While there are verified cases of shingles in people of all ages – even adolescents – the risk of shingles appears to peak in those age 65 and older (as seen in the chart at left).
Dr. John Merrill-Steskal has spent 22 years as a Family Medicine Physician. He believes that doctors can help promote healthy behaviors by becoming more engaged on social media. Throughout the past year, in an effort to help shape public perception on a variety of medical topics such as vaccines, Dr. Merrill-Steskal has begun hosting a monthly radio show, blogging at The term “vaccine hesitancy” is a relatively recent term in medicine, a term used to describe patients who are worried about the safety, efficacy, or necessity of receiving immunizations. Vaccines are safe and have a proven track record of saving lives. As a result, doctors have been caught somewhat off guard by the notion that anyone would have second thoughts about the benefits of immunization.
Recommendations commonly publicized on how to respond to the vaccine hesitant patient are admirable, and have a calm, respectful tone. For example, doctors are encouraged to engage patients and respond to their concerns, while giving a clear message to recommend vaccination. Since treating patients disrespectfully or with disdain will only serve to alienate them further, being respectful, calm, and clear in our communication is our best chance at tipping the scales in favor of vaccination
The problem with this approach, however, is that physicians are on the defensive before a discussion even begins. And as in sports, a good defense without an offense will not win the game. Because of where we talk to patients, doctors are at a critical disadvantage: the physical place in which physicians engage patients about vaccines is typically the exam room, and by the time patients have arrived to the clinic they may well have already formed their opinions about vaccines.
As a result, physicians are forced to respond and react to concerns, and must attempt to reclaim ground that has already been lost. In other words, because of the nature of where physicians physically interact with and engage patients, we are by default always on the defensive as we work to dispel myths and misinformation regarding vaccine safety or efficacy.
To make a true difference on vaccine hesitancy, I think doctors must engage patients where the dialog is happening in real time: in the world of social media.
Every day patients acquire information, discuss concerns, and formulate opinions within the realm of social media. By the time a patient enters the exam room, their mind may already be made up about vaccines. While our discussions with individual patients in exam rooms will always be important, it is becoming equally important for physicians to enter the dialog where it is being created, before the patient arrives at the clinic. Physicians need to pay attention to what patients are talking about on social media, and need to be a part of that dialog. If we don’t, we will always be on the defensive.
It is time to go on the offensive, and is the only way we will win the game.
Dr. Merrill-Steskal is joined by a guest on his monthly radio show.
Dr. John Merrill-Steskal has recently been accepted to the 2016 American Academy of Family Physicians Vaccine Science Fellowship, an elite fellowship program which only accepts two providers per year. We look forward to learning more about his work in the area of immunization education and we suggest readers also check out his other immunization related blog posts such as Past and Present: Rubella and Zika and Can the anti-vaccine movement be convinced with more positive messages?
In this guest post, we hear from Heidi Parker, MA, Executive Director of 
In case you’re wondering who he is, 
I will be Kimberly’s voice as I continue to promote awareness of meningococcal disease, which includes MenB. I don’t ever want another parent to experience what I have. And more important, I don’t want another person to experience what Kimberly did when she battled for her life.
This guest post by Franklin Health Pediatrics pediatrician, Dr. Gabe Civiello, highlights the importance of 
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Every Child By Two’s State of the ImmUnion campaign is honoring National Immunization Awareness Month (#NIAM16) with a Blog Relay highlighting the importance of vaccines across the lifespan. 
Simply put, vaccines work! The World Health Organization estimates that vaccines save 2.5 million children’s lives every year. In fact, immunization is considered one of the greatest public health achievements of the 20th century.
Dr. Elizabeth (Betsy) Rosenblum, who is a Professor of Clinical Medicine at UC – San Diego Health System, with joint appointments in the Departments of Family Medicine & Public Health and in Reproductive Medicine, works hard to help protect pregnant women and their babies from pertussis. 
Some of my patients tell me “I’ll get the Tdap vaccine, but I want to wait until after the baby is born.” Certainly, getting the vaccine is better than never getting it. However, this plan offers far less protection. In order for a baby to have protective antibodies circulating in his/her system from the moment of birth, the vaccine must be given at least 3-4 weeks prior to delivery. Currently in the United States, the recommended time of Tdap vaccination for pregnant women is between 27-36 weeks (6-8 months of pregnancy).
The answer to this question is a resounding YES! All family members, caregivers, and others who will be around an infant should be certain they are up-to-date with Tdap vaccine. When everyone around a baby is vaccinated, this provides a ‘cocoon’ of protection, greatly minimizing the chances a baby will get sick from the disease.
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