Monday, August 10, 2020

Vaccines: Still Protecting Your Health in An Ever-Changing World

Sue Bornstein, MD
Internal Medicine Specialist, Dallas

Member, Texas Medical Association (TMA) Board of Trustees

Editor’s Note: August is National Immunization Awareness Month. This article is part of a Me&My Doctor series highlighting and promoting the use of vaccinations.

I can say without hesitation where I was on Sunday, July 29, 1962. As an 8-year-old Dallasite, I stood in line with my family to receive a sugar cube soaked with the newly released Sabin polio vaccine. On two consecutive Sundays, more than 900,000 Dallas residents were immunized against the polio virus.
Percy Luecke Jr., MD, a Dallas pediatrician, was chosen by the Dallas County Medical Society to help organize this mass immunization. Dr. Luecke worked with local health authorities, civic, and religious leaders to make these vaccination events possible. In a 2017 Dallas Morning News article about the mass immunizations, James Luby, MD, then chief of infectious diseases at UT Southwestern Medical Center in Dallas, said, “I think the public was convinced that the problem was significant and that they could play a role in defeating the disease by being immunized.” Thanks to similar vaccination programs across the country, no year-round transmission of polio has occurred in the U.S. since 1979. However, international travelers can – and have – brought the virus into this country. 

Vaccines are among the safest and most effective tools against
preventable infectious diseases like influenza, measles, and
tetanus. Photo by Heather Hazzan, SELF Magazine 
Many things have changed since 1962. We’ve seen the exponential rise of the internet and social media and its influence in our culture. We live in a 24-hour news cycle. Mistrust of the pharmaceutical industry is rampant. Celebrities are now increasingly looked to as experts in health and medical treatment. In his book The Death of Expertise, scholar Tom Nichols says about the U.S.: “We do not have a healthy skepticism about experts: instead, we actively resent them, with many people assuming that experts are wrong simply by virtue of being experts.” I agree with Nichols’ premise. This is a dangerous trend.

Texas is one of 16 states that allows parents to bypass vaccine requirements to enroll their children in school by claiming a conscientious exemption. The exemption rate for kindergarten students has risen from 0.3% for the 2005-6 school year to 2.15% for the 2018-19 school year, to 2.24% for the 2019-20 school year. However, some private schools have reported exemption rates greater than 50%. This, combined with the recent data showing 44% fewer Texas children received their immunizations during the early days of the COVID-19 pandemic, raises concerns. At this shrinking vaccination rate, will “herd immunity” – protecting a community from disease by vaccinating enough people in it – remain effective?

Another major change that has occurred since 1962 has been the worldwide shift in causes of death from infectious diseases to non-communicable diseases. In 2015, the chronic diseases of diabetes, heart disease, stroke, and cancer were the top four causes of death in Texas and the U.S. Vaccines are the biggest reason fewer people die from infectious diseases. We must stay committed to getting our shots to continue that success.

Vaccine-preventable infectious diseases like influenza are bad enough, and many of them can lead to other life-threatening conditions. For example, pneumonia – which occurs in some patients with the most severe flu cases – has led to cardiac complications within a week of the pneumonia diagnosis. People with diabetes, asthma, chronic obstructive pulmonary disease (COPD), and other chronic lung diseases also are at higher risk of more severe illness from influenza and invasive pneumococcal diseases. The COVID-19 pandemic has shone a bright light on the connection between infectious diseases and chronic illness, since people who die from COVID-19 often also have an underlying chronic illness.  

One thing that hasn’t changed since 1962: Vaccines are among the safest and most effective tools available to and used by physicians. Yet vaccine hesitancy and even refusal are increasing. How can physicians increase their success in getting their patients vaccinated? One way is by recommending vaccinations as a routine part of a patient’s care. Vaccination should be a routine procedure. Getting your shots should be the norm; not the exception. 

Your doctor might counsel you about vaccines. He or she might try to convince you why immunizing is the best choice. Please listen and discuss with an open mind. Some physicians use tools from accredited medical associations like the American Academy of Pediatrics and American Academy of Family Physicians to help them discuss vaccines with their patients. Medical Economics magazine also provides patients with a better understanding about how their physician might approach vaccines

Paul Offit, MD, a pediatrician and expert on vaccines at The Children's Hospital of Philadelphia, noted, “Vaccines are a victim of their own success. We have largely eliminated the memory of many diseases.” TMA’s “Talk To Your Patients About” series goes into detail about the many infectious diseases prevented by vaccination, including influenza, measles, polio, tetanus, and others. 

Vaccine development and distribution continues to evolve. We no longer must wait in lines to get vaccinated, as I did as a child. Scientists are working harder than ever to produce a COVID-19 vaccine. Vaccines protect us from illness and death, which is why it’s so important we continue to take advantage of them.

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