What to Know about mpox

On Wednesday, August 14, 2024, the Director-General of the World Health Organization (also known as the WHO) declared mpox a global public health emergency. This declaration was due to a rapid increase in cases of mpox in several countries in Africa, particularly in the Democratic Republic of the Congo (DRC). The hike in mpox cases has been closely watched by international health experts who are concerned that the virus could spread to even more African countries and potentially outside of the African continent. By identifying the very real threat of this outbreak, health professionals and governments from around the globe will be able to work together towards stopping the spread of mpox and end the current outbreaks.

What is mpox?

You may have heard of this virus before but perhaps under its former name (monkeypox). It was called that because the Monkeypox virus causes the illness. Now, though, this disease is known as mpox. The monkeypox virus that causes mpox is related to the same group of viruses that causes smallpox (but it is not related to chickenpox). The virus that causes mpox has been found in small rodents, monkeys, and other mammals, mostly living in Central and West Africa. Mpox is consistently present in these areas, so it is considered “endemic” in those places. For comparison, many diseases are considered endemic in the U.S., such influenza (flu), chronic hepatitis, and HIV.

What is the disease like?

The most common symptoms of mpox are a skin rash or lesions (often looking like sores) which can be anywhere on the body. Rashes and lesions typically last around 2–4 weeks. This type of rash usually starts as a flat sore which may itch or become painful as it next blisters and fills with liquid. Finally, scabs will develop and fall off of these areas as the rashes and lesions heal. Other frequent symptoms include fever, headache, sore throat, swollen lymph nodes, fatigue, muscle aches, and back pain. But the exact symptoms and severity will differ from person to person. Although rare, it is also possible to be infected with mpox without developing any symptoms. Symptoms of mpox usually start within a week of exposure, but can start anywhere from 1–21 days after being exposed. While symptoms should clear up between 2–4 weeks, it can take longer for people with weak immune systems, children, and those who are pregnant.

It is very important to be aware that there is potential for serious complications due to mpox symptoms. Some of these include bacterial infections of open lesions, sepsis (an infection of the blood), pneumonia, severe dehydration and/or malnutrition caused by vomiting and diarrhea, inflammation of many organs, and even death.

How is mpox spread?

Mpox is spread through direct contact with infected people, animals, contaminated materials, and infected pregnant individuals can pass the virus to their unborn baby. Among humans, mpox can be spread face-to-face (talking/breathing), skin-to-skin, mouth-to-mouth, and through close contact (through respiratory droplets); it can also spread through touch, kissing, or sexual interaction. People with mpox are infectious and can pass the disease on to others until all sores have healed and a new layer of skin has formed.

How is mpox treated?

Mpox treatment is focused on managing the symptoms, healing rashes and sores, managing pain, and preventing complications. Some antiviral drugs that were originally developed to treat smallpox have been used to treat mpox, and more studies are in progress to determine how effective these may be.

How can mpox be prevented?

There is an approved mpox vaccine that can assist in preventing infection. The vaccine should be given within 4 days of coming in contact with someone with mpox. For high-risk people, such as health workers who may be exposed and individuals with specific risk factors, mpox vaccination is highly recommended, particularly during an outbreak. Anyone with known or suspected mpox should be quarantined and cared for away from others who may contract the virus.

Other Questions?

While this may seem far removed from the safety of the United States, diseases like mpox should never be underestimated. Learning and understanding these kinds of health issues is critical because no one can guarantee that a highly contagious virus like this will not slip through the cracks and accidentally show up on our doorstep. With international travel being as convenient and accessible as it is today, we have a responsibility to know what is happening in the rest of the world, and to do what we can to keep ourselves and others safe and healthy. We are very fortunate to have global leadership that is taking a proactive approach to the current outbreak and working with people from all over the world to contain this virus as much as possible. Still, though, we must take whatever steps we can — even if that is just making sure we are educated — to be prepared, and engage in safe, preventive health practices.

Feel free to message my Facebook page with questions and thoughts. I love hearing from you and have been amazed at the incredible, thoughtful questions I have received! It is refreshing (and reassuring) to see so many people truly interested and invested in their health and the health of their loved ones and communities. I am always here as a resource that you can access and, most importantly, trust.

