To vaccinate or not to vaccinate? – First world problems

Please excuse this temporary (out)break in our scheduled OBlogcast as we address our country’s current state of affairs. 

Our most trending topics in the news line up include: Deflate-gate, Droning while under the influence, and Measles. Really?

At least the first two provide some entertainment relief for the globally indifferent/ social escapists out there.

But how do we explain the over the top mayhem over the measles outbreak, reminiscent of the not too long ago Ebola days? 

It is a formerly eradicated disease. One for which we have a functional and time tested vaccine. If there ever were a medical chip (vaccine) shot  this would be it, folks!

And weren’t we just about ready to perform a rain dance to develop a successful Ebola vaccine? Yet when it comes to measles ( or the flu, pertussis, hepatitis, chicken pox) we have reverted back to our original paranoia of this (evidence based) medical hocus-pocus called immunization!

I empathize with those parents that have consternation about vaccines, I really do.  I am certain they only want what is best for their children. 

Still yet, I can’t help but feel frustrated that children in underprivileged countries pointlessly die, due to a lack of the very science and resources that we have, but choose not to use. 

And mostly due to misinformation from the likes of Rand Paul and Jenny McCarthy!

Forgive me, but I dare say referencing these guys  for vaccination safety is as sensible as letting me operate on the brain tumor you don’t have (reference my handle for increased ironic effect).

Here are some of the common myths that perpetuate the (unnecessary) debate.

1. Vaccines don’t really work:-

” Every year, like clockwork, after I get my flu shot, I feel achy, have a fever and feel cruddy. One year,  I didn’t get it and I was fine”..

A vaccine is like an unpleasant speed date for your immune system.

You are briefly introduced to a virus or bacteria in a safe and controlled environment where you learn all the negative details about the organism and save it to your immunologic hard drive.

If you are exposed to the same low life again,  your immune systems spares you the awkward second date faster than you can say gesundheidt. 

Bottom line: Your immune system just can’t protect you against a disease without having been exposed to it at least once.

Vaccines facilitate this by using part of the virus/bacteria or using its dead or live but subdued ( attenuated) forms.

My patient probably felt achy and feverish because her immune system was responding to the watered down virus and doing its job- the alternative ( going on a blind date with the flu ) would have been a lot worse. As far as not having the flu the year she abstained from the shot,  just pure luck.

2. Vaccines are not safe:-
Actually, the diseases they are protecting you from, are the real culprits. But sure, just like taking an aspirin or having a cavity filled or even crossing the street on a sunny day with the birds chirping, can all have their dangers, vaccines are no exception.

But before you go into bubble boy mode, realize that the only likely side effects of vaccines are having an allergic reaction or a febrile seizure. And even those are very uncommon. The media frenzy over autism, gait abnormalities and other mental/behavioral defects are extremely rare and unreproducible ( read: coincidental).


3. If everyone around me is vaccinated, aren’t I already protected?

One of the conveniences of being in the military is the revocation of medical autonomy when it comes to making obvious ( and evidence based) choices.

In other words, if you are an active duty member, it is mandatory for you to obtain all CDC recommended vaccinations -barring any legitimate medical circumstance such as being immuno-compromised, having an allergy or religious restrictions to a vaccine component.  

This is important because of something called the herd phenomena. Those people that can’t be immunized on account of the aforementioned restrictions, rely on the immunity of the “herd” to shield them from being exposed.

The military realizes that in close quarters such as barracks, hospital settings and on the front, it is critical to optimize the herd’s immunity and thus keep the disease prevalence low.

But it only works if most people that can be immunized, are. In other words, if everyone used the above question as an excuse, it would be impossible to eradicate disease.

Vaccines work, unfortunately, you only really hear about them when that one in a million person develops a rare unforeseeable side effect or complication from having received one.

Their effectiveness is difficult to quantify because you can’t demonstrate a disease NOT happening.

Then again, you can’t demonstrate a car accident NOT happening every time you get behind the wheel either. It doesn’t mean driving safely and wearing a seat belt isn’t helping.

Important vaccines to obtain particularly in pregnancy:
1. Flu- anytime during pregnancy
2. MMR ( measles, mumps, rubella)- prior to conception or after delivery
3. TDAP (tetanus, diphtheria, pertussis- anytime after 27 weeks and preferably once in each pregnancy
4. Varivax ( if not immune to chicken pox)- prior to conception or after delivery
5. HPV- age 12-26 at anytime in pregnancy

Thanks for reading! #vaccinate
Be happy, Be healthy!

ObGynKanobi OUT!

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