My new favourite vaccine mock PSA

Anyone who has followed this blog has had to put up with my intermittent vaccine rants.

Here we go again.

Jimmy Kimmel had a little rant on his show this week about vaccines complete with “real doctors” saying why vaccines are important.  I don’t often like Jimmy Kimmel’s humour.  He is sometimes a bit too much for me.  But, this was perfection.

Perfection.

Check it out.  Show your friends.

Last-day-of-rotation-Tuesday Tuesday

It is Top Ten Tuesday day, but given that I can’t even keep up with the books released years ago and the list is the top ten 2014 releases I am looking forward to, I feel that it is pointless to try to do it.

So, I present to you last-day-of-rotation-Tuesday Tuesday.

Yes, I feel like the two Tuesdays in the title are necessary.

What that means, I don’t know.

I will, however say that these past four weeks, I have learned that I can learn about Infectious Diseases.  The learning curve is huge and that is pretty cool.

Also, I realized this week that it wasn’t me lecturing my husband about the importance of the flu shot, me telling him that we have a few people I was following on ID with the flu or even the TV reports of deaths from the flu in another province to convince him to get a flu shot.  It was… Drumroll please… His barber.  True story.  There is a man chopping hair who is doing his part to promote public health.  That is awesome.

Seriously, he went to get a haircut and got a flu shot that I have been semi-nagging about for months on the way home.  Pretty awesome.  Now if only I can get him to make an appointment with our doctor to get his TDaP and MMR updated.  If only.

I also learned last week that (disgusting fact) tampons cause toxic shock syndrome by acting as a physiologic abscess.  ICK.  Thank goodness they sorted out which materials promoted bacterial growth and that high absorbency tampons were the main culprits back in the 80s before I really considered this an important issue.

Oh, and that toxic shock syndrome can occur not in women and not in tampon use.  Okay, I did know that, but I never really thought about it that much or considered it as a high level differential until this rotation.

On to Neurology tomorrow.  Yet another rotation that makes me nervous due to my sheer ignorance.  I can do brain tumours.  Everything else is going to be a bit sketchy until I can read and see a few cases.  Thank goodness for lots of references, good staff and basic medical knowledge.

I had a friend in med school who was awesome at neuro… So awesome that she plans to do it for a living one day. I wish she was here to tell me what to do.

I sense another giant learning curve about to start.

Only 6 off-service rotations to go…

“Don’t be one, get one!”

I am back on my vaccine rant.  I wrote about it previously, with regards to the flu shot. I saw a video I thought was relevant.  I have also seen a few cases that are relevant.

I am on peds emerg, as you have probably noticed and well, I see a lot of sick kids.  And kids get sick.  No matter what you do.  Such is life.

But, I saw a 25 day old  baby who was very, very sick with the flu.  His Mom and two older siblings were sick earlier in the week and gave it to him.  Now, his life was at risk.  Maybe they would have gotten the flu anyway, but maybe if they had all been vaccinated, they would have protected their youngest sibling.

Rick Mercer, a delightful Newfoundlander who talks on all sorts of subjects did one of his “rant with Rick” features about flu shots.

Don’t be one, get one!

I also had a small battle with some parents who refuse to vaccinate their children (that is one’s own call). The concern was that they kid had cut his head open on a rusty nail and I suggested the tetanus vaccine.  They refused.  I reviewed the risks of tetanus.  I didn’t realize that they were against vaccines, I just thought he was due for one.  They started ranting at me about autism and stem cells.  I presented the evidence, but they made their own decisions.  That is a right we have.   I just informed them of what to watch for, reviewed risks and benefits and took some deep breaths.

I get it.  We all need to be educated in our own ways.  We all have our own ethical-moral decisions to make.

But, when I see little babies who may have whooping cough, a preventable illness, or people spreading the flu like wildfire, I can’t help but question it.

There is no evidence for the whole autism thing.  Heresay, some experiences, but no scientific evidence.  The one study that suggested it was a sham. Autism runs in families, it is a different way of thinking, not something that kills children.   Often, when you see children with autism, you may notice that the parents have a few traits.  Not always, but sometimes.  I have seen fabulous healthy people who happen to have autism do all kinds of fantastic things in life.