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

If you want to read more about the WHO’s recent decision to declare mpox a global public health emergency, here is a press release that gives an overview of the issue and the decision: https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern

If you are interested in learning more about mpox, the Centers for Disease Control and Prevention (CDC) has an overview and more information here: https://www.cdc.gov/poxvirus/mpox/about/index.html

The WHO has even more details about mpox, including its signs, symptoms, and important advice for prevention available here: https://www.who.int/news-room/fact-sheets/detail/monkeypox

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Dr. Casey

Diseases Then and Now

Modern and preventive medicine have made such an incredible impact on saving lives. One of the first things you learn about in public health is how health concerns have significantly shifted in developed countries recently. These societies used to be focused on “acute” diseases. Acute diseases (or conditions) happen suddenly, can be very severe, and usually only last a short time (typically days or weeks). Examples of common acute diseases today include the common cold, asthma attacks, migraines, appendicitis, strep throat, etc. From this list of examples, it probably seems like acute conditions are fairly mild, and these typically are. The acute issues I just named all have treatments and medical interventions, and if there are no complications, they clear up pretty quickly. So, in the United States, for example, people do not spend much time worrying about acute conditions.

Instead, we worry about “chronic” diseases. Chronic diseases (or conditions) develop slowly, last a long time (months, years, or indefinitely), may get worse over time, and typically can be managed by medical intervention but cannot be cured. These conditions may need ongoing medical attention and may limit a person’s ability to perform daily activities. Some examples of chronic conditions include diabetes, arthritis, Alzheimer’s disease, heart disease, HIV/AIDS, and many other illnesses with which we are familiar.

This has not always been the case, though. Why is that? Well, as recently as the early 1900s, infectious diseases were the main causes of death in the U.S. Infectious diseases would generally be considered acute diseases. Still, in the society of the early 20th century, outbreaks of these diseases, which spread rapidly among populations with lower knowledge and standards of sanitation and hygiene, were extremely deadly. In fact, many of the infectious diseases that were so deadly at the time were spread by poor sanitation such as contaminated drinking water. Life expectancy in the year 1900 was only 47 years old. People did not live long enough to have the “luxury” of dealing with the chronic diseases so many struggle with today.

The three leading causes of death in 1900 were pneumonia, tuberculosis, and diarrhea / enteritis. These three causes, together with diphtheria caused 1/3rd of all deaths! Even more unfortunately — of these deaths, 40% were among children under 5 years old. Essentially, much of the population did not live long enough to develop the chronic diseases that plague our society today. Many did not live long enough to even attend grade school.

So what happened that shifted the acute vs. chronic disease paradigm in the U.S., and when did it happen? This transition from acute to chronic illness began around the 1950s in the United States, and many factors contributed to this change. Some of the most important of these were:

v Improvements in sanitation and hygiene (particularly drinking water, living conditions, food processing, etc.)

v Development of antibiotics like penicillin (1940s)

v Development and use of other medications to treat infections and illness

v Improvements in disease testing and diagnosis

(Earlier and accurate diagnosis means earlier and more effective treatment and minimization of spread)

v Educating and increasing awareness among the public

v Vaccines!

Looking at the list of some of the leading causes of death from 1900, many of the causes are easily preventable, and that is exactly what happened — people started taking actions like those listed above and preventing diseases when possible. Public health initiatives such as sanitation, education, vaccination, and more were put into place and big changes started to happen. Just in terms of immunization, vaccines knock out almost half of the list of leading causes of death from 1900 (smallpox, diphtheria, influenza, pneumonia, tuberculosis, and even cholera and typhoid if needed)!

Many of the leading causes of death today are preventable by maintaining the disease control and proper sanitation established over the last 100+ years, and by making healthy lifestyle choices, increasing health education and awareness. The latter of these efforts are more challenging, as it is much harder to change a person’s lifestyle (such as to stop eating processed, fatty foods and start exercising 4–5 days a week) than it is to take an antibiotic or get a vaccine. We definitely have a challenge in front of us. But it is extremely important that we keep up the decades of preventive health work we enjoy now by contributing to community immunity, being vaccinated as appropriate, quarantining when sick, practicing good hygiene, etc. Thanks to the public health initiatives and medical developments that have mostly ended widespread, constant infectious disease outbreaks and other deadly acute disease threats in the U.S., we now have the privilege of longer lives in which we can work to reduce our chronic health risks.

