A Social Responsibility to Get Vaccinated?

Paul A. Offit, MD


July 12, 2010

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Hi, my name is Paul Offit. I'm talking to you from the Division of Infectious Diseases and the Vaccination Education Center, Children's Hospital, Philadelphia [Pennsylvania].

One thing that I'd like to talk about is a notion that has been lost over the last 50 years, and that is whether it's one's social responsibility to get vaccines. I think it's probably the rare physician who has to make the argument that one should get vaccinated and make sure that their children get vaccinated, because a choice to not get a vaccine not only affects your own children, but it affects the children sitting next to them.

For example, there are hundreds of thousands of people in this country (many of whom are children) who can't be vaccinated. They can't be vaccinated because they're getting chemotherapy for their cancer, or they can't be vaccinated because they're getting immunosuppressive therapy for their rheumatologic diseases or their transplants. They depend on those around them to be vaccinated because 'if they're living among a population that is relatively unvaccinated, they're the ones who are most likely to get a vaccine-preventable disease, and are most likely to suffer with that disease.

But I think physicians feel that they can't make that argument. However, I think that they can, and that a physician has to make it clear to the parent that the parent is responsible to children in their waiting room. Probably the best example is an outbreak of measles that occurred in San Diego [California] in 2008. There was a set of parents who chose not to vaccinate their child and took their child to Switzerland, where the child got measles. Because the child had a fever and a rash, and the parents were unclear as to what was causing it, they went to the doctor's office. In that doctor's office, they exposed 3 more children, all of whom were less than a year of age who hadn't been vaccinated because they couldn't have been vaccinated yet against measles, and all 3 of them got measles. One of them got measles severely and suffered severe dehydration.

I think that one can make a social responsibility argument. I think because this isn't a car seat, this is a vaccine where a choice that you're making affects not only your child, but the child who comes into contact with your child. I think it's your responsibility, actually arguably, to make it clear that a choice to not have a child vaccinated' affects your waiting room, and it affects everyone with whom the child comes in contact. I think it's worth a shot.

Thanks; again, this is Paul Offit. If you want more information about vaccines, please check out the Website at Children's Hospital of Philadelphia.


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