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Vaccines: Fact or Fiction

October 12, 2018

In Point of Health episode 40, “Vaccines: Fact or Fiction,” Dr. Thomas Schenk, Senior Vice President, Chief Medical Officer for BlueCross BlueShield helps break down the facts about vaccinations. 

Transcript

Snyder:

Welcome to Point of Health! A BlueCross BlueShield of Western New York audiocast to keep you updated on key issues in the rapidly changing healthcare industry. I’m Julie Snyder from BlueCross BlueShield of Western New York and the host of Point of Health.

We want to provide focus for listeners on health insurance and healthcare in this free audiocast series.

One of the many ways forms of preventive care that we take to avoid illnesses and stay healthy is getting vaccinated.

Vaccines have been scientifically proven to be both safe and effective, but common misconceptions about vaccines can make it confusing.

We’re pleased to welcome Dr. Thomas Schenk, our health plan’s senior vice president, chief medical officer, to Point of Health he’s going to help break down the facts about vaccinations. 

Dr. Schenk joined our company in 2014 and oversees our clinical strategy, medical management, and all medical affairs, to ensure positive health outcomes for the nearly one million members we serve across upstate New York.

Schenk is a pediatrician by trade and served as managing partner at Delaware Pediatric Associates prior to joining the health plan.

Dr. Schenk:

Thanks for having me back! 

Snyder:

Let’s just start by explaining fundamentally, how does a vaccine work?

Dr. Schenk:

So the way a vaccine works, is pretty straight forward actually, what it does is exposes your body (immune system) to components of a thing that would normally make you sick and allows your immune system to respond to that and build immunity.  So, if you do encounter the actual thing that will make you sick, whether it is a bacteria or virus, you’ll be prepared to handle that, a less significant infection or no infection at all.

Snyder:

We often hear that vaccines can cause the diseases that they are meant to prevent and those sort of things we hear is everything are everything from I got the flu shot and in a week I have the flu, to really much more severe reactions that may actually cause a disease they are meant to prevent.

Is that true?

Dr. Schenk:

So vaccines cannot cause the disease that they are protecting you against because vaccines do not contain the things that cause those diseases. Vaccines these days are vaccines that are usually recombinant, or they’re broken down bits and pieces of a bacterium so there is no danger of catching the disease from the vaccine. There are some vaccines that are live vaccines and they tend to be viral vaccines specifically chicken pox vaccines, mumps, measles, and rubella. But even in those cases, the viruses used in the vaccines are not the actual viruses that will cause the illnesses. So, you cannot catch the illness from the vaccine. 

Synder:

So how do you as a practicing physician know, scientifically, what is the evidence that will help us know that a vaccine is both safe and effective? 

Dr. Schenk:

Vaccines go through a drug process at the FDA like any other kind of therapy that becomes approved in the United States. Vaccines are one in which we see studies developed all around the world because they are developed in different places. So, we look at studies that are not only done to prove their effectiveness and safety through the FDA, but we look at studies worldwide so we can pull together as many people as possible to really understand the safety and effectiveness of a vaccine.  Vaccines are something people should be very comfortable with a level at which they are studied. There is just a ton of information about the safety of vaccines. That’s not to say that vaccines don’t have side effects associated with them, but the safety of the vaccine far out ways any danger of getting a vaccine and the side effects tend to be very mild side effects. 

Synder:

Certainly we’ve nearly eradicated polio worldwide and no one would ever argue that the vaccine that was created for polio was not lifesaving for thousands if not hundreds of thousands of children. That being said as a pediatrician, probably more so than around adult vaccines like a flu shot. Let’s just talk, as a pediatrician you’ve probably receive many questions from parents about vaccines. Is it Gwyneth Paltrow that came out really against vaccines? I mean I feel like were going right to TMZ, but let’s talk a little bit about why parents are really questioning vaccines and what the common media narrative has been, good or bad. 

Dr. Schenk:

A lot of what a pediatrician does is around the prevention of illness because many children are healthy and so a huge part of our job is to make sure they maintain that health and we don’t allow things that are avoidable to come along and damage a child.

So, vaccines are a cornerstone of the practice of pediatrics. You know in the media there have been popular figures who’ve have been against or have been negative toward vaccines as long as there have been vaccines. You can go back in time and read about the development of the first vaccine which was for small pox and even then you will see articles in the paper from public figures at the time that are anti-vaccine and even some that did not vaccinate their children as a result of that.

That anti-vaccine movement has been around since the discovery of vaccines. Having said that, most recently it has been people like Jenny McCarthy and I think Gwyneth Paltrow did have a little something to say about vaccines. We’ve even seen people unfortunately in public office that’ve had negative opinions of vaccines or questioned the effectiveness of vaccines and it’s unfortunate because it sort of slows down our momentum around making sure that our society is protected.

That is one of the key roles that pediatricians serve and one that is really important. I think, I’ll just take one minute to just comment on in my practice career, the connection or the imagined connection I’ll say, between vaccines and autism is something that I had to deal with every single day when I would take to parents about vaccinating their children. That is a link that is completely disproven, it shouldn’t even be a topic of conversation anymore at this point, but one that even now still lingers in some people’s minds that seems to be concerned about.

Synder:

Well this really helpful dialogue Dr. Schenk. When we come back from a short break our health plan’s senior vice president, chief medical officer will continue setting the facts about vaccines. I’m Julie Snyder, Vice President Corporate Relations and you’re listening to Point of Health.