I can’t fix what has happened to families.  I don’t know why your kids were perfect and suddenly changed.

I do know the risks of dying from those diseases are higher than the risks of autism.

And I do know vaccine formulations have been changed to avoid thimerosol, the preservative everyone is scared of, where possible.

And I know people worry about the stem cell lines used in production of the vaccines.  That is a moral issue and I can’t really judge on that.  But I do caution people to think long and hard about the decision.

I am sure you recall Penn and Teller.  They also do a very entertaining, but educational feature on vaccines.  I have it included here, but I will warn that there is some VERY strong language at the end of the video, so please don’t watch it if you are sensitive to this or have others around (the first time I saw it was on a peds ward nursing station looking for presentation material… oops).

The moral of the story again is that vaccines save lives more than they take them.  And I feel very strongly about them.  I also understand others feel strongly the other way.  That is their opinion, just like I have mine.  I just wish it wouldn’t have such an impact on others.

I promise I will give this rant up for a little while now.

Why getting stabbed might save a life (and why you should too).

Image from actionalexandria.org.

I got my flu shot today.

It was my first day back after vacation and I was wandering around the surgery ward trying to stay awake (the first 5am of the week hurts, especially after a week of 7 and 8ams) when the lovely charge nurse grabbed me.  I instantly presumed I was in some sort of demand.  Probably someone needs home care forms filled out before discharge or something.  But no, she just wanted to make sure I knew they were giving out flu shots in the unit’s conference room.  And that if I haven’t had one already, I should get one.

This made my day.

No, I am not the sort of person who gets cheap thrills from pain.

I am, however the sort of person who loves some good convenience.  And a flu shot in the very area I am working is just that.

Plus a free pen and an awesome sticker never hurt anyone either.

So, I rolled up my sleeve and got the job done.

Total time out of my day 15 minutes (including the waiting period so they can ensure you don’t pass out, nor go into anaphylaxis).  During said time I managed to drink my coffee, check my blog, check Facebook and my email, plus finish organizing my to-do list.

When you really get down to it, I did something super productive and really did not lose any time in doing it.

Win!

Odds are at least half of you reading this will now roll your eyes and say something like, “The flu shot? Seriously Trisha, I got one once and I got sick anyway.  What a waste!”

I will now respond in kind.

That is a stupid argument.

Blunt? Yes.  Honest? Yes.

Just about every time I get the flu shot, I develop a low grade fever, aches and feel crappy for a day or two.  It is how I roll with just about every vaccine.  My body really likes to take things on full force.

Does this suck?  Heck yes!

But, it is not as bad as the real flu.

Oh, and the flu shot is an attenuated virus.  It can’t give you the flu.

Herein lies the issue.  Most people assume every cold they get is the flu.  No sir.  And other people assume that when they start barfing their brains out that is the flu.  Wrong.

The flu is actually a cold on steroids (though steroids would potentially relieve some cold symptoms, so scratch that).  If you have had a real flu, you know.  You can’t work with a flu.  You have a fever and pain and all kinds of delightful snotty/coughy symptoms.  And maybe some vomiting or nausea.

The flu kills people.

Probably not you.  You are probably healthy and young (unless of course it is H1N1 or the Spanish flu).  It kills babies.  And old people.  And sickly people.  The people who you should be trying to protect.

People who die of the flu often die of things like pneumonia and thus things like insurmountable infection and respiratory distress.  Not good ways to go.  Not on my top ten, that is for sure.

And yes, I am sure most of those people who can get the flu shot do (unless of course one has egg allergies).  But not all of them do.  Yet, they still get out.   They go to malls and touch the same things our grubby hands touch.  Or they are taken care of by people like me who work in the hospital and come into contact with all kinds of lucky stuff.

So, let us think for a second… People who are susceptible to this illness are all around us.  And they could die.  But, we won’t get a two second needle to help protect them?  I am pretty sure most of you were against small pox.  Bet you are glad people back in the day sucked it up and got vaccinated!  That helped to protect you.

