Immunization has been one of the most remarkable public health achievements of modern times, it has not only slowed down child mortality, eradicating certain diseases to be wiped off, and reduced outbreaks of conditions that could potentially kill, but also raised awareness of the seriousness of the emerging threat to these immunization campaigns during World Immunization Week from April 24–30. The rise in vaccine-preventable diseases is a cause for concern, as misinformation, population growth, funding cuts, and humanitarian crises jeopardize years of progress. This article explores the ongoing challenges in immunization and the global consequences of failing to maintain vaccination rates.

In the past decade, vaccines have saved more than 150 million lives, making immunization one of the most effective tools in preventing infectious diseases. However, even with these gains, the global health community is experiencing setbacks. Increased outbreaks of vaccine-preventable illnesses like measles, meningitis, and yellow fever have risen alarmingly. Illnesses that were previously almost eradicated, such as diphtheria, are coming back in some areas. WHO, UNICEF, and Gavi have all issued urgent calls for governments to invest in immunization programs to prevent further health crises.

While the United States has come far in vaccination efforts, the effects of no longer continuing immunization programs would be disastrous. If vaccination programs were to be discontinued in the country, diseases such as measles would instantly become much larger outbreaks than they are at present and spread to infect tens of thousands or more. Even those who never travel outside the nation might encounter sick carriers within their own communities and thus be subject to rapid spread of diseases that are otherwise preventable.

Consider measles. Although the U.S. has experienced a decline in measles cases due to strong vaccination efforts, outbreaks elsewhere in the world—particularly in nations with low vaccination rates—could do serious damage if the U.S. were to discontinue vaccinating. Complacency about vaccine-preventable diseases can be fatal. The dangers of being infected with these diseases may appear to be low, yet each person is at risk and nobody can tell if they will be the "one in 10,000" to die from an illness that could be prevented by a basic vaccine.

Why Health Systems Are Struggling to Keep Up?

Measles is coming back particularly perilously globally. Since 2021, incidence has been increasing, following declines in immunization coverage that happened during and following the COVID-19 pandemic. Measles cases increased to an estimated 10.3 million in 2023—a 20% rise from the previous year—according to WHO estimates. The trend is predicted to continue into 2024 and 2025, with outbreaks worsening across the globe.

Last year, 138 nations recorded cases of measles, and 61 of these had large or disruptive outbreaks. This is the highest number of outbreaks since 2019, and the trend is expected to increase in the next few months. Measles, which is a very infectious viral infection, is not only a public health threat but also overburdens health systems, taking away resources that can be used to address other critical health issues.

Meningitis and yellow fever have also increased substantially in recent years. In Africa, meningitis cases jumped in early 2024 with over 5,500 suspected cases and close to 300 fatalities in only three months. That is a major upsurge from other years, highlighting the necessity for proper immunization coverage. The same is true of yellow fever, whose cases are on the rise in Africa as confirmed cases appear in nations where the disease was on the decline in the last decade.

Role of Funding and Humanitarian Crises

One of the largest dangers to immunization campaigns is the decline in international funding for health programs. A recent WHO rapid stock take in 108 countries found that nearly half of these countries experience moderate to severe interruption in vaccination campaigns and routine immunization programs because of reductions in donor support. Least developed countries are being compelled to make difficult choices between important services, which tend to come at the cost of lifesaving vaccination programs.

Humanitarian emergencies, including armed conflicts and natural disasters, add complexity to the delivery of immunizations. Children in conflict or fragile areas are most at risk. In 2023, an estimated 14.5 million children did not receive all routine vaccine doses, a decline from 13.9 million in the previous year. Those children reside in areas where access to healthcare services is drastically reduced, which increases their likelihood of acquiring preventable illness.

The growing global health crisis underscores the urgent need for continued investment in immunization. Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, emphasized that vaccines have saved millions of lives over the past five decades. However, without proper funding and political will, these hard-won gains are at risk. The WHO is urging governments, especially in lower-income countries, to invest in vaccines, as they are one of the most cost-effective interventions for public health.

The international health community also urges continued efforts to build more resilient immunization systems and to ensure vaccines reach the most at-risk communities. WHO and its agencies have initiated efforts like the "Big Catch-Up," to vaccinate children who lost doses due to the COVID-19 pandemic. The effort, supplemented with ongoing investment in mass vaccination campaigns, is critical to stopping subsequent outbreaks and saving lives.