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Dr. Casey

It Takes Work to Stay Well

Like everyone else, I do a lot of things. In addition to being a researcher, professor, advocate, writer, mentor, and other professional roles, I’m a mother. And that is my most important job. If you ask my oldest, “What is your mom’s most important job?” He would say, “Making sure we are healthy, safe, and happy.” That’s because I remind him of that almost daily (especially when he is supposed to be doing something for his health that he is not very excited about — like turning off the screen to brush his teeth before bed or trying new vegetables that he insists he has had and make him “sick,” ha). When I have to insist on an action that is important for his health but that he may not enjoy as much as playtime, I try to explain why it is important (more than just, “veggies make you big and strong”). I want him to really understand why he needs to wash his hands and get enough sleep and things that sometimes aren’t fun. I approach these situations with the same mentality as when I am teaching medical students or talking with patients, because it is important for people to know the why behind actions. I wouldn’t tell a patient they should have their blood sugar checked, “because I said so.” As I am always saying, providing information and answering questions is extremely important, and it shows respect for others that you will take time to help them understand. A little respect goes a long way.

Thinking about this made me want to talk about some “why’s” about vaccination.

Why is it important for my child to be “up-to-date” on vaccinations?

I am so glad you asked! There are several reasons, some of which I will discuss in this post (and others in future posts).

Vaccines help keep kids healthy!

This one is probably pretty obvious, but it cannot be overstated.

Vaccines help kids build immunity before they are exposed to possibly harmful, and even deadly, diseases. These diseases include hepatitis B, mumps, polio, tetanus, whooping cough, and chickenpox, among many others.

There are countless things we cannot always (or completely, or sometimes ever) control or protect our children from: motor vehicle collisions, social media, environmental disasters, bullying, genetic diseases, bad influences, to name very few. But vaccine-preventable diseases are something we can protect them from. This makes taking action to prevent whatever pain, harm, and negative outcomes we can even more important. We have to intervene in the few ways that we can to keep our children healthy and safe (and happy).

Vaccine-preventable diseases have not gone away…

In the U.S., we are very fortunate that we no longer face many of these diseases on a daily or even regular basis. So fortunate that…sometimes it can be easy to forget how dangerous they are, or even that they still exist. Personally, I don’t spend much time worrying about polio. However, individuals in Pakistan and Afghanistan cannot say the same because there are still cases of polio in those countries. I live in a country where it has been eliminated, and my family has been vaccinated against it.

We have seen a resurgence of measles in the U.S., and part of that is because we live in a society where global travel is easy and fairly convenient. Unvaccinated people may travel to places where there are measles and bring the disease back to the U.S. with them.

Sometimes people see decreased rates of diseases and think, “I don’t need to get a vaccine for that! It’s not a big issue anymore!” However, that is a false sense of security. The reason the rates are lower is because of ongoing vaccination.

Take this analogy: Joe has high blood pressure. A doctor prescribes Joe medication and his blood pressure goes down over time. Joe thinks, “Hey, now I don’t have high blood pressure, so I don’t need to take this medication!” and Joe stops taking the blood pressure medicine. Well…what do we know is going to happen?

When Joe stops taking his medication, his blood pressure is going to go up again. The reason it went down was because it was being maintained by the medicine he was taking. The same is true for vaccines and the diseases they prevent.

Vaccine-preventable diseases are expensive

Health care can have high costs for individuals, their families, and even for society overall. This can be in the form of doctor visits, medication, hospital stays, and other direct medical costs. It can also be costly by forcing your child to miss days of school, and you having to miss days of work to care for him or her, or having to pay someone to care for your child while you work. A vaccine followed by no sick visits to the doctor, no medicines, no hospital stays, and no missed work or school and no paying for extra childcare is a much wiser (and less painful) investment.

It’s more than just your child’s health at stake

Vaccines prevent infectious diseases, meaning diseases that are spread easily from one person to another. When you child gets sick from one of these diseases, it puts many other people at risk, too. Children come in contact with other children, teachers, siblings, parents, grandparents, among others, and children somehow tend to touch everything (which is one of life’s mysteries). When a child gets sick, it may quickly put numerous others at risk, and some of those people may be extra vulnerable to illness, making diseases riskier for them than the average person. Also, in a previous post, I discussed the concept of herd immunity. By making sure your child is vaccinated, you are doing your part to increase the immunity of the community as a whole, helping protect those who are not able to be vaccinated for health reasons.

What’s the take-home message?

These are just a small handful of reasons why it is so important for your child to stay current on their vaccinations, but I wanted to highlight these because I think they are some of the most important ones. Staying up-to-date on vaccines is so important! With our busy lives and the overactive world we live in, it is easy to let deadlines slip by, but vaccines should be something that you make a top priority. You will never look back and regret protecting your child from suffering a painful or deadly disease. As parents, preventing whatever harm we can is the least we can do for our children. It takes work to stay well, and until they are old enough to be out on their own, our kids are depending on us to keep them healthy.

