HIV and ID Observations

Fear of vaccines are legion among many parents, with enormous public health resources devoted to defusing this fear and trying to debunk common myths.  I find this site particularly useful.

(Talk about a “hot button” topic.  Read this to get an idea about how passionate views on vaccine safety can be.  Wow.)

This fear, however, isn’t limited to parents.  With the updated adult immunization schedule just released, I thought I would share a recent e-mail I received from a very experienced internist:

A man with nasal polyps on inhaled steroids regularly, requests Zostavax. Would you counsel avoiding the injection out of concern for him developing disseminated zoster with the vaccination, or is this not a concern? Would the vaccine have any effect on the likelihood of lung cancer recurrence, which was surgically resected last year?

The answer to the first question is easy — no.  (Guidelines here, reviewed by me here.)

But the second question?  Why would someone worry that the zoster vaccine would cause a relapse of cancer?  Is there yet any biologic or epidemiologic data that could possibly link immunization with cancer recurrence or progression?

Yet if the vaccine is given, and the cancer then recurs, will the patient — and his doctor — connect the two?

One of the first lessons in Statistics 101 is that correlation does not mean causation.  But boy this is a hard lesson to learn.