Patient Perception from Internet on Adverse Effects vs Benefits of Vaccination - An Internet Message from a Public Figure in Hong Kong Cecilia Young* and TH Tai Independent Researcher, Kowloon, Hong Kong *Corresponding Author: Cecilia Young, Independent Researcher, Kowloon, Hong Kong. Received: March 07, 2018; Published: April 30, 2018

1. Short Communication
Patient Perception from Internet on Adverse Effects vs Benefits of Vaccination -
AnInternet Message from a Public Figure in Hong Kong
CeciliaYoung*andTHTai
IndependentResearcher,Kowloon, Hong Kong
*CorrespondingAuthor:Cecilia Young, Independent Researcher, Kowloon, Hong Kong.
Received:March07, 2018; Published:April 30, 2018
ACTA SCIENTIFIC MEDICAL SCIENCES
Volume2 Issue 2 May2018
Introduction
Influenza viruses are important human respiratory pathogens
that can cause seasonal influenza epidemics and out-of-season
sporadic cases and outbreaks. Influenza occurs globally with an
annual attack rate estimated at 5%-10% in adults and 20%-30%
in children [1]. Yet, a message on Internet during winter peak of
2018 influenza has provoked widespread discussion in Hong Kong
regarding vaccination [2,3].
ContentoftheInternetvoice message
The voice message on internet raised several questions regard-
ing influenza vaccination [4]:
The exposure to information including from Internet may be
associated with negative effect on public’s perception towards
healthcare programmes, such as vaccination. General public ob-
jects to vaccination due to fear of adverse effect, perception of in-
sufficient test, ‘public panicking’, necessity, and lack of information
of vaccine [14].
From February 07, 2018 [2,3], a 5-minute voice message has ap-
peared on Internet forum. It is released by a Hong Kong celebrity
in private discussion and uploaded by other people on a parents’
forum which then spread through Internet, in which the content
mainly focuses on the harmful ingredients like mercury and alumi-
num, bacteria existence may cause iatrogenic disease, mutation of
bacteria due to human and animal DNA mixing, high risk and low
effectiveness of vaccination [4].
Widespread of the message through Internet led to intense
public discussion regarding the issue, and various healthcare pro-
fessionals have responded to the event in announcement [5] and
news [6-11], including government official [5], legislator [6,7], and
professor [8-11]. The vigorous debate among various groups trans-
formed the issue into an event of societal level.
1. The vaccine contains mercury and aluminum as part of the
composition
2. Scientists “gamble” about the type of influenza virus by
chance
3. The vaccine is produced by injecting bacteria into chicken’s
body and then the eggs contain the bacteria, such mixture of
human and animal DNAcausemutation
4. The bacteria become “super-bacteria” after the injection
into human body and cause iatrogenic illness of a healthy
person.
These claims have raised vigorous public concern and discus-
sion, which may lead to discouragement of vaccination by the pub-
lic.
Responsefromvariousmedicalprofessionals
A group of medical professionals responded quickly after the
spread of voice message on Internet.
Composition
A group of medical professionals stated on Internet that all
Hong Kong independently packaged single-dose seasonal influenza
vaccines does not contain thimerosal [12].
Effectivenessof vaccine
A statement from the Department of Health claimed that this
season’s vaccine strains closely match the influenza viruses that are
circulating this winter influenza season in Hong Kong [5].
Theanimal-basedvaccinewouldnotcauseadverseevents to
host
A news article mentioning the opinion of Professor YUENof the
University of Hong Kong state that the vaccine is injected to the egg
and the production is based on the embryo of chicken. The virus is
then killed and followed by isolation and purification of antigens.
Thus most of the vaccines are purified. The amount of remaining
egg white is negligible and is harmless[10,11].
Patients’perception isstrongly affected byInternetinforma-
tion
Internet exposure can significantly affect patient perception of
vaccination. Viewing typical vaccine-critical websites for only 5-10
minutes increases the perception of risk regarding vaccinations
and decreases the perception of risk regarding the omission of vac-
cinations as compared to visiting a control site [13].
Mistrust towards the authorities (government, public health
professionals) also plays a role in vaccine hesitancy, as parents
who did not fully vaccinate their children held feelings of distrust
towards government [15].
