“In my experience, women are willing to get the flu shot to protect their unborn babies. I don’t know why, but they’re not as willing to get the vaccine to protect their own health.”
as concerns about the safety of vaccine ingredients such as aluminum adjuvants and about the number of vaccinations on the recommended childhood vacci- nation schedule. Dr. Terk has a strategy for refuting unfounded resistance from parents. “The first thing I do is ask for specific
reasons a parent has concerns and what resources the parent used to create the concern or reinforce it. Requiring specif- ics is important because it allows me to understand what information I might need to call upon to answer the concern. It also requires the parent to cognitively clarify what may be a nebulous fear,” he said.
Once he understands the underlying
concern, Dr. Terk says it’s easier to be a reliable resource for the parent. Plus, if the parent has consulted an unreliable, non-evidence-based source, he can point out that the foundation underlying vac- cine recommendations is “usually much stronger than what the parent was using to research the concerns.”
cine, pages 27–32, or online at http://bit .ly/1gbJynu.)
Physicians say there’s no doubt Dr.
Wakefield’s report and the subsequent media firestorm influenced patients’ comfort level with vaccinations. An accompanying editorial in BMJ also charged that unbalanced media reporting, along with an ineffective response from government and medi- cal professionals, contributed to harm- ing the public’s health as fewer people around the world received the recom- mended vaccines. Litjen (L.J.) Tan, PhD, Immuniza- tion Action Coalition (IAC) chief strat- egy officer, says that in the aftermath of the initial report, physicians and other health practitioners were ill-prepared to
inform the public of the safety of vac- cines. The Minnesota-based IAC (www
.immunize.org) receives funding from the Centers for Disease Control and Pre- vention (CDC). It promotes immuniza- tions by distributing educational materi- als for health professionals and the pub- lic on the delivery of safe and effective immunization services. “Health professionals and public health advocates did not do a good job informing the public about vaccine safe- ty and chose to rely solely on the pro- vider conversation. We chose to believe that in the absence of a broader action, sane minds would prevail,” Dr. Tan said. Physicians on the front lines of dis-
ease prevention say inaccurate informa- tion about the safety and efficacy of vac- cines complicates their efforts to immu- nize adults and children against deadly diseases. Jason Terk, MD, a Keller pediatrician and member of the Texas Medical Asso- ciation Be Wise — ImmunizeSM
Advisory Carol J. Baker, MD Erica Swegler, MD 32 TEXAS MEDICINE January 2014
Panel, says he commonly encounters vaccine-hesitant parents in his practice. Reasons for their caution include the alleged connection between vaccines and autism spectrum disorder, as well
Countering vaccine resistance Vaccine-preventable disease outbreaks are making headlines. For instance, as of October, 2,652 pertussis cases had been reported to the Texas Department of State Health Services. That number surpasses the 2,218 cases of the disease reported in 2012. Physicians like Deborah Fuller, MD, a Dallas obstetrician-gynecologist and past chair of the TMA Council on Health Pro- motion, hope new tetanus, diphtheria, and pertussis (Tdap) vaccine recommen- dations from the CDC’s Advisory Com- mittee on Immunization Practices (ACIP) will help thwart the spread of pertussis and save lives. ACIP now recommends all pregnant women be vaccinated with Tdap dur- ing each pregnancy. Since implementing the recommendation in her practice, Dr. Fuller says all of her obstetric patients receive the vaccine in their third trimes- ter. She reports that so far none have re- fused the Tdap vaccine.
“I inform patients of the benefits of Tdap vaccination, and I hand out copies of articles from local newspapers about the pertussis outbreak. I think that com-
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