By Alan Koenigsberg, M.D.

Continuing the discussion about health, this week I’d like to look at preventative care. With the High Holidays just a few weeks away, and most of us planning to attend services in-person, this is an ideal time to discuss vaccinations.

I went to get mine just a few days ago at my local Sam’s pharmacy, where I have gotten my vaccinations for years. My family physician’s office offers vaccines, but they are later in the year, only by appointment and actually cost more there. Other than some mild soreness, no side effects at all.

I received two vaccines this past week: the higher-potency influenza vaccine for older adults, along with the newer RSV vaccine. RSV is respiratory syncytial virus, a virus that causes lung infections in children and sometimes in older adults.

The latest COVID-19 vaccines have not yet been released. When they are available, most likely in the next month, I’ll get that one.

I am not immunocompromised and am not at greater risk for infection or illness. I read the medical journals, consult with my primary care physician and follow the science.

Interestingly, while I was filling out the consent form for the vaccines, I overheard the following two conversations among the pharmacy patrons. I was at the next window, filling out my forms, not eavesdropping.

The first conversation, started by an older man, dealt with his concerns about side effects of the newer RSV vaccine. He had not heard much about it and asked the pharmacist about it. She took quite a bit of time to discuss potential side effects and after she finished, he decided to get the vaccine. While he was filling out the consent form, he asked that his information not be made available to the state, but only his personal physician. The pharmacist explained, if I understood correctly, that he needed to give his consent or he couldn’t get the vaccine.

I thought it quite ironic that he wanted to know what the side effects were, but wouldn’t allow side effects he might experience to be shared in the database. If people weren’t willing to share their experiences, we would have no information about side effects.

Besides, my understanding — and I could be wrong — is that the pharmacy does not share the person’s personal information when providing data on side effects.

The second conversation involved an older woman who, when picking up her prescriptions, was asked if she wanted to get the vaccines and replied that she didn’t get vaccines. She didn’t need them, she said.

Here she is at the pharmacy, getting whatever prescription medications she needed, but believed she “didn’t need” actual preventative care.

As physicians, we are asked regularly what we can do to help our patients avoid medication treatments and prevent illness. When we counsel weight reduction, exercise, less alcohol consumption, cigarette smoking cessation, better sleep hygiene, more fruits and vegetables, less processed carbohydrates and so on, you can well imagine how well all that gets followed.

Yet, when we have safe and effective, simple preventative vaccines that can help us avoid serious illness, there are people who avoid getting that care.

The lack of scientific understanding and the lack of the ability to discern how science works, what is safe, whom to listen to for medical advice, is a serious concern for me.

I didn’t talk to those two people, but when in the past I have asked, apparently naively, why the people who were vaccine hesitant didn’t discuss their concerns with their internist, they without exception told me they did not have a primary care physician. I just don’t get it.

It is my opinion that every adult, just as with children who have pediatricians, should have a primary care physician, someone they trust and from whom they can get reliable medical information. If you don’t, please do so.

Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas. He can be reached at
akoenigsberg@mac.com.