It is a concept called herd immunity.  Kind of like how kids these days aren’t getting measles or whooping cough and such.  Well, they weren’t… Until people started to refuse to immunize their kids.  Now kids get those things again.  And die.  Not as many as before, but more than when I was a kid.  Because the majority of the herd is no longer immune.  For a variety of both good and bad reasons… More on that some other time.

I am not talking a vaccine with significant moral sequelae here (unless you are allergic to eggs).  And maybe you are opposed to stem cell research or something.  They grow the stuff in chicken eggs.  Not human fetuses.  And they test it on animals.  Not baby cells.  And it doesn’t go to the animal tests until it is otherwise safe.  So, unless you are a protector of chicken egg rights (which some people are and I respect that decision), you really don’t have to freak out about current vaccine techniques… Unless you go waaaayyy back.  Or talk about some other vaccines, which I am not addressing here.

Even then, sure some people feel very strongly about animal rights or stem cell use and what have you.  I do know that this is a very small portion of people.

And NO I haven’t heard anything official about flu vaccines causing autism.  I know people worry a ton about thimerosal, a preservative used to prevent bacterial growth in vaccines (their purpose is to keep us safer).  If you are concerned, there are thimerosal free flu vaccines available.

There are potential side effects with the vaccine.  There are potential side effects to taking a Tylenol or a vitamin supplement too.  Bad stuff happens sometimes.  Most of the time you get a sore arm.  Maybe a low grade temperature.  I won’t lie, there are scary side effects like Guillian-Barre syndrome.  You can also develop liver failure from Tylenol.  Or anaphylaxis from an antibiotic.  Probably won’t stop you from taking those.

So, why is it that the uptake for flu vaccines is so low?

Hmmm…

This is some serious needle fear. Image from cbc.ca.

People are scared of needles.

Indeed they are.  People are generally more scared of death.

The vaccine doesn’t always work.

This is true.  The method in which viruses are identified for use in the next year’s vaccine is based on flu patterns in the opposite side of the world.  Scientists use all kinds of cool techniques to predict what will be prevalent in our area.

Sometimes scientists are wrong.  And sometimes the viruses just change really fast.  Thus, sometimes, the vaccine may not protect you from one of the strains of flu that is going around that year.  Or it may only offer partial immunity.  This is the same reason why you can’t have one vaccine and be set for life.  Viruses change too fast for that stuff.

But, like other things in like, the overarching notion is that sometimes you just have to hedge your bets.

I know a few people who feel that hedging their bets is equivalent to not bothering with the vaccine.  In fact, in health care workers… People who are told they should get the vaccine, uptake is disturbingly low.  And they work with the people most at risk.

I am not sure if that says they really like their jobs or that they really hate their patients.

Yes, it is your body and your decision.

Again, I reiterate that you can get the flu too.  And it will suck.

But not only that… To me (and public health theory), it is basically putting your coworkers and patients at undue risk for the flu.  You might bring it in to them.  You could be the tipping point, the index case.  I know I wouldn’t want to have the flu outbreak of unit x on my head.  It sounds extreme, but it can happen.

I work in oncology.  So, many of my patients are immunocompromised.  They got their flu shot.  But, they might not be as good at fighting the flu despite that.  If I go to work sick… I am exposing them to that risk.  People feel safe in the hospital and here I am hacking virus all over them.  Seems cruel to me.  Sure, I have my right to security of person, but don’t they have the same right?  And as health care consumers, shouldn’t they be protected.  That is the whole reason we dress like fools to see people with contagious diseases… Not just for ourselves, but for others too.

I work in a hospital.  Someone always has to be there.  That is how it works.  When you get sick at 3 am, there is someone there.  If everyone gets the flu, then who will be there?  Yet another good reason to try to prevent illness, both in you and in co-workers who may not be able to get the shot for medical reasons.

I got my flu shot today.  Yes, my arm is a bit sore.  But, I am riding on my flu shot high horse.  I did my part to protect myself and my patients, as well as my family and friends.  I have asthma… The tables could turn at any minute.  I am one of those people who can die from the flu.  But, so can my friend’s baby girl and by grandfather.  I quite like them.  Please don’t give them the flu.

*This is a link up with Medical Mondays – a once a month blog hop for blogs about all things medical.  Check out some of their posts of medical awesomeness from medical professionals/students/spouses and the like!