Prev Med-Vaccine Safety

Question 1

Reasons some people don’t want vaccines

Answer 1

Ineffective, infectious, toxic, allergic and immunologic reasons.

Question 2

What is the good thing about using VAERS?

Answer 2

Permits monitoring of known adverse effects, detects signals of rare effects and allows for hypothesis generation.

Question 3

Limitations of VAERS

Answer 3

Reporting efficiency is low and cannot be used to prove incidence of adverse effects. Note that VSD (vaccine safety datalink) is the source that can actually give you true incidence.

Question 4

What does the institute of medicine’s role in vaccine recommendation?

Answer 4

Meta-analysis of published literature on adverse effects of vaccines

Question 5

Good study to quote for people concerned about MMR and autism

Answer 5

California study

Question 6

Why do we say there is no association between aluminum and autism?

Answer 6

You can’t because exposure to aluminum in the GI tract vs. hematogenous exposure is completely different. There may possibly be an association because alum activates the inflammosome which is associated with autoimmune disorders.

Question 7

Is natural immunity better that artificial immunity?

Answer 7

Yes, if you survive. However, note that if you don’t get a disease in childhood, it will be worse as an adult.

Question 8

How do you respond to a mother that doesn’t want to put her child at risk for the greater good?

Answer 8

Rather than say your kid will be at 35x risk for measles, share a personal story and they will respond better. Also explain that risk of omission is greater than risk of commission.

Question 9

How should you approach the shared decision making process with a patient that brings you information they found?

Answer 9

Show them sort A and B information that is more credible.

Question 10

What constitutes substantial risk?

Answer 10

Prevalence in community and mortality/morbidity of the associated disease.