nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Monday, November 29, 2010

Flu Vaccine Acceptance

There's a free article in the New England Journal of Medicine on longstanding reluctance to accept the flu vaccine.  (For a news article see WaPo Health, Nov 26)

I've been getting the vaccine annually for over thirty years.  No problems, and no illness.  As a doctor, who gets exposed every day, I'm thankful.

As far as other vaccines go, I've seen cases of lockjaw, measles encephalitis, mumps in adults that caused sterility.  Fortunately, I began practice too late to see cases of polio, but as a child--before the vaccine--there were about 100,000 cases of polio a year in this country.

The case for vaccines seems clear.  The case for flu vaccine is slightly different; not everybody who gets the shot becomes immune, but most do and this confers a herd immunity that inhibits the transfer of the disease.  Which means many fewer people get it, and those who are vulnerable are less likely to die of it.

Again, a pretty straightforward case.

But acceptance of the vaccine among the general population remains unchanged.  Most shocking, only about half of health care workers received the H1N1, knowing full well that they were in a position to pass on the disease to the most vulnerable patients through daily contact in clinics and hospitals.

Casual contact is enough to transmit the disease.  Physical contact with the virus is the best way, but aerosol transmission works fairly well, too.  The contagious person just needs to go to the grocery store to expose a handful of people.

While vaccine deniers have some influence, it's small, according to the authors.  By contrast they find that the most reliable predictor of continued vaccination for flu  "depends on past experience with being vaccinated against seasonal influenza."  My guess is, they mean that "no experience," or experience of an adverse reaction (like sore arm, or fever) leads to non-acceptance.

That's all well and good, and efforts to educate the public should continue.

But, I'm still surprised that a large percentage of the public will allow themselves to be a walking, lethal danger to those infants and elderly in the country that might not survive the infection.

Doc D

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