Rev Electron Biomed / Electron J Biomed 2015;1:3-5.
KNOWLEDGE ABOUT VACCINES
1Mª Rosario Bachiller Luque, 2José Mª Eiros Bouza
1Pediatría y 2Microbiología. Facultad de Medicina. Universidad de Valladolid
Shortages or withdrawal of vaccine distribution channels for different reasons not contribute to confidence in the effectiveness and vaccine safety2.
The introduction of new vaccines in the recommended schedules is an issue with unquestionable ethical implications which go beyond the scope of health-patient relationship. It requires an exercise of caution and a critical position, similar to that adopted with drug innovations or new technologies. Must be governed by criteria of effectiveness, safety and efficiency, based on scientific evidence3. The opportunity cost analysis is key in this process and in addressing potential conflicts of interest4.
When programming vaccine strategies should be taken into account the greater needs and problems of vaccination disadvantaged groups, socially excluded, low resources that are more frequently found deficiencies in vaccination or by access difficulties or other causes5. In a dynamic society where information is missing dizzying clear content that will underpin the benefits of vaccination. Few measures like this, in public health, have contributed to the control of infectious diseases and improving the quality of life throughout the world and the reduction of infant morbidity and mortality6.
When a new vaccine to the immunization schedule is incorporated is particularly important information, both the health authorities and pharmaceutical companies and professionals provide the population and the echo of it in the media including advertising7. Pediatricians and other health professionals, especially nurses play a key role in the decision of the parents about the vaccine8. When a parent decides not to vaccinate often referred to health professionals in their environment as main and more direct information. The widespread use of internet with no proven enormous amount of information contributes to spreading misconceptions and myths about vaccines9-10 ideas. The antivaccination movements makes arguments often denied by science, such as autism alleged relationship with measles vaccination-mumps-rubella advertising are scheduled to children during their second year of life. The risk management frivolous vaccination relying on arguments with little scientific basis, creates confusion and loss of confidence in the recommendations of professionals11-12.
It should make the effort necessary to enable immunization reach all children in the world and achieve the number four Millennium Development Goal of reducing the mortality rate by two-thirds of children under five years this year 2015 compared to 199013.
Vaccination is not compulsory in Spain, it made important that differentiates us from other countries; It is recommended, but all users and health, we must be aware of the importance of it for both their own benefit and for the Community and the constraints that this imposes on our country14-15. Vaccinations in the Spanish National Health System are part of the service portfolio that is approved by the Interterritorial Council16. Are the autonomous communities that offer this service and they have the power to set their calendars, which are financed in substantial part by the public health system. While there are still challenges ahead vaccination coverage in Spain17-18, despite not mandatory, it is superior to that of some countries where it is compulsory vaccination. This is due among other reasons to the involvement of health professionals, institutional promotional campaigns, the diffuser, educational and informative role of scientific societies and the gratuitousness of the vaccines of the official calendar19-20. But in our view is the widespread acceptance of vaccines and the weaknesses of the movement against what qualifies them substantially implantation21.
We must not abandon our responsibility to understand the motivations of patients, their preferences, their values and their limitations. Face confrontation is essential empathy that allows us to explore the emotions of the people who trust us with their health and validate their feelings, although we do not agree with their point of view. Understand and not judge are the bases. For this it is essential, mainly in the field of primary care, improve our communication skills and acquire deliberative habits in order to achieve the desired results in a climate of respect objectives. All need to devote time, which is "gold" for a clinical care and must be a priority commitment to health education of the population.
1.- Bachiller MR, Eiros JM. Política de vacunas. El Norte de Castilla, 18 de junio de 2015, pag 25.
2.- http://vacunasaep.org/profesionales/noticias/desabastecimiento-vacunas-tosferina [consultado el 5 de julio de 2015]
3.- Graaf H, Faust SN. Fluarix quadrivalent vaccine for influenza. Expert Rev Vaccines 2015; 22: 1-9.
4.- Bloom DE. Valuing vaccines: Deficiencies and remedies. Vaccine 2015; 33 Suppl 2: B29-B33.
5.- Welburn SC, Beange I, Ducrotoy MJ, Okello AL. The neglected zoonoses-the case for integrated control and advocacy. Clin Microbiol Infect 2015; 21: 433-443.
6.- Rees P, Edwards A, Powell C, Evans HP, Carter B, Hibbert P, Makeham M, Sheikh A, Donaldson L, Carson-Stevens A. Pediatric immunization-related safety incidents in primary care: A mixed methods analysis of a national database. Vaccine 2015.
7.- Wagner A, Kundi M, Zwiauer K, Wiedermann U. Paediatricians require more information before they routinely co-administer the meningococcal B vaccine with routine infant vaccines. Acta Paediatr 2015 doi: 10.1111/apa.13100
8.- Taddei C, Ceccherini V, Niccolai G, Porchia BR, Boccalini S, Levi M, Tiscione E, Santini MG, Baretti S, Bonanni P, Bechini A. Attitude toward immunization and risk perception of measles, rubella, mumps, varicella, and pertussis in health care workers working in 6 hospitals of Florence, Italy 2011. Hum Vaccin Immunother 2014; 10: 2612-22.
14.- Pérez-Rubio A, Eiros-Bouza JM, Bachiller MR. [Comment on "Evolution of the serotype coverage for the current anti-pneumococcal vaccines"]. Rev Esp Quimioter 2015; 28: 167-8.
15.- Eiros-Bouza JM, Pérez-Rubio A. [Burden of influenza virus type B and mismatch with the flu vaccine in Spain]. Rev Esp Quimioter 2015; 28: 39-46.
18.- Álvarez Aldeán J, Aristegui J, López-Belmonte JL, Pedrós M, Sicilia JG. Economic and psychosocial impact of rotavirus infection in Spain: a literature review. Vaccine 2014; 32: 3740-51.
20.- Cortés I, Pérez-Camarero S, Del Llano J, Peña LM, Hidalgo-Vega A. Systematic review of economic evaluation analyses of available vaccines in Spain from 1990 to 2012. Vaccine 2013; 31: 3473-84.
21.- Eiros Bouza JM, Bachiller Luque MR, Armentia Medicna A, Pérez Rubio A, Martín Armentia B, Luquero Alcalde FJ. 100 mensajes en vacunación. Eirba Analistas SL, DL VA 350-2014, ISBN 978-84-940880-3-2, Valladolid, 2014, 119 pags.