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Credit: Alexis Lira

During the winter months, practices often see an uptick in patients who come in with respiratory infections — mainly the common cold — and flu. One such patient scheduled an appointment because she had a fever, cough, body aches, and generally felt like she had been run over by a train (she had not). These are classic signs of the flu virus, which typically becomes dominant during the colder months.

As I suspected, she tested positive for influenza. Unfortunately there was no medication I could give to cure her since this is a virus and does not respond to antibiotic therapy. And because her onset of symptoms was outside of the timeline for giving her antiviral medication, I couldn’t give her Tamiflu.

When I asked her if she had been vaccinated this year she replied that she had not.

In fact, she went on to tell me that she hadn’t been vaccinated the last 10 years.

“I got the flu from the last vaccination and besides, they don't work,” she explained.

My next patient was in for a review of recent labs tests and a routine follow-up of his hypertension and COPD. I asked him if he’d had a flu shot this year and if he’d ever had a pneumonia vaccination. He replied that he never gets vaccinations — not even the flu shot.

At this point, I tried to explain why vaccinations are beneficial and safe. I tell him that thousands of people die each year from flu – more than 18,000 since October 2018, according to the Centers for Disease Control and Prevention ­– and that he’s more vulnerable because he has COPD and is over 65.

I asked him why he refuses to get the flu shot, and his reply was one that I hear often: he claims he knows many people that have gotten sick right after getting the shot.

The visit ended with a vague promise that he’d consider it but I know that in all likelihood he will not get those vaccinations. Instead, I will worry about what will happen to him if he gets pneumonia or influenza.

The spread of misinformation has meant more patients are refusing vaccines

While scenarios like these aren’t new, in the last few years it has become more common for patients to refuse vaccinations. During the 2017-18 flu season, the rate of adults who were vaccinated was estimated to have dropped by 6.2 percent from the previous season.

And the consequences of refusing to be vaccinated for many diseases can be severe.

Measles, for example, a vaccine-preventable disease, was declared eradicated by the CDC in 2000. This was linked to ongoing, effective vaccination programs. Yet in 2019 we are having a measles epidemic in several locations in the United States, which is mostly attributed to lower vaccination rates in these cities.

Meanwhile, a report was recently released regarding a young boy who was stricken with tetanus in 2017 after getting a cut on his forehead. His parents refusing to have him vaccinated meant that he was in the hospital for 57 days – mainly in the ICU – and racked up medical bills that exceeded $800,000.

Yet despite overwhelming evidence of the complications from not being vaccinated, the huge amount of information, and misinformation, available on the internet still results in patients refusing vaccines. There’s so much information floating around out there that it can be difficult for non-medical people to understand what is legit and what is downright false.

Moreover, social media has added to the anti-vaccine narrative. In fact, according to a 2018 article published in the National Science Review, vaccination rates dropped drastically after emotional, anecdotal events were shared on social media. And this can make my job, as an NP, difficult. The overwhelming amount of misinformation that exists – and shared – makes trying to convince patients why they should be vaccinated all the more difficult.

Despite the noise, it’s hard to dispute that immunizations against diseases can save lives

While I do understand the average person is simply trying to do what’s best for themselves and their family – and that it’s sometimes difficult to find truth among all the noise – it is hard to dispute that immunizations against diseases such as flu, pneumonia, and measles, can save lives.

Although no vaccination is 100 percent effective, getting a flu vaccination, for example, greatly diminishes your chances of getting the flu. And if you do happen to get it, the severity is often reduced.

The CDC reported that during the 2017-18 flu season, 80 percent of children who died from the flu were not vaccinated.

Another good reason to vaccinate is herd immunity. This is the concept that when the majority of people in a society are immunized for a particular disease, it prevents that disease from spreading in that group. This is important to help protect those members of society that cannot be vaccinated because they are immunocompromised — or have an impaired immune system — and may save their lives.

So when I have patients, like the ones mentioned earlier, I focus on discussing the potential risks of not getting vaccinated, the benefits of doing so, and the potential risks of the actual vaccine itself.

I will also often explain to my patients that every medication, vaccination, and medical procedure is a risk-benefit analysis, with no guarantees of a perfect outcome. Just as every single medication comes with a risk for side effects, so too do vaccines.

Yes, getting vaccinated carries the risk for allergic reaction or other adverse events or “side effects,” but because the potential benefits far outweigh the risks, getting vaccinated should be strongly considered.

If you’re still not sure… Because there is a lot of information regarding vaccinations, it can be difficult to figure out what is true and what isn’t. If, for example, you’re interested in learning more about the flu vaccine — benefits, risks, and stats — the CDC section on influenza is a great place to start. And if you’re interested in learning more about other vaccines, here are a few resources to get you started:

Seek out reputable studies and resources, and question everything you read

While it would be wonderful if I could prove to my patients beyond doubt that vaccinations are safe and effective, this isn’t necessarily an option. To be honest, I’m am sure that most, if not all, providers wish this. It would make our lives easier and set patients’ minds at ease.

And while there are some patients who are happy to follow my recommendations when it comes to vaccinations, I am equally aware that there are those who still have their reservations. For those patients, doing your research is the next best thing. This, of course, comes with the caveat that you get your information from reputable sources — in other words, seek out studies that use large samples to define their statistics and recent information backed by scientific methods.

It also means avoiding websites that draw conclusions based on one person’s experience. With the internet an ever-growing source of information — and misinformation — it’s imperative that you constantly question what you read. In doing so, you are better able to review the risks versus the benefits and perhaps arrive at a conclusion that would benefit not just you, but society as a whole.