To Vaccinate or Not To Vaccinate: A Laboratory Perspective

Course overview

Protection from infectious disease has been a quest since the beginning of human history. A major advancement in this endeavor was the development of vaccines. Although we do not have vaccines for every infectious microorganism, today there are vaccines for 30 diseases. Vaccines don't always prevent infection and transmission altogether, but they do work to either prevent or ameliorate/mitigate disease by reducing complications and symptoms through generation of memory and protective antibody-producing B cells and T cells. Laboratory serology testing, which measures antibody concentrations specific for a particular microorganism, is a useful and important tool for determining exposure and, for a handful of vaccine-preventable diseases, for assessing immunization status associated with immunity. For some common vaccine-preventable diseases with high global impact--like hepatitis B, measles, mumps, and rubella--determining vaccine status is sometimes needed for a variety of reasons. Clinical scenarios for determining vaccine status include testing for women considering pregnancies, healthcare workers, and vulnerable populations (i.e., very young individuals and cancer patients) at risk of severe complications from natural infections. Awareness of the limitations of serology testing coupled with appropriate test result interpretation for assessing vaccine status associated with immunity is vital to patient care. Most importantly, although laboratory evidence of immunization status is key to optimal patient management, it is only one criterion in the decision to vaccinate or not to vaccinate. After this presentation, participants will be able to: - Recognize the relationship between antibodies, vaccines and immunity - Describe the limitations of assessing vaccination status for vaccine-preventable diseases - Discuss when and how to use laboratory results to inform and guide patient management