Please stay with us; you’re listening to Point of Health.

Before the break, we discussed common misconceptions about vaccinating children and I think that as you stated really, the evidence is so strong that really parents have an obligation to continue to keep their children healthy by all means not which the least is vaccines, but is it true that older adults really don’t need to get vaccines nor as many vaccines? 

Dr. Schenk:

So, older adults and adults in general should still be thinking about vaccines. I feel like a lot of people think vaccines are a thing that happens to little kids and babies, but in fact vaccines are something you should be keeping current with really through your entire life.

There is another peak, when you get to be older, older than 50. So, adults want to get vaccines that are boosters for them, but there may also be new vaccines that they didn’t get as a child that they may be eligible for. So, there are things like diphtheria tetanus and pertussis boosters. There is a vaccine for shingles called Zostavax which is an important one to get. There are two vaccines for phenomena that adults over 50 should have at some point. Then adults should get an influenza vaccine every single year. There’s even another vaccine which we usually give to teenagers, but if you didn’t get it when you were a teenager, you can still have when you’re an adult and that is a vaccine for human papillomavirus vaccine that actually prevents that virus from causing cancer. It was really the first vaccine designed to prevent cancer as an outcome and something we really should be paying more attention to.

Synder:

The HPV vaccine, is a three step vaccine, for both boys and girls?  

Dr. Schenk:

Yes, HPV vaccine is now two shots instead of three. People become eligible to receive the vaccine when they turn nine. Usually they receive it around their 11th birthday, but some people will go through all their teenage years and decline it or not be offered that vaccine depending where their getting medical care. You can still receive it at the ages 20-26 from a family physician or a OBGYN. 

Synder:

So certainly there is a misconception that vaccines are unnecessary if the disease isn’t prevalent anymore. We talked about polio for instance. Can you to us about that the necessity of vaccines for a disease that is essentially eradicated? 

Dr. Schenk:

The idea that a disease isn’t something that we see all the time that you no longer need to be vaccinated anymore, is one of the most dangerous kind of idea that floats around when we talk about vaccines because the reason that many of the illnesses are held at bay and we aren’t seeing them is because people are vaccinated. Not just because some people are vaccinated, but most people are vaccinated. We’re vaccinating our society at a high rate and that builds immunity in all of those individuals.

Some people that a vaccine does not work very well or for others that didn’t get vaccinated; if you can build a cushion around them, it’s called herd immunity so they don’t ever come into contact with that illness you’re also preventing them from receiving the illness. Things like a childhood vaccine such as Haemophilus Influenza B, which is a bacteria that can cause meningitis.

Before I started practicing pediatrics, hospitals were literally full of children suffering from meningitis from that bacteria. The bacteria can result in death and it can result commonly in deafness. By the time that I was practicing, it was becoming a common vaccine administered to infants. I saw three cases of that my entire career and if you had spoken to some of my older partners, all they did was take care of children affected with meningitis six hours a day. Vaccines make an enormous difference, but once the illness goes away, we still need to keep pressure on that illness or it will come back.

Synder:

So were recording this in fall, it is October in upstate New York and the ads have already started about the flu vaccine. Basically, I can get the flu vaccine basically anywhere I have to buy anything. Is there anything you want to stress about the flu vaccine? Who should get it? Where should they get it? 

Dr. Schenk:

Everyone older than six months should have a flu vaccine every single year. You can get the flu shot at grocery stores, pharmacies, flu vaccine pop-up clinics or your physician’s office. Young children generally will go to their pediatrician for those vaccines. Many locations will not vaccinate young children due to consent issue and the noise around giving vaccines to little kids. Once your child is older or you are an adult, you can go to any of the locations given to get the vaccine. It is important to do every year.

Synder:

What about our seniors? Anyone over 65 and older, what type of vaccine do you like them to have every year? 

Dr. Schenk:

As I mentioned, senior citizens should make sure they’ve gotten their shingles vaccine and they only need to get that once. They should have their phenomena vaccines, which again you need to do once, but there are two of them. Then, the flu shot should be every year. Some senior citizens will get a version of the flu shot that is a little bit stronger, because they have less reactive immune systems. If you are in that position, and have several illnesses to manage, it would make sense to get your vaccine through your physician so you know you’re getting the right one. If you are otherwise healthy, it is less important. 

Synder:

According to the CDC, there was a recent study in the Journal of Clinical Infectious Diseases that stated that flu vaccination reduced deaths, ICU admissions, ICU length of stay and overall duration of hospitalization for people that are admitted for the flu. So again especially thinking about our parents, our grandparents or the seniors in our lives, it is a very important and could be lifesaving vaccination.

Dr. Schenk:

Yes, that is absolutely true. I think physicians have known for a long time that the flu vaccination is effective in preventing serious illness with influenza, its been in the last couple of years that data has been aggregated for studies to appear. We know when people are vaccinated for influenza, people get significantly less ill and there are many fewer hospitalizations. The chances of going to a urgent care drop by roughly 80 percent and many lives are saved at the end of the day. It is a key thing we need to do in the fall and now is the right time to go get that vaccine. 

Synder:

Well this has been a very compelling Point of Health and I think very timely. Every time Dr. Schenk comes on to Point of Health our numbers go through the roof. You are one of the most guests. So we are certainly glad to have you back in studio.

I’m Julie Snyder, Vice President Corporate Relations, here today with Dr. Schenk our health plan’s Senior Vice President, Chief Medical Officer, thank you for listening.