PA2016! Posted November 11, 2015 Share Posted November 11, 2015 Student Here.....So its that time of year again for flu shots. With so many people out there now against vaccinations this raises a question.... With standard vaccinations (MMR, Hep, varicella, ect.) we have plenty of evidence that we can use to show parents/patients that vaccination is a good thing and why they should vaccinate. I fell like there is enough evidence to win that argument, but what they decide to do after that is up to them... So, regarding the flu vaccine, which changes every year, may or may not work, and no evidence to back the yearly vaccine that is produce... How am I supposed to convince my patients that they should still get this if they are skeptical? Is it even worth the discussion if they are opposed? Just wondering how you guys handle this in clinic. Thanks Link to comment Share on other sites More sharing options...
CAAdmission Posted November 11, 2015 Share Posted November 11, 2015 Natural selection is designed to take care of people who don't believe in vaccinations. Link to comment Share on other sites More sharing options...
bigdawg1986 Posted November 11, 2015 Share Posted November 11, 2015 Russian Roulette anyone? I'm agnostic about them personally, but still get them, Primarily because my hospital affiliations will make me wear a mask on premises if I don't have it lol... But I tell patients that the benefits of getting it simply outweigh the risks of not with a certain patient population. Use other examples such as the shingles, and pneumococcal vaccine, hell even bring up smallpox! It's not too hard to convince people, unless they regularly visit a chiropractor and are vegans. Then, as stated... Natural selection. Sent from my SM-G900V using Tapatalk Link to comment Share on other sites More sharing options...
Marinejiujitsu Posted November 11, 2015 Share Posted November 11, 2015 You won't win an argument with a parent set on no vaccinations. I don't even try. There was a study I recently read that states an anti-vaccination parent is more likely to give in and vaccinate if you don't pressure then. They will hear it from family and friends. When they ask your opinion I would answer. Sent from my SAMSUNG-SM-N920A using Tapatalk Link to comment Share on other sites More sharing options...
cbrsmurf Posted November 11, 2015 Share Posted November 11, 2015 Natural selection is designed to take care of people who don't believe in vaccinations. Except it also endangers the people around them who cannot get vaccinations for medical reasons Link to comment Share on other sites More sharing options...
cinntsp Posted November 12, 2015 Share Posted November 12, 2015 So, regarding the flu vaccine, which changes every year, may or may not work, and no evidence to back the yearly vaccine that is produce... How am I supposed to convince my patients that they should still get this if they are skeptical? Is it even worth the discussion if they are opposed? Even in unmatched years there is some cross-reactivity benefit, so in that case it may not prevent the infection but can potentially lessen the severity. The NNT is 33 in matched years and 100 in unmatched years. In kids it's even better with a NNT of 8. It's probably more important for your patients that have a history of lung disease(COPD) than most others. Don't sweat it if your patients don't want it. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted November 12, 2015 Administrator Share Posted November 12, 2015 You won't win an argument with a parent set on no vaccinations. I don't even try. I won't win most arguments on diet, exercise, or smoking cessation, either. Doesn't mean I don't try. Link to comment Share on other sites More sharing options...
Marinejiujitsu Posted November 12, 2015 Share Posted November 12, 2015 True. We just need laws in place to make it a non issue. Sent from my SAMSUNG-SM-N920A using Tapatalk Link to comment Share on other sites More sharing options...
BruceBanner Posted November 12, 2015 Share Posted November 12, 2015 I could care less. If they don't want it, not my problem. They'll be back with the flu or they wont, makes no difference to me. Same with diet, exercise, smoking, etc. If I sense they are in a place to listen, I'll give them my little locker room coach speech, but I'm not going to waste time talking to someone who has no real motivation to change their crap lifestyle. Link to comment Share on other sites More sharing options...
