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Vaccinations

[Editor’s note: This article takes a pro-vaccination stance. It is SurvivalBlog’s position that every parent has the right to raise their children as they see fit and that mandatory vaccination programs are an overreach of governmental authority. Aside from the discussion of whether the vaccinations cause reactions of one sort or another, there is an ethical issue on what materials are used in the production of vaccines. SurvivalBlog will never advocate using vaccines that are manufactured with aborted fetal tissue and/or toxic ingredients.]

Now back to my initial story about having to get a vaccine due to a lack of records in our possession. With the exception of sanitation and possibly the development of antimicrobials, vaccines have been responsible for more lives saved than any other invention/discovery by man. “It is estimated that 3 million children are saved annually by vaccination, but two million still die because they are not immunized. Tetanus, measles, and pertussis are the main vaccine-preventable killers in the first years of life.” (Vaccine. 1999 Oct 29;17 Suppl 3:S120-5)

The United States is currently in the worst pertussis (whooping cough) epidemic this country has seen in fifty years, due to a lack of compliance with health care recommendations as well as a waning immunity in the older population. In a first world country where vaccines are readily available, we are having the worst outbreak in 50 years. Imagine what it would be like when organized health care is not available, or don’t imagine and just look at what is happening in Syria in regards to polio– a disease that had almost been completely eradicated. Quoting from the UN and WHO regarding polio, due to the “seriously damaged health infrastructure, poor health access and utilization because of insecurity inside Syria, and massive movements of vulnerable and at-risk populations in and out of Syria – all make controlling the outbreak and rendering health protection to Palestine refugees in Syria and across the region very challenging.” Look at how easily measles made it into a first world country that is mostly vaccinated. All it takes is one person being around you or your family with a communicable disease, and you not having protection, to make all your other preparation obsolete. It is difficult to take advantage of all your preparations if you are too sick to move or if you are dead from a preventable disease.

In recent months, pertussis has taken a back seat as a mysterious “polio-like” illness with paralysis that has hit the pediatric population in this country. The suspicion is that it is related to the Enterovirus that swept the country last fall and this winter, but in all reality the scientific community doesn’t have an answer. There’s no answer when the top specialists are working on the problem. Trust me; disease will become a significant concern in a broken society.

There is a movement in this country to not vaccinate. It has entered into almost everyone’s conversation these days. As a physician, I can tell you neither I nor any of my partners have ever seen a severe reaction to a vaccine and this encompasses over 100 years combined medical experience. I am not saying adverse reactions don’t happen; there is no such thing as 100% safe medicine, food, liquid, et cetera. Obviously, there are people out there who have had severe reactions to vaccines or the warnings would not be present on the handouts we give to parents concerning potential reactions, and there wouldn’t be a fund to pay for vaccine-related injuries. It just isn’t anywhere as prevalent as the misinformed claim.

I have, however, personally seen severe disease and even death from various vaccine-preventable diseases in the unvaccinated population.

I am not going to argue with people who are anti-vaccination, as you can’t convince someone of the best available scientific evidence if they are convinced there is a conspiracy or that the falsehoods spread on the Internet are real. I am just stating that if you really understand the disease process and what will happen with health care and public health in a break down of basic services scenario or in a pandemic situation, then vaccination would be a “no-brainer”. Just like with those who accept the inherent risks associated with driving, what it comes down to is the benefits outweigh the risks, and if you are truly preparing for a major disaster, vaccination should be part of your family’s prepping plan.

Antimicrobials

Right now, the medical profession practices what is called evidence-based medicine, meaning there is enough scientific evidence to support the care and treatment that are currently provided. Will I tell you that all medicine is safe? Absolutely not! Will I tell you antibiotics are over prescribed? Absolutely! I see reactions to medications and improper use of medications constantly.

Alexander Fleming, a British bacteriologist, discovered penicillin in 1928 by accident when he sloppily left a Petri dish of bacteria unwashed in his lab. He found a substance (later named penicillin) growing on it that killed the bugs, and modern-day antibiotics got its start. Fleming shared the Nobel Prize in 1945 for the discovery. The biggest problem with antibiotics is overuse. The rampant use of antibiotics has resulted in super resistant bacteria that nothing can kill. If anyone is going to prescribe an antibiotic for you, they should be able to answer what bacteria are they treating.

So what should you know about antimicrobials in a disaster situation? Are antibiotics found in local pet stores safe for humans? How long will stored antimicrobials remain viable?

From a professional stand point, in a non-disaster scenario, I would strongly recommend against the use of any antimicrobial not prescribed by your physician, as I have seen severe reactions with antibiotics (look up Stevens Johnson Syndrome). However, if I had no other alternative in a disaster situation and I knew what I was treating, I would use anything available, including pet antibiotics, antibiotics I found in the neighbor’s medicine cabinet, antibiotics that were years out of date, et cetera. The key here is the part about “if I was in a disaster scenario and knew what I was treating”. If you don’t know, you could absolutely do more harm than good. The one class of drugs I would definitely avoid, if more than a year old, would be tetracycline, minocycline, doxycycline, due to issues involving the kidneys.

