Hospital volunteers best err on the side of vaccination caution

Ask Dr. Keith Roach M.D

Hospital volunteers best err on the side of vaccination caution

DEAR DR. ROACH: I am a 74-year-old female who would like to volunteer at one of the local hospitals. My bloodwork indicated that I have an immunity for measles, German measles and chickenpox, but not for mumps. My personal physician believes that it would be smart to get the MMR vaccination and that the benefits outweigh any possible side effects, which are uncommon.

What is your advice, given the fact I can opt out of getting this vaccine with a physician’s OK? I am hesitant about possible side effects, especially at my age, and because there is not a single vaccine only for mumps, I’d be getting injected with vaccines I do not need. I also have not heard of any outbreaks of mumps in this country, unlike those of whooping cough. — M.M.

ANSWER: People born before 1957 generally are considered to be immune to measles, mumps and rubella. However, perhaps 1 or 2 percent of people may still not be immune to mumps, whether by waning immunity from natural infection over time or never having been exposed. For a health care worker (that includes the very valuable volunteers who help in many hospital areas), it is reasonable to consider revaccination. There is no clear rule for someone in your unusual situation.

Unfortunately, there have been recent outbreaks of mumps, many associated with colleges. In the U.S. in 2018, there were over 2,000 reported mumps cases. My opinion is that you should either get the MMR vaccine (the risks for someone in their 70s are still small), or absent yourself from the hospital in the unlikely event of a mumps outbreak near you. *** DEAR DR. ROACH: I have not seen any comments on cyanoacrylate for wound treatment in your column. My wife cut her finger recently, and it took quite a long time for it to clot (she is a healthy and fit 70, walking 1,500 miles a year). That situation prompted thoughts of cyanoacrylate when there recently was a sale on single-use tubes at a local store.

Are there any negatives to keeping some in our first aid kit for sealing a deeper cut after cleansing? — L.V.L.

ANSWER: Cyanoacrylate is used in hospitals for wound closures (Dermabond is the name of one such prescription medication), as they are waterproof, have antimicrobial properties and are easy to use — for experts. Cyanoacrylate isn’t appropriate for home or field use, as the wound needs to be appropriate in size, depth and shape, correctly prepared and very clean. Closing an infected wound is a terrible idea, and trying to glue a wound that is too deep is not likely to be effective. Lori Boyle, an advanced nurse practitioner and wound care expert I spoke to, said, “The only time that should be done is after the zombie apocalypse and there’s no medical provider available.”

A consumer product that I think is a better fit for a first aid kit is a liquid formulation bandage made with an antiseptic, benzethonium chloride, in a formulation with nitrocellulose and castor oil, which dries to protect the wound (New-Skin is one brand name).