{"id":250,"date":"2009-01-22T10:14:40","date_gmt":"2009-01-22T15:14:40","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=250"},"modified":"2009-01-22T10:14:40","modified_gmt":"2009-01-22T15:14:40","slug":"fear-of-vaccines-not-just-parents","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/fear-of-vaccines-not-just-parents\/2009\/01\/22\/","title":{"rendered":"Fear of Vaccines:  Not Just Parents"},"content":{"rendered":"<p>Fear of vaccines are legion among many parents, with enormous <a href=\"http:\/\/www.cdc.gov\/vaccines\/spec-grps\/parents.htm#myths\" target=\"_blank\">public health resources<\/a> devoted to defusing this fear and trying to debunk common myths.\u00a0 I find <a href=\"http:\/\/www.immunize.org\/\" target=\"_blank\">this site<\/a> particularly useful.<\/p>\n<p>(Talk about a &#8220;hot button&#8221; topic.\u00a0 Read <a href=\"http:\/\/www.nytimes.com\/2009\/01\/13\/health\/13auti.html?_r=1&amp;emc=eta1\" target=\"_blank\">this <\/a>to get an idea about how passionate views on vaccine safety can be.\u00a0 Wow.)<\/p>\n<p>This fear, however, isn&#8217;t limited to parents.\u00a0 With the updated <a href=\"http:\/\/www.cdc.gov\/vaccines\/recs\/schedules\/adult-schedule.htm\" target=\"_blank\">adult immunization schedule just released<\/a>, I thought I would share a recent e-mail I received from a very experienced internist:<\/p>\n<blockquote><p><span>A man with nasal polyps on inhaled steroids regularly, requests Zostavax. Would you counsel avoiding the injection out of concern for him developing disseminated zoster with the vaccination, or is this not a concern? Would the vaccine have any effect on the likelihood of lung cancer recurrence, which was surgically resected last year?<\/span><\/p><\/blockquote>\n<p>The answer to the first question is easy &#8212; no.\u00a0 (Guidelines <a href=\"http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/rr57e0515a1.htm\" target=\"_blank\">here<\/a>, reviewed by me <a href=\"http:\/\/blogs.nejm.org\/index.php\/2008\/06\/02\/zoster-vaccine-guidelines-official-answers-but-still-some-questions\/\" target=\"_blank\">here<\/a>.)<\/p>\n<p>But the second question?\u00a0 Why would someone worry that the zoster vaccine would cause a relapse of cancer?\u00a0 Is there yet any biologic or epidemiologic data that could possibly link immunization with cancer recurrence or progression?<\/p>\n<p>Yet if the vaccine is given, and the cancer then recurs, will the patient &#8212; and his doctor &#8212; connect the two?<\/p>\n<p>One of the first lessons in Statistics 101 is that <a href=\"http:\/\/en.wikipedia.org\/wiki\/Correlation_does_not_imply_causation\" target=\"_blank\">correlation does not mean causation<\/a>.\u00a0 But boy this is a hard lesson to learn.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fear of vaccines are legion among many parents, with enormous public health resources devoted to defusing this fear and trying to debunk common myths.\u00a0 I find this site particularly useful. (Talk about a &#8220;hot button&#8221; topic.\u00a0 Read this to get an idea about how passionate views on vaccine safety can be.\u00a0 Wow.) This fear, however, [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8,9],"tags":[138,234,281,488,823,963,967,1008,1009,1010],"class_list":["post-250","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","category-policy","tag-cancer","tag-correlation","tag-doctor","tag-immunization","tag-safety","tag-vaccination","tag-vaccines","tag-zostavax","tag-zoster","tag-zoster-vaccine"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/250","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=250"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/250\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=250"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=250"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=250"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}