Vaccinations to Public Health, Research Paper Example

Abstract

There is a conflict over whether children should get immunized or not and whether the benefits of immunization outweigh the negative impacts. Scientific studies have shown that immunization is clearly beneficial while there is no clear evidence that demonstrates negative effects. It is therefore necessary to increase the communication between physicians and caregivers of young children to encourage them to be immunized. Government health care agencies and the media should be recruited to partake in this effort.

Introduction

Immunizations have revolutionized the health of our world. Since the development of the smallpox vaccine in 1798 by Edward Jenner, scientists and physicians have been encouraged to find ways to foster human immunity against other common diseases. As a consequence, a goal of modern healthcare practice is to ensure that young children receive vaccinations against many bacterial and viral infections that are common for their age group. In many cases, these vaccinations help protect against potentially deadly diseases which range from measles to hepatitis B. While it is recommended that children receive a certain schedule of vaccinations until age 6, many parents opt their children out of this process because they believe that vaccines are either ineffective or detrimental to the health of their child.

It is difficult to determine whether vaccines cause harm or good from an observational standpoint. However, there have been many scientific studies that aim to determine the difference in mortality and morbidity of children who have received vaccinations compared to those who haven’t. Parents who choose not to immunize their children claim that no scientific studies have determined that vaccines actually prevent disease, that there are no long-term studies on vaccine safety, no tests can determine the effects of multiple vaccines, that vaccine ingredients are toxic in nature, and that vaccinations are the likely cause of autism and other behavioral disorders. Since scientific data can clearly demonstrate that these points are false, it is essential for the government and physicians to find ways to explain the benefits of vaccination to the population.

One major argument against vaccination is that one vaccine doesn’t necessarily prevent the disease it was intended to stop. A primary example of this phenomenon is the influenza virus. Every year, it is recommended that people, especially those at risk for respiratory illness, get a shot to immunize them against the virus. While it may at first seem absurd that it is necessary to receive a new shot each year, this need is derived from the unique biology of the virus. As the virus infects a host, it is able to integrate into its DNA and change itself to become more virulent. During the flu season, the virus will evolve until it is able to bypass the antibodies that were produced by the virus from the previous season. Therefore, it is the responsibility of researchers to determine the likely course of evolution that the virus will take and to create a weakened or dead virus that can be injected into members of the population that will allow them to become immune to the new virus.

Provided that a majority of the community receives the flu vaccine each season, it is likely that they will remain protected against the virus itself. However, it is still possible for them to get the illness because they are not protected against every strain of the virus because it continues to evolve. Therefore, to completely eliminate certain viruses, such as the flu, it is necessary to eliminate its ability to grow and evolve. To do so, it is essential to maximize the portion of the population that is immune. This is a concept known as herd immunity, in which most members of the population are not susceptible to the virus, so there is a decreased chance that it will be transmitted from person to person. Herd immunity is therefore at its strongest when a maximum number of individuals are receiving the vaccination.

A second claim against vaccination is that there is not currently enough research studies that demonstrate efficacy of vaccinations. However, these individuals fail to read the many peer reviewed journal articles that indicate that there is a significant increase in survival for the individuals who are vaccinated compared to those who are not. Aside from these studies, it would be useful to think of this problem conceptually. Before vaccinations, diseases such as smallpox and polio were prevalent and contributed to death or a severely impaired lifestyle. After widespread use of vaccinations against these diseases, these two disappeared from the developed world. Although this information was not gathered for the purposes of determining vaccination efficacy, retrospective studies have demonstrated these vaccines were clearly effective due to a downward trend in mortality over the years that the vaccine became more popular and affordable. While there is not long-term data for every vaccination, as some are considered new, scientists are relatively certain that short-term benefit could be extrapolated to indicate long-term benefit.

The last major argument against vaccinations is that its ingredients are toxic and that they could cause autism and other behavioral disorders. However, there are no scientific peer-reviewed studies that demonstrate this.It is possible that vaccines in third world countries may be toxic due to their inability to properly formulate effective shots or due to a limitation of funds. However, this is certainly not the case of vaccinations that are distributed in first world nations. In the United States, the U.S. Food and Drug Administration oversees the formulation and distribution of vaccinations and would not approve the use of any drug that showed too high of a toxicity during its examination in clinical trials. In fact, drugs must go through three phases of clinical trials before they can be placed on the market, and many of them fail to make it. After drugs are placed on the market, they are continuously monitored for safety; if problems are detected, the drugs will be removed from use. Therefore, toxicity isn’t an issue because there are many programs in place to monitor this.

