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LEGISLATIVE
INTRODUCTION

VACCINATIONS:

Public Health vs Personal Choice

By Rodolfo Molina, MD

I recently received an email from my nephew's wife in- first vaccine to protect against smallpox in 1798. Since then, there

have been numerous effective vaccines against prior known epi-
forming all family members of her due date and also re-
questing that we receive a DTaP vaccine if we plan to
grandparents-patients ask me about is the Tdap, an improved ver-
visit her and the baby. It reminded me of a question I'm hearing demics and illnesses that are potentially lethal. The vaccine my
more frequently by my patients who are grandparents: "Is it safe to sion of the typical tetanus booster that was licensed in 2006. This
get this vaccination while taking my arthritis medications?" A new- newer version contains an additional component to protect against
born is scheduled to get their first three doses of diphtheria, tetanus, pertussis. All adults, especially those who will be around young in-
and acellular pertussis (DTaP) vaccination (and some other vacci- fants and who can unwittingly pass this potentially fatal disease,
nations) by six months. After 15 months, they receive another should be vaccinated with this newer vaccine.
booster. Our Primary Care colleagues are doing a great job educat- Despite vaccinations having armed our immune systems leading
ing parents about vaccinations. to longer life spans, there is still controversy surrounding their ad-
The idea and practice of immunization is hundreds of years old, ministration. In 1998, Andrew Wakefield and 12 colleagues pub-
dating back to Buddhist monks drinking snake venom to confer im- lished an article in the Lancet stating there may be a link between
munity to snake bites. In the 17th century, the practice in China in- the MMR vaccine and the development of autism putting into ques-
volved smearing a skin tear with cowpox to protect against tion the safety of vaccinations. However, that article has now been
smallpox. Edward Jenner is given credit for the development of the completely debunked because of faulty data (reported sampling was

18 San Antonio Medicine • February 2019