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What Is Ring Vaccination?

Medically Reviewed by Melinda Ratini, DO, MS on May 24, 2022

Ring vaccination is a type of vaccine strategy. If a person is exposed to a virus, a vaccine for that virus is given to others who are in close contact with that person, such as close family and friends. Public health officials use it as part of a public health response to limit the spread of vaccine-preventable diseases.

Ring vaccination helped put an end to smallpox in the last half of the 1900s.

How Does Ring Vaccination Work?

There are a lot of issues to consider with ring vaccination. For it to work well, public health officials need to:

  • Investigate the person, time, and place involved in exposure to the virus
  • Quickly survey who needs to be included in the ring of people to receive vaccines
  • Do thorough research to find infected people and those at risk for infection in a short period of time

Once health officials can identify primary or secondary contacts of the person affected by the virus, they give those people the vaccine. A primary contact is someone who is directly exposed to someone who has the virus. A secondary contact is someone who has been in close contact with a primary contact, but not directly with the sick person.

This way, it protects everyone who has been or could have been exposed to the virus. The goal is to help a small “ring of people” build immunity against the virus and limit its spread.

What Are the Pros and Cons of Ring Vaccination?

Ring vaccination advantages include:

  • Efficient use of resources such as limited vaccines and staff to give them
  • Lowered odds of the virus spreading
  • Cost-effectiveness: You only need a limited number of vaccines to complete the ring.
  • Highly effective for areas with isolated communities that have small populations

There are disadvantages to the ring vaccination strategy, such as:

  • Contact tracing to find people at risk for exposure takes a lot of time and effort.
  • There are higher odds of missing high-risk people within the ring.
  • It’s expensive and time-consuming to follow up for more shots if needed.
  • It can be hard to keep up with public demand.
  • It only works if the vaccine is effective after an exposure. Some vaccines must be given before exposure to be effective.

Ring Vaccination vs. Mass Vaccination

Mass vaccination is another type of public health strategy. In this plan, large numbers of people are given the vaccine. Health experts do this to prepare and protect the public from possible exposure to infected people. It also guards against future infections.

When a large number of people get vaccinated around the same time, unlike ring vaccination, it can help build “herd immunity.” This is a term that experts use when a large portion of society has immunity (protection) against a certain virus. This then cuts down the spread from person to person. It also helps to protect those who are unvaccinated against a certain virus.

Mass vaccination advantages include:

  • It lessens the need for contact tracing of those who might be infected and others around them.
  • Public officials and authorities can be less alert or cautious about the virus spreading in public spaces.
  • It lessens the odds of the virus causing a future attack.
  • It makes it difficult for the virus to mutate.
  • It gives the public a sense of security.
  • It cuts down panic and uncertainty about possibly being exposed to the virus.

But mass vaccinations also have several drawbacks:

  • They require a lot of resources such as a large stock of vaccines to meet the demands of a huge population.
  • It can be very costly to roll out this strategy, as it requires a lot of supplies and well-equipped facilities.
  • The plan requires large-scale staff training to give vaccines to a large number of people.
  • It may be hard to get everybody’s consent. If it’s mandatory, it might affect your choice to refuse medical care.
  • It may take a lot more time to vaccinate large populations. Specific guidelines need to be set before you get the vaccine.

Ring Vaccination vs. Targeted Vaccination

Targeted vaccination is a type of public health strategy that experts use to protect vulnerable groups. These are people most likely to get infected first or to have serious symptoms during a large-scale spread of a virus.

Basically, when the viral infection is picking up speed, public officials ask themselves who should be vaccinated first and why. To find this answer, experts have to consider long- and short-term consequences.

For example, during the COVID-19 pandemic, the first couple of rounds of available vaccines were targeted toward:

  • Older people in long-term care facilities
  • People 75 or older
  • Health care workers like doctors and nurses
  • Front-line essential workers and first responders
  • Those with weak immunity

This was done to lower the risk of severe infection and the number of deaths during the first wave of infections. Officials also did it to reduce the burden on health care institutions like hospitals and on society at large. As more vaccines became available, the target groups were expanded to fit younger and healthier people.

Unlike ring vaccination, this strategy targets a larger number of people based on age and risk for exposure than those immediately around infected people.

Ring Vaccination vs. Cocoon Strategy

Cocoon strategy is a type of vaccination program designed to protect newborns from contagious and deadly infections such as whooping cough (also called pertussis).

According to research, nearly 75% of babies with whooping cough get it from someone in their household. About two-thirds of affected babies under 6 months are hospitalized because of this condition.

Because infants under 6 months are too young to be vaccinated, those in close contact with the baby such as parents, siblings, and grandparents get the vaccine to create a protective “cocoon.” This limits the virus from spreading.

This is similar to ring vaccination, except the vaccine is given to people in close contact with someone before they can spread the virus.

What Diseases Have Ring Vaccinations Been Used For?

Health organizations have used the ring vaccination strategy for:

Show Sources

SOURCES:

Arizona State University: ‘Ring Vaccination as a Control Strategy for Foot-and-Mouth Disease.”

CDC: “Ring Vaccination.”

Emerging Infectious Diseases: Effectiveness of Ring Vaccination as Control Strategy for Ebola Virus Disease.”

Hawaii Medical Journal: “Ring vaccination versus mass vaccination in event of a smallpox attack.”

Human Vaccines and Immunotherapeutics: “The case for ring vaccinations with special consideration of oral cholera vaccines

JAMA Network: “Analysis of COVID-19 Risk Following a Ring Vaccination Intervention to Address SARS-CoV-2 Alpha Variant Transmission in Montreal, Canada.”

Mayo Clinic: “Herd immunity and COVID-19: What you need to know.”

Proceedings of the National Academy of Sciences: “Targeted vaccination and the speed of SARS-CoV-2 adaptation.”

Texas Children’s Health: ‘Nation's First ‘Cocoon Strategy’ Vaccination Program Delivers 10,000th Immunization.”

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