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About Dr. Casey

Dr. Casey, PhD, MPH, is Director of Epidemiology and Public Health and associate professor of family medicine at the University of South Alabama Whiddon College of Medicine with a concurrent appointment in USA Health Mitchell Cancer Institute’s Division of Cancer Control and Prevention; she is also Director of the Masters of Public Health Program at Spring Hill College. Dr. Casey holds a masters and doctoral degrees in Public Health from the University of Alabama at Birmingham and a postdoctoral fellowship at Harvard T.H. Chan School of Public Health.

Her research interests include behavioral epidemiology, childhood/adolescent vaccination, cancer prevention, health communication, and reducing health disparities, emphasizing rural settings. Dr. Casey is a staunch advocate for increasing vaccination to lower rates of preventable diseases; she has led several studies to improve vaccine uptake.

Dr. Casey has held top leadership roles with non-profit organizations such as VAX2STOP CANCER, was elected Chair of Alabama’s Cancer Control Coalition, and is on the executive committee of Alabama’s vaccination task force. She is active in many prominent organizations, including the American Public Health Association and Society of Behavioral Medicine. With over 50 scientific publications and numerous national presentations, and invited talks, Dr. Casey is a widely respected expert in the field of vaccination.

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What You (Might) Be Wondering about Immunity

I get asked a lot of questions about medicine, health, vaccines, and similar things by many people. Sometimes people seem embarrassed or even somewhat apologetic when they ask these things. But really, I appreciate it when people take the time to ask questions. It is great knowing that people want to be informed, and helping with that is one of my roles as a scientist and public health professional. I encourage everyone to ask questions. Many times people are not necessarily opposed to doing something to protect their health (like getting a vaccine), but they might not have taken that action yet because there is something they aren’t sure about or there is something they need clarified. That is something I completely understand; when in doubt, sometimes it feels like the safest thing to do is — nothing. However, it is important to ask a trusted source for the information you need so that you can take action, and feel confident in the health choices you are making. And that is where I come in!

I get a lot of similar questions from people, which tells me that there are areas related to health and science that are 1.) important to a lot of people, and 2.) obviously unclear (although I already knew both of those!). And I know it can be difficult to speak up and ask questions about anything, even if it’s something you really want to know. So, with that in mind, I thought I would tell you about some questions that I get a lot, in case you might have the same ones. This will likely be the first of several of these posts, and please feel free to send in messages to my Facebook page with other questions you would like to have answered. If you don’t ask, you will never know. So, here are just a few common questions I hear about vaccines and immunity.

What is “natural” immunity?

Natural immunity is the type of immunity a person has after they have a disease. For example, the chickenpox vaccine was not yet available in the U.S. when I was a child in the early 1990’s. As a very contagious disease, it was very common for children to catch and spread chickenpox (my little sister very generously gave it to me). But if you got chickenpox, one of the “bright sides” was that you were very unlikely to ever have it again because you had developed natural immunity to the disease. This was because, when you had chickenpox, your body’s immune system made antibodies to fight the disease, giving you immunity. So, if you came in contact with chickenpox in the future, your immune system would recognize it and be able to quickly make the antibodies to fight it off. This kind of immunity is called natural, meaning it is not gained through vaccination.

Is natural immunity safer than immunity from a vaccine?

NO. To gain natural immunity, someone has to actually be infected with the disease. Diseases can be painful, serious, and even deadly. They also often have many side effects that can be dangerous. When a person gets sick with a disease, no one knows how their body will respond or how seriously the disease will affect them. Getting immunity from a disease can be risky and unpredictable, and you have to experience the disease. It is what I tend to think of as doing something, “the hard way.”

Immunity from a vaccine (also called vaccine-acquired immunity) is a much safer way to gain immunity from a disease. With vaccination, a dead or very weak form of the disease is introduced into your body. Your immune system learns to produce antibodies to protect you, but you do not have to experience the risks of actually having the disease, like with natural immunity. The most recent scientific studies show that vaccination has more benefits and far fewer risks than natural immunity.

What is “herd immunity” (and won’t that protect me enough?)?

This term became more well-known (or at least more used) when COVID-19 vaccinations became available but many people were hesitant to be vaccinated. Herd immunity (also called “community immunity”) means that enough people in an area have become immune to a certain disease that it is very difficult for the disease to spread. One of the main benefits of herd immunity is that it helps protects people who are not able to vaccinated, like the very young or people with immune system issues. In this situation, the more people who have immunity, the more difficult it is for a disease to spread.

