This
week we watched a Frontline Special about vaccines and their increasingly
controversial role in American society. The video was very interesting and
shed light upon the issues surrounding vaccines, as well as provided a good
deal of background information in regards to the history of vaccinations. While
the video brought up potential risks of vaccinations for children, such as a
possible yet unsupported link to autism, it made me realize how beneficial
vaccines are to society. In American society today it is easy for us to forget
about the risk of infectious diseases that once killed thousands because of the
work that vaccinations have done in eradicating them as a major health concern.
A
very intriguing concept discussed in the video was herd immunity, which
articulates that the immunization of a large portion of the populations works
to protect those who are not immunized by reducing the presence and spread of
infectious diseases. This protection is more beneficial to groups that are at a
higher risk of contracting infectious diseases such as children and the
elderly. Problems can arise when herd immunization breaks down as a result of
too few people receiving immunizations, therefore increasing the prevalence of
certain diseases in that population and reducing the protection of those not
immunized.
Health
professionals regard vaccination as a special type of medical treatment because
it goes further than benefiting only the person being vaccinated. By one person
being vaccinated it reduces the threat of that person contracting and
potentially transmitting the disease to another person. On large scales this
helps protect many people from the spread of diseases. Although the benefits of
vaccinations are clear, the decision upon whether or not a child receives a
specific vaccine should ultimately be left up to the child’s parents, who will
hopefully understand the benefits to their child and society as a whole.
While
many children receive the recommended immunizations from their physicians, this
is not the case with everyone. The main reason this is so is due to concerns
from the child’s parents that certain vaccinations pose a greater health threat
than they prevent. These notions are perpetuated from new stories on the
internet and television. For public health policymakers to increase vaccination
rates they need to make the public aware of the significant benefits to
vaccinations as well as clear up the discrepancies circulating. In American
Society, the best way to reach the people is through advertisements on
television and the internet. If vaccination ads were used to target populations
around the country with the lowest rates it is reasonable to assume that the
rates will rise, similar to the Montana meth project, which was an ad campaign
to reduce the presence of crystal meth in high usage areas of Montana and was
incredibly successful.
Jameson,
ReplyDeleteI completely agree with your idea that we easily forget the risk of infectious diseases. For me, the moment in the special where students saw cases of different diseases solidified how important vaccines are. I also like your idea of an advertisement campaign.
Jameson – Thank you for your thoughts on vaccines. Like you, I really enjoyed this video, and I can tell that it made you think about this subject in a new light. I think that it outlined both sides of the immunization argument in a fairly objective way, and although I still feel that immunizations are worth the risk on the population level, as a clinician and 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 or themselves (in the case of patients) for diseases that seem to be nearly eradicated, such as polio. Herd immunity, as you mentioned, is 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. Nice job on your explanation.
ReplyDeleteYou make a very good point about vaccines’ differences from typical medicines when you say that they treat both the person and the community. It is also a in a special category in that it is a preventive intervention – you get it before you have the disease or symptoms. I loved your point about us forgetting what it’s like to suffer from the diseases like polio which, within just the past century were so devastating. It’s easy to have this lack of recognition specifically because vaccines are preventive, so people never see the benefit at any one time or in any measured way, except to say “hey, I didn’t get that disease. Maybe it was the vaccine”.
There are some groups that think about others when they get vaccinated - parents who work with children or high-risk populations, for example, protect their own children if they get vaccinated against the flu so that they don’t bring it home – it’s less a decision for themselves as it is for their children. But 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), public health officials, who keep the population risk in mind should be involved in deciding who gets vaccines.
One reason that children don’t get vaccinated is, like you said, that their parents feel that the risks outweigh the benefits. But there are many other reasons, including 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 knowledge of prior immunization status if moving to a new clinic, or lack of vaccine at the clinic, regional or national level. Do you think that the main reason is always that the parents feel like the risks don’t outweigh the benefits? Can you think of populations where perhaps the other factors are more influential?
Finally, the most challenging part of this topic is convincing more people to get their vaccinations. The first step is determining, within the population of interest, why children do not get immunized. If the main cause is the parents’ decisions, then I completely agree with you that strong and widely-distributed communication strategies are part of the way to increase rates. Is this all that needs to be done? What other interventions would be needed or help in the process? Are there other types of interventions that would be needed if some of the other barriers listed above are the main problems? 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?
Just some things to think about. You did a great job with this blog, and I can tell that it really made you think about this in a new way. I’m looking forward to blog #4!