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Sunday, March 16, 2003Q: Do you have any advice for physicians who are hesitant about receiving the vaccine or giving it? A: We have made an effort to educate the population about what the vaccination is like and the possible complications. Because vaccinations stopped in 1972, we probably don't have many physicians under the age of 60 who have ever vaccinated or have ever seen a vaccination reaction. However, in the course of providing this education, I think people have tended to overreact to just how dangerous the vaccine is and may have overemphasized those dangers. For example, it's not true to say that anybody with HIV is going to have a serious problem. It means that some proportion of those who are immunosuppressed may have more serious reactions than others. We also talk about pregnancy as being a contraindication for the vaccine. But that is based primarily on the fact that it has been recommended that no pregnant woman receive a live virus vaccine of any sort. But if you look at the studies, it's pretty hard to make out a case for women in pregnancy experiencing all but the most minuscule possible risk to themselves or their infants. I think it needs to be kept in mind that this is a relative risk, it's not an absolute certainty that if you have any of these conditions you are going to have serious reactions. Q: What is your view on vaccinating the general public before a smallpox outbreak is detected? A: There are those who feel keenly that they should have the right to judge for themselves whether or not they are willing to take the risk [posed by the vaccine]. And it's complicated in another way. Do we have a precedent for licensing a commercial product and then not permitting access by the public? Nobody could think of any precedent for this at all. The president has said he would not recommend [vaccination for the general public], and I would not recommend it. But if there are those who want [the vaccine], it will have to be explained to them that they do pose a risk to other people. But the risk is small. Four of us got together and produced a paper published in JAMA [Oct. 16, 2002] on contact vaccinia. What impressed us was that those who are transmitting the vaccinia were, by and large, very young kids in close contact with other very young kids or with their home caregivers. I think there were only a couple of instances where adults transmitted the disease to someone else. In both cases, they were in extremely close contact, like a wrestler who was wrestling with somebody else. But the thing that impressed us was how seldom it occurred. Remember that the next time you read about hospital officials refusing to vaccinate their staffs, or, as in the case of San Francisco General Hospital, barring them from vaccination. And remember that the next time you read statements in the media that make the vaccine sound as dangerous as the disease. posted by Sydney on 3/16/2003 12:33:00 PM 0 comments 0 Comments: |
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