Check out this story I just posted on Newsworthy:

OOPS! It didn't link...

Doctors May 'Fire' Parents Who Don't Vaccinate Children

Well I don't think that's acceptable (and would never happen here. Although here kids health problems are mostly managed by GPs anyway. They're only referred to paediatricians for more complicated conditions. GPs are the ones involved with vaccines. But I know no British GP would turn away a family because of their vaccination decision). It should still be a parent's choice, and I can understand why a parent may be concerned, if they've had a child with autism. Of course there's no evidence whatsoever of a link between the MMR and autism, but I can still understand the fear. Instead the doctor should be talking to the parents, trying to calm their fears or make a compromise, such as vaccinating later, or individual vaccines (if they're available). Their priority should be the child.

That is exactly what happened to me, in a way. Around 16 I got HPV and was treated for it. Every year I went for a pap, it came back pre-cancer cells and they'd have to freeze them or have a LEAP procedure. I didn't have insurance for several years so I didn't go to the doctor for probably 4-5 years. So then 2 years ago, they found cervical cancer and had to have a big piece of my cervix removed. They said it came from HPV. This is one reason I believe in health care for everyone and vaccinations - because my visit to the oncologist-gynecologist and the surgery he did on me cost a fortune and could have been prevented if I'd had coverage - or if they had the HPV vaccination years ago. By the time they released the HPV vaccination I already had cervical cancer and I was "too old" to get the vaccination. They said I wasn't a candidate.

Now, they offer it to all girls over a certain age and I think that's a GOOD thing. You can't believe how scary it was for them to tell me at 28 that I had stage 1 cancer. On top of that, they said because of all the scarring on my cervix from all of those procedures over the years, plus the surgery - and there being something sort of wrong with my uterus that it would be extremely difficult for me to conceive children. And all that could've possibly been prevented from a simple vaccination and going to the doctor every year for an exam.

Some states in Australia (such as the one I live in) don't require healthcare workers (or indeed anyone else) to get the BCG. All I had to do before commencing medicine was get a Mantoux test. If it was negative, you were fine (which mine was). If it was positive, you were asked about BCG vaccination, and if you didn't have it, you were required to get a chest X-ray once every 2 years (happened to a friend of mine).

A (different) friend of mine is doing medicine in the state to the north of me, and she was required to get the BCG. I hear, however, that it has variable efficacy in adulthood.

Is the Mantoux test where they inject the bubble of liquid underneath your skin and monitor it 24 hours (I think) later?

I was thinking about this again today when I was working on the labour ward. Our hospital has just started offering the swine flu vaccine to staff. And I was undecided on if I should get it or not (although we are seeing swine flu within our hospital, and some people are seriously ill), and was still trying to weigh up the risks of the vaccine (VERY tiny, but potentially very damaging, risk of some rare neurological condition) against the risk of the disease (for me, as a young fit person, probably minimal, despite my increased chance of exposure through my job. BUT young, fit people have become critically ill with swine flu in Australia during their winter, such that they've required ventilation and even ECMO... plus also the consequences for healthcare provision should I, and other members of hospital staff, be off sick).

But I was on labour ward today and started to ask myself if it would be irresponsible of me to NOT get the vaccine when I'm working with pregnant patients. Of course some will have been vaccinated (as it's being strongly recommended for pregnant women, as a significant number have already ended up seriously ill, or dead, from swine flu), but others won't have. One of the obstetricians also made the point that it could be considered hypocritical for him to recommend his patients have the vaccine, if he hasn't had it himself.

Anyways, my questions are this (and I'd particularly like to here from the people who are anti-vaccines)...

- If you were pregnant, would you be happy to be treated by doctors and nurses/midwives who you knew had NOT been vaccinated?
- Do you feel it is the responsibility of those providing care to pregnant women to be vaccinated themselves (if the woman has chosen not to have the vaccine), so as to reduce the chance of pregnant women being exposed to the virus?

I don't think it would be irresponsible of you as a healthcare worker to choose to not receive the vaccine yourself. I think if the pregnant mothers do not choose to get the vaccine for themselves (which it IS recommended to get the vaccine if you are pregnant), they can't expect everyone around them to get the vaccine just because they didn't feel it necessary to receive it themselves. Did I make sense? If you can't protect yourself, you can't expect everyone around you to put things in their bodies to protect you. I do realize that, like with every other vaccine, there is a certain percentage of being unprotected and still being able to catch the thing that you're vaccinated against, but the first step for a pregnant woman would be to protect herself and her child by receiving the vaccine.

I also work in a hospital (although not in a clinical department) and have chosen to not receive the vaccine just because I am a healthy 20 year old female without pre-existing conditions, being immunocompromised, or having any respiratory weaknesses, and do not yet feel comfortable with the idea of the vaccine. My sister-in-law, niece, and nephew have all three received the vaccine via nasal spray, however, and are just fine.

I've been reading this forum on and off. It's brought up some interesting points and debates, I think a lot of people have some very interesting, and informative, opinions.

When I read this post, I agreed with Lauren. When she said it wouldn't be irresponsible for you not to get vaccinated.

I mean, the way I think of it, thats like saying, "Okay I don't want to get the flu, I'm not going to wear a facemask, but I want everyone else around me to wear a facemask"

If I was really that worried about getting sick, I'd get vaccinated. It's not up to everyone else to keep me from getting the flu. I mean, yes, people should take care, doing simple things like washing their hands, covering their mouths when they cough and sneeze etc etc. I'd expect people to do the bare minimum, but I wouldn't expect them to get vaccinated just because I don't want to get sick.