PA2016! Posted November 12, 2015 Author Share Posted November 12, 2015 Appreciate the responses guys! Even in unmatched years there is some cross-reactivity benefit, so in that case it may not prevent the infection but can potentially lessen the severity. The NNT is 33 in matched years and 100 in unmatched years. In kids it's even better with a NNT of 8. It's probably more important for your patients that have a history of lung disease(COPD) than most others. Don't sweat it if your patients don't want it. cinntsp, What study/studies are you referencing? Thanks! Link to comment Share on other sites More sharing options...
cinntsp Posted November 12, 2015 Share Posted November 12, 2015 cinntsp, What study/studies are you referencing? Thanks! It was something I remembered from a past EMRAP podcast. I went back and found the episode and actually found a post where I asked the EMRAP team for the sources, lol. Here you go: JeffersonT,Di Pietrantonj C,RivettiA,Bawazeer GA,Al-Ansary LA,Ferroni E.Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 2010 Jul 7; (7):CD001269. doi: 10.1002/14651858.CD001269.pub4.PMID: 20614424. Jefferson T, Rivetti A, Di Pietrantonj C, Demicheli V, Ferroni E.Vaccines for preventing influenza in healthy children. Cochrane Database Syst Rev. 2012 Aug 15;8:CD004879. doi: 10.1002/14651858.CD004879.pub4. PMID:22895945. Cates CJ, Rowe BH.Vaccines for preventing influenza in people with asthma. Cochrane Database Syst Rev. 2013 Feb 28;2:CD000364. doi: 10.1002/14651858.CD000364.pub4.PMID: 23450529. JeffersonT,Di Pietrantonj C,Al-Ansary LA,Ferroni E,Thorning S,Thomas RE.Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev. 2010 Feb 17; (2):CD004876. doi: 10.1002/14651858.CD004876.pub3. PMID: 20166072. Poole PJ, Chacko E,Wood-Baker RW, Cates CJ. Influenza vaccine for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006 Jan 25; (1):CD002733. PMID: 16437444. Cheuk DK, Chiang AK, Lee TL, Chan GC, Ha SY.Vaccines for prophylaxis of viral infections in patients with hematological malignancies. Cochrane Database Syst Rev. 2011 Mar 16;(3):CD006505. doi: 10.1002/14651858.CD006505.pub2. Review. PubMed PMID: 21412895. Link to comment Share on other sites More sharing options...
PA2016! Posted November 12, 2015 Author Share Posted November 12, 2015 Thanks! Link to comment Share on other sites More sharing options...
NLRP3 Posted November 14, 2015 Share Posted November 14, 2015 Student Here.....So its that time of year again for flu shots. With so many people out there now against vaccinations this raises a question.... With standard vaccinations (MMR, Hep, varicella, ect.) we have plenty of evidence that we can use to show parents/patients that vaccination is a good thing and why they should vaccinate. I fell like there is enough evidence to win that argument, but what they decide to do after that is up to them... So, regarding the flu vaccine, which changes every year, may or may not work, and no evidence to back the yearly vaccine that is produce... How am I supposed to convince my patients that they should still get this if they are skeptical? Is it even worth the discussion if they are opposed? Just wondering how you guys handle this in clinic. Thanks You are making some broad sweeping generalizations here... None of which are particularly true. Cinnstp made some good points. But there is evidence that it works. Sure it doesn't work as well as MMR, Hep or VZV, but that is more due to the virus and the antigenic drift and shift, as well as low replication fidelity. However it works, some years better than others. However I think that the conversation is important to have, especially with at risk populations, because it is what is best for the patient, even if it is inconvenient for you. Link to comment Share on other sites More sharing options...
swooshie1 Posted November 18, 2015 Share Posted November 18, 2015 I have the conversation with patients, and specifically ask if they are intimately in contact with the very young or frail / very old. I put some stock into the "shedding of the virus" aspect when I have the discussion with my healthy adult population and ask them to think about whether their asymptomatic viral infection might be of concern to a close contact. Link to comment Share on other sites More sharing options...
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