Importance of Herd Immunity

Vaccination not only protects the individual—it also safeguards communities. This phenomenon, referred to as "community immunity" or "herd immunity," is when a high percentage of the population has been vaccinated, thus limiting the transmission of disease. This is especially important for those who are unable to be vaccinated because of medical conditions or age, such as infants, older adults, or those with weakened immune systems.

By vaccinating ourselves and our kids, we not only protect our loved ones but also protect the others in our communities who cannot get vaccinated. Keeping vaccination rates high is what makes sure diseases that used to cause widespread sickness and death stay under control and never come back.

Vaccine-Preventable Disease Outbreaks Across The World

• Pertussis (Whooping Cough)
• COVID-19
• Measles
• Mumps
• Meningitis
• Influenza (flu)
• Human Papillomavirus (HPV)
• Hepatitis A

What Can You Do to Keep Your Family Safe from Vaccine-Preventable Diseases?

Keeping your family safe from vaccine-preventable diseases is important to make them healthy and safe. By keeping pace with recommended vaccinations, not only are you keeping your loved ones safe but also your community. Here's how you can do it:

1. Adhere to Immunization Schedules

The initial and most critical step is to adhere to the recommended immunization schedules for your family and yourself. These schedules are formulated to give protection in a timely manner against a variety of preventable illnesses. Sticking to these schedules ensures that people, particularly children, get vaccinated when they are most effective. This can avert outbreaks of diseases such as measles, whooping cough, and mumps.

2. Support Herd Immunity

Vaccines do not only immunize individuals, but they also immunize populations, a process referred to as "community immunity" or "herd immunity." If large numbers of people are vaccinated, it becomes more difficult for infection to spread. This is particularly important for groups that cannot themselves be vaccinated, like babies that are too young for some vaccines or people who have weakened immune systems from such diseases as cancer or HIV. By getting vaccinated and your family, you're helping protect the most vulnerable members of your community.

3. Stay Current on Vaccines for All Household Members

It's not just kids who require vaccines. Adults need to stay up to date on their immunizations as well. Many illnesses, such as the flu or shingles, can strike adults as well. Keeping all members of your household current on their vaccinations helps keep herd immunity intact and stops outbreaks.

4. Know the Consequences of Not Vaccinating

If vaccination levels fell, diseases that have been almost eliminated or contained could return. Diseases such as measles, whooping cough, and even polio have returned in regions with low vaccination levels. These diseases were once all but eliminated in much of the world but remain a threat, especially if vaccination levels fall.

5. Guard Future Generations

Vaccinating now doesn't only keep your family safe today—it helps to keep future generations healthy. By maintaining high levels of immunization, we ensure our children's children—and their children—are safeguarded against illnesses that were once widespread. If we discontinue vaccination, we might be fighting infections that we previously believed to be a relic of the past, and which create serious public health issues.

6. Stay Informed About Disease Outbreaks

Recent disease outbreaks like pertussis (whooping cough), measles, mumps, and COVID-19 have proven that vaccination efforts are always a concern. Keeping yourself updated regarding current outbreaks and vaccination schedules changes ensures that you can protect your family more effectively. Being aware of the when and where of outbreaks will also enable you to take preventive actions against exposure.

Our communities' well-being, and that of their most vulnerable, rely on common effort. If we stop vaccinating, the consequences could be dire, resulting in preventable deaths and overwhelming health systems.

Emily Kramer-Golinkoff struggles to breathe easily. Living with advanced cystic fibrosis, she finds everyday tasks like walking and showering draining and difficult.

Cystic fibrosis is the most common fatal genetic disease in the United States, affecting around 40,000 people. Yet Kramer-Golinkoff’s case is particularly challenging because her condition stems from a rare mutation. As a result, the treatments that benefit 90% of cystic fibrosis patients are ineffective for her.

This situation isn’t unique to cystic fibrosis. Across many genetic diseases, major scientific breakthroughs have uncovered hidden mutations behind severe illnesses and led to life-changing treatments. However, for patients with rare genetic variations, therapeutic options remain limited, forcing them to place their hopes in emerging gene therapies.

