Saar Kuzi
Alessandra Coutinho Fernandes
William Cope
Richard Tapping
Kashif Ahmad
Reda Sadki
Shubhra Kanti Karmaker Santu
Adam P Rusch
Elle Meisner
Nereyda Ochoa
Landon J. Kunzelman
James DotimasFA16 Immunization Module’s Updates
Warning Signs: Contraindication for Vaccinations and Public Safety
Vaccines are essential components to public health for a variety of reasons. In many cases, such as polio, the production of vaccines has dramatically changed the number of deaths per year due to illness associated with certain pathogens. Vaccines help the body fight off pathogens by increasing the production of memory B and T cells in the body which are part of the adaptive response. These cells are more easily activated and differentiate faster upon activation. This allows for a quicker and more robust immune response which can prevent a majority of the deleterious effects of infection.
In general, vaccines are well received within the scientific and medical community, however, there are certain instances in which giving a vaccine may be contraindicated. The main contraindications that a physician needs to be aware of are any sort of allergic reaction to a previous dose are vaccine component that caused anaphylaxis. In addtion, patients with a compromised immune system or immunodeficiency disorder are aften contraindicated for disease; especially for live attenuated vaccines. Pregnancy is another risk factor for vaccination in certain cases such as zoster, varicella, live attenuated influenza, and measles, mumps and rubella. A complete list of contraindications can be found at the following links for pediatric and geriatric patients respectively.
http://www.cdc.gov/vaccines/hcp/admin/contraindications-vacc.html
http://www.cdc.gov/vaccines/schedules/hcp/imz/adult-contraindications.html
Finally, vaccine safety is imperative because public confidence in vaccine safety is already quite controversial. Herd immunity refers to the concept that if most of the population gets immunized the spread of contagious disease is greatly contained. Therefore, people have to trust vaccines! Reducing the number of adverse effects of a vaccine by paying close attention to contraindications is one method of preserving public confidence. Another very important component is public health education. Many people are bombarded with misinformation on the web concerning negative effects of vaccinations that are simply not supported by empirical evidence. This problem could be more easily avoided if the general public had more access to basic immunology education. Here you will find a short, informative video explaining the basics of how immunizations work that I believe would be effective in educating the general populus.
Sources:
http://www.cdc.gov/ncird/index.html
Galazka AM, Lauer BA, Henderson RH, Keja J. Indications and contraindications for vaccines used in the Expanded Programme on Immunization. Bulletin of the World Health Organization;62(3):357-366.
Dr. Tapping's Slides on Immunization Basics
I agree with @Owen that its not necessarily a lack of education as far as anti-vaxers are concerned. Most people who do not vaccinate have received a college education and are usually on the older side. I think a problem is that once someone has made up their mind on something like vaccine's are dangerous, basic scientific arguments are not enough to persuade them. Even prominent members of the scientific community might be dismissed as their arguments go against the ingrained perceptions held by anti-vaxers, and therefore would be negated by an intense confirmation bias (the so-called backfire effect). I feel the best way to overcome such a situation HAS to be on an individual level between the patient and their physician. Discuss the personal reasons for why someone has chosen to forgo vaccinations and work WITH them to enable the patient to understand why vaccination is much more beneficial than the alternative.
I agree that educating the public about the role of vaccines is important but in general, I see the anti-vaccine movement not as a lack of education but rather as due to prominent figures in the community being given loud voices which resonate with societal fears. The best way to avoid this is to provide equally loud feedback from prominent and already known members of the scientific community to speak back. The other thing which the scientific community must do is contact those who are the strongest proponents of the anti-vaccination movements and attempt to change their views because this will strongly sway follower back to obtaining vaccines. Precautions and contraindications mean that we need a stronger herd immunity in order to protect those who cannot receive the vaccine.