Self-care, prevention and fake news

Disease prevention and the promotion of self-care become two critical pillars when sustaining individual and community health. Specifically, although it has been practiced for millennia, the World Health Organization defines self-care as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker”.

Essentially, “self-care” refers to the development of an active, informed and responsible attitude towards the goal of maintaining the best possible health conditions in life and reducing the risks of diseases that can be prevented or managed through individual free will.

Naturally, the individual and responsible care for one’s own health is interconnected with the one provided by Health administrations as a fundamental part of the so-called “Welfare State”. The connection between these two is made quite evident in matters like the development and implementation of the Vaccination Schedule approved by the Interterritorial Council of the Spanish Health System.

Vaccination is a cornerstone to reducing the individual and collective impact of vaccine-preventable diseases. It encompasses all ages throughout life, from pregnant women and infants to teens, adults and the elderly. And while it is fair to acknowledge that our country’s pediatric vaccination coverage is a source of national pride, the same cannot be said for vaccination in adults, an age group where vaccine acceptability is still far from reaching the optimal standards set by local and international health organizations.

Paradoxically, the success of childhood vaccination programs in Spain has led to the false perception that the use of vaccines to prevent infectious diseases is only meant for children. While this way of thinking might be sustained in diseases like polio, congenital rubella, diphtheria or smallpox, reality has consistently shown us that other diseases like seasonal flu, tetanus, shingles or pneumonia still pose a substantial factor for morbidity and mortality in all age ranges, but particularly so in older adults or those with underlying conditions, which are, in fact, the most vulnerable.

Over the last years, improving adult immunization programs has become a main goal for public health authorities in most developed countries. This stems from reasons such as demographic aging projections –nearly 40% of Spaniards will be over 65 years old by 2050–, as well as the aforementioned low vaccination rates and the expected increase in the amount of resources that will be needed in order to provide health and social care to a larger percentage of aging and sick citizens.

Regarding this situation, we need to boost investment in programs that will promote vaccination among the older population and improve their knowledge and acceptance of the value of vaccines in life. Programs to keep them updated about changes, or inform them about which vaccines are recommended for them and their benefits, and even alert them of when they should visit their healthcare centers to receive them.

Furthermore, these programs, fundamentally inspired by scientific evidence, could help counteract the spread of the so-called “fake news” that have proliferated in our field in recent years. Unfortunately, those who spread these conspiracies fuel a crisis of truth that undermines the research efforts and rigorous work of assessment agencies. Moreover, also by generating a social alarm surrounding matters like vaccination, these opposers hinder the use of calm dialogue, which would otherwise help in resolving any reasonable doubts and making informed decisions.

In the face of hundreds of articles published in scientific journals where information is validated and reviewed by peers, the spheres in charge of spreading vaccine myths consciously disregard these scientific facts by using alarmism and lies as a means of tribal cohesion.

In vaccinology, wasting time and not taking action against the type of cynicism that promotes a state of affairs where truth does not matter will have a double effect measured in human lives.

1. Firstly, it will enlarge locations liable to suffer from infection outbreaks by undermining the protective and collective effect of herd immunity. 
2. Secondly, it will force us to make unnecessary use of our ever increasingly limited and dysfunctional arsenal of antibiotics. As a consequence, the irrational use of these valuable medications will facilitate the emergence of antibiotic resistance. In simpler terms, many bacteria will change their structure and cease to respond to drugs meant to target them.

In short, it is time to act… as the set phrase says: better safe than sorry… something we are all collectively responsible for.