I just had another thought, if a parent chose to go the anti-vaccine route, and it just so happened that their doctor was also anti-vaccine, if the parent were that uncomfortable with it, they could always request another doctor, right? I mean, EVERYONE (pretty much) has that choice and right to make that decision. It's not just ONE person deciding not to vaccinate - ALOT of people choose not to vaccinate...there may be doctors in that category. Just because a person is a doctor doesn't mean they are void of that choice are they?

*Disclaimer - These are just my thoughts, if anyone disagrees with my thoughts, please discuss ideas rationally, don't attack me personally; it won't get you anywhere :)*

There are a small number of doctors who aren't completely in support of vaccinations, but they are by far in the minority (and even then, many of them aren't completely against vaccines either, but advocate alternative schedules, or delaying vaccines instead). The vast majority of doctors would encourage parents to vaccinate their children. The reason for this is that doctors actually understand the medical evidence that is out there and are able to see through the lies and myths produced by anti-vaccination groups. The same can't always be said for members of the public. :P

The flu and swine vaccines are slightly less clear cut, because most doctors are young and fit, so are at low risk from serious consequences should they catch either of those diseases (unlike the potentially life threatening consequences of measles, HiB or meningitis C in a child), so making the decision to have THOSE vaccines is a harder one, but choosing not to have them doesn't mean that the person is anti-vaccines, or that they wouldn't vaccinate their children.

Over the past week, I have seen a commercial on TV regarding meningitis and being sure to protect your children from it, etc. I had not seen that commercial until the past couple of months. Is meningitis making a come-back or something? They are pushing it very strongly here.

I just read this news story from the BBC about a 1-year old who died from meningitis. http://news.bbc.co.uk/2/hi/uk_news/england/wear/8328748.stm

I don't remember it being a "huge" deal when I was a kid because everyone was vaccinated. Is it because of people not vaccinating that they are coming out with these meningitis vaccination campaigns now?

I think it depends on the country, because different countries are prone to different strains of meningococcus, and so not every country requires the same vaccine. The meningitis C vaccine only came out here when I was in my teens, and there was big campaigns at that time for all children, teens and university students (particularly those living in halls of residences) to be vaccinated. I've not seen any big meningitis vaccine campaigns here since then really.

If I remember rightly when I was in New Zealand in 2004 they'd just brought out a meningitis B vaccine (as that was the biggest problem there).

Of course meningitis can also be caused by haemophilus (for which there has been the HiB vaccine since the 90s I think) and pneumococcus (for which there is the pneumococcal vaccine, which I believe has been used in the US for many years, but has only recently been introduced to the UK).

I think many parents don't even think about the risk of meningitis because the HiB vaccine and the men C vaccine have reduced the incidence of the disease significantly. Less children are dying from it, so there's less media attention. But probably many are unaware that this is a result of vaccinations (I suspect few people are even aware that one of the things the HiB vaccine protects against is meningitis).

But bacterial meningitis (or meningococcal septicaemia to be more correct) is probably the most deadly of all of the conditions which we today have vaccines to prevent. And not only deadly but it can leave children deaf, blind or requiring limbs to be amputated to save their lives. It's a horrible, horrible disease, but I think some people don't even realise that it's out there, or that they could so easily protect their child with those vaccines.

I don't think I actually answered your question... I wonder if the reason for the campaigns now is because of the drop in parents vaccinating their kids?

That article doesn't say which type of meningococcus that boy had, so it may have been one of the ones for which we don't currently have a vaccine.

I have a question - or three.

So this woman I work with came in our office whose entire family has had Swine Flu - all 5 members except her. I asked about the germs, and she's like "No, only if I have diarrhea and go around touching things would I be contagious". I disagreed with that. I wasn't asking if she was "contagious" anyway - she doesn't have Swine Flu. I was asking if the germs are being transported among people who aren't sick. Because, I know for a fact that you CAN give germs to other people, and then they give them to someone else. That's how kids get sick all the time. If they go out and play with a kid who was around another kid who is sick, then they could be exposed to the germs. That's not to say that they WILL get sick though.

I think that if you're exposed to the germs then you're still carrying around the germs, even if you don't have the illness. That's how kids get sick. You can get germs from other people if they have come in contact with the germs too. I've read about it and know from my science classes that it's true too. We even teach our kids here in America how germs are transported through an exercise where a few of the kids play with toys that has a [non-toxic, non-harmful] substance on it. The toys are taken away and the kids are left to play as an entire group. At the end of the day, they shone a sort of light on all the kids hands, revealing that the substance was on all of their hands. They used this exercise to show little kids how germs are transported.

Is that true of the Swine Flu? Does someone who is not sick with the Swine Flu but who has been exposed still carry the germs of the illness? Is it possible for someone to get sick from those germs? If not, why?

Would this non-transportation of germs be the difference between a "bacterial" illness and a "viral" illness?

Oh.my.gosh. Jodi - what you said above officially has me freaked! I was diagnosed with HPV last year and my PAP came back with pre-cancerous cells too. However, a few weeks after I found out (and before my gyno had the chance to freeze them) I lost my job and therefore my health insurance. I hope I don't have Cervical cancer. That seriously scares me!!!

OMG! In this case, since I've been there, I wouldn't risk it - I'd go back and just tell them you don't have insurance and that you can only pay like $5 a month on your bill or something. Sometimes when they know you don't have insurance, they will charge you less than if you have insurance anyway. Because that's an important thing to have done so it doesn't turn out to be cervical cancer. Once it's full blown cancer and you have to go see an oncologist, then you're talking big bucks!!

Just to throw this out there
The Ontario Government made the H1N1 shot available to the public.
The line I drove by today was a 4 hour wait for the shot.