Citation:Cecilia Young andTHTai.“PatientPerception from Internet on Adverse Effects vs Benefits of Vaccination -AnInternet Message from a Public
Figure in HongKong”.ActaScientific MedicalSciences2.2 (2018) 45-47.

2. PatientPerceptionfromInternetonAdverseEffectsvsBenefitsofVaccination- AnInternetMessagefromaPublicFigurein HongKong
Vaccination perception is negatively affected by exposure to In-
ternet information, as parents and general public tend to be nega-
tively influenced by Internet opinion regarding vaccination safety,
and current initiatives aiming to reach and influence parents’ deci-
sion to vaccinate have not adequately abated the influence of the
online anti-vaccination movement [16].
Healtheducation andpromotionaboutvaccination
Individuallevel
Parents’ decision regarding vaccination mainly depends on phy-
sician recommendation, effectiveness and risk of temporary side
effects (presence of mercury-containing preservative) [17]. Diffu-
sion of negative information online and lack of knowledge about
vaccines were identified as the key causes of vaccine hesitancy
[18]. A study suggested that for individual-based health education,
a medical consultation regarding information about influenza vac-
cination and a clear recommendation by the presenting physician
is a strong factor on accepting vaccination [19].
At the primary care practitioner level, parental education on
influenza vaccine regarding efficacy and safety may also help to
improve pediatric vaccination rates. General public often weighs
vaccine effectiveness heavily [17], and physicians should provide
sufficient information to general public before making decision on
vaccination. For example, physicians should state there are varying
effectiveness of vaccinations season in various countries, and effec-
tiveness of vaccine against influenza A and B in 2017-2018 season
is reported to be 36% in US[20].
Medical professionals should well-educate public regarding the
use of preservatives in vaccine. Physicians may inform general pub-
lic the existence of thimerosal, and that it is very unlikely to cause
adverse outcomes [21]. Also, the peak body mercury burdens af-
ter exposure to thimerosal-containing vaccines did not exceed the
maximumburden of mercury even in underweight infants [22].
Physicians may also educate general public on egg allergyin
view of vaccine hesitancy. Before vaccination, relevant medical his-
tory of allergy should be well-obtained, and potential allergic risk
should be well-explained. Egg-related severe allergic reaction is
extremely rare, as anaphylaxis after vaccination is rare in all age
groups [23]. A study stated that egg-based trivalent influenza vac-
cine can be safely administered even in children with severe egg
allergy [24].
Communitybased
The event provides a good example for the tremendous effect of
mass media, such as Internet, on general public perception and
hence affect population health in terms of healthcare coverage.
As general public opinion on Internet may produce great effect
on public perception towards vaccination, there might be a need of
public health intervention through effective ways using Internet
and online resources [16].
It is thus encouraged for the public to learn to verify Internet
information through database search in order to acquire better
searching and critical appraisal skills, as the establishment of ac-
curate and authoritative online healthcare database may enhance
general public medical knowledge [27]. It is also suggested that
healthcare professionals should consider to promote population
health programmes through Internet. Parents nowadays are more
affected by information from Web sites and electronic means of
communication [28].
Conclusion
The event is thus a good reminder for authorities, including
government and medical professionals, to notice the importance
and powerfulness of Internet information spread among general
public, which may have tremendous effect on public perception
and decision-making regarding healthcare programmes includ-
ing seasonal influenza vaccination. We suggest there is a need to
strengthen public health education through Internet materials, as
well as guidance to appraise information, and the education mate-
rial should focus on vaccine effectiveness and clarifying the misun-
derstandings of vaccination.
Bibliography
1. “Weekly epidemiological record. 23 November 2012, 87th
year”.WorldHealthOrganization47.87 (2012): 461-476.
2. YuenLTand LiSW.“Recording suspected to be from Kay
Tse- vaccination will cause infection.” (2018).
3. YuenLT.“Recording suspected to be from celebrity Kay
Tse-Receiving influenza vaccine will get sick” (2018).
4. HOSteam Water Ice Forum.“Recording comment oninflu-2
enza from celebrity Kay Tse.”(2018).