Ultimately, parents who decide to not vaccinate their children are hurting both their children and other members of the population who may have not been vaccinated for various reasons. If a child remains unvaccinated, it is more likely that he or she will contract a life threatening illness or die from an illness that would not be considered deadly to other members of the population. Furthermore, not vaccinating a child interferes with herd immunity; if there is a small group of children in a pre-school class who are not vaccinated and the rest are, and one child gets sick or carries the virus, it is more likely that the other non-vaccinated children within this group will become sick as well. Lastly, children who are not vaccinated become a host through which bacteria and viruses can evolve. This increases the likelihood that an individual who is immunized will contract the disease because they have not been immunized against the evolved form.

Since failing to immunize children could have a detrimental effect on an entire population, it is the role of the government and physicians to alleviate this communication issue. Unfortunately, the “anti-vaccination” movement has gained many supporters as a consequence of opinions posted on social media and televised stories on the news. This is clearly a public health crises, and effort must be made to counter the inaccurate information that “anti-vaccination” supporters attempt to disseminate. As a consequence, the government should initiate public health programs to promote the vaccination of young children to alleviate these rumors or to enact legislation that would require children who attend school to receive them. In addition, physicians should regularly remind their patients of the necessity of receiving vaccinations while providing scientific evidence that demonstrates their usefulness and the downside of not receiving any vaccinations.

In order to initiate an effective public health campaign, the government must first conduct statistical studies to determine the demographics of their population that have not been vaccinated. It may be necessary to conduct this research at both state and federal levels. This would help identify whether there is a socioeconomic, racial, gender, education, geographic, and age ambiguity between those who choose to vaccinate their children and those who do not. This information could be used to specifically target the populations who are most at risk. In addition, this would determine whether children are not receiving vaccinations because they are not affordable; in this instance, it would be preferable to communicate ways that vaccinations could be achieved through help of the government rather than explain its benefits. If economic ambiguity is not the only risk factor for lack of vaccination, it is essential for the government to utilize public service announcements that explain the benefits of vaccinations and the harms of not receiving them. These advertisements could range from television ads to postings on public transportation to brochures in clinics. This effort should be accompanied by mobile public health workers who create and supervise programs that will aim to spread this valuable information.

Literature Review

In “Private Vaccination and Public Health: An Empirical Examination for U.S. Measles”, the author argues that although vaccinations are somewhat expensive, the financial consequences of not vaccinating young children is more costly (Phillipson, 1996). Using data from the National Health Interview Survey on measles vaccinations between 1984 and 1990, he demonstrates that “the more prevention of infectious disease responds to prevalence in this manner, the less it responds to price, thereby lowering the role of Pigouvian price subsidies”. It is therefore reasonable to vaccinate young children against the measles and other diseases at an early age to ensure that the disease does not spread to other members of the population, thus causing unreasonably high healthcare costs for them and their families.

In “Influenza vaccination: policy versus evidence”, the author provides justification for issuing the influenza vaccination (Jefferson, 2006). The influenza vaccination is one of the most largely debated vaccinations and is one of the shots that parents believe causes unrelated health problems in their children. Furthermore, some parents refuse to support this vaccination because they believe that a vaccination that must be repeatedly administered is not effective. This article discredits this belief by explaining that a new influenza vaccine must be created every year because the disease is constantly evolving; a strain that plagued the majority of individuals the previous season is therefore no longer relevant. The article explains the cost of developing the influenza vaccine in addition to its yearly distribution to the population. Since the flu is a constantly evolving disease, one flu shot is not enough to protect an individual for a lifetime, and it is recommended that high risk patients, especially children, receive one yearly. Since a large amount of money was invested in the initial vaccine development, it is not expensive to continue the research that is required to develop vaccines against the evolved strain. Therefore, vaccinating children against influenza is both financial feasible and beneficial to their health.