As far as longevity of antibiotics, there were studies by the U.S. military that looked at ciprofloxacin out to 10 years, depending on the environment in which it had been stored. Ciprofloxacin was the most bioavailable after prolonged storage, but multiple antibiotics retained some potency long past their expiration date.

The pharmacist will tell you antibiotics are good to one year past their date of sale, but like with food storage environment is everything. In all reality the antibiotics in your medicine cupboard have probably lost considerable efficacy by year two, but that wouldn’t prevent me from using them if I was in a dire situation. Sunlight and heat are probably the worst environment for medications followed by high humidity. Ideally a cold, dark, dry environment would be ideal for antibiotics. I would suggest storing antibiotics in a fridge after placing them in a dark bag with an oxygen absorber. So let’s say you buy fish antibiotics or online antibiotics or over-the-border antibiotics. How do you know how to use them?

In my opinion, the best resources for someone trying to determine what they are treating and what they should be treating with is The Sanford Guide to Antimicrobial Therapy with Clinical Microbiology Made Ridiculously Simple as a back up for those who really want to study the pathogens you are dealing with. I would also have a Dorland’s Medical Dictionary in my library to define terms found in both the other books. The Sanford Guide takes a condition, lists symptoms, lists common causes and first, second, and third line treatments for many of the conditions as well as the dosage. The drawback is that you would have to know things like “tinea cruris” means “jock itch”, in order to look up the therapy. This is where the dictionary would come in handy. While parts of all these books will be way over the head of someone who has never studied microbiology or is unfamiliar with biological terms, Micro Made Ridiculously Simple does contain descriptions of symptoms caused by various common bacteria. The best thing about the Sanford guide is that it is extremely small and light weight yet packed with tons of useful knowledge, and if I had to go with just one antimicrobial guide it would be the Sanford. It usually runs $15-$20.

To sum up, while I personally think clean, potable water is the most important preparation anyone can make, personal health preparation should be a high priority on your preparation list if you want to continue to enjoy your current quality of life after an event.

Waste Elimination

When confronting sanitation issues, the basics are still the most important. Practicing good personal hygiene, such as bathing regularly and washing hands before handling food, eating, and after using the toilet, will prevent the spread of pathogens. However, sanitation can be over done. All these antimicrobial soaps and hand sanitizers are probably contributing to the emergence of MRSA (Methicillin Resistant Staph Aureus) and other resistant bacteria that are so prevalent in the news now days.

I don’t think the importance of waste elimination can be overemphasized, despite it not being a very palatable subject (no pun intended). In addition to treatment of drinking water, proper waste disposal is vital for maintenance of health in a grid down scenario. Assuming TEOTWAWKI will eliminate indoor plumbing, we may all be digging outhouses in the backyard.

So how does this translate into basic preps for the homeowner? Obviously, the answer is where will your waste disposal occur? I’m not suggesting you dig an outhouse in your back yard tomorrow, unless you already have a bug out location built and stocked. If that is the case, then you might want to consider a just-in-case alternative location for waste elimination. I’m talking about having at least a bucket with bags or sawdust that can be used indoors and having reviewed or printed off the information in the article from this website “An Essential Prep: The Outhouse, by KMH“.

I’m trying not to be redundant, but if you have at least considered where waste will occur in a scenario where you lack indoor plumbing you will be well ahead of the rest of the population. Just remember that any waste elimination should be at least 200 feet from a water source and that proper sanitation is a must for healthy living. In addition to thinking about water and sanitation from a healthcare standpoint, I suggest we all be proactive in getting our medical preps in order. There have been a number of excellent articles about first aid kits, so I would like to discuss other aspects of personal healthcare preparation.

Personal Healthcare Preparation

Medications

In addition to keeping accurate records of your vaccinations and health history in your bug out bag (so you don’t have to get that extra tetanus shot), I strongly suggest that anyone that is on daily medication have at least one to three months storage of the medication.

This can be difficult if you are on a fixed budget, especially with the prohibitive cost of pharmaceuticals. However, this can be accomplished a number of ways. The easiest and most obvious is to order your medication as a 90-day supply and always try and refill when you have a month left. Unfortunately, this method is subject to the whims of your insurance company (who continues to attempt to practice medicine without a license, but again I digress). If your insurance is such that a 90-day supply is not allowed, you may need to save up and buy a months worth of medicine at the same time you fill your insurance-covered prescription. If you are on multiple medications that are essential to your health, this may take a while to save up and buy with cash so you are always a month ahead.