As you have probably already guessed, the answer to the second part of this question — won’t herd immunity provide enough protection — is no. Reaching the level of herd immunity in a population can be very difficult, especially if the disease is especially contagious, or if it is a disease (like a virus) that can mutate into new variants. The best way to make sure you have immunity is by getting vaccinated. By doing this, you can protect yourself, and you can contribute to herd immunity which may protect others, too.

Other Questions?

Feel free to message my Facebook page with your own questions. I will answer everything I can, and if I don’t know the answer, I will find someone who does. Asking questions is how we learn, and how we make informed decisions. Everyone should be able to get the information they need to decide what is best for their health. I am here to help make that connection, and I look forward to being a resource that you can trust.

Be Well; Be Kind,

Dr. Casey

Want to Learn More?

If you are interested in reading more about different types of immunity and how they work, the Centers for Disease Control and Prevention (CDC) has some great information here: https://www.cdc.gov/vaccines/vac-gen/immunity-types.htm

If you would like to learn more about herd immunity, National Geographic has a great article discussing it here: https://education.nationalgeographic.org/resource/herd-immunity-strength-numbers/

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About Dr. Casey

Dr. Casey, PhD, MPH, is Director of Epidemiology and Public Health and associate professor of family medicine at the University of South Alabama Whiddon College of Medicine with a concurrent appointment in USA Health Mitchell Cancer Institute’s Division of Cancer Control and Prevention; she is also Director of the Masters of Public Health Program at Spring Hill College. Dr. Casey holds a masters and doctoral degrees in Public Health from the University of Alabama at Birmingham and a postdoctoral fellowship at Harvard T.H. Chan School of Public Health.

Her research interests include behavioral epidemiology, childhood/adolescent vaccination, cancer prevention, health communication, and reducing health disparities, emphasizing rural settings. Dr. Casey is a staunch advocate for increasing vaccination to lower rates of preventable diseases; she has led several studies to improve vaccine uptake.

Dr. Casey has held top leadership roles with non-profit organizations such as VAX2STOP CANCER, was elected Chair of Alabama’s Cancer Control Coalition, and is on the executive committee of Alabama’s vaccination task force. She is active in many prominent organizations, including the American Public Health Association and Society of Behavioral Medicine. With over 50 scientific publications and numerous national presentations, and invited talks, Dr. Casey is a widely respected expert in the field of vaccination.

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Dr. Casey

Public Health 101

My senior year of college, I told my family that I was going to graduate school for public health. They were excited and supportive, but also a bit confused. I was going to graduate school to…work at the health department? Well…no. I had always been interested in health and medicine; how was this going to help me achieve my goals? What was “this”? And truthfully, even I didn’t fully understand the field that would become my life’s work back then — that it is huge, diverse, and applies to practically all areas of life and to everyone in ways we don’t even realize. I didn’t fully grasp its mission, its reach, or how incredible of an impact one can make through public health. Two decades later, I’m still amazed. But back to the start…

Growing Awareness

Now, in 2024, many more people have some understanding of what public health is, or at least have heard the term, compared to prior decades. That is mostly due to the COVID-19 pandemic, when the term “public health” suddenly seemed to be everywhere. Still, though, I find that many people aren’t exactly sure what it means. To be honest, that is understandable. One reason for that is because public health means a lot of things. Public health is connected to countless areas of everyday life that you might never think of. I guess, in some ways, public health is typically more of a behind-the-scenes presence, and that is usually how we want it. If public health is front and center, it often means something is very wrong (like, for example, COVID, or an environmental public health disaster like Chernobyl).

So Then What Is Public Health?

There is not one definition, but generally, public health is the science of protecting and improving the health of individuals and their communities. Public health has a broad definition because it encompasses so many things. To accomplish something as big as “protecting and improving health,” a lot has to go into it. Here are just a handful of examples of how public health works to do this:

· Researching diseases

· Detecting and tracking infectious diseases (like flu or measles, for example)

· Preventing diseases through advising the public about precautions to take and things like vaccinations

· Promoting healthy lifestyles (such as educating people about healthy eating and the dangers of tobacco use)

· Injury prevention through policy change

· Promoting environmental health for our communities

And countless other ways.

How Is Public Health Different from Clinical Medicine?

