Tag: education

Would Osler Stand for Anti-Vaccine Folks Using His Famous Quote?

I often find myself having to reset my irony meter after reading some of the anti-vacccine memes and posts that people send me.

Like when anti-vaccine folks quote the Founding Fathers

Would Osler Stand for Anti-Vaccine Folks Using His Famous Quote?

Or they quote William Osler…

You remember William Osler, don’t you?

In 1910, as smallpox outbreaks continued and anti-vaccine folks made it harder to get folks vaccinated, he wrote:

“I would like to issue a Mount-Carmel-like challenge to any ten unvaccinated priests of Baal. I will go into the next severe epidemic with ten selected, vaccinated persons and ten selected unvaccinated persons – I should prefer to choose the latter – three members of Parliament, three anti-vaccination doctors (if they can be found), and four anti-vaccination propagandists.

And I will make this promise – neither to jeer nor jibe when they catch the disease, but to look after them as brothers, and for the four or five who are certain to die, I will try to arrange the funerals with all the pomp and ceremony of an anti-vaccination demonstration.”

William Osler on Man’s Redemption of Man

Want to vote on whether Osler would pick Jim Meehan to be one of the anti-vaccination doctors for his challenge?

Anyway, the Osler quote that Meehan posted, about not taking medicine, doesn’t mean what he thinks it means.

Osler wasn’t telling folks to not take any medicines.

“Osler himself prescribed relatively few drugs, his basic armamentarium consisting of quinine for malaria, digitalis for heart failure, opiates for pain and coughs, and iron and arsenic for anemia.”

Would Osler stand by his famous quote today?

He just meant that folks should avoid medicines that weren’t necessary and had no chance of working. Medicines, at the time, which often did more harm than good.

While you likely could apply his statement to the overuse of antibiotics, he certainly wasn’t talking about vaccines!

More on Would Osler Stand for Anti-Vaccine Folks Using His Famous Quote?

Where Are All of the Vaccine Advocates?

With more outbreaks and increased talk of vaccine exemptions, one thing often gets lost.

Most people vaccinate and protect their kids because they understand that vaccines are safe, with few risks, and necessary.

Where Are All of the Vaccine Advocates?

Unfortunately, unlike the highly vocal minority of folks who are against vaccines, we rarely hear from vaccine advocates.

There are a lot of them out there though.

And we are finally starting to hear more about them!

“One woman took four of her kids for the M.M.R. that week.”

Amid a Measles Outbreak, an Ultra-Orthodox Nurse Fights Vaccination Fears in Her Community

Like the story of a nurse in Brooklyn who is educating vaccine-hesitant parents in the middle of a measles outbreak.

And how vaccine-hesitant parents in Oregon are attending vaccine workshops to learn about vaccines from medical professionals.

“The response has been overwhelmingly positive. In exit surveys, the vast majority of people who attend our workshops say they’ve decided to vaccinate their children as recommended by the American Academy of Pediatrics.”

How do you get anti-vaxxers to vaccinate their kids? Talk to them — for hours.

Had you heard their stories yet?

How about the story about the mom who started the group South Carolina Parents for Vaccines?

“Nelson tries to counter bad information online with facts. But she also understands the value of in-person dialogue. She organized a class at a public library and advertised the event on mom forums.”

A Parent-To-Parent Campaign To Get Vaccine Rates Up

Did you know that a mom in Colorado, who started the group Community Immunity, put up a billboard to help raise immunization rates in her community?

Or that a group of parents formed Vaccinate California and helped support the passage of SB 277 and improved vaccination rates in California?

Did you know that there are similar immunization advocacy groups in Arkansas, Colorado, Florida, Hawaii, Idaho, Maine, Minnesota, Nebraska, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Texas, Washington?

Other communities have Immunization Coalitions and Facebook groups to help answer questions and educate parents about vaccines.

Are you ready to join these vaccine advocates?

More on All of the Vaccine Advocates

Vaccine Signs You Might See at Your Pediatricians Office

Does your pediatrician have any signs or posters up on the doors or walls?

If they do, it is probably just a sign alerting you that flu vaccines are available or a reminder to cover their cough when they are sick.

Or maybe they have some educational posters up to educate parents about the overuse of antibiotics, how to wash your hands, or when to call poison control.

Vaccine Signs You Might See at Your Pediatricians Office

Some pediatricians also have signs and posters about vaccines and vaccine preventable diseases:

Do your kids get a lollipop after their vaccines, or just protection against life-threatening diseases?
Do your kids get a lollipop after their vaccines, or just protection against life-threatening diseases?

Thank vaccines and herd immunity.
Thank vaccines and herd immunity.

Skipping some vaccines? Are you going to say sorry if your kids get a vaccine-preventable disease?
Skipping some vaccines? Are you going to say sorry if your kids get a vaccine-preventable disease?

Does your pediatrician have separate waiting rooms for unvaccinated kids?
Does your pediatrician have separate waiting rooms for unvaccinated kids?

