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Managing Vaccine-Preventable Diseases in Antivaxxer Age

SEATTLE – Hospitals need to make sure staff members know how to deal with vaccine-preventable diseases (VPDs) that have re-emerged at least partly because of the antivaxxer movement, according to a new report.

The article published recently in the journal Anesthesia & Analgesia discusses measles, mumps, diphtheria, and other VPDs and how many healthcare providers are encountering the potentially serious and even fatal diseases for the first time because of the high rates of vaccine refusal.

Study authors from Virginia Mason Medical Center in Seattle review and update procedures, especially for operating rooms and ICUs.

"The increasing incidence of VPDs in the United States and Europe and the persistence of VPDs globally means that all clinicians must be prepared to manage infectious diseases previously believed to be controlled or eliminated in order to deliver the highest quality of care to all patients," the study authors stated.

The review cites a variety of factors as contributors to the resurgence of VPDs, including the anti-vaccine movement, the decreasing effectiveness of certain vaccines, adaptation of disease-causing pathogens, and travel to countries where disease rates are higher.

Especially when vaccine refusal rates are high, according to the report, herd immunity might not be achieved, putting entire communities at risk of VPD outbreaks.

The review offers as an example the measles outbreak linked to visits to the Disneyland theme parks in Southern California, stating that those "highlighted vulnerabilities of both vaccinated and unvaccinated individuals when exposed to a highly contagious airborne pathogen and the importance of herd immunity.”

Nine major VPDs are covered in the article, including measles, mumps, rubella, pertussis, diphtheria, influenza, meningococcal disease, varicella (chickenpox), and poliomyelitis. The diseases, mostly spread by respiratory transmission, can cause severe cardiovascular, respiratory, or neurological complications, according to study authors.

The authors discuss the use of isolation and, in some cases, personal protective equipment to prevent further transmission when patients with VPDs are hospitalized. They also recommend broader use of immunizations at hospitals that don’t yet require them.

"Hospital-based physicians … should be prepared to diagnose and treat patients with VPDs while protecting themselves, their own families, and other patients from infection," the authors emphasized.

"That these established vaccines, which have reduced once-feared diseases to memories, are now actively avoided makes every case of measles-induced blindness or Varicella pneumonitis more tragic," University of Chicago’s Avery Tung, MD, added in an accompanying editorial.

Tung urges anesthesiologists to take advantage of "teachable moments" during preoperative evaluations to provide patients with accurate information about the benefits and safety of vaccines.