If you have read any of my posts, you have probably seen that I put a lot of emphasis on prevention, and this is what sets public health apart. Much of clinical medicine (meaning the physicians, nurses, and other healthcare providers we rely on every day) focuses mostly on treating people after they have gotten sick or been injured. Public health, rather, works to prevent sickness and injury from happening at all.

In my opinion, do you know what is better than the absolute best, top-of-the-line treatment? …Never needing a treatment because the disease it treats has been prevented!

While the ideals of public health are amazing and a society that can live focused totally or even mostly on prevention would be practically a dream, that is not the society in which we currently live. It is unlikely any of us will see a society like that in our lifetimes due to the many infectious and chronic diseases that are so common throughout the world. So while a public health (meaning prevention)-driven society is something we can strive for, the reality of that is still a long way away. Which is why the hybrid health strategies combining clinical medicine and public health meet are the best fit for our needs. We have clinical medicine to treat and even cure existing health issues we battle, and this is vitally important. And we also work to introduce preventive, public health strategies however we can to help move towards a prevention-focused society.

I’m sure I will be talking more about public health in the future, but for the moment, C. Everett Koop, a former U.S. surgeon general, has a great quote that I think really ties some of these ideas together. He said:

“Health care is vital to all of us some of the time,

but public health is vital to all of us all of the time.”

Be Well; Be Kind,

Dr. Casey

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Can an “Eliminated Disease” Become Un-eliminated?

Did you know that there are certain diseases that are considered eliminated in some parts of the world? If you are anything like me or my students, your first thought might be — How? Or maybe just — Wow. Or, I am sure there are plenty of people out there whose first thought is — Prove it, and/or — Yeah, right. Regardless, it is a pretty amazing concept to think about: Eliminating. A. Disease. But before I get too far ahead of myself, I want to explain what I mean by “elimination.”

Control, Eliminate, Eradicate

These are three important terms in public health and in general healthcare when it comes to diseases, so I want to take a minute to explain them one at a time.

Control. Control means using treatment and taking actions to make the outcomes of a disease better and to minimize its spread. Think about influenza (the flu), for example. Seasonal flu comes around every year, and we cannot completely prevent it (although vaccines help a lot!). So, we control the flu by doing things like: avoiding contact with people who are sick, washing our hands frequently, and disinfecting shared surfaces, among other things.

Eliminate. Elimination means stopping a certain disease from being transmitted in a specific location or area, but not removing the disease worldwide. Basically, clearing a region of a specific disease. In the United States, we can thank Dr. Jonas Salk and the vaccine he developed for eliminating polio. Actually, polio has been eliminated from almost every country in the world, which is a good lead in to the next term…

Eradicate. A disease is declared eradicated when it is not found or transmitted anywhere in the world. It seems practically impossible. In fact, only two infectious diseases have been completely eradicated…ever. The only human disease that has been officially eradicated is smallpox (in 1980). I will probably come back to smallpox sometime because it is a fascinating and amazing journey, but for now, the main thing to know is that, thankfully, it is something we do not have to worry about!

What Diseases Have Been Eliminated in the U.S.?

In the U.S., the following human diseases are considered eliminated: smallpox, malaria, polio, rubella, mumps, diphtheria, and measles, with several other diseases close to reaching that status. This means that, even though there might be some cases of these diseases here and there, there have been no ongoing disease transmissions for over a year. We have had so much success eliminating many of these diseases largely thanks to vaccines that have given people protection from being infected. However, back to our original question…

Can a Disease Lose Its Elimination Status?

Unfortunately, the answer is YES. Elimination does not mean that a disease cannot come back to a region or area, but usually, cases of that disease would come in from another place (like visitors bringing germs along). When an event like this happens, the next steps really depend on what the community is like. For example, if visitors bring in a few cases of the mumps, but members of the community are all up to date on their vaccines (which include mumps), then these outsider cases probably won’t have a huge effect on the people there. However, if members of the community have started thinking they aren’t at risk for mumps because no one ever gets it where they live, and they have stopped getting vaccinated for it, then they are far more likely to catch the mumps that are now in their area, and to spread it to others who have lowered their guards and stopped vaccinating.

Why Is This Important Right Now?

Understanding the importance of how diseases spread — and right under our noses without us suspecting anything — is critical. Right now, we are seeing an example of this every day when it comes to the measles. As a refresher, measles is a serious, even life-threatening virus that is mainly transmitted through the air (when people cough or sneeze, for example) and through other close contact. Measles is one of the most contagious of all infectious diseases! The Centers for Disease Control and Prevention (CDC) say that up to 9 out of 10 susceptible people who have close contact with a measles patient will develop measles. The disease is especially common among children, but measles can be prevented through a combined vaccine often called “MMR” (meaning it vaccinates against measles-mumps-rubella). Just one does of MMR vaccine is around 93% effective at preventing measles!

