Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, August 27, 2015

Immunization As A Social-Medical Priority

"[Fewer than five to ten percent of parents have strong, anti-vaccination views, yet] many more parents have doubts and concerns."
"[A declaration of immunization] coupled with a requirement to meet with public health if it's not up to date, provides the opportunity to understand why the parent hasn't fully vaccinated the child."
"[Such a meeting between parent and public health representatives would present an opportunity] to fully inform those [parents] who may be hesitant." 
"Physicians have a critical role to play in vaccination. It’s an important issue to me because it’s difficult … to understand why a demographic is ignoring medical advice."
Dr. Chris Simpson, past president, Canadian Medical Association

"We're looking to have a very reasoned, rational conversation with our patients, and not have a situation where someone is telling them what to do."
Dr. Cindy Forbes, president, Canadian Medical Association

"While immunization is an area that impacts the practice of a majority of CMA members, both family practitioners and specialists, the medical community has not been very vocal in the current conversations."
"This is a vacuum that CMA could fill by playing a major role in bringing together the expertise to support its members, work(ing) to improve immunization rates and ultimately improve population health."
Canadian Medical Association background paper on immunization uptake

In Canada, the provinces consistently fall below national targets for vaccine coverage for six preventable diseases: invasive meningococcal disease, invasive pneumococcal disease, varicella, pertussis, influenza and rubella. The goal is to ensure that sufficient numbers of children entering school and throughout their school years receive regular vaccinations to ensure herd immunity. Parents, on registering their children for school attendance, are required to fill out a record of their child's immunization history.

Ontario and New Brunswick are the two provinces where childhood vaccination is mandatory, and even they are falling behind national vaccine coverage targets. Increasingly, parents are balking at having their children vaccinated. They have fallen prey to false and misleading claims that vaccines harm children, that inoculations have the capacity to cause other illnesses like autism, or convey not immunity but actually infect their children with the very same active disease-causing properties immunization is supposed to evade.

At the Canadian Medical Association's annual general council meeting, while voting members rejected a proposal for a national compensation program to affect those in the public who may suffer from injuries effected through immunization -- rare though the occasions may be -- there was a more general agreement that governments be encouraged to authorize a firm requirement that parents be expected to proffer proof of vaccination before their children will be admitted to school.
Video thumbnail for Why vaccinate: a Montreal doctor's explanation
When the goal of herd immunity is not achieved through vaccine uptake -- a larger percentage of children immunized to ensure that the much smaller minority that are not are unlikely to become infected and start a flood of disease outbreaks, the system breaks down. The current and growing phenomenon driving down immunization rates for avoidable diseases is leading to a collapse of herd immunity. The resolution that passed targets parents whose children have been "inadequately vaccinated", without calling on mandatory immunization.

Over a third of Canadian parents now appear to believe that vaccines actually cause outbreaks of the diseases they are formulated to protect against or prevent. Outbreaks of measles in the United States and parts of Canada sharpened the focus on the issue. Measles infection is concerning since it is a hugely infectious disease capable of causing blindness, brain swelling and severe respiratory disease, including death in severe and rare cases.

In Ontario, exemptions on religious grounds have been accepted up until the present time. But with the growth of a contingent of parents suspicious of medical science coupled with the perceived greed of pharmaceutical companies suspected of creating a market for themselves, parents have been increasingly rejecting vaccinations for their schoolchildren. Implementation of the full schedule of recommended shots for children is of vital importance, however. Not only for the health and welfare of individual children, but for the entire population of schoolchildren.

Video thumbnail for Doctors group calls for parents to prove immunization to schools

"[Should a child suffer a severe side effect resulting in a permanent handicap, rare though it is], we thought they should know they would be compensated for the rest of their lives. Statistically the risks are very low [but while vaccines are overwhelmingly safe], we have to be honest. There are side effects to vaccines."
"I was worried [myself] as a parent, 'Will my kid be the victim — the one in 10 million or six million (who develops) severe encephalitis with this vaccine'?"
"But if everyone decided not to vaccinate their children, we would be back to a situation where we would have tens, and maybe hundreds of deaths yearly in Canada from measles."
Quebec physician Dr. Pierre Harvey, CMA board member
In the end, the motion was rejected, in part due to concerns it might send the wrong message to the public that vaccines are dangerous. Realistically speaking, however, it might have been a far better decision to proceed with the recommendation to aid parents and children, however rare the occasion might be when such assistance can make a huge difference to the quality of life of someone whose condition was brought about as a result of a rarely-occurring side effect.

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