VACCINES – THE WAXY TRUTH

Vaccines are undoubtedly one of the best investments in health. Immunisation programmes have contributed enormously to reducing the burden of infectious diseases, and are responsible for much of the falling rates of morbidity and mortality worldwide.

The evidence unequivocally supports that immunization is an absolutely fundamental component of global efforts aimed at efficient and cost-effective improvement of public health. There is lot of confusion in translating the principles of immunization into clinical practice. Epidemiological compulsions and economic constraints have compelled the WHO and Government of India to practice its own immunization schedule. The spread of information—and misinformation—has also changed through the internet and blogging. A high priority is placed on freedom of speech, irrespective of the accuracy of its content. Misinformation about immunization, whether intentional or not, needs to be countered urgently to help recipients of vaccines seek reliable facts and trust health professionals. Thus there exists lots of confusion between the public and health professionals in confronting the right immunization schedule to the children. Confusion is further aggravated because different institutions and pediatricians follow different schedules in their practice. The doctors are often compelled to follow their own schedule after synthesizing the variously practiced schedules which may not even be optimal.

The one-size-fits-all approach is not sustainable in vaccine prevention of diseases. In the past three decades, vaccines have been shown to elicit variable responses in distinct geographical environments. For example rotavirus vaccines that were proven effective in Europe, Latin America, and the USA were much less immunogenic in low-income countries like India. Disentangling the relative contribution of varying epidemiology patterns, environmental factors, and host genetic factors contributing to the success of a vaccine, or to adverse vaccine outcomes, is a major challenge.

But the provision of clear, concise, and authoritative information is not enough. Horizons should be broadened with an diverse range of expertise: for example, anthropologists can help to improve understanding of the cultural basis of behavioral responses, including religious radicalism; validated questionnaires developed by social scientists can be used to probe issues of risk perception that are not good through quantitative approaches; and evolutionary biologists can explain the theories underpinning altruism and cooperation, which are major issues affecting herd immunity. In the next decade, information for the public needs to be systematic, through knowledge of our strengths and weaknesses, comprehensive, through inclusion of all scientific expertise, and credible, through understanding of how to generate trust and communicate effectively with policy makers and the public.

Nonetheless professional medical education has a major role in understanding the above determinants as well as advocating the right information to the public. Hardly these issues are neither taught nor stressed in the medical education. As we being true professionals, it’s the responsibility of the doctors ought to know these by further reading and update their knowledge on these practical issue. Truth is always bitter.

Dr.P.Ganeshkumar MD

ganeshkumardr@gmail.com

The author is a public health specialist and academician