In fact, in large part due to measles vaccines, measles was declared eliminated in the U.S. in 2000. Unfortunately, the case isn’t closed. Right now, we are getting closer and closer to measles being “un-eliminated” in the U.S. as the numbers of measles cases continues climbing. Between January 1, 2020 and March 28, 2024, the US has had 338 documented cases of the measles. But, 29% of those cases were in just the first quarter of 2024, which is not a good sign for case numbers for the rest of the year.

Some important things to know are that, of the 338 measles cases, two out of three patients (68%) were unvaccinated for measles. Another 29% of these cases did not know if they had been vaccinated or not, showing how important it is to know our own medical history and advocate for ourselves. Unfortunately, the numbers given here reflect the general population’s prevention, as measles vaccinations have been steadily decreasing for several years.

The Double-Edged Sword of Successful Disease Prevention

This is what I tend to think of as a double-edged sword in the amazing job that public health and medicine have done in eliminating measles in the U.S. It is remarkable that, in the present day, the risk of measles is so low that most people have gone their whole lives without experiencing or even seeing the life-threatening effects of measles. While that is a huge achievement, it tends to lower the population’s guard for protecting against the disease. People are less likely to understand how severe measles can be. And because people do not feel as threatened by measles, they are less likely to take preventive actions like vaccination. When something seems less “real,” or like it doesn’t apply to us, we are not motivated to take action, and this applies far beyond health. For example, I am probably not actively thinking about what kind of maintenance I could or should be doing for my car on a daily basis. I am triggered to action when a “change oil” light comes on. It’s not that I don’t like my car or am just lazy; it is more that, as a society, we have so many things going on at once, that many things do not get our attention until they become a problem or we feel threatened.

So what is critical, is that we don’t fall into the trap of false security just because things seem stable. We cannot treat our health, and the health of others, as a guarantee until it’s not. Because one day, it is possible, and even likely, that there could be a resurgence, change, or unexpected happening in health as we know it, and we want to be protected and to protect others if and when that happens. We should never pass up opportunities to prevent diseases when they are easily available. We should always hope and strive for the best, but prepare for anything we can.

. . .

For More Information

To read more about polio and the development of its life-saving vaccine, check out the World Health Organization’s page: History of the Polio Vaccine

https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-polio-vaccination#:~:text=By%201994%2C%20polio%20had%20been,in%20less%20than%202%20decades.

To read about the crusade against and successful defeat of smallpox, head to the Centers for Disease Control and Prevention site and take a look at their History of Smallpox page. It is pretty incredible to see what humans were able to accomplish with the world working together!

https://www.google.com/search?q=when+was+smallpox+eradicated&rlz=1C1GCEB_enUS1070US1070&oq=when+was+small&gs_lcrp=EgZjaHJvbWUqBwgAEAAYgAQyBwgAEAAYgAQyBggBEEUYOTIHCAIQABiABDIHCAMQABiABDIHCAQQABiABDIHCAUQABiABDIHCAYQABiABDIHCAcQABiABDIHCAgQABiABDIHCAkQABiABNIBCDI3NTRqMGo3qAIAsAIA&sourceid=chrome&ie=UTF-8

To read a lot more information about measles and vaccination and see where I found some of my information for this post, visit the “Measles (Rubeola)” page on the CDC website:

https://www.cdc.gov/measles/index.html

. . .

About Dr. Casey

Dr. Casey, PhD, MPH, is Director of Epidemiology and Public Health and associate professor of family medicine at the University of South Alabama Whiddon College of Medicine with a concurrent appointment in USA Health Mitchell Cancer Institute’s Division of Cancer Control and Prevention; she is also Director of the Masters of Public Health Program at Spring Hill College. Dr. Casey holds a masters and doctoral degrees in Public Health from the University of Alabama at Birmingham and a postdoctoral fellowship at Harvard T.H. Chan School of Public Health.

Her research interests include behavioral epidemiology, childhood/adolescent vaccination, cancer prevention, health communication, and reducing health disparities, emphasizing rural settings. Dr. Casey is a staunch advocate for increasing vaccination to lower rates of preventable diseases; she has led several studies to improve vaccine uptake.

