Question

Read the passage given below and answer the three questions. Write the answer in proper APA format with correct in-text citations.

1. Should vaccines be mandatory, or should getting vaccinated be an individual choice?
2. Why is it important for the Canadian government to promote preventative care?
3. Is there a strong case, as Dr. Noni MacDonald argues, for integrating teaching about vaccines and immunization into the school curriculum?

Introduction

Canada’s reputation for universal healthcare is impressive. But can we still learn something from a Caribbean island with a Communist regime? Doctors cited in the following piece by Rachel Browne say that we can and we should. It may be a matter of life or death. The article was first published in Maclean’s magazine on February 11, 2015.

“What Cuba Can Teach Canada” by Rachel Browne

When a group of doctors and professors from Nova Scotia took a trip to Cuba in 2006 to study how the country managed infectious diseases, they were struck by how knowledgeable the average person was about vaccines, and decided to conduct an informal experiment: Quiz random passersby on the streets of Havana about their basic knowledge of their country’s vaccine safety program (the process by which vaccines are created and made safe) and their personal immunization records. “Without fail, everyone knew exactly what immunizations they already had, the scientific evidence behind them, and at what ages they needed to be updated,” says John Kirk, professor of Spanish and Latin American studies at Dalhousie University, whose research focuses on Cuba’s health care system. The research team also asked the Cubans their opinion on anti-vaccine movements in countries such as Canada and the United States. “They were dumbfounded. They thought we were joking,” Kirk recalls. “I guarantee you won’t meet a single person there who has doubted vaccines for a moment. For Cubans, vaccines aren’t only seen as a basic human right, but also as an obligation.” Upon their return, Kirk and his colleagues wrote an article for the Canadian Journal of Infectious Diseases, in which they conclude Canada can learn a great deal from the Cuban approaches to vaccinations and health care. The numbers say it best. According to the WHO’s 2014 global summary on vaccine-preventable diseases and academic studies, Cuba has not had a single reported case of measles since 1993, nor rubella since 1989. Five cases of mumps have been reported since 2000; the last one was in 2010. And pertussis hasn’t been reported since 1994. In contrast, Canada has had 2,203 cases of measles, at least 1,529 cases of mumps, and 21,292 cases of pertussis reported since 1990. At a time when new cases of preventable diseases are regularly cropping up and a loud—albeit small—contingent of “anti-vaxxers” keeps getting louder, it’s a good time to figure out how to change those numbers. Granted, Cuba’s population is around one-third the size of Canada’s, but Dr. Noni MacDonald, professor of paediatrics at Dalhousie University and consultant to the WHO’s committee on vaccine safety, who went on the research trips with Kirk, says one of the most innovative aspects of its public health system is its emphasis on vaccine education from an early age—something that’s lacking in Canada. From the time kids start school through to graduation, vaccination is consistently incorporated into courses and class discussions. “Our schools need to be teaching about vaccines and immunizations and their importance to our health, starting in primary school,” says MacDonald. “I don’t want a course in vaccinology. I want the topic woven into the fabric of our curricula: into science, history and health.” This might include discussing how military campaigns throughout history were brought down because of vaccinepreventable diseases or the outbreak of smallpox during the founding of Canada. She says this would be an effective way to prevent anti-vaccine ideology from makings its way into society in the future. Kirk attributes Cuba’s immunization successes to the higher number of doctors in the country and their deep relationships with community groups and the government. There is approximately one doctor for every 200 Cubans, compared to one doctor for every 476 Canadians. Cuba’s Family Doctor and Nurse program, which started in 1984, lies at the heart of the country’s health care system. Their mandate is geared toward preventive—instead of curative—medicine, as they cannot afford to treat illnesses as they come up. The program makes a point of meeting with patients twice a year and keeping meticulous immunization records. They are directly involved with education campaigns in schools, and students get a checkup every month. Kirk says this closeness with medical staff fosters trust and builds personal relationships between doctors and patients. Just as important as the primary care providers, Cuba’s community groups carry out directives from health authorities and follow up on vaccine schedules. For example, the Committees to Defend the Revolution and the Federation of Cuban Women, established in 1960 after the revolution, go into neighbourhoods on a regular basis to discuss legislation and government policies, and share news about personal and public health. Every year, the Federation of Cuban Women tracks down every baby to ensure he or she has been immunized. MacDonald says it’s unlikely such enforcement of immunizations would ever occur in Canada, but it shows the potential for community groups to shoulder some responsibility for public health outcomes and awareness, especially when Canada does not have a national vaccine registry. “Even if vaccines weren’t mandatory, Cubans would do it anyway,” she says. “Because they’ve been taught how to do it [and] they’ve been asked to participate in it, they’ve been asked to take pride in doing it.” For Eve Dubé, a medical anthropologist at Laval University studying vaccination ethics, Canada is a world leader in health services, but Health Canada could take a page from the Cubans on vaccine awareness. She is co-authoring a study on the vaccine choices of pregnant women in Canada, most of whom are choosing to vaccinate their children, but aren’t fully confident in their choice—meaning they might change their minds as their children grow older. “What we see is that these mothers— whether they decide to vaccinate or not—are still unsure whether they’ve made the right decision,” she says. “They are trusting friends, family members, even themselves, more than health care professionals.” Dubé says it’s not enough for parents to simply agree to get their children vaccinated; they need deeper understanding in order to prevent them from changing their minds or forgetting to keep immunizations up-to-date. At home, Kirk says he has tried to get the province of Nova Scotia to consider implementing some aspects of the Cuban model, such as mandatory courses on health, but he isn’t hopeful this will happen any time soon. A government minister told him the optics of doing so wouldn’t be so great.” He wondered how we, a province in a wealthy, developed country, could learn from a rinky-dinky communist country. But we need to do something soon. We’ve been looking at it through the wrong end of the telescope for too long and we’re paying the price.”