Your health care provider should be willing to write an extra prescription or change to the 90-day supply if you talk with them and explain that you want to be ahead just in case of future money issues, disaster, travel, or unforeseen circumstances. If you don’t have a regular health care provider, you may need to establish a relationship with one before asking them to write for extra medication. Most health care providers don’t have a problem with this, as long as there is a standing relationship with the patient. Another method to increase your emergency supply would be to obtain an extra month or two from abroad. In particular, Mexico and South America prices are significantly less expensive on most medications. However, the controls that are in place to assure safety and efficacy of medications in the United States are not the same in other countries, so buyer beware. It will be important to have a prescription to show customs if you are asked when re-entering the country.

There is still another option, but it will only work with things that are multi-dose delivery medications, such as asthma medicines. Assume you are on albuterol; when you see your physician for your yearly check up, ask him to give you 12 refills and then make sure and refill your medicines every month whether you are out of the medicine or not, or if you are on a daily inhaled steroid, such as Flovent one puff once or twice each day, ask your doctor to write the prescription for two puffs twice per day, even if you are on a lower daily dose. That way you will get multiple months out of one prescription, and as you continue to fill the prescription every month you will quickly have your month reserve. Finally, ask if your provider has any samples, again explaining that you w ould like a few extra doses in case of unforeseen issues. Most physicians are more than happy to help you if they have samples of your particular medication.

Physical Health

Other personal medical preparation should involve resolving issues now that you have been having or ignored for multiple years.

I understand that most people don’t have time to go to the doctor, be referred to a specialist, get that bum knee or torn rotator cuff operated on, and then spend all that time rehabbing the injury. However, imagine what might happen if you continue to ignore the warnings your body has been giving you and all of the sudden there is not the medical care available to you that we take for granted. How are you going to survive in a world of no conveniences if that injury or illness gets so bad you can’t perform your share of the load or even handle the basic activities of daily living?

If you are the person that is refusing to get that physical exam, those tests that sound less than fun, address embarrassing concerns or nagging injuries, you probably would be better off stopping all of the preparation now and enjoy spending your resources on entertainment and frivolities before disaster strikes. You most likely will struggle in a post apocalyptic world with physical restrictions and just think how upset you would be knowing you could have fixed those things. I am not saying that those with physical disabilities are doomed; I’m saying if you have a physical issue that can be fixed, now is the time to see someone about it.

Dental Health

Now let’s talk about dental health maintenance. Can you imagine what life would be like when a dental visit isn’t possible? What will you do with the abscessed tooth, the cavity that is keeping you awake at night, the broken tooth, the heat/cold sensitive tooth? I hate mouth pain, so a deficiency in this healthcare preparation scares me more than others. I have read accounts of what passed for dental care prior to the invention of modern techniques, and I say “no, thank you” to pulling a tooth without anesthetic. My personal preparation in this regard is that I have made friends with a number of dentists in the hope that I would have a resource in TEOTWAWKI scenario :).

However, regardless if you make friends with a dentist or invite them into your preparedness circle, everyone should have optimal oral hygiene at all times, so that if an event occurs you aren’t already in trouble from an dental point of view. Routine dental maintenance while services are available is a must. Resolve those problems now; stop procrastinating.

Do your preparedness supplies include the ability to continue routine dental care after an event? Do ?ou have toothbrushes, toothpaste, floss? Do you have the means and correct tools to extract a tooth if you have to? What about a supply of numbing agent? Do you even have instructions on how one goes about extracting a tooth if necessary? There was an episode of The Deadliest Catch where a fisherman tries to extract his own tooth with pliers and ends up breaking the tooth. What would be worse, being stuck on the Bering sea with a sore tooth or a sore broken off tooth? Dentistry is a vocation and skill and when amateurs play at it, all sorts of bad things can happen, so I would also advocate that your cache include at least some form of written information on the management of dental problems (if you are unable to cache a dentist) so that you aren’t having to make it up as you go. We have purchased the book Where There Is No Dentist, but I’ll still be trading anything to my dentist friends for their help, if I have a real problem.

Physical Fitness

If you are the average American, you are likely overweight and out of shape. You might be under the assumption that you can procrastinate getting into shape in that you will be forced to get in shape with all the manual labor you will be doing once society falls apart. This is probably true; however, if you have to bug out or run from danger before all that manual labor forces you to get in shape, it probably behooves you to do something about your fitness level now.

A nutritionist I work with outlined the most common reasons we, as a nation, are out of shape and overweight.

1. We eat out entirely too much. At most we should be eating out once per month.
2. Every convenience and entertainment in our life promotes a sedentary life style. Find something active that you enjoy doing, and get out and do it. Exercise for the sake of exercise is rarely sustainable over the long haul, unless you enjoy the activity.
3. We take second, third, and fourth helpings at each meal, or we require a dessert after every meal. If you eat like you should be managing your money i.e. living off of 75% of your take home pay, then you should eat until you are 75% satisfied.

Below are some standard charts of where you should be for optimal weight.

Based on these charts, I should be at least 6 foot 4 inches tall; I’m not. While I think all the personal health preps are important, this one may be the one that saves your life in the first weeks after a disaster.