Известный вам Juan Gervas MD вместе с двумя студенческими медицинскими организациями и своей NoGracias создали эти 10 заповедей для врачей.
Идеи развития проекта и исправления ошибок приветствуются
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INTO ENGLISH http://equipocesca.org/en/decalogo-de-uso-racional-de-vacunas-madrid-noviembre-2015/
TEN COMMANDMENTS FOR THE RATIONAL USE OF VACCINES
November 2015. Farmacríticxs, IFMSA-Spain and NoGracias
Introduction
«Vaccines are a treasure that is not defended and it is improved by simply repeating that mantra. The vaccine treasure requires good use and a continuous critical evaluation, in relation to developping and maintaining the vaccination schedules. Vaccination policies have been very poor in the recent decades, in the scientific, professional and political areas. This has arose «vaccine hesitancy» in the population and in some extreme cases, rejection as a whole. The medical students integrated into Farmacríticx and IFMSA-Spain and healthcare providers members of NoGracias are developing a project that promotes the best use of vaccines, and they have develop the decalogue commandments to promote the rational use of vaccines «
First proposal. Vaccines are a treasure. Throughout more than two hundred years they have helped to avoid many causes of suffering and death. For that, it is neccesary to use vaccines properly. In any case, vaccines are never 100% effective and there are always several causes for failure, such as non compliance with the schedule.
Second proposal. Vaccines have a price, which has been increasing in recent years. The high price limits their supply to the developing countries. It is therefore appropriate that vaccines have a reasonable cost to make them accesible to everyone.
Third proposal. All vaccines are not equal, and not all are equally necessary. For example, measles produce herd immunity (protects the vaccinated and the unvaccinated) while the tetanus vaccine protects only vaccinated people. Therefore, we should appreciate the differences between vaccines, as not all are equal; between diseases, as they are not always identical; and between the epidemiological conditions in the area.
Fourth proposal. Vaccines are medications with benefits and adverse effects, even when used properly. For example, measles can cause one encephalitis per million.
Fifth proposal. Professionals and the Administration have a duty to inform patients (and their legal representatives for minors) about vaccines, its likely benefits and risks, in a way that is clear and that fits their understanding, empowering them to make an informed decision.
Sixth proposal. Some vaccines are universal since they are necessary, efficient and safe, and they should be included in the National Health System (NHS) vaccination schedule. Thus, vaccines such as those against poliomyelitis, diphtheria, measles, rubella, mumps, pertussis and tetanus should be financed by the NHS. The inclusion criteria are: the knowledge about the natural history of the disease and the human response, a positive benefit/risk balance and a price that prioritises public health aspects. Therefore, the choice of those vaccines included in the schedule should not depend on economical interests and these interests should not limit their improvement.
Seventh proposal. Both the lack of vaccines and their incorrect use have negative effects. A rational use of vaccines is needed, which includes the formulation (either multicompound or single dose), the administration (combined, simultaneous), the route of administration (intramuscular, intradermal, nasal and other) and the vaccination schedules.
Eighth proposal. Vaccines must have at least the same pharmacovigilance as any other medication. But, as they are used systematically in healthy individuals, their safety is vital and an in-depth study should be performed before and after their commercialisation.
Ninth proposal. There should not be any differences between the Spanish regions in the vaccination schedules mentioned above, since there are no differences in the geographical distribution of the pathogens.
Tenth proposal. Since vaccines are not and will not be perfect, it is necessary to promote and accept the scientific debate that supports a continuously improving process and helps to approach the «vaccine hesitancy» of the population.