Answer 1

Answer 1: Vaccination should mandatory.

• Humans can get infected with a host of pathogens.
• Many of these pathogens spread from person to person.
• Sometimes, they spread to such an extent that they infect the majority of the people in the community.
• Many diseases have no cure.
• While some recover due to young age, lack of comorbid conditions, low pathogenic load some don't.
• In some cases, the infection is so severe that they need intensive care. This subgroup has a high mortality rate.
• Even those people who recover are not able to reach their pre-disease state. Some form of residual deformity remains (for example - infertility in males with a history of mumps infection).
• These deformities can reduce a person's productivity. This can socially and economically impair an individual.
• If a large number of people suffer from these types of impairment, then it can affect the community or country. If the young population of the country becomes unhealthy, it can negatively impact the country's economy.
• Treating disease and deformity puts a lot of pressure on the finances of the nation.
• Vaccines are medicines that prevent diseases from developing in an individual.
• They help healthy individuals to develop immunity against pathogens before getting infected and diseased.
• Therefore, for the betterment of the individual and the community vaccinations should be made mandatory.
• People who are skeptical about vaccinations should be counseled about the risk-benefit ratio of the decisions they make.
• Vaccination is a very effective tool to protecting the physical and economical health of the nation.

Answer 2: It is important to promote preventive care because:

• Preventive care helps to prevent diseases from occurring.
• The amount of money and resources that need to be spent on preventive care is much less compared to curative care.
• Preventative care includes but not limited to health education, immunization, screening for common disease, and research and development.
• By preventing disease, we are avoiding disease and deformity.

Answer 3: Yes there is

• There are a lot of myths about diseases.
• Every individual has a unique opinion about how diseases occur and need to be managed.
• Most of the time, these concepts are scientifically incorrect.
• The modern age of the internet has made easy dissemination of wrong information possible.
• More and more educated people are developing unscientific views about disease and disorders.
• If this pandemic of misinformation is not culled immediately, it can have far-reaching effects on the individual and community.
• The only way to stop this from happening is health education.
• Like with any form of education, it should be started as early on as possible.
• It is easy to influence young malleable minds.
• Such children who have been exposed to the right knowledge about vaccines at an early age will not be deterred by misinformation.
• Therefore, information about vaccination should be imparted to young minds early on in a form that is easy for them to grasp.