“Smallpox and its Eradication” provides an example in which vaccination has virtually eliminated disease. Smallpox was once a major cause of death in Europe, but early development of this vaccination was inexpensive and easy to make and removed the threat of this disease from first world nations. Interestingly, smallpox had been a massive threat to the human existence throughout history. Well-kept records demonstrate that it existed in ancient Egypt and China. In 1786, however, the disease was eradicated forever by Edward Jenner. This physician observed that maids who worked with cowpox infected cows never displayed smallpox symptoms. Since the two diseases were similar, Jenner inoculated his patients with cowpox by creating cuts in their skin and inserting liquid from cowpox papules. Many survived the inoculation process and lived knowing that they would not contract the deadly smallpox. This process was repeated for many years until the modern vaccination was developed which would use a dead or weakened form of the virus rather than the live one to ensure safety.

“Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century” discusses the relationship between health education and health literacy and how it’s being used as a communication strategy to promote public health (Nutbeam, 2006). This article demonstrates that it is important to provide information to the public so they are able to fully understand their health. This is relevant to immunizations because it could encourage previously uneducated individuals to participate in methods to improve their health.

“Risk Communication for Public Health Emergencies” discusses community preparedness for health risks (Glik, 2007). The topics covered include environmental risk communication, disaster management, health promotion and communication, and media and communication studies. The topics that are relevant to this study include disaster management, health promotion and communication, and media and communication studies. It is essential to determine when an epidemic could occur, where, and how to communicate prevention to those at risk for infection. Media and communication is an essential part in ensuring population health and keeping the number of those affected as low as possible.

“Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits” calls to attention the fact that although patient and caregiver communication with the physician is essential, the type of communication that is used could differ based on the race and ethnicity of the patient (Johnson et al., 2004). When the physician interacts with different people, it is essential for him or her to have a basic understanding of the beliefs and demographics of a potential group in order to best treat the patients and explain to them the consequences or necessity of treatments in a way they could understand. It is essential to consider that interacting with people of different races and ethnicities can extend to their language. If patients are unable to speak English, a physician should be prepared to have a translator onsite or subscribe to a telephone translation service.

Discussion

The article “Private Vaccination and Public Health: An Empirical Examination for U.S. Measles” demonstrates that vaccinating the public against widespread threats is more cost effective than avoiding the vaccination altogether. It is essential to consider that many aspects play a role in determining the cost of healthcare or the lack thereof. In the United States, it is clear when these costs will occur both to individuals and to society as a whole. On a small scale, vaccinations will cost families out of pocket copayments and will require the physician or pharmacy to be reimbursed by health insurance organizations. On a large scale, the public will have to pay a greater amount of money for individuals who contract the illness who do not have health insurance in tax dollars. If a vaccination is created to protect the population against a virulent disease, it is therefore necessary to encourage a large portion of the public that receiving the vaccination is more beneficial than not.

It is therefore important to invest in communication for immunization. Conveying the message that immunizations are necessary occur on a number of levels and it is necessary to ensure that this message is carried out properly. According to the World Health Organization, “the quality of the interaction between health workers and caregivers is decisive to ensure completion of the vaccination schedule”. As a consequence, the first level that communication should be fostered within includes the interaction that occurs between doctors and their patients. While it is standard for many doctors to recommend vaccinations to their patients and their families, it has been found that many caregivers do not fully understand the necessity of these vaccinations. Rather than solely creating a schedule for each patient that describes when they should or should not receive a vaccination, doctors need to explain the severity of each disease, the scientific validity behind booster shots, and the importance of sticking to the schedule for each shot. Furthermore, the physician should explain the advantages of vaccination on the community level, which will prevent other children from getting sick and the disease from evolving to a potentially more virulent strain that would be able to infect even those who had received the shot. In addition, the physician should convince her patient’s caregivers to convince those that interact with their child to be immunized as well for the same purpose.