Dr. Casey has held top leadership roles with non-profit organizations such as VAX2STOP CANCER, was elected Chair of Alabama’s Cancer Control Coalition, and is on the executive committee of Alabama’s vaccination task force. She is active in many prominent organizations, including the American Public Health Association and Society of Behavioral Medicine. With over 50 scientific publications and numerous national presentations, and invited talks, Dr. Casey is a widely respected expert in the field of vaccination.

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How Vaccines Keep Us Safe from Everyday Germs

Many consider vaccines to be one of the greatest achievements in medicine. Many even consider vaccines to be one of the most important inventions in all of human history. Vaccines (which are also called vaccinations or immunizations) save millions of lives every year by helping a person’s body learn how to protect itself from certain diseases.

What do vaccines protect against?

Vaccines help protect against illnesses called infectious diseases. Infectious diseases are caused by germs like bacteria, viruses, parasites, or fungi. These are germs we are exposed to almost every day in some way. But sometimes these germs can get into your body, multiply, and cause an infection. There are many different kinds of infectious diseases, and some of them are very common. You have probably heard of many of them and you might have even been sick with an infectious disease at some time in your life. Some examples of infectious diseases that many people have heard of are chickenpox, flu (which is short for influenza), hepatitis, measles, meningitis, and polio. These are just some examples of the many types of infectious diseases out there.

While we cannot avoid all the germs that can cause these diseases, there are things we can do to lower the chances of getting sick. One of the most important things we can do is to get vaccinated when possible. There are many safe and effective vaccines that can help protect us from different diseases. Vaccines help train your immune system to work faster and give better protection from some serious diseases.

What is the immune system?

The immune system is a complex system in your body made of organs, tissues, and cells that helps protect you from harmful germs. The main job of the immune system is to keep you healthy. When germs like bacteria and viruses get into your body and cause an infection, your immune system fights the infection and the germs that caused it. Vaccines work with your immune system to make your protection from a disease even stronger.

How do vaccines work?

Vaccines help teach your immune system how to recognize and fight germs that can cause infections. Different vaccines help protect from different diseases, and many of these are serious diseases. For example, a chickenpox vaccine teaches your body to identify and fight germs that can cause chickenpox. With the help of a vaccine, your immune system can fight an infection better and faster.

Many vaccines have a very small amount of weak or dead germs for the diseases they prevent. So when you get a vaccine, your immune system thinks a bad germ has gotten into your body. The germs from the vaccine won’t make you sick, but they will make your kick your immune system into action. Your immune system will help to fight off the germ and will remember it, so if that type of germ ever enters your body again, your immune system will know to attack it. That’s right; you can be protected from a serious disease without having to get sick!

Even if a vaccine does not totally prevent a disease, it lowers the chances of the illness being as serious, which means a faster and easier recovery. It also lowers the chances of spreading the illness to others. Vaccines protect you and the people around you. Since they were invented, the number of adults, children, and babies who get sick or die from diseases that can be prevented by vaccines has gone down incredibly. Some diseases have even been eliminated thanks to vaccines!

But as long as there are germs and diseases, people will get sick. No matter how careful we are, there are many things we can’t control. That’s why it’s so important to take whatever actions we can to keep ourselves and the people around us healthy. One of the easiest things we can do with a huge impact on protecting health is getting vaccinated.

. . .

About Dr. Casey

Dr. Casey, PhD, MPH, is Director of Epidemiology and Public Health and associate professor of family medicine at the University of South Alabama Whiddon College of Medicine with a concurrent appointment in USA Health Mitchell Cancer Institute’s Division of Cancer Control and Prevention; she is also Director of the Masters of Public Health Program at Spring Hill College. Dr. Casey holds a masters and doctoral degrees in Public Health from the University of Alabama at Birmingham and a postdoctoral fellowship at Harvard T.H. Chan School of Public Health.

Her research interests include behavioral epidemiology, childhood/adolescent vaccination, cancer prevention, health communication, and reducing health disparities, emphasizing rural settings. Dr. Casey is a staunch advocate for increasing vaccination to lower rates of preventable diseases; she has led several studies to improve vaccine uptake.

Dr. Casey has held top leadership roles with non-profit organizations such as VAX2STOP CANCER, was elected Chair of Alabama’s Cancer Control Coalition, and is on the executive committee of Alabama’s vaccination task force. She is active in many prominent organizations, including the American Public Health Association and Society of Behavioral Medicine. With over 50 scientific publications and numerous national presentations and invited talks, Dr. Casey is a widely respected expert in the field of vaccination.

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