Patients with an irrational fear of vaccinations
Vaccines inspire fear—almost as much fear as the diseases they’re meant to prevent. Dr. Brady and Nurse Rebekah discuss the cases they’ve seen.
Dr. Brady: If it weren’t for vaccines, I think I would have already died of measles, tetanus or rabies; suffered permanent damage from H. flu, rubella or polio; or been incredibly sick from typhoid, yellow fever or mumps. Infections are a major cause of death worldwide. According to the World Health Organization, they account for six of the top ten causes of death in low-income countries. In high-income countries, where vaccination tends to be widespread, infection accounts for only one of the top ten causes of death.
It’s not that I’m looking forward to any of the alternatives—heart disease, stroke and cancer topping the list—but I’m happy to avoid any and all ailments that I can. Measles—there’s a vac for that. Polio—there’s a vac for that. Swine flu? There’s a vac for that, too. I wish there were a vaccine for everything, but for now, I’ll take what they’re giving. I know that a vaccination, like everything else in medicine, and everything else in life, has a risk. There are no certainties. But there are calculable odds, and that’s a good enough strategy for me.
Nurse Rebekah: Poor Dr. Salk. All that work to invent the polio vaccine and people are walking around just snubbing their noses at vaccines in general. I don’t know about you, but I don’t think my iPhone would get great reception in an iron lung. Vaccinate away, please! Kids today don’t even have to suffer through the chicken pox. I kind of think that’s a little unfair, though…itchy pox never hurt anyone (ha ha); they built character and gave Calamine lotion a guaranteed demographic.
Imagine, though, if there were a vaccine for the common cold…think of all those companies that would be out of business! Wait a second, talk about a conspiracy! What if the cure for the common cold is out there, but scientists are holding out on us for financial reasons? Nah, what am I talking about? They would still make money from all the people who refuse to get vaccinated.
How do you handle a patient who refuses vaccination?
Brady Pregerson, MD, a returned Peace Corps volunteer and winner of the 1995 Wise Preventive Medicine Scholarship, completed his medical school at the University of California, San Diego, and his residency at Los Angeles County General Hospital. He has authored three medical pocket books for nurses and doctors, as well as the educational web sites erpocketbooks.com and gotsafety.org.Dr. Pregerson currently works as an emergency physician in Southern California. He writes, "Although the ED environment may be quite different from working on the hospital floor or in an office setting, I am hopeful that you can take these tips and apply them to your own specific work situation." You can buy his books on lessons from the ER, including Don't Try This At Home: Lessons from the Emergency Department and Think Twice: More Lessons from the ER, at amazon.com.
By Brady Pregerson, MD