“We feel pure joy for our friends who have been saved from this sinking ship,” said Kramer-Golinkoff, 40. “But we’re also desperate to join them. It’s incredibly hard to be among the few left behind.”

The difficulty isn’t just scientific—market forces are also at play. Drug companies prioritize developing treatments for the most common mutations to ensure larger markets.

“You need a large enough patient group in a major market for a company to stay interested,” explained Dr. Kiran Musunuru, a gene-editing specialist at the University of Pennsylvania. This results in what he calls “mutational discrimination.”

Charities like Emily’s Entourage, a nonprofit Kramer-Golinkoff helped establish, aim to break these barriers. Their fundraising has fueled early-stage gene therapy research that could benefit patients regardless of their specific mutations.

Although widespread availability of these therapies is still years away, “just having these treatments enter clinical trials provides immense hope,” Kramer-Golinkoff said.

Kramer-Golinkoff’s journey with cystic fibrosis began when she was diagnosed at six weeks old. The disease causes thick, sticky mucus to build up in the body due to a malfunctioning CFTR protein, leading to infections, blockages, and organ damage.

Despite her best efforts, her condition has deteriorated over time. She earned a master’s degree in bioethics, traveled, worked, and built friendships, but eventually developed CF-related diabetes and other complications. The pandemic forced her into isolation with her parents in the Greater Philadelphia area.

“CF is truly a monster of a disease,” she said.

Meanwhile, many others with cystic fibrosis have experienced remarkable health improvements thanks to CFTR modulator therapies that correct the defective protein. These treatments significantly boost lung function, alleviate respiratory symptoms, and enhance overall quality of life.

Unfortunately, these modulators aren’t an option for patients with rare or unknown mutations. Gaps in genetic testing, particularly in underrepresented communities, contribute to these inequities. Research indicates that Black cystic fibrosis patients are more likely than white patients to fall into the group who don’t benefit from available therapies.

To address these disparities, scientists are focusing on “mutation-agnostic” gene therapies—treatments designed to work across all mutations. This strategy is gaining traction in diseases affecting both the lungs and the eyes.

“There’s a strong push to develop these therapies,” said Dr. Garry Cutting of the Johns Hopkins Cystic Fibrosis Center.

Most of the 14 experimental gene therapies for cystic fibrosis aim to deliver healthy CFTR genes directly into patients' cells, correcting the underlying defect regardless of the mutation.

One such therapy, partially funded by Emily’s Entourage, began a clinical trial in November at Columbia University. The goal is to assess the treatment’s safety and effectiveness.

Despite her worsening condition—living with just 30% lung function, diabetes, and lung hypertension—Kramer-Golinkoff remains hopeful.

“You have to make careful choices about how to spend your limited energy,” she said. “But we’re incredibly excited about the promise of gene therapies. They can’t come soon enough.”

When we think of sleep, we often imagine a passive, resting state. However, the brain is remarkably active during certain stages of sleep, particularly during Rapid Eye Movement (REM) sleep. This unique phase, characterized by vivid dreams and increased brain activity, plays a crucial role in maintaining brain health across the lifespan.

Scientists have long known that sleep is essential for memory consolidation, emotional regulation, and cognitive function. But REM sleep, which makes up about 20-25% of an adult’s sleep cycle, appears to be especially important. During this phase, the brain undergoes processes that not only strengthen neural connections but also clear out potentially harmful waste products that accumulate during waking hours.

One significant study published in *Science*, 2013, demonstrated that sleep, particularly REM and deep sleep stages, enhances the brain’s glymphatic system—a network responsible for removing toxins. Researchers found that during sleep, brain cells shrink slightly, allowing cerebrospinal fluid to wash more freely through the brain tissue, flushing out metabolic waste. Accumulation of such waste, including proteins like beta-amyloid, has been closely linked to neurodegenerative diseases such as Alzheimer’s. This study suggests that insufficient REM sleep could impair the brain’s cleaning system, potentially increasing the risk of cognitive decline over time.

Beyond waste clearance, REM sleep appears to play a vital role in emotional health and learning. A study published in *The Lancet Neurology*, 2020, highlighted that REM sleep enhances the brain’s ability to process and store emotional memories. Participants who achieved more REM sleep after exposure to emotionally charged images were better able to manage their emotional reactions the next day. The findings point to REM sleep as a kind of overnight therapy, helping individuals recalibrate emotional experiences and maintain psychological resilience.