There is no benefit, just extra risks, if you delay your child's vaccines.
There is no benefit, just extra risks, if you delay your child’s vaccines.

Vaccine preventable diseases are just a plane ride away.
Vaccine preventable diseases are just a plane ride away. Get vaccinated before you travel.

Parents of Earth, are your children fully immunized?
Long ago, everyone vaccinated their kids.

Unvaccinated children exposed to measles are quarantined for at least 21 days.
Hopefully you will never see a quarantine sign at your pediatrician’s office.

Got questions about vaccines?

Get your answers before your pediatrician puts up a sign that they are firing all unvaccinated kids.

More Vaccine Signs and Posters

Avoiding the Most Common Vaccine Errors

Although it would be great if mistakes never ever happened, the best we can do is to understand that mistakes do sometimes happen and take steps to avoid them.

How can we avoid mistakes and errors about vaccines?

Avoiding Vaccine Errors

It can help to:

  • understand the 7 Rights of vaccine administration, including that you give the Right vaccine to the Right patient at the Right time by the Right route at the Right injection site and then follow it with the Right documentation
  • use a 2d barcoding  system with your EMR to help catch vaccine errors before administration
  • use a screening checklist to help avoid giving vaccines that are contraindicated
  • double check vaccines that look alike or have names that sound like, such as DTaP and Tdap
  • double check expiration dates
  • make sure you aren’t giving live vaccines within 28 days of each other, unless they are given at the same time
  • make sure you aren’t giving the wrong dosage amount for the patient’s age, as some vaccines have different formulations depending on the age of the patient, including flu shots, hepatitis A, and hepatitis B vaccines
  • be careful so that you don’t give a combination vaccine, such as Pediarix, Pentacel, Kinrix, Quadracel, or ProQuad, inappropriately

That we are have a 4-day grace period does help avoid the need to revaccinate some kids when vaccines are given a little too early.

“With the exception of rabies vaccine, ACIP allows a grace period of 4 days (i.e., vaccine doses administered up to 4 days before the recommended minimum interval or age can be counted as valid). However, if a dose was administered 5 or more days earlier than the recommended minimum interval between doses, it is not valid and must be repeated. The repeat dose should be spaced after the invalid dose by the recommended minimum interval.”

Ask the Experts About Scheduling Vaccines

In many cases, as long as vaccine doses were administered less than or equal to 4 days before the minimum interval or age, then they can still be counted and are considered valid.

Common Vaccine Errors

It’s easier than you think to prevent vaccine errors.

Especially if there are more than one child in the room getting vaccines, either the tray itself or the vaccines should be labeled with each child's name so that they don't get the wrong vaccines.
Especially if there is more than one child in the room getting vaccines, either the tray itself or the vaccines should be labeled with each child’s name so that they don’t get the wrong vaccines. Photo by Vincent Iannelli, MD

When are you most likely to make a vaccine error?

When you are doing something that isn’t routine, which most commonly happens when folks delay or skip some vaccines and are now playing catch-up.

In addition to the tips above, remember that:

  • the first dose of the rotavirus vaccines must be given by 15 weeks
  • the rotavirus vaccine series must be completed by 8 months (32 weeks)
  • ProQuad, the MMR and chicken pox combination vaccine, is not licensed for kids who are older than 12 years, although if a teen or adult did get ProQuad, it could be considered an off-label dose and could still count.
  • Kinrix and Quadracel, the DTaP and polio combination vaccines are only licensed for the 5th dose of DTaP and 4th dose of polio in children who are 4 to 6 years old, so wouldn’t be appropriate for an 18-month-old, even if he needs both (DTaP and polio) vaccines. Earlier doses can sometimes count as off-label doses though.
  • the combination vaccines Pediarix and Pentacel are only licensed up through age six years, but don’t necessarily need to be repeated if given to older kids.
  • children and adolescent’s get a pediatric dose (0.5ml) of the hepatitis A vaccine, while older teens, who are at least 19-years-old, get an adult (1.0ml) dose. Since most kids get vaccinated when they are younger, many pediatricians may not have the adult version of the hepatitis A or even realize that there is a different version.
  • children and adolescent’s get a pediatric dose (0.5ml) of the hepatitis B vaccine, while older teens, who are at least 20-years-old, get an adult (1.0ml) dose. Since most kids get vaccinated when they are younger, many pediatricians may not have the adult version of the hepatitis B vaccine or even realize that there is a different version.

Most importantly, even when giving vaccines on schedule, be sure to triple check everything. This is especially important if multiple kids in the same room are getting immunizations.

Also remember that vaccine errors should be reported to the ISMP National Vaccine Errors Reporting Program (VERP) or VAERS, with the correct dose repeated if necessary.

What to Know About Common Vaccine Errors

Although none of these vaccine errors are very common (hundreds of millions of doses of vaccines are given in the United States each year), understanding which ones occur the most often can help to make sure that they don’t happen in your office.

More on Common Vaccine Errors

Updated September 16, 2018