Vaccinations

In the Frontline Special Vaccine Wars, the benefit of vaccines is put into question and both sides of the argument are highlighted. While some parents are concerned for their children of the possible side effects that vaccines may cause, there is the fact that these vaccinations prevent their child from suffering as well as contracting the disease and passing it on to other vulnerable populations. Both sides are justified in their viewpoints, and the question of, “Should vaccinations be a societal responsibility or a parental choice?” is left up in the air.

The video did influence the way I look at vaccines and the negative or positive views surrounding them. I remember the Swine Flu scare when I was in high school, and the vaccine being offered in the school. And I remember those who were against getting it because they were afraid of the side effects, and I did not know a single person who contracted the swine flu. The fact that it did not seem like a threat to our town may have caused so many people to deny the preventative measure. On the other hand, the vaccination may have been what had kept the outbreaks at bay. This documentary brought to light these kinds of dilemmas that have gained in prevalence. In a society where public health and preventative care has become increasingly important, the question of “When is it all too much?” is difficult to gage an answer to.

According to the NIH, “herd immunity” is the notion that when a majority of the population is immune against a certain illness, the spread of the disease is contained and the chance for an outbreak is greatly lessened. Populations that are ineligible for immunization are less likely to contract the disease, as well, because there is a lower prevalence. This principle of course relates to public health because it is a reliable and population method to bring a contagion at bay in a population, and to prevent it from becoming a problem. Once a vaccination is developed and tested, its use on a population can save many lives, especially those in high-risk populations. The mere fact that the amount of people susceptible is lessened greatly decreases the chance of a crisis.

A vaccination is different from other public health measures because it is essentially left up to a parent to decide whether or not their child is protected. While doctors and nurses have a strong opinion on the matter and there is a strong sense of social obligation, the health of populations is up to parents. Naturally, some parents will opt their child out of the required vaccinations. According to the documentary, this is due to unfounded fears about rare cases of side effects and crazy internet stories. The public is easily influenced by the media; our culture has become more susceptible to influence from internet blogs than from scientific findings. Of course, with the risk of side effects and rumors of a relationship to autism, however unfounded, some parents are unwilling to take that risk. Children may also not be vaccinated if they do not have access to a physician, for example if they are the children of illegal immigrants or possibly if they are born using a midwife. Also, if parents are uninsured and unable to pay health fees the possibility of getting vaccinated diminishes. As a whole, the fact that the illnesses we vaccinate for are hardly seen anymore, the need for vaccines does not seem that pressing. But it is these vaccinations that prevent outbreaks.

As a public health professional, I would increase the prevalence of vaccinations through media campaigns. Such propaganda worked against the tobacco and cigarette industry, and I am sure it could work again. The difficulty in this is that the scientific relationship between vaccinations and horrible side effects is much more controversial than the negative health effects caused by smoking cigarettes. Regardless, the internet is the “fuel on the fire of vaccination fears” and the unfounded fears should be dispelled as much as possible.

Passive smoking

“Tobacco use kills more than 5 million people per year,” according to the World Health Organization. In the United States, over 18% of deaths each year are attributed to smoking; about 50,000 of which is the result of second-hand smoke inhalation.

In January 1981, the British Medical Journal published a historically paramount study conducted between the years of 1966 to 1979, entitled “Non-smoking wives of heavy smokers have a higher risk of lung cancer”. During this study, 91,540 Japanese non-smoking wives were followed up for the period of time above mentioned (fourteen years) and mortality rates due to lung cancer were analyzed. A relationship was found between the amount that a husband smoked (the intensity of their addiction) and the mortality of their non-smoking wives due to lung cancer.

Several aspects of the study were interesting. The study was thorough in that it explored other possible cancers and illnesses relating to smoking and alcohol consumption, but the correlations were not statistically significant. The findings specified one risk – lung cancer in households with smoking husbands. Another important detail of the study was that spouses were questioned independently. The study was designed well in that it explored various illness and risk behavior possibilities in a huge number of subjects from varying backgrounds, which allows for the validity of trends found in the data. Also, the fact that it was designed with the use of independent questionnaires is vital, because this detail eliminates the possibility of bias due to the cultural pressures of male dominance, for example.

Ending with indisputably conclusive data on such a controversial and economically significant product requires a well-designed study that proves the epidemiological causality of the relationship between cigarette smoke and lung cancer. The aspects needed for a successful epidemiological causality study, as suggested by Mary Schneider, were included – a "dose-response relationship" between the severity of a husband's addiction and the development of lung cancer in his wife, almost 100,000 subjects, a strong statistical suggestion of the relationships between secondary smoke exposure and lung cancer. The results were indicative of the cause-and-effect relationship that researchers in the arena of disease are looking out for, although in this case it is suggestive as a risk rather than completely evidential. Takeshi Hirayama’s study on passive smoking has withstood the test of time, because after forty years his results are still reputable.

This study spurred greater awareness of the dangers of carcinogen-inhalation involved in cigarette smoking and the threats to health that second-hand smoke inflicts. This dangerous, addictive agent has affected so many lives regardless of if a person actively chooses to smoke or simply lives with a smoker. With 48.2 million smokers in the United States and 2.4 billion smokers worldwide, not only are these people put at risk but also those that live with or near them. This pushes the number of deaths due to cigarettes up much higher than the estimations might indicate.

Introductions

The air I breathe is heavy with smoke from the wood-burning cooking fires of a rural village in Guatemala. I had spent the morning doing arts and crafts with young children in the surrounding area. Dressed in little more than ripped shirts, their unwavering smiles radiated past the dirt on their skin, clothing, and the once-white walls. Their sanguinity despite their living situation was contagious. But in this moment, I witness a different kind of hope. An elderly woman dressed in traditional garb hobbles into the local health clinic where I have been working. I greet her and the woman tells me about her ailments. As I listen intently to her Tzutujil-accented Spanish, she shares that she is 94 years old and lives alone – her husband and all four of her sons had been killed in the civil war. A look of relief takes over as she thanks me for coming to her village and she thanks God for sending us. Even though her life is hard, her faith in the forces greater than us sustains her. Her hidden strength amazes me and I realize that when faced with hardship, we must grasp onto what we have left and recognize that it is alright to acknowledge life’s difficulties and ask for help.

My name is Ginny; I am a freshman from Princeton, New Jersey. In high school, I went on a trip to provide aid to mudslide refugees in Guatemala, where I saw first-hand the needs that public health serves – a demand that is insatiable. Also, as an EMT and volunteer in a New Jersey health clinic, I realized how many health issues can be prevented, and how much needs to be addressed in health care. This turned my eye toward the field of Public Health. I am particularly interested in global environmental health, especially water quality’s effect and the complex issues surrounding water rights (privatization vs. public access).

Public health is a dynamic field that is constantly updated and continually progressive, focusing on optimizing the quality of life of individuals and populations. The field incorporates both treatment and prevention -- in doing this, it is interdisciplinary. It combines social science, politics, and humanities, and allows for the cultivation of both scientific and personal creativity.

The first two classes were helpful in providing definitions for health and policy, and offered excellent background as we delve into more specific topics. Something I found particularly interesting was the lesson on epidemiology and how the field came about by “father of epidemiology” John Snow during a cholera outbreak. I had heard of the field but had not learned of the detailed procedures that it involves. This topic is intriguing because it is highly relatable, for news of outbreaks pervade everyday life. Various past biological threats such as the swine flu, anthrax, food-borne illness hit close to home, while we hear of many severe outbreaks in other world regions. I am taking Introduction to Public Health to learn more about the field (for its broadness can be overwhelming) and hopefully find my niche. So far the possibilities seem endless!