Not only do we, as future providers, need to know how to diagnose and treat patients, but we also have a responsibility to prevent disease whenever we can. Certainly we can provide counseling in our offices for patients to encourage them to stop smoking, lose weight, exercise more, drink more water, eat more vegetables, eat less fat, eat more of the right fat, reduce sodium, drink alcohol, don’t drink alcohol, get screened for cancer, buy a dog, engage in leisure activities to reduce stress…this list is endless. Almost all disease prevention requires effort from the patient. As we have learned, and almost anyone can see if they consider the generally poor health of their neighbors, people prefer pills, not plans to make themselves healthy. The incidence of diabetes, cardiovascular disease, and cancer are on the rise. More shockingly, in 2014 when we have the technology and knowhow to video chat with friends on all corners of the globe from a hand held device, the incidence of infectious disease is on the rise.
In the last year, news of the spread of Ebola has caught the attention of the world. That attention brought support and aid which have been effective at reducing the rate of spread and the distance to which the disease has spread. People came together to work toward a common goal: to reduce the morbidity and mortality of a disease. Unfortunately the Ebola Virus is not the only infectious disease that is getting global attention. Here, in the wonderful United States of America, diseases that were almost non-existent are beginning to reemerge in children and affect the function of schools and communities which not only inhibits learning but can have potentially fatal consequences in persons with weak immune systems. Many parents are blatantly disregarding the importance of vaccinating their children against diseases. A growing number of educated affluent whites are taking a dangerous stance against this preventative option, not on the basis of religious objections, but because some past-their-prime former model made claims that a vaccine was responsible for her child’s unfortunate Autism.
Since that claim “studies” have been published claiming that they have found links between vaccines and any number of morbid medical conditions. What about all of the epidemiological data that exists which shows beyond a doubt that vaccines do not cause harm, and in fact have improved the health of billions of people here in the US let alone globally? Decades of monitoring, studies, studies of studies, meta analyses, and billions of humans can all attest to the fact that vaccines have improved public health and reduced the burden of sick individuals on their families and the healthcare systems. And let me be clear on this fact: none of the so called studies that have tried to connect vaccine use with a negative outcome have followed scientific protocols or procedures, and with that poorly gathered data impossible speculations have been made to try and give the vaccines a bad reputation. Many of the “connections” are strictly coincidental. They are as coincidental as my bicycle crash this morning and the turkey dinner I had two weeks ago. And, for the record, all of the “research” that people were using to support the movement against vaccines have been unanimously discredited.
So where does this leave us as future practitioners? Between a rock and a hard place.
How do we dispel these rumors and encourage our patients to utilize vaccines? We are likely to be accused of being in cahoots with the drug companies, or trying to make our practice more money. How can we prove to our average family that the vaccine works? Their children simply don’t get sick, but do they know they were exposed and that the antibodies the vaccine helped them create were effective at destroying a pathogen before it created a disease state?
This is a delicate conundrum which will test our ability to communicate, our resolve, our respect and reverence, and force us to flirt with that fine line between educating and coercing. I personally believe that this challenges our very foundation of primum non nocere. By failing to encourage vaccination we may be putting others in harm’s way. There is no easy answer but we will all be faced with the difficult task of educating people about the true benefits and risks of vaccination. Working with our patients to encourage participation in vaccination programs is as important as counseling them on the benefits of healthy lifestyle choices as adults. Perhaps vaccination is itself a lifestyle choice.
And you thought getting into PA school was the hard part…
Sam Elzay PAS-1, Campbell PA Class of 2016