Vaccines. They seem like one of the most controversial topics of our time.
I’ve never quite understood the deep mistrust of vaccines – I studied biology over a decade ago now, and was lucky enough to spend most of that time studying microbiology. We studied the various types (live, attenuated, dead), how they work (helping your body produce antibodies to the specific pathogen of interest), and celebrating the successes of vaccines – like Jonas Salk, the scientist who happened through a mixture of luck and preparation, to develop one of the first successful vaccines for polio. He’s also famously remembered for deciding not to patent it and when questioned about this, responded with the question, ‘would you patent the sun?’.
I’m pretty thankful for Dr. Salk’s work because my great aunt was infected with polio, and it seriously affected her quality of life. My memory of her was that she was always smiling, generous and never complained, though I also know she spent her childhood in treatments and had many complications from these – leading to functional blindness and the inability to bear children. Large-scale vaccinations against polio meant that, unlike my beautiful great aunt, I never had to worry about contracting it – in a generation, the disease was almost eradicated. I find that remarkable. It makes me sad to think that within another generation, we might be reversing that trend.
I’ve been preparing to go on some extended travel to southeast Asia and getting fully vaccine’d up. I was struck by a few things when visiting the local travel clinic and then later a physician.
My experience at the travel clinic left much to be desired. I had done some homework before going and read all of the health advisories for the region I will be visiting on the Government of Canada website. When I arrived, the nurse was on her phone and seemed mildly annoyed at my knock. She reviewed some good information with me, though seemed irritated by my many questions – I believe questions are the key to understanding. I left with a folder containing tons of great info, a recommendation of what to ask for from my physician, and a general malaise about the risks I would be exposing myself to because I didn’t feel like I yet had a solid understanding.
I then booked an appointment with my physician, who happened to be away – a young physician was covering for her. I really enjoyed my conversation with him because it was very honest and direct, he answered all of my question (and allowed me the space to ask them) and then prescribed the vaccines that I would need.
He then left and the nurse came in to give me my influenza vaccine. This was a little strange for me because she arrived with an open, unlabelled needle and gave me the injection – I left thinking about how this indicated how much trust the medical system was asking from me. I wasn’t shown any packaging indicating what it was, I wasn’t shown that this needle was new – I was asked to believe that this was all done. I think a lot about trust – and more specifically, about improving trust. While I do believe that the nurse took all necessary precautions, the questions I’m left with is: how much does this lack of verification contribute to the building anti-vaccination movement? How can we turn this into an opportunity to build trust?
We hear a lot about the influenza vaccine – I know so many people who say, ‘well I got the vaccine and I still got sick’. Yes, it’s most certainly true that the influenza vaccine doesn’t give you 100% immunity against the flu. But it does significantly boost your immunity and reduces your risk of getting it, which matters a lot when you live in a community. Building community-level immunity helps ensure that people who we are living alongside with immune systems that are less able to fight off something like the flu are less likely to get it.
You have to weigh your own risks against a larger risk. Without adequate information and an ability to ask questions so that you’re comfortable with your level of risk, it’s fairly difficult to make an informed decision – so I can understand why it’s easier at times to just opt out.
In talking about vaccines with people I know, I find I generally hear one of two points of view – yes, let’s make sure people continue to get vaccines, or, no, I don’t believe in vaccines because I or someone I know got sick from one. It deeply sucks that people have fallen ill from vaccines – everything from a flu to much more serious complications. And we can’t pretend that this doesn’t happen, because it does. I believe the opportunity here is to engage – in understanding why people have such a deep mistrust of vaccines so that we can start there in working to build up that trust.
Through my recent experience preparing for travel, I also learned that you can get your titres tested for FREE where I live – this will tell me the amount of antibodies in my bloodstream for anything that I’m considering getting a vaccine / booster for. I find this amazing because it helps me make informed decisions based on my own personal, internal chemistry.
In weighing my own risks, I decided not to take Dukoral – a vaccine that helps prevent traveller’s diarrhea – because I have an allergy to formaldehyde, and I couldn’t be sure that I wouldn’t have a severe reaction. I now have to mitigate my risk with added caution in choosing where and what to eat, which seemed like a better decision and one that I made in consultation with a pharmacist.
Disengaging and walking away from the systems that make our lives tick is one answer. There is of course, another answer – one that is much more difficult, though I believe much more important. For those of us who believe deeply in vaccines, we can choose to engage and listen to those who mistrust vaccinations so that we can better know how to develop more robust, human-centred systems to build that trust. I think it also speaks to the importance of helping everyone develop a deeper understanding of statistics – on how people can make their own informed choices on the risks associated with vaccines, both for themselves and the loved ones that they live beside.