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Outbreak Outrage

by Jeff A. Drasnin, MD, FAAP, pediatrics

I’ve written several posts on vaccines and vaccine refusal, but it’s time for a follow-up. Recent events have given us all opportunity to think, reflect and educate.

Social media, popular media, and countless internet sources are all very powerful influencers of sentiment. As a connected purveyor of all of the above, I find it very interesting to see how the messages have changed in recent weeks since the outbreak of measles began at Disneyland. 

Prior to this most recent outbreak, the vast majority of vaccine-related articles, blogs and Facebook posts that came across my radar were “antivax.” The annual whipping boy was the flu vaccine. 

For years, I have wondered what the flu vaccine did to deserve so much conversation and condemnation. Even among those patients and families who traditionally follow recommendations, I will run into flu vaccine refusal. I’ll hear things like, “Oh, I got that once and I GOT the flu.” “I was so sick the year that I got one.” “I never get the flu.  I don’t need it.” “It’s ‘just the flu’. I will deal with it if I get it.” 

While it’s important to remember that everyone is entitled to an opinion, I’m bothered by the varying degrees of these less than completely factual statements. As physicians, it is very easy to get frustrated by those who don’t follow our advice. After all, we are the experts. Do these patients know that, statistically, the flu is the most common vaccine-preventable disease that can kill you? More people die every year in the United States from complications of influenza than all other diseases that we vaccinate against combined. The flu is a very common disease that is easy to spread and can be deadly. There are people who question the flu vaccine but the disease is seen as the problem.

Enter measles, January 2015.

Now, people who have chosen not to vaccinate have become the problem. The mainstream, vaccinating public treats them like an enemy. We read that their poor choices are putting the rest of us at risk – putting our country at risk. From Facebook posts and blogs to open letters to the public and political cartoons, the buzz to condemn these poor choices has risen from crickets in the woods to a raging mob. The emotional driver is significant and, to most open-minded thinkers, appropriate. 

Here are the facts about the measles vaccine: The vaccine is very effective even after one dose. Appropriate protection is achieved for more than 90% of vaccinated people upon receiving that dose. After dose #2, this statistic, of course, is even higher. I certainly respect the argument that we all should be vaccinated to protect those who are too young to receive the vaccine, for medical reasons cannot be vaccinated, or are among the small percentage of those individuals who have gotten vaccinated but for some reason the vaccine did not stimulate a protective response from the body. But the vast majority of the vaccinated public is not at risk from those who have chosen not to vaccinate.

This has my curiosity piqued.

The flu runs rampant every year and kills thousands – why don’t we express such anger at those who have chosen not to get their flu vaccine? They can also spread this deadly illness to those who are too young to be vaccinated, were vaccinated but not protected, or cannot be vaccinated for medical reasons.

While I am a strong supporter of vaccination, I draw the comparison between reaction to the measles vaccine and the flu vaccine to hopefully make a point. To put a positive spin on the recent outbreak, so that we can move the needle forward (pardon the pun). To educate and help some to make more informed decisions. 

Sometimes, fear drives the human decision-making process. Anger can be polarizing, and rarely changes minds. The answer is education. Our lives are full of teachable moments. This is one of those moments.

Here it is: The people most at risk for measles are those who have chosen not to vaccinate. Instead of being angry at them, let’s channel that emotion into educating them. Let’s use this opportunity to help them and indirectly ourselves. Let’s seize this moment and advance population health. 

Anger will not do that. Put down your swords but not your energy. Harness it. Channel it. Opportunity is knocking. 

Tweet me your thoughts and opinions: @drazworld 

Dr. Drasnin is an athenahealth client specializing in pediatric medicine at ESD Pediatric Group in Cincinnati, Ohio.

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