Vaccines for the Internist - American College of Physicians · 6 Vaccines for the Internist §Whenbacteria or viruses enter the body their job is to multiply. •In order to do this

Vaccines for the Internist:

October 4, 2019 SD Chapter Meeting American College of Physicians

Dr Neil Goodloe, MD

Vaccines for the Internist: A discussion on a complex social issue

Neil Goodloe, MD

Infectious Disease provider

Western South Dakota

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Acknowledgement

§ This session is made possible through generous support by the Centers for Disease Control and Prevention (CDC).

§ The session has been partially supported by funding from Merck & Co., Inc.

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Adult Immunization Resource Hub

§ Developed as part of ACP’s I Raise the Rates initiative. § Provides updated clinical information, patient education

materials, quality improvement guidance and much more.§ For more information, visit:

www.acponline.org/ai

http://www.acponline.org/ai

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ACP Advance QI Curriculum

§ Learn core QI skills that empower you to implement practice-changing initiatives to increase adult immunization rates in your practice.

§ Additional ACP Advance offerings include a physician-led coaching service and chronic care resources.

§ To learn more, visit:

www.acponline.org/acpadvance

http://www.acponline.org/acpadvance

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Vaccines for the Internist

§ Vaccines are a public health tool to combat illnesses that have effected humanity for generations

§ First we need to understand how vaccines work and remember how the body fights illness

https://www.cdc.gov/vaccines/index.html

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§ When bacteria or viruses enter the body their job is to multiply.• In order to do this they must invade and evade.• This is called an infection• The immune system uses white blood cells

• Macrophages: Antigen, "Eaters"• B-lymphocytes: Antibody, "Notifiers"• T-lymphocyte: Search and Destroy, "Digesters", Memory

• Bleach and H2O2


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§ Vaccines did not begin with Jenner’s use of cowpox (1796 CE) to provide protection against smallpox• There was an earlier use: Chinese employed smallpox

inoculation as early as 1000 CE.• Practiced in Africa and Turkey as well, before Europe

and the Americas.§ Louis Pasteur’s 1885 rabies vaccine lead

to bacteriology and developments of antitoxins and vaccines against diphtheria, tetanus, anthrax, cholera, plague, typhoid, tuberculosis.

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§ With the improvement in methods for growing viruses the vaccines for polio, measles, mumps, and rubella have reduced the global disease burden greatly.

§ Now recombinant DNA technology and new delivery techniques are leading scientists in new directions.

§ The impact on global travel, war and social unrest have direct impact on vaccine-preventable diseases.

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§ It is important for your patients to be educated and informed• This is harder than it appears in a quantality versus

quality pay system• ACP, CDC, Merck all have documents to help


https://www.acponline.org/system/files/documents/practice-resources/patient-resources/adult-immunization-2018.pdf

https://www.merckvaccines.com/Professional-Resources/Pages/Home

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§ Vaccines imitate an infection•"I always get the Flu after the Flu shot".•It causes the immune system to produce T-lymphocytes and antibodies.•The job is to create the “memory” T-lymphocytes and B-lymphocytes to fight that disease in the future.•It takes a few weeks for the body to produce T-lymphocytes and B-lymphocytes after vaccination.•Timing is everything


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§ The “Overloaded Immune System” Misconception§ Receives multiple vaccines at once§ Expanded immunization schedule

•studies demonstrated it was not more likely to cause adverse effects when given in an expanded schedule than when they are administered separately.

The College of Physicians of Philadelphia

http://www.collegeofphysicians.org/

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§ Spread out the time to receive vaccinations “just in case” this misconception is inaccurate.

§ No scientific evidence to support§ Maintains risk of contracting preventable

diseases.



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§ The “More Vaccinated Than Unvaccinated People Get Sick” Misconception

§ Outbreak of measles in the United States• Unvaccinated people aren’t the only ones at risk• No vaccination is 100% effective

§ Public Health: the more unvaccinated population the greater risk for endemic or ongoing exposure



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§ 500 people who have been exposed to an outbreak:490 have been vaccinated, 10 have not.• Different vaccines provide different rates of

protection, assume that 98 of every 100 people (98 % effective)• 10 of the unvaccinated people, 100%• Vaccinated 10 people, 2% of the vaccinated

• Try Flu math with 60% immunity to strains




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Questions?

Documents

Vaccines for the Internist - American College of Physicians · 6 Vaccines for the Internist §Whenbacteria or viruses enter the body their job is to multiply. •In order to do this