Are vaccinations still a medical miracle?
Want to see a bunch of people get up in arms? Recommend a new vaccination. While vaccines were once accepted as a medical miracle (no more polio!), today’s parents closely examine the risk/benefit ratio of any and all recommended vaccinations.
And who can blame them? With a ton of scary stories linking vaccinations with autism (never mind the fact that numerous scientific studies have debunked the link), more and more Americans are refusing vaccines. In our “Great Vaccination Debate” series, Dr. Brady Pregerson and Nurse Rebekah Child share their thoughts on vaccination—and how to deal with patients who refuse immunization.
Dr. Brady: Have you had your flu shot? This year we have two: the regular seasonal influenza vaccine and the special H1N1 vaccine. I had both. The first one hurt my shoulder for more than a week; it was nothing very bad, just a mild occasional discomfort. That rarely happens to me. I don’t know if it was the ingredients or the needle placement, but I believe it was the latter because it felt painful even before the nurse started pushing the 0.5 milliliters of clear liquid through the needle.
Turns out that I probably didn’t need that one because the majority of the circulating influenza this year looks to be the novel H1N1, aka “swine flu.” A few weeks later, the swine flu vaccine became available and I took that one, too. I’m playing it safe—and it turns out that one didn’t hurt a bit. Not a side effect I could notice.
I’m a big vaccine proponent, but I have to admit I was a little scared of the H1N1 shot. I don’t know why. There was no reason to be. And the odds of a serious side effect are like a million to one. I’ll take those odds any day over a probably 25 to 30 percent chance of getting the swine flu and a 0.8 percent chance of death if you get it. But why did I ever worry? I guess it turns out no one is immune to vaccine scares, not even the choir used to hearing all the sermons of their benefit.
Nurse Rebekah: This is the first year that I’ve taken a flu shot. I personally think flu shots are a conspiracy. Every year the recommendations for who should get the flu shot gets broader and broader. I have a sneaking suspicion that those recommending the flu shot also own stock in the companies that produce those snappy little vials. But I have no proof of that, just my own theories getting the best of me.
Anyway, in eight years of nursing, I’ve never received a flu shot, and I’ve never had the flu. But never say never, right? Since I’m working full-time and attending school full-time, I felt like I really shouldn’t take any chances this year. So I buckled down and took my needle(s) like a champ.
I agree that needle placement is everything—it is a lost art. Honestly, I would rather have a first-semester nursing student give me an IM injection than a seasoned nurse. Most seasoned nurses don’t put it in the right place. My first injection was given subcutaneously and the second injection was given pretty much intra-articularly; the first by a nurse of more than 20 years and the second by a nurse of more than 40 years. Two fingers below the acromion process, people! Two fingers!!!
Yes, even healthcare professionals hesitate before agreeing to a new vaccination. But for the most part, they understand just how important vaccinations are. In part 2 of The Great Vaccination Debate, Dr. Brady and Nurse Rebekah explore some of the most common causes for vaccine refusal.
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