5. YU.“DHreiterates that influenza vaccination is safe and ef-
fective”. Department of Health (2018).
6. Sing Tao Daily. “Vaccination is useless? Chan Pui Yin point-
to-point “fact check”, states unverified information is
harmful.” (2018).
7. H2O Steam Water Ice Forum. “Is vaccination useless? Chan
Pui Yin refutes every point by “fact check”, who blames the
release of unreliable messages could be lethal- Yahoo
News”. (2018).
Citation:Cecilia YoungandTHTai.“PatientPerception from Internet on Adverse Effects vs Benefits of Vaccination -AnInternet Message from a Public
Figure in HongKong”.ActaScientific MedicalSciences2.2 (2018) 45-47.
46
General public, especially adolescents, does not show enough
sophistication of appraisal skills to correctly judge on information
from Internet sources, and some even does not search on Internet
to verify information. Public tends to be affected by first-impres-
sion of information on Internet [25], tends to judge information
based on instinctive response [25], as well as tends to believe in
majority of websites if in doubt, instead of critically appraising the
material [26]. Mcpherson., et al. also stated that many people re-
quire greater skills for assessing the quality and trustworthiness
of online health information [26].

3. Volume2 Issue2 May2018
©Allrights arereserved byCeciliaYoungandTHTai.
8. Rumors of bacteria and mercury in seasonal influenza vac-
cine- YuenKwok-yung rebuts Kay Tse (2018).
9. H2O Steam Water Ice Forum. “Rumor about the presence of
bacteria and mercury in seasonal influenza vaccine -Yuen
Kwok-yung rebuts the speech from Kay Tse.” (2018).
10. Hong Kong Economic Times. “Crazy spread of the “anti-vac-
cine” recording from Kay Tse; Yuen Kwok-yung : completely
wrong.” (2018).
11. H2O Steam Water Ice Forum. “Crazy spread of the “anti-
vaccination” recording from Kay Tse Yuen Kwok-yung: This
is completely wrong- Hong Kong Economic Times.” (2018).
12. Médecins Inspirés. Declaration. (2018).
13. Cornelia Betsch, et al. “The influence of vaccine-critical
websites on perceiving vaccination risks”. Journal of Health
Psychology15.3 (2010): 446-455.
14. Walter D., et al. “Risk perception and information-seeking
behaviour during the 2009/10 influenza A(H1N1)pdm09
pandemic in Germany”. Euro Surveillance 17.13 (2012):
20131.
15. Wilson K., et al. “Parental views on pediatric vaccination:
the impact of competing advocacy coalitions”. Public Under-
standingof Science 17.2 (2008): 231-243.
16. Tustin JL.,et al. “Internet Exposure Associated With Canadi-
an Parents’ Perception of Risk on Childhood Immunization:
Cross-Sectional Study”. JMIR Public Health and Surveillance
4.1 (2018):e7.
17. Emuella MFlood., et al. “Parent preferences for pediatric in-
fluenza vaccine attributes”. Clinical Pediatrics 50.4 (2011):
338-347.
18. Dubé E., et al. “Understanding Vaccine Hesitancy in Canada:
Results of a Consultation Study by the Canadian Immuniza-
tion Research Network”. PLoSONE11.6 (2016): e0156118.
19. Wolfgang Poeppl., et al. “Influenza vaccination perception
and coverage among patients with malignant disease”. Vac-
cine 33.14 (2015): 1682-1687.
20. Budd AP., et al. “Update: Influenza Activity - United States,
October 1, 2017-February 3, 2018”. MMWR Morbidity and
Mortality Weekly Report67.6 (2018): 169-179.
21. William W Thompson, et al. “Early thimerosal exposure and
neuropsychological outcomes at 7 to 10 years”. New Eng-
landJournalof Medicine357.13 (2007): 1281-1292.
22. RJ Mitkus., et al. “A comparative pharmacokinetic estimate
of mercury in U.S. Infants following yearly exposures to
inactivated influenza vaccines containing thimerosal”. Risk
Analysis 34.4 (2014): 735-750.
23. McNeil MM., et al. “Risk of anaphylaxis after vaccination in
children and adults”. The Journal of Allergy and Clinical Im-
munology137.3 (2016): 868-878.
