"Dr. Sevilla, what do you think about the Ebola virus," a patient recently asked me. My patient and I talked about the recent news reports stating that over 1,500 people have died because of the virus. "There's a vaccine that's being developed," I told my patient. "Well, that's great. I'm definitely going to get it, IF...."
"IF...," I asked my patient. "Well, Doc you know how these things go. IF it's covered on my insurance, IF there are no side effects, and IF there are no bad preservatives in the shot, then sign me up."
According to this article, human trials for a proposed Ebola vaccine will start this week. However, I really don't think the future Ebola Vaccine will matter. Let's change the word "Ebola" to "Influenza" or "The Flu" for a second. Yes, Ebola has killed around 1,500 people, none within the United States. Influenza kills from 300 to 49,000 people EACH YEAR in the United States according to numbers from the Centers for Disease Control and Prevention. How successful are we (and I'm including me in this) at giving our patients influenza vaccine? We can do better. I can do better.
Here are the factors determining whether patients in the United States will consider taking a proposed Ebola vaccine:
Law of Vaccine Supply and Demand: Remember the Flu H1N1 epidemic from 2009? The country was obsessed with the Bird Flu, like they are now with Ebola. My patients were scared to get the Bird Flu, and they refused the regular Flu vaccine because H1N1 was initially not included. Then, a few months later, H1N1 was included. What happened? Suddenly, demand dropped. In the vaccine world, in my experience, when there is no supply (like the current Ebola non-vaccine) or few supply, the demand goes way up. However, when there is an abundance of flu vaccine (like this year), many patients gladly refuse the vaccine.
Insurance Coverage: A common question I get whether it's prescription drugs, testing, or vaccines is this one: Is it covered by my insurance company? Now, don't get me wrong. I'm very sensitive to this. My guess is that an initial wave of potential Ebola vaccine will not be covered, or will have spotty coverage, and this will drive down demand. In general, the annual influenza vaccine is covered by insurance. Do my patients take the flu vaccine? Some do, and some don't.
Side Effects: "Dr. Sevilla, I don't want the vaccine because I'm allergic to it." How many doctors have heard this before? With a potential Ebola vaccine, people are scared of Ebola, but some are more scared of potential side effects of a vaccine. Of course, there are some legitimate allergic reactions. But, I believe some patients use mild reactions as a cop out to receive any vaccine, especially the yearly Influenza vaccine.
Preservatives: As soon as a potential Ebola vaccine is announced, I predict the anti-vaccine extremists will be out there on social media and traditional media - trying to scare the public that the Ebola vaccine is worse than Ebola itself. They have previously used the excuse that preservatives and additives to vaccines in the past to try to scare people. Will this decrease demand? We'll see.
The truth of the matter is that we probably won't see an Ebola vaccine any time soon in the United States. Trials are set to begin in the United States, but the first vaccines will likely be deployed to the epidemic areas of West Africa. Don't get me wrong, it is a tragic situation in that part of the world. But, the hype that is being generated by people and by the press in this country, is overblown, in my opinion, at this point in time.
My patients ask me about a potential Ebola vaccine and Ebola treatments every day. When these vaccine and treatments actually become a reality in this country, will patients take the vaccine? Will you take the vaccine? Think about it...
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