GESTIÓN EN SALUD PÚBLICA: BioEdge: The dangers of not being vaccinated are real

domingo, 10 de marzo de 2019

BioEdge: The dangers of not being vaccinated are real

BioEdge: The dangers of not being vaccinated are real

Bioedge

The dangers of not being vaccinated are real

by Michael Cook | 10 Mar 2019 |

Here is a case study from STAT about the danger of not vaccinating children. A 6-year-old boy from Oregon received a cut on his forehead while playing on the family farm. His parents washed the wound, sutured it and dressed it. Six days later the lad was in hospital being treated for the first case of paediatric tetanus in the state for 30 years. He was in hospital for 54 days, 47 of them in intensive care, followed by 17 days in a rehabilitation centre. The cost of hospitalisation was over US$800,000, which did not include an air ambulance, the rehabilitation and follow-up care. (The details are in a case report here.)

The boy had not been vaccinated against tetanus, a disease which has become rare in the United States because of antibiothics and vaccines. It is a terribly painful and dangerous disease. Between 2009 and 2015, only 197 cases were reported – of whom 16 died. However, statistics like this did not convince the boy’s parents. They spurned the pleas of doctors to vaccinate the boy against tetanus, as well as measles, mumps, rubella, chickenpox, polio, and a range of other dangerous diseases.

The World Health Organization has identified “vaccine hesitancy” as one of the top ten threats to global health in 2019. It says that vaccination prevents 2 to 3 millions deaths a year. But many people are refusing to allow their children to be vaccinated. As a result, at least in part, there has been a 30% increase in measles around the world. “Some countries that were close to eliminating the disease have seen a resurgence.”

In January, the governor of the state of Washington declared a state of emergency in two counties because of a measles outbreak.

The reasons for refusing immunisation are complex and vary from region to region. WHO says that they include “complacency, convenience and confidence”. Public health experts point out that vaccine refusal not only puts the individual child at risk but also others in the community through “herd immunity”. When 95% of the population is vaccinated, unvaccinated children are also protected. But if the proportion declines, unvaccinated people are at risk of infection.

Michael Cook is editor of BioEdge.

It often takes a newsworthy tragedy to make us think deeply about difficult ethical issues. One example is our lead story this week. The parents of a brain-damaged West Point cadet, Peter Zhu, asked a court to order a hospital to retrieve his sperm so that the family name can be carried on. No sooner said than done. Justice John P. Colangelo, of the New York Supreme Court, Ninth Judicial District, directed Westchester Medical Center to collect the sperm and have it stored. A court hearing will be held on March 21.

The outcome of this case will be interesting, partly because it pits ethics based on family ties against ethics based on personal autonomy. Peter’s parents know that they cannot get their son back, but they believe that they have a right to a possible child to carry on the family name. But bioethicists point out that grandparents do not have a right to a grandchild and that Peter never consented to such a procedure. A family's tragic loss is shaping up as a clash of cultures, collective versus individualistic, Asian versus Western.