This blog deals with the benefits and the risks of vaccines as discussed in “Vaccine Wars”. The program looks at the different views of vaccines. Some people believe that there are a lot of health issues that stem from vaccinations, including serious problems such as autism. There are parents, teachers, Public Health officials, and scientists who are all involved in the debate. The program looks at the beliefs and practices, as well as the research that has been done.
I have been in various countries and have been required to have multiple vaccines; some countries will not allow you to enter without certain vaccines. After seeing the diseases that can be prevented by vaccines really affected my views of vaccines. In an area in India, a very large portion of the population had polio – a disease that does not even exist in North America because of vaccines. It was not uncommon to see people unable to walk. Also, in Canada children are vaccinated in school – the only people who did not get vaccinated were those with medical conditions; there were never moral debate about vaccines. Thus I was surprised to see on the program that parents are very anti-vaccinations and that it can be a very serious battle to get people to be vaccinated. However, the program did not change my views about vaccines.
Herd immunity is the idea that if most of the population is vaccinated it would minimize the spread of disease because fewer people are at risk. Naturally if most people are protected or immune to a disease and the disease is more readily controlled the general population does not have to fear diseases that could have severely harmed the population. Polio is again the perfect example: it used to be rampant but with the vaccine, it is no longer an issue.
Vaccinations are different than other personal health decisions because it also affects others. For example, cancer patients are very susceptible to diseases and face dire consequences if they are infected. However if everyone is vaccinated/immune the likelihood of cancer patients becoming ill is diminished. Currently, parents and health care providers are the people who are in the decision process on whether or not a child will be vaccinated. Similarly since everyone has rights, no one can be forced to be vaccinated. However, those choosing not to be vaccinated put others in society at risk. This raises the question whether vaccinations should be an individual choice given its overall impact over society.
Vaccination rates could be increased by more advertising of the benefits of vaccines. There could also be incentives to be vaccinated, like getting a free check-up. Getting people to return for booster shots, especially in India, proves to be a challenge. Simply doing things, like ensuring getting vaccinated is convenient, helps a lot; obviously people are more likely to do something if it is convenient. For example, an easy way of doing this is every time someone goes to the doctor, the doctor would check which vaccines someone needs and administer them at the same time as addressing the original needs of the patient.
Parents/patients are often concerned about side-effects (which are usually minor) or do not think that vaccinations are necessary because the disease is uncommon and there is herd immunity. Physicians want their patients to be vaccinated so they do not get sick. Healthcare systems want people to be vaccinated so that diseases are less common and are unable to spread.
Hello Kat,
ReplyDeleteI found your background rather compelling and felt it added great depth to your argument. Certainly, in other countries the "vaccine war" is very different or non-existant, which makes one wonder why it has gained such strength in America. Just like you, I was very surprised by the program, finding it hard to understand why so many people were anti-vaccination. In the end, I also think more advertisements should be produced to highlight the benefits of vaccination. I really enjoyed reading your post, especially, as I said, because of your personal experiences.
Wren
I love your stance on raising awareness to the good aspect of vaccinations. I agree at that telling everyone about the good that vaccines do and shy away from the adverse effects then people will understand that the benefits outweigh the harms.
ReplyDeleteHello Kat – You did a great job on this blog! You did a really nice job of outlining the issues and your stance on them. Like you, I really enjoyed this video because it made me think about different sides of vaccines and like you enforced the feelings I already had. To give the video credit, I think that it outlined both sides of the immunization argument in a fairly objective way, and although I definitely feel that immunizations are worth the risk on the population level, as a soon-to-be-aunt, I realize the fears that go through each individual parent’s mind when they feel that there may be dire consequences to their children for diseases that seem to be nearly eradicated, such as polio. Though of course in India, it’s a very real issue still - it’s scary to think about how quickly it could resurface if we do get too nonchalant about it. It must be very frustrating seeing first-hand the impact that these vaccines have and then seeing the opposition to them on the other side of the globe. It is powerful what time can do, quickly, to erase the fear and realized impact.
ReplyDeleteNice job also explaining herd immunity, which is as you mentioned the protective effect that an unimmunized person benefits from due to a large proportion of those surrounding him or her (the herd) having been immunized. The herd acts like a wall or barrier through which the disease has difficulty penetrating. The problem is that herd immunity is never completely protective, and loses significant efficacy as the herd shrinks.
Vaccines are in a special category of medical interventions for exactly the reason you mentioned, that they are protective not only for the patient receiving the vaccine but also for the community in which that person lives. They are also a prophylactic type of health intervention, which you give now for immediate and future protection. People don’t have the disease yet when they get the vaccine, and so it is difficult for that person to realize the benefit. Of course, most of us don’t think about protecting others when we get vaccines – we’re just thinking of ourselves. For that reason, in addition to patients (if adults) and guardians (if not), I believe that public health officials, who keep the population risk in mind should be involved in deciding who gets vaccines. You mention that immunization cannot be forced on people, but actually currently the state does have the right to do so. It’s been law since 1905 after a Supreme Court decision Jacobsen vs Massachusetts, which involved a man who didn’t want to get vaccinated against smallpox. The court ruled that the state has the right to vaccinate a person against his or her will if the state felt that not doing so would put the public in harm’s way. Most states feel that it’s too political so they don’t enforce this, but they are able to. Do you think that this should be enforced?
There are many reasons, as you mentioned in your blog, that children may not get their recommended immunizations, including personal choice of the parents not to immunize their children, lack of access to care, lack of follow-up in a timely manner (missing the 3rd of three in a series of vaccines, for example), lack of physician or healthcare staff to perform the immunization for any number of reasons, lack of prior immunization status if moving to a new clinic, or lack of vaccine at the clinic, regional or national level. I’m sure you have had exposure to many of these reasons in your time abroad – I would love to hear any stories you might have!
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ReplyDeleteFinally, the most challenging part of this topic is getting more people to get their vaccinations. The first step is determining, within the population of interest, why children do not get immunized. In inner cities, for example, is it due to lack of access to care, to frequent changes in clinics, to lack of money to pay for vaccines, or to opposition on the part of the parents? I loved your approach to this – that you realized that the issue is multifactorial and that you have to attack it from many angles. Making access easy is crucial to increase vaccination rates, as is advertising/communicating the fact that they are available.
Really nice job! I look forward to reading your next blog.