24. Matthew JGreenhawt., et al. “Safe administration of the sea-
sonal trivalent influenza vaccine to children with severe egg
allergy”. Annalsof Allergy,AsthmaandImmunology 109.6
(2012): 426-430.
25. Jaimie L Freeman., et al. “How Adolescents Search for and
Appraise Online Health Information: A Systematic Review”.
The Journalof Pediatrics (2018).
26. McPherson AC., et al. “Seeing is believing? A mixed meth- ods
study exploring the quality and perceived trustworthi-
ness of online information about chronic conditions aimed
at children and young people”. Health Communication 29.5
(2014): 473-482.
27. Freund O.,et al. “The ability of older adults to use custom- ized
online medical databases to improve their health- related
knowledge”. International Journal of Medical Infor- matics
102 (2017): 1-11.
28. Freed GL., et al. “Sources and perceived credibility of vaccine-
safety information for parents”. Pediatrics 127.1 (2011):
S107-S112.
Citation:Cecilia Young andTHTai.“PatientPerception from Internet on Adverse Effects vs Benefits of Vaccination -AnInternet Message from a Public
Figure in HongKong”.ActaScientific MedicalSciences2.2 (2018) 45-47.
PatientPerceptionfromInternetonAdverseEffectsvsBenefitsofVaccination- AnInternetMessagefromaPublicFigureinHongKong
47

4. PDF: https://www.actascientific.com/ASMS/pdf/ASMS-02-0040.pdf

5. Patient Perception from Internet on Adverse Effects vs Benefits of Vaccination -
An Internet Message from a Public Figure in Hong Kong
Cecilia Young* and TH Tai
Independent Researcher, Kowloon, Hong Kong
*Corresponding Author: Cecilia Young, Independent Researcher, Kowloon,
Hong Kong.
Received: March 07, 2018; Published: April 30, 2018
Introduction
Influenza viruses are important human respiratory pathogens that can cause
seasonal influenza epidemics and out-of-season sporadic cases and outbreaks.
Influenza occurs globally with an annual attack rate estimated at 5%-10% in
adults and 20%-30% in children [1]. Yet, a message on Internet during winter
peak of 2018 influenza has provoked widespread discussion in Hong Kong
regarding vaccination [2,3].
From February 07, 2018 [2,3], a 5-minute voice message has ap- peared on
Internet forum. It is released by a Hong Kong celebrity in private discussion and
uploaded by other people on a parents’ forum which then spread through
Internet, in which the content mainly focuses on the harmful ingredients like
mercury and alumi- num, bacteria existence may cause iatrogenic disease,
mutation of bacteria due to human and animal DNA mixing, high risk and low
effectiveness of vaccination [4].
Widespread of the message through Internet led to intense public discussion
regarding the issue, and various healthcare pro- fessionals have responded to
the event in announcement [5] and news [6-11], including government official
[5], legislator [6,7], and professor [8-11]. The vigorous debate among various
groups trans- formed the issue into an event of societal level.
Content of the Internet voice message
The voice message on internet raised several questions regard- ing influenza
vaccination [4]:
1. The vaccine contains mercury and aluminum as part of the composition
2. Scientists “gamble” about the type of influenza virus by chance
3. The vaccine is produced by injecting bacteria into chicken’s body and then
the eggs contain the bacteria, such mixture of human and animal DNA cause
mutation
4. The bacteria become “super-bacteria” after the injection into human body
and cause iatrogenic illness of a healthy person.
These claims have raised vigorous public concern and discussion, which may
lead to discouragement of vaccination by the public.

6. Response from various medical professionals
A group of medical professionals responded quickly after the
spread of voice message on Internet.
Composition
A group of medical professionals stated on Internet that all Hong Kong
independently packaged single-dose seasonal influenza vaccines does not
contain thimerosal [12].
Effectiveness of vaccine
A statement from the Department of Health claimed that this season’s vaccine
strains closely match the influenza viruses that are circulating this winter
influenza season in Hong Kong [5].