A second level of communication that is the physician’s responsibility is to determine whether the patient had seen other physicians and whether they were offered immunizations. For example, a gynecologist may offer a Gardasil vaccination to a young child who has not yet been sexually active to protect against HPV. It would be beneficial for the primary care physician to know whether or not this has occurred, so the shot could be recommended if it had not yet been given or avoided if it has. Therefore, the physician should be certain to interview the patient’s caregiver at the time of each appointment to determine whether the patient had seen other physicians and what the outcome of the visit was. The physician should then contact the other doctor’s office to retrieve copies of documentation that pertains to the patient’s health so as to have a complete understanding of the care that is being given outside the primary care office. This communication should extend to inquiries about walk-in clinics and pharmacies where the client could have potentially been vaccinated against influenza.

“Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits” discusses the importance of how the physician communicates with specific patients. Occasionally, the race and ethnicity of a patient indicates that he or she has a predisposed concept of what their medical care should be, which includes refusal of use of conventional medicines. A physician should be aware of this and determine which of his or her patients falls into this category during the treatment process. In this situation, it is essential for the physician to make the patient and caregiver understand the basis for vaccinations and how they are helpful. However, it is also essential that the physician does so in a way that is respectful and patient, as the patient and caregiver may not accept the treatment immediately. Furthermore, it is essential for the physician to ensure that the parents of the patient, when the patient is under the age of 18, are truly in agreement as to whether the vaccination should or should not be given.

A relevant example of this is in several Middle Eastern cultures in which the father is responsible for making decisions for the family. While this leadership role should be respected, it is essential for the physician to determine the wishes of the mother, if present, and the child. It is essential for the physician to be somewhat persistent in explaining vaccination benefits because this single decision could potentially have impact on other members of the community.

“Smallpox and its Eradication” explains how vaccinations were originally created and how they were modernized to ensure safety. While the processes used to create the vaccinations in the 1700’s were crude and potentially fatal due to the unavailability of technology, modern vaccinations are safe and safety has been confirmed in clinical trials and long-term observation of patients who had received them. It is also important to consider that even though the original vaccinations were somewhat dangerous, they were accepted as necessary because they greatly decreased the chance that one would contract a fatal disease. Since modern vaccinations are safe and there is no evidence that they cause any illness, it is essential for physicians, researchers, and the media to work together to demonstrate the safety of vaccinations.

While a majority of research studies that confirm the safety of vaccinations are published in peer-reviewed medical and research journals, the target readers for these are typically other physicians and researchers. This is useful because it informs those that work on the front line against these diseases about what is safe and what should be recommended to patients, but it emphasizes a clear gap between the knowledge of professionals in the field and a typical individual. Therefore, it is necessary with professionals to work with the government and the media to determine ways they can spread important messages about health and discoveries in science in a manner that the layperson could understand.

An important way that this could occur is by using science writers to create stories for local and national news stations. While many new channels have sections for health and technology, many don’t, and this needs to be encouraged. The media is the primary way in which many individuals receive messages that impact their lives and health technology should be considered equally as important as world news. Therefore, we should lobby local, state, and national governments to convince them of the necessity of understanding healthcare. This influence could be used to either require or encourage health segments in different forms of the media, including internet, television, and the newspaper. People should be made aware of when they are faced with health threats and what they could personally do to stop them.

An additional way that the government could assist with the public health effort is utilizing the efforts of the U.S. Public Health Service and state and local public health agencies to spread the message that vaccinations are important. This issue should be considered pressing to these agencies because vaccinations or the lack thereof ultimately has a direct impact on the health of the population. Therefore, it is essential for these agencies to issue public service announcements that provide information about the necessity of vaccinations, where they are given, and how they can get them inexpensively if finances are an issue.

References

Fenner et al. (1988). Smallpox and its eradication. Retrieved from https://extranet.who.int/iris/restricted/handle/10665/39485

Glik DC. (2007). Risk Communication for Public Health Emergencies. Annual Review of Public Health, 28: 33-54

Jefferson, T. (2006). Influenza vaccination: policy versus evidence. British Medical Journal, 333(7574): 912-915.

Johnson et al. (2004). Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits. 94(12): 2084-2090.

Nutbeam D. (2006). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promot. Int., 15 (3): 259-267.

Phillipson T. (1996). Private Vaccination and Public Health: An Empirical Examination for U.S. Measles. The Journal of Human Resources, 31(3): 611-630.