- © 2008 Canadian Medical Association or its licensors
Rolando Ulloa-Gutierrez recently highlighted the serious issue of public misperceptions about pertussis, as well as its prevalence and effects.1 Over 20 years of practising rural family medicine in southern Manitoba, I have sensed that my patients have become increasingly sceptical about immunizations and there has been an increasing rate of refusal to be immunized. In an unrelated letter in the same issue of CMAJ, Mark Diotallevi noted the differences between how testimonials and evidence affect patients' decisions regarding therapy.2
It is my impression that these two issues are linked. The rates of vaccine-preventable illnesses and of serious complications from these illnesses are so low in Canada that few physicians and few patients have ever seen a case. We are nearly 2 generations removed from the Canadians who witnessed epidemics of these illnesses: testimonials about polio, diphtheria and pertussis are much less prevalent today than they were a number of years ago.
If we are to convince patients that stories about adverse effects of vaccination are overstated or incorrect, we will probably need to use testimonials along with evidence. As Ulloa- Gutierrez pointed out, many countries continue to struggle with vaccine- preventable illnesses. If we turn to them for testimonials, perhaps more Canadians will again come to understand the importance of immunization and we will be able to avert future epidemics.
Footnotes
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Competing interests: None declared.