The animal-based vaccine would not cause adverse events to host
A news article mentioning the opinion of Professor YUEN of the University of
Hong Kong state that the vaccine is injected to the egg and the production is
based on the embryo of chicken. The virus is then killed and followed by
isolation and purification of antigens. Thus most of the vaccines are purified.
The amount of remaining egg white is negligible and is harmless [10,11].
Patients’ perception is strongly affected by Internet informa- tion
Internet exposure can significantly affect patient perception of vaccination.
Viewing typical vaccine-critical websites for only 5-10 minutes increases the
perception of risk regarding vaccinations and decreases the perception of risk
regarding the omission of vac- cinations as compared to visiting a control site
[13].
The exposure to information including from Internet may be associated with
negative effect on public’s perception towards healthcare programmes, such as
vaccination. General public ob- jects to vaccination due to fear of adverse
effect, perception of in- sufficient test, ‘public panicking’, necessity, and lack of
information of vaccine [14].
Mistrust towards the authorities (government, public health professionals) also
plays a role in vaccine hesitancy, as parents who did not fully vaccinate their
children held feelings of distrust towards government [15].
Vaccination perception is negatively affected by exposure to In- ternet
information, as parents and general public tend to be nega- tively influenced
by Internet opinion regarding vaccination safety, and current initiatives aiming
to reach and influence parents’ deci- sion to vaccinate have not adequately
abated the influence of the online anti-vaccination movement [16].

7. Health education and promotion about vaccination Individual level
Parents’ decision regarding vaccination mainly depends on physician
recommendation, effectiveness and risk of temporary side effects (presence of
mercury-containing preservative) [17]. Diffusion of negative information online
and lack of knowledge about vaccines were identified as the key causes of
vaccine hesitancy [18]. A study suggested that for individual-based health
education, a medical consultation regarding information about influenza vac-
cination and a clear recommendation by the presenting physician is a strong
factor on accepting vaccination [19].
At the primary care practitioner level, parental education on influenza vaccine
regarding efficacy and safety may also help to improve pediatric vaccination
rates. General public often weighs vaccine effectiveness heavily [17], and
physicians should provide sufficient information to general public before
making decision on vaccination. For example, physicians should state there are
varying effectiveness of vaccinations season in various countries, and effec-
tiveness of vaccine against influenza A and B in 2017-2018 season is reported
to be 36% in US [20].
Medical professionals should well-educate public regarding the use of
preservatives in vaccine. Physicians may inform general pub- lic the existence
of thimerosal, and that it is very unlikely to cause adverse outcomes [21]. Also,
the peak body mercury burdens af- ter exposure to thimerosal-containing
vaccines did not exceed the maximum burden of mercury even in underweight
infants [22].
Physicians may also educate general public on egg allergy in view of vaccine
hesitancy. Before vaccination, relevant medical his- tory of allergy should be
well-obtained, and potential allergic risk should be well-explained. Egg-related
severe allergic reaction is extremely rare, as anaphylaxis after vaccination is
rare in all age groups [23]. A study stated that egg-based trivalent influenza
vac- cine can be safely administered even in children with severe egg allergy
[24].
Community based
The event provides a good example for the tremendous effect of mass media,
such as Internet, on general public perception and hence affect population
health in terms of healthcare coverage.
As general public opinion on Internet may produce great effect on public
perception towards vaccination, there might be a need of public health
intervention through effective ways using Internet and online resources [16].
General public, especially adolescents, does not show enough sophistication of
appraisal skills to correctly judge on information from Internet sources, and
some even does not search on Internet to verify information.

8. Public tends to be affected by first-impres- sion of information on Internet [25],
tends to judge information based on instinctive response [25], as well as tends
to believe in majority of websites if in doubt, instead of critically appraising the
material [26]. Mcpherson., et al. also stated that many people re- quire greater
skills for assessing the quality and trustworthiness of online health information
[26].
It is thus encouraged for the public to learn to verify Internet information
through database search in order to acquire better searching and critical
appraisal skills, as the establishment of ac- curate and authoritative online
healthcare database may enhance general public medical knowledge [27]. It is
also suggested that healthcare professionals should consider to promote
population health programmes through Internet. Parents nowadays are more
affected by information from Web sites and electronic means of
communication [28].
