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Monday Apr 18, 2016

Seeing the Diseases Vaccines Prevent Illustrates Importance of Immunizations

Editor's Note: In recognition of National Infant Immunization Week, the AAFP is participating in a blog relay to discuss the critical role vaccines play in protecting children, families and communities against vaccine-preventable diseases. You can follow the conversation on social media using #NIIW.

It was a hot, humid day in Cap-Haitien. I was a premed student serving as both an extra pair of hands and as a medical interpreter during my first medical mission trip to Haiti.

The magic of being in the country of my roots enveloped my senses. A deep sense of pride swelled within me as I heard the ocean in the distance, smelled the spices that I had grown up eating and marveled at the intense beauty of the terrain. However, that pride was repeatedly flattened by grief from the immense poverty that surrounded me. Even though it has been more than 10 years since that trip, the images of so many people in need of the type of care I had taken for granted continue to drive me today.

I remember seeing a teenager stiff from tetanus and unable to swallow. His mother held him and pleaded for help.  

I held an infant, feverish with pneumonia, who improved after my group paid for penicillin, IV fluids and oxygen.  

We forget that American children used to routinely die from diseases that now can be prevented by vaccines. However, this is not the reality in many countries.  

Today marks the beginning of National Infant Immunization Week(www.cdc.gov) which highlights the importance of protecting infants from vaccine-preventable diseases and celebrates the achievements of immunization programs across the country.  

As a family doctor, one of the most important roles I play in my patients' lives is preventing disease and improving health. Every day I discuss the role of vaccines in health maintenance with my patients as a means to protect them and at-risk populations.  

Thankfully, we are in an era where terrible diseases like polio, Haemophilus influenzae type B and measles are no longer commonplace in our country. However, in California (where I live), there are many parents who still choose not to vaccinate their children despite overwhelming evidence that demonstrates the safety and effectiveness of immunizations. As a result, we have witnessed the devastating effects of disease outbreaks.  

Family physicians and other primary care stakeholders in my state have had to work hard mitigating a measles outbreak(www.cdc.gov) and the dangerous rise of pertussis, or whooping cough(www.cdph.ca.gov), in recent years.

The importance of vaccination resonates with me, personally, as a mother of three. When I returned to work after the birth of my youngest child, I had to consider exposing my child to potential antigens brought home from work. I was concerned that the decisions of others could affect the health of my own newborn.

I changed my practice and became more proactive in educating parents about vaccinations. Some parents entrusted their children to my counsel. For others, I decided that I may not be the right physician for them. Although I was torn between caring for patients and doing no harm, I knew I could not withhold vaccinations from a child who lacks the ability to make an informed decision. I also knew that not vaccinating families put others in our community at risk. With that said, I have gladly welcomed families who may have questions about immunizations or decide to use a catch-up schedule.

In California, we have adopted a law that emphasizes an individual's obligation to protect others. Specifically, it eliminates religious and personal belief exemptions for vaccines. This is an important step because the benefits of immunizations are not confined to the individual. Vaccination -- or lack of it -- can affect others unknowingly. Consider the newborn, too young to get vaccinated, or the immunocompromised person undergoing chemotherapy. 

In a world that is so interconnected(jpids.oxfordjournals.org), we must be diligent to protect those at most risk, our children. Giving children the recommended immunizations by age 2 is the best way to protect them from more than a dozen serious -- but preventable -- diseases.

The CDC is right to trumpet the role immunizations have played in reducing the burden of illness in our society(www.cdc.gov). Primary care physicians can add our voice by posting information in our waiting rooms and exam rooms(www.cdc.gov). The CDC also has resources to help physicians(www.cdc.gov) get the word out by working with local media, using social media and more. We all can do our part.

It is easy to forget our past and to ignore the fact that the threat of preventable disease is palpable in other countries. For me, I remember those days on the mission field and the children whose fates were sealed without the option of prevention that too many among the privileged are rejecting.

Marie-Elizabeth Ramas, M.D.,  is the new physician member of the AAFP Board of Directors.

Posted at 10:21AM Apr 18, 2016 by Marie-Elizabeth Ramas, M.D.

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