Research has clearly documented(www.ncbi.nlm.nih.gov) the rise in vaccine hesitancy in recent years, and many patients continue to be reluctant to allow their children to be vaccinated or to accept vaccines themselves. That's part of the reason the AAFP launched its Vaccine Science Fellowship program in 2009.
Current AAFP Vaccine Science Fellows David Cope, M.D., middle, and John Merrill-Steskal, M.D., right, pose with AAFP liaison to the CDC's Advisory Committee on Immunization Practices Margot Savoy, M.D., M.P.H., at the CDC's Edward R. Roybal Campus in Atlanta.
The current class of AAFP Vaccine Science Fellows -- David Cope, M.D., of Bountiful, Utah, and John Merrill-Steskal, M.D., of Ellensburg, Wash. -- recently visited AAFP headquarters in Leawood, Kan., and told AAFP News they see this hesitancy growing in their communities.
According to Merrill-Steskal, Washington has a large vaccine-hesitant and anti-vaccine population, especially in the Western part of the state.
"The way to improve vaccination rates involves continued clear, positive messages about vaccines and outreach by physicians to community members," he said.
Because his patients spend a significant amount of time on social media, Merrill-Steskal said he uses these communication channels to promote his Triple Espresso M.D.(espresso3md.wordpress.com) blog, which often focuses on research supporting vaccine use and safety.
"I share my blog posts on Facebook, where they are spread throughout our community," he said. "Our hospital organization also has a large Facebook following, and they have been instrumental by sharing my posts, as well."
- Current AAFP Vaccine Science Fellows David Cope, M.D., and John Merrill-Steskal, M.D., recently spoke with AAFP News about their experiences during the fellowship.
- Both fellows traveled quite a bit in the past year, each attending about 10 vaccine-related meetings, including multiple meetings of the CDC's Advisory Committee on Immunization Practices.
- Applications for the 2017-2018 AAFP Vaccine Science Fellowship positions currently are being accepted, with a submission deadline of April 3.
Merrill-Steskal also teaches the medical students he precepts at the University of Washington Medical School in Seattle how to overcome concerns of vaccine-hesitant patients.
"Talking to vaccine-hesitant patients is not always an intuitive discussion," he said. "Sometimes it's more straightforward and simple than it seems. It's helpful for patients to hear a clear, positive message that a particular vaccine is safe and effective, will prevent disease, and prevent them from dying or ending up in the hospital. Meanwhile, I try to personalize the message to that patient and emphasize that there is not a downside to receiving it."
Additionally, Merrill-Steskal hosts a monthly radio program called Dr. John's Radio Show,(eburgradio.org) which he also uses as a platform to promote vaccines.
Next month, he noted, he'll have two medical students on the show to discuss common concerns about vaccines, "as well as the evidence that supports vaccine safety and the infrastructure in place that ensures vaccine safety," he said.
Cope agreed with Merrill-Steskal that virtually no controversy exists in the medical community about the safety and efficacy of vaccines, but there still is a significant amount of apathy and/or complacency about the topic among physicians, especially those who are younger.
"I think this comes from an older generation where vaccines are well-established and routinely given, so we just assume that's being done," he said. "But then at some point in our career, we come across a vaccine-preventable disease and realize that not all patients are getting vaccinated.
"When you think of all the missed opportunities, it's truly a tragedy that we allow this to happen."
Instead, Cope said family physicians need to hold their feet to the fire, motivate each other to advocate for vaccines daily with patients and within the community, and set in motion processes in their clinics to ensure vaccines are being administered.
2016-2017 Vaccine Science Fellows Share Their Experience
Both fellows traveled quite a bit in the past year, with each attending about 10 vaccine-related meetings. Both attended multiple meetings of the CDC's Advisory Committee on Immunization Practices (ACIP).
"I was really taken aback at an ACIP meeting when it was presented that from 2000 to 2015, 20.3 million cases of measles were prevented by the measles, mumps and rubella vaccine," Cope said. "It's been fascinating. The fellowship is set up to expose you to these venues and opportunities to see how these systems work. To see all of the work that goes into making the decisions and recommendations has permanently changed my perspective."
Regarding, for example, the ACIP discussion on whether to recommend live attenuated influenza vaccine (LAIV; FluMist) for the 2016-17 flu season: "The process was very thoughtful and deliberative and backed by science," he said.
Merrill-Steskal also said he was impressed by how open the ACIP vaccine evaluation process was. "From the early clinical trial phases through FDA licensing and then ACIP recommendations, it's a very thorough and transparent process," he said. "This was very refreshing to see."
The fellows also attended a meeting of HHS' National Vaccine Advisory Committee (NVAC), where they were asked to present on the financial barriers of immunization in populations. Merrill-Steskal said this conference was interesting because it offered a different perspective.
"The NVAC committee looks more at the big picture and vaccine programs and supply," he explained. "What I took away from the meeting was how so many people are working very hard in our country to ensure that vaccines are available to people who need them and that these people are passionate about vaccines."
In addition, the fellows attended the Society of Teachers of Family Medicine's Conference on Practice Improvement, which addressed clinical improvements to increase vaccination rates, Cope said.
Cope said future vaccine science fellows should likewise be prepared for a busy calendar. As for takeaways from his time as a fellow, Merrill-Steskal said so far, this has been the best year of his career as a family physician.
"A very special benefit to participating in the fellowship is that there is no substitute for going to these meetings, meeting people and developing connections; this facilitates opportunities to continue to work on vaccine-related topics and promote vaccines," he said.
2017-2018 AAFP Vaccine Science Fellowship Applicants Sought
Applications for the 2017-2018 AAFP Vaccine Science Fellowship positions currently are being accepted, with a submission deadline of April 3. The two fellows selected will work with mentors to become more knowledgeable about vaccine science and policy.
Applications should be emailed to Pamela Carter-Smith, M.P.A., along with a curriculum vitae, letter of interest, completed conflict of interest form and letter from the physician's institution or department agreeing that 10 percent of the applicant's time can be devoted to the fellowship.
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