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My War with the Anti-Vaxxers

My War with the Anti-Vaxxers

In the 19th and first half of the 20th century, infectious diseases killed many. In fact, in the 1918 influenza pandemic, 2 million people around the world succumbed to this virus. The discovery of Penicillin yielded a great weapon in our fight against the early demise of peoples from these infections. However, they failed to address the problem of deadly viruses. The next great weapon in our infectious disease arsenal appeared with the discovery and development of vaccines. By 1977, smallpox was eradicated around the world. In a like vein, polio was wiped out of the Western Hemisphere by the year 2000. Measles and Pertussis were considered nearly eradicated in the Western Hemisphere as well up until the last few years.  Science and history clearly give rise to evidence that the eradication of these diseases was the direct result of these vaccination campaigns. Why are we seeing a resurgence of nearly eradicated infections? A big reason is that parents are taking advantage of vaccine exemptions and choosing not to vaccinate their children. Not only do they put their own children at risk, but others, especially immune-compromised children. In fact, many doctors no longer accept unvaccinated children as patients for this very reason. We do not want our more susceptible patients to fall victim to these diseases while sitting in our waiting rooms. According to a survey of doctors on SERMO, the largest social network exclusive to physicians, 79% of doctors feel that unvaccinated kids should not be allowed to attend public schools. “…79% of doctors feel that unvaccinated kids should not be allowed to attend public schools.”   Many...
Keeping Up With Vaccinations for People With Diabetes

Keeping Up With Vaccinations for People With Diabetes

Research has shown that patients with diabetes are more prone to getting various types of infections, which in turn can increase their risk for hospitalizations. According to Cecilia C. Low Wang, MD, FACP, it can be challenging for clinicians to ensure that their patients with diabetes are up to date with vaccinations against common infections. “Oftentimes, clinicians are busy focusing on the management of diabetes and disease-related complications,” she says. “Prevention efforts like immunizations can sometimes take a backseat to other diabetes care issues.” Influenza & Pneumonia The American Diabetes Association, the CDC, and other groups have developed recommendations to guide clinicians on the vaccinations that should be administered to patients with diabetes. Influenza and pneumococcal vaccines are recommended for all individuals with diabetes (Table 1). The flu is among the most common infections in diabetics and has been linked to high morbidity and mortality as well as an increase in hospitalizations. Published data have shown that the influenza vaccine helps reduce diabetes-related hospital admissions by nearly 80% during flu epidemics. Studies have also shown that people with diabetes appear to be at higher risk for pneumococcal infection and nosocomial bacteremia, which has a mortality rate that has been reportedly as high as 50%. “The flu and pneumonia are preventable infectious diseases,” says Dr. Low Wang. “Safe and effective vaccines are available and can greatly reduce the risk of serious complications from these infections.” The American Diabetes Association notes in its annual Standards of Medical Care in Diabetes that there is sufficient evidence to support that people with diabetes have appropriate serological and clinical responses to the influenza and...
Updating Adult Vaccination Recommendations

Updating Adult Vaccination Recommendations

Research has shown that current vaccination rates for adults are low. “There are 14 different infectious agents for which vaccines are recommended for adults, but vaccination rates are low for a number of reasons,” says Carolyn B. Bridges, MD. “There is limited public awareness about the need for vaccines for adults besides influenza. Also, patients rely on recommendations about vaccines from their providers, but many providers don’t routinely assess vaccination status and follow with recommendations for the vaccines their patients need.” Each year, the Advisory Committee on Immuni­zation Practices (ACIP) reviews and updates its recommended immunization schedule for adults aged 19 and older. Each February, the schedule is updated on the CDC website (www.cdc.gov/vaccines). The schedule provides a brief summary of ACIP recommendations using figures and footnotes to describe which patients are recommended to receive each vaccine and a table that describes the primary contraindications and precautions for each vaccine. Strategies for Improvement A number of strategies can help incorporate adult vaccinations into clinical practice, including systems changes so that vaccines are routinely assessed and offered. Other strategies include using reminders for healthcare providers (HCPs), such as prompts in electronic health records, using protocols or standing orders for office staff, and sending reminders to patients about needed vaccines. According to Dr. Bridges, one of the most important elements in improving vaccination rates is making sure patients hear from their provider about which vaccines they need. The CDC has partnered with many organizations to update the Standards for Adult Immunization Practice. The standards are a call to action for providers to: – Assess vaccination needs among patients in every clinical...
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