In the everyday practice of medicine, we providers often ponder why patients refuse certain health recommendations. We believe that if we present the patient with current standard guidelines, they will acquiesce with our proposed treatment plan. In the case of minority populations, this does not occur as regularly as we would like. I have noticed over the years that patients are skeptical of these recommendations, particularly, vaccines.
Edward Jenner, born 1749, was considered the predecessor of immunology. It was through his experimentation with cowpox he proved that persons could be “immunized” against small pox. He inoculated a small boy with cowpox then later exposed him to small pox. The boy never developed the deadly disease.
Vaccines have definitely evolved since those rudimentary beginnings. There was a time when measles was considered an epidemic with more than 55,000 cases annually. For pediatricians practicing prior to 1985, it was not uncommon for them to see meningitis caused by bacteria called haemophilus influenza. Due to current immunization guidelines, I have never had to deal with this life threatening illness.
Probably one of the most infamous vaccine inventions was that of the polio vaccine. In 1952, Jonas Salk produced the first polio vaccine and was heralded as a hero and eased the fear of thousands of parents who worried about their children contracting polio. Polio was and is a crippling and potentially fatal illness. There is no cure and worldwide eradication can only be achieved through vaccination. In 1994 however, polio elimination was certified in the Americas.
Interesting Vaccine Facts
- 1945 The first flu vaccine began being used
- 1955 Inactivated polio vaccine was licensed
- 1964 The Advisory Committee on Immunization Practices(ACIP) held its first meeting
- 1964-1965 The largest rubella epidemic in the United States (20,000 cases)
- 1980 Smallpox declared eradicated in the world
So what causes patients to be skeptical about vaccines? Is it a phobia of needles? Is it the expense? Is it the misconception that vaccines cause health illnesses? Or is it a distrust of the medical system in general?
The patients I encounter have expressed a wide variety of rationales as to why they avoid immunizations. For some, the Tuskegee Experiment is difficult to forget. And as a physician of color, I too can empathize with that level of hesitation in regards to the healthcare system. Those providers that committed that atrocity violated the Hippocratic Oath (Do no harm) and destroyed the very foundation of the physician/patient relationship: trust.
For that reason and many others, there are several safe guards in place to protect patients. One of which is the consent form. Immunizations are recommended but not mandatory unless in the case of children who will be attending public schools. Patients are counseled about the vaccine and its side effects. There is also an organization with whom all adverse events are reported. Most side effects are mild such as tenderness or swelling at the site and some minimal redness. These minor reactions resolve within the next few days.
Many adults believe that vaccines are just for young children and adolescents. That could not be further from the truth. The Centers for Disease Control is a reputable source for what is recommended and at what time. Visit cdc.gov for the most up to date guidelines.
As we enter influenza season, here are a few general immunization recommendations:
- All adults should receive yearly influenza
- Td (tetanus) every 10 years and a one -time booster of Tdap (contains the whooping cough vaccine)
- Pneumococcal once at age 65 or sooner if any co- morbid conditions such as diabetes or respiratory illnesses
- Zoster (shingles) once at age 60
- Many other vaccines recommended if patients meet the specific category
The bottom line: discuss with your healthcare provider about which vaccines are recommended for you at this time. Because of science and modern technology, diseases that were once common are not anymore. It was because of vaccines that small pox was eradicated from the world!
Now on to our first success story: As you recall, I placed a challenge to you to make some lifestyle changes. A delightful 80 year old took me up on that offer and decided to stop repeating the same old excuses and actually decided to commit to a regimen of regular exercise and making better food choices. She has been using the Leslie Sansone DVDs and she has lost 10 pounds. I hope her story will encourage others and provide the spark to ignite this momentum.
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