Conclusion
The event is thus a good reminder for authorities, including government and
medical professionals, to notice the importance and powerfulness of Internet
information spread among general public, which may have tremendous effect
on public perception and decision-making regarding healthcare programmes
includ- ing seasonal influenza vaccination. We suggest there is a need to
strengthen public health education through Internet materials, as well as
guidance to appraise information, and the education mate- rial should focus on
vaccine effectiveness and clarifying the misun- derstandings of vaccination.
Bibliography
1. “Weekly epidemiological record. 23 November 2012, 87th year”.
World Health Organization 47.87 (2012): 461-476.
2. Yuen LT and Li SW. “Recording suspected to be from Kay Tse-
vaccination will cause infection.” (2018).
3. Yuen LT. “Recording suspected to be from celebrity Kay Tse-Receiving
influenza vaccine will get sick” (2018).
4. H2O Steam Water Ice Forum. “Recording comment on influ- enza
from celebrity Kay Tse.” (2018).
5. YU. “DH reiterates that influenza vaccination is safe and ef-
fective”. Department of Health (2018).

9. 6. Sing Tao Daily. “Vaccination is useless? Chan Pui Yin point- to-point
“fact check”, states unverified information is harmful.” (2018).
7. H2O Steam Water Ice Forum. “Is vaccination useless? Chan Pui Yin
refutes every point by “fact check”, who blames the release of unreliable
messages could be lethal- Yahoo News”. (2018).
8. Rumors of bacteria and mercury in seasonal influenza vac- cine- Yuen
Kwok-yung rebuts Kay Tse (2018).
9. H2O Steam Water Ice Forum. “Rumor about the presence of bacteria
and mercury in seasonal influenza vaccine -Yuen Kwok-yung rebuts the speech
from Kay Tse.” (2018).
10. Hong Kong Economic Times. “Crazy spread of the “anti-vac- cine”
recording from Kay Tse; Yuen Kwok-yung : completely wrong.” (2018).
11. H2O Steam Water Ice Forum. “Crazy spread of the “anti- vaccination”
recording from Kay Tse Yuen Kwok-yung: This is completely wrong- Hong Kong
Economic Times.” (2018).
12. Médecins Inspirés. Declaration. (2018).
13. Cornelia Betsch, et al. “The influence of vaccine-critical websites on
perceiving vaccination risks”. Journal of Health Psychology 15.3 (2010): 446-
455.
14. Walter D., et al. “Risk perception and information-seeking behaviour
during the 2009/10 influenza A(H1N1)pdm09 pandemic in Germany”. Euro
Surveillance 17.13 (2012): 20131.
15. Wilson K., et al. “Parental views on pediatric vaccination: the impact
of competing advocacy coalitions”. Public Under- standing of Science 17.2
(2008): 231-243.
16. Tustin JL., et al. “Internet Exposure Associated With Canadi- an
Parents’ Perception of Risk on Childhood Immunization: Cross-Sectional Study”.
JMIR Public Health and Surveillance 4.1 (2018): e7.
17. Emuella M Flood., et al. “Parent preferences for pediatric in- fluenza
vaccine attributes”. Clinical Pediatrics 50.4 (2011): 338-347.

10. 18. Dubé E., et al. “Understanding Vaccine Hesitancy in Canada: Results
of a Consultation Study by the Canadian Immuniza- tion Research Network”.
PLoS ONE 11.6 (2016): e0156118.
19. Wolfgang Poeppl., et al. “Influenza vaccination perception and
coverage among patients with malignant disease”. Vac- cine 33.14 (2015):
1682-1687.
20. Budd AP., et al. “Update: Influenza Activity - United States, October 1,
2017-February 3, 2018”. MMWR Morbidity and Mortality Weekly Report 67.6
(2018): 169-179.
21. William W Thompson, et al. “Early thimerosal exposure and
neuropsychological outcomes at 7 to 10 years”. New Eng- land Journal of
Medicine 357.13 (2007): 1281-1292.
22. RJ Mitkus., et al. “A comparative pharmacokinetic estimate of
mercury in U.S. Infants following yearly exposures to inactivated influenza
vaccines containing thimerosal”. Risk Analysis 34.4 (2014): 735-750.