Lack of REM sleep, on the other hand, has been linked to a range of mental health issues, including depression, anxiety, and even increased susceptibility to post-traumatic stress disorder (PTSD). Researchers believe that when REM sleep is disrupted, the brain's ability to regulate emotions falters, potentially leading to heightened emotional reactivity and poorer stress management.

Moreover, emerging evidence suggests that REM sleep might be essential for creativity and problem-solving. During REM, the brain forms novel connections between seemingly unrelated pieces of information—a process thought to underpin moments of insight and creative thought. This might explain why "sleeping on a problem" often leads to a clearer solution the next morning.

Given the importance of REM sleep, ensuring healthy sleep habits becomes critical. Experts recommend maintaining a regular sleep schedule, creating a restful sleeping environment, and limiting substances like caffeine and alcohol, which can interfere with REM sleep. Additionally, managing stress through mindfulness, exercise, and relaxation techniques can help promote deeper, more restorative sleep.

In a world that often glorifies sleeplessness and hustle culture, recognizing the profound impact of REM sleep on brain health serves as an important reminder: sometimes, the smartest thing you can do for your mind is simply to get a good night’s sleep.

We have all have experienced fevers, there are many different beliefs about it in different cultures and multiple ways to treat it, ranging from modern medicine to ancient practices. When one has a fever, their body feels warm and weak, they also do not have energy to do extended movements. As fevers are a range, some being slight to others being signs of dangerous conditions, dealing with them can be tricky. Things like fever dreams, conversations and thoughts are often incoherent. There are things called fever hallucinations as well, but why does this happen?

Fever means your body temperature has gone above what's normal. But what's "normal" can be a bit different for everyone and can change based on how active you are and the time of day. Generally, a fever is when your temperature is higher than 99 degrees Fahrenheit in the early morning or above 100 degrees Fahrenheit at any other time.

Do Fevers Make Us More Irritable?

In a 2013 review published in the Journal of Pain and Symptom Management, the researchers found that not only do fevers cause people to feel cold, weak and other bodily sensations, but the participants also expressed emotional changes, vivid dreams/hallucinations.

In one of the interview with a participant from the study, researches noted them experiencing feelings of anxiousness, crabby, angry and frustrated, “Like I said, I think fever is really tied in to how you feel emotionally. Because I know every time I have a fever, I just get snotty, for lack of a better term, because I'm just really agitated.”

“I feel tired. I feel irritable”

How Is Body Heat And Brain Health Connected?

Harvard Heath explains a part of your brain called the hypothalamus acts like a thermostat for your body. When you're healthy, it keeps your body at its usual temperature. A fever happens when the hypothalamus gets set to a higher temperature than normal. This change in the brain's thermostat is usually caused by tiny things in your blood called pyrogens.

According to a 2023 review by Yale School of Medicine heat can change things in the environment, it can also change how our brains work. In a study, researchers found that even small increases in temperature while the brain is active can really change what the brain does, and sometimes these changes can be negative.

Experts from Yale explain that changes in temperature in the brain also affect how our nerve cells (neurons) fire signals. These cells have tiny pumps that give them electrical energy, which they release when the brain is active. The researchers found that if brain cells get heated up too fast, faster than these pumps can adjust, the cells might become more active or less active than usual.

Even tiny temperature changes from brain stimulation can lead to big changes in neuron activity. As neurons get warmer, they can even stop working, and when they cool down again, they can become very easily excited.

Fever Hallucinations and other Psychological Affects

According to an Infections & Chemotherapy 2022 review, fevers can cause febrile convulsions, which is a seizure caused by a fever in young kids. It can also cause confusion, like not understanding where you are, not recognizing your surroundings. It can also cause unstable emotions, conscious and cognitive disturbances like illusions on hallucinations.

These can also be symptoms for things like influenza infections or encephalitis. Like the Yale experts explained even small temperature changes can have such a big impact on brain activity, we need to start paying attention to these small changes. He points out that it's a basic rule of physics that when you send electricity through wires to stimulate the brain, you will create heat, both in the wires and in the brain tissue itself.

Researching more on these matters can help us find better treatments and help doctors change the course of several procedures to help their patients.