We benefit from fully vaccinated communities

DEAR DR. ROACH: I read your views on vaccinations and was bothered about one issue. Who are “anti-vaxxers” — those opposes to vaccinations — putting who at risk by not having their kids vaccinated? Primarily others of like minds, it seems. Those who are vaccinated are not at risk, right? The only others I think might be at risk are future generations if we could ever fully eradicate such diseases, but that is a small probability.

I support people’s right to deny entering programs they disagree with, even if they are ignorant. — T.R.

ANSWER: You would be correct if vaccines were 100 percent effective and if everyone could get them, but neither of those are true.

Two doses of measles vaccine are about 99 percent effective, but that means with widespread measles transmission, one person in a hundred could still get measles even if vaccinated. The reason that hasn’t happened in the past few decades is that there has been enough vaccine coverage that there has not been widespread transmission, so even people who are potentially susceptible are never exposed. This is called herd immunity, and is the major reason that people seldom die from measles now.

Success of vaccines has led to where people no longer know how serious measles can be. Once vaccine coverage drops below 95 percent, then sporadic cases and ongoing transmission are possible, and we are seeing that now in several communities.

Some children, adults are unable to be vaccinated due to underlying immune deficiency, illness or chemotherapy. These are at extreme risk of death from measles, and the only way to protect them is through herd immunity. I believe there is a moral obligation to get vaccinated for a person who lives in society to protect others.

Since people are infectious with measles before it can be diagnosed, a person’s right not to get immunized is outweighed by the cost to others, at least during an outbreak. This is why health officials are able to quarantine people who are not vaccinated and potentially infectious, and on rare occasions, to forcibly vaccinate them.

Even if a person has the right to decide against immunizations, I feel personally obligated to try to convince them that the risk of the disease.

DEAR DR. ROACH: I recently had a cancer growth removed from my upper arm by a dermatologist. I was instructed to use Vaseline on the wound. I told them I use an antibiotic with pain reliever. I was told that because this is an antibiotic, I will become immune to the usage. Does the topical antibiotic have the same effect as a pill or shot? Will I become immune as described, or is it safe to use as I have done for 40 years? — W.B.

ANSWER: I agree with your dermatologist. Petrolatum, such as Vaseline, is effective at keeping a wound moist, which promotes healing, and acts as a barrier to keep out dirt and bacteria.

Topical antibiotics may have additional usefulness in areas of skin infection or to reduce a dangerous bacteria like MRSA, but is no better than petrolatum for a clean surgical wound. Downsides to topical antibiotics include resistance, but also skin reactions.

(Write to Roach at 628 Virginia Drive, Orlando, FL 32803.)