Maintaining the battle against vaccine-preventable neurological diseases in the United States.

Few experts remain in the United States on the infectious vaccine-preventable neurological diseases (VPNDs). This is a mark of the changing epidemiology that has come with publicly available, often free, and sometimes mandated vaccinations in the U.S.A. over recent decades. Three main challenges to maintaining the battle against VPNDs exist in the U.S.A. today: (1) The variable uptake of vaccinations known to be safe and effective among the healthy U.S. population; (2) Waning awareness among physicians and community members on VPNDs; and (3) The global nature of travel, migration, medical tourism, and work. The mobility of the U.S. population and dependence on herd immunity in the USA for some residents may no longer be appropriate. This situation emphasizes the value of a global neurological disease framework for neurologists-in-training that could ultimately save lives in the USA. VPNDs must remain a part of the curriculum and board certification of both pediatric and adult neurologists in the USA given changes in U.S. policy and sentiment.