Re­mem­ber why vac­cines are so im­por­tant

Easy to for­get how dev­as­tat­ing in­fec­tious dis­eases, such as Span­ish flu and small­pox, were to the peo­ple’s health glob­ally

The Hamilton Spectator - - HEALTH - DR. JEFF KWONG

Last week, my col­leagues at Pub­lic Health On­tario set up a quar­an­tine tent at the MaRS Dis­cov­ery Dis­trict. But in­stead of keep­ing the pub­lic away from the iso­la­tion area, the idea was to ex­pose peo­ple to the harsh re­al­i­ties of vac­cine-pre­ventable ill­nesses.

Clad in pe­riod dress and made up to look like they had dis­eases, such as small­pox, measles or Span­ish flu, a team of pub­lic health ex­perts played the roles of peo­ple af­fected by real-life out­breaks through­out On­tario’s his­tory.

Their goal was to help shed light on how they af­fected fam­i­lies and com­mu­ni­ties be­fore vac­cines ex­isted.

The in­ter­ac­tive event was part of Na­tional Im­mu­niza­tion Aware­ness Week, but like many of my col­leagues work­ing in pub­lic health, I think about vac­ci­na­tion all year round.

As a fam­ily doc­tor, I pro­vide pa­tients of all ages with the shots they need to stave off avoid­able sick­ness.

From early child­hood in­oc­u­la­tions that ba­bies re­ceive in their first 18 months of life to the shin­gles and pneu­mo­coc­cal bac­te­ria vac­cines rec­om­mended for adults be­gin­ning at age 65, there are vac­cines to help us stay healthy through­out our life­span.

I also work as an epi­demi­ol­o­gist, do­ing re­search to an­swer ques­tions about vac­ci­na­tion, such as how many peo­ple re­ceive im­mu­niza­tions, who gets them and what kind of im­pact pro­grams such as the an­nual flu shot cam­paign have at a pop­u­la­tion level.

One rea­son I’m pas­sion­ate about this work is that vac­cines have had tremen­dous health ben­e­fits. They’re one of the most suc­cess­ful and cost-ef­fec­tive in­ter­ven­tions avail­able. They save lives and avert the suf­fer­ing as­so­ci­ated with ill­nesses, such as per­tus­sis (whoop­ing cough) or mumps.

A re­cent out­break of mumps in Toronto drew at­ten­tion to the need for adults born be­tween 1970 and 1992 to check their vac­ci­na­tion sta­tus to be sure they are pro­tected from the highly con­ta­gious — and po­ten­tially dan­ger­ous — ill­ness.

The most com­mon symp­toms in­clude sore and swollen sali­vary glands, fever, headache, mus­cle aches and fa­tigue. In males, this virus can also cause in­flam­ma­tion of the tes­ti­cles. Mumps of­ten clears on its own, but in rare cases there can be se­ri­ous com­pli­ca­tions, such as deaf­ness or in­flam­ma­tion in the brain or the tis­sue cover­ing the brain and spinal cord.

It’s pre­sumed that any­one born be­fore 1970 would have been in­fected nat­u­rally; peo­ple born af­ter 1992 should have re­ceived two doses of a mumps-con­tain­ing vac­cine as part of the reg­u­lar im­mu­niza­tion sched­ule. If you’re in the 25-47 age range — or if you were born out­side Canada — you might have only re­ceived one dose of the vac­cine.

Out­breaks of measles have also oc­curred in re­cent years — and it’s one of the most con­ta­gious in­fec­tious dis­eases around. The measles vac­cine is highly ef­fec­tive, so it’s im­por­tant to make sure yours is up-to-date, par­tic­u­larly if you plan to travel to places where measles spreads reg­u­larly. Con­ve­niently, the measles and mumps vac­cines are grouped to­gether in a sin­gle vac­cine.

One day, I’d love to see a com­pre­hen­sive im­mu­niza­tion reg­istry to help On­tar­i­ans and their health-care providers keep track of all the vac­cines they have re­ceived. But for now, it’s up to all of us to keep track of our own im­mu­niza­tions.

If you re­ceive a vac­cine, be sure to record it and let your doc­tor know. Fam­ily physi­cians like me can put that in­for­ma­tion into your chart and print it out if you need it. But, if you got the shot from an­other health-care provider and don’t tell us, we won’t have any way of know­ing that.

Al­though we still of­fer peo­ple the yel­low paper vac­ci­na­tion cards so they can keep their own records, a tool called CANIm­mu­nize of­fers a dig­i­tal op­tion. The free app can be used to keep track of your vac­ci­na­tions and those of your chil­dren or other fam­ily mem­bers. You can also use the app to get re­minders for rou­tine im­mu­niza­tions or boost­ers.

For many peo­ple, it’s tough to imag­ine what it’s like to live through an out­break of small­pox or Span­ish flu. In a way, vac­cines have be­come a vic­tim of their own suc­cess. They’re so ef­fec­tive that it’s be­come easy to for­get how dev­as­tat­ing the dis­eases vac­cines pre­vent are.

We’re for­tu­nate that im­mu­niza­tion erad­i­cated small­pox and that other ill­nesses, such as diph­the­ria and po­lio, are now rarely seen in Canada. But it’s im­por­tant to re­mem­ber that we can all play a part in pre­vent­ing his­tory from re­peat­ing it­self.

Jeff Kwong is an as­so­ci­ate pro­fes­sor in the De­part­ment of Fam­ily and Com­mu­nity Medicine and the Dalla Lana School of Pub­lic Health. He is also a sci­en­tist at Pub­lic Health On­tario, a se­nior sci­en­tist at the In­sti­tute for Clin­i­cal Eval­u­a­tive Sci­ences and a fam­ily physi­cian with the Toronto West­ern Fam­ily Health Team. Doc­tors’ Notes is writ­ten by mem­bers of the U of T Fac­ulty of Medicine. Spe­cial to Toronto Star


Shelly Bolotin, a sci­en­tist with Pub­lic Health On­tario, is made up to look like she has small­pox at a re­cent im­mu­niza­tion aware­ness event in Toronto at the MaRS Dis­cov­ery Dis­trict.

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