Making rash decisions- should your family receive vaccinations?

The current measles outbreak in the United States highlights the ongoing controversy over to immunize or not to immunize. As a physician I do recommend immunization when indicated; as a person, I received vaccinations for many diseases for which I am at risk, and permitted my children to be vaccinated.

Remember that vaccination or immunization (which are in general terms synonymous) is a medical procedure and vaccines are drugs; and so their use should be subject to the same scrutiny as any other drug or procedure. Until recent years, immunization has been almost universal in the United States, so we  forget that its use should be individualized. that is,

What contagious diseases is a person likely to be exposed to?

What are the risks versus benefits of any particular vaccine for that person?

What are the risks versus benefits to other people?

Until the recent decades most people were at risk for most infectious diseases, so we recommended vaccination for everyone, unless contraindicated (this means a medical reason not to do it)

The  developed countries  have eliminated or controlled many of the environmental sources of contagious disease;  indoor plumbing, water treatment facilities, screens on  windows, and air purifiers. We screen our blood supply, wear gloves to prepare food, inspect restaurants, and put signs in many public restrooms reminding us to wash our hands.

wash your hands sign
How many times have you seen this sign in public places?

However, we have not eliminated another source of infectious disease- and that is other humans. It is rare that we isolate or quarantine people with infections-although with the recent Ebola scare that happened. Most of us will admit that we have gone to work, school or social events with symptoms suggestive of infection- a cough, runny nose, upset stomach- and by doing so put our friends and colleagues at risk.

If I had high cholesterol, it is my right not to take a cholesterol lowering drug to try and prevent a heart attack. If I have a heart attack, I will not transmit that to another human being. But if I fail to get an influenza vaccination, and contract influenza, and transmit that to a relative, friend, or a patient- is that my right?

I hope we can get past the politicization and polarization of this issue, and develop policies that meet the needs of both individuals and society.

UpToDate, a respected ,well researched medical publication, offers this information on

Childhood vaccines  and Adult vaccines

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