23. McNeil MM., et al. “Risk of anaphylaxis after vaccination in children
and adults”. The Journal of Allergy and Clinical Im- munology 137.3 (2016):
868-878.
24. Matthew J Greenhawt., et al. “Safe administration of the sea- sonal
trivalent influenza vaccine to children with severe egg allergy”. Annals of
Allergy, Asthma and Immunology 109.6 47 (2012): 426-430.
25. Jaimie L Freeman., et al. “How Adolescents Search for and Appraise
Online Health Information: A Systematic Review”. The Journal of Pediatrics
(2018).
26. McPherson AC., et al. “Seeing is believing? A mixed meth- ods study
exploring the quality and perceived trustworthi- ness of online information
about chronic conditions aimed at children and young people”. Health
Communication 29.5 (2014): 473-482.
27. Freund O., et al. “The ability of older adults to use custom- ized
online medical databases to improve their health- related knowledge”.
International Journal of Medical Infor- matics 102 (2017): 1-11.
28. Freed GL., et al. “Sources and perceived credibility of vaccine-safety
information for parents”. Pediatrics 127.1 (2011): S107-S112.
Volume 2 Issue 2 May 2018

11. 楊幽幽牙科醫生
Dr. Cecilia Young Yau Yau
內容授權於原文醫藥人
以全篇原文為準
**以上內容已得病人同意使用作公共衛生教學用途
當中 "我們" 或 "示範中的方法" 指牙醫業內一般做法或其中一種
做法
內容只作一般公共衛生教育用途，病人應該與醫生商量自己的處
理方法。
所有牙醫均可進行公共口腔衛生教育，而公共衛生(Public
Health )或社會牙醫科
(Community Dentistry )更是牙科內的一個科目。
牙醫專業守則
1.6 牙科／口腔健康教育活動
1.6.1 牙醫可以參與真確的牙科／口腔健康教育活動，例如演講
及作 專業發表..............
1.6.3 向公眾提供的資料應具權威性、合宜並與一般經驗相符。
該等 資料應有事實根據、清楚易明及用詞淺白。
香港牙醫管理委員會 香港牙醫專業守則
http://www.dchk.org.hk/docs/code_c.pdf

12. 楊幽幽牙科醫生教育系列 以下為公共口腔衛生教育系列關鍵字
嵌塞 牙縫刷 腎病 致命牙齒脫位 膿 退縮 戒煙 骨質疏鬆 腫脹 四環素染色 楊幽幽牙科醫生 更薄的牙齒 刮舌板 牙齒長出 牙
齒不可逆性牙髓炎 水氟化 X光對生育期內婦女的影響, 什麼年紀最適合箍牙, 假牙, 傷口處理, 公共衛生教育, 剝牙, 副作用,
口腔種植, 成人矯齒成效如何, 止血, 正確刷牙及使用牙線方法, 楊幽幽牙科醫生口腔教育系列 注意事項, 洗牙流血點解, 活
動假牙托, 流血不止, 滿口牙套可以箍牙嗎, 漂牙, 牙周病, 牙周病患者是否可以箍牙. 透明牙箍有用嗎, 牙柱, 牙橋, 牙痛, 牙
瘡, 牙肉流血, 牙醫, 牙骹, 種牙, 空姐接觸的宇宙射線會否影響胎兒, 笑容, 箍牙會唔會失敗, 脫牙, 蛀牙, 關節 好唔好
以下為公共口腔衛生教育系列關鍵字, 阿士匹靈,抗血小板劑,抗凝血劑, 抗生素, 關節僵硬,銀粉, 矯正, 植牙, 膿腫, 研磨劑,
刷蝕牙齒, 態度, ,撕脫, 乳齒, 細菌, 口氣, 咬, 矯正器, 腦膿腫, 刷牙, 緩衝作用, 過氧化尿素,齲齒,檢查,咀嚼, 複合, 牙套, 牙冠
增長手術,
環孢素A, 失智症, 牙,科, 牙橋, 牙科疾病, 牙科脫牙,牙科問題, 牙髓, 牙周膜, 牙菌膜, 矯齒,根管治療, 洗牙齒表面, 微電測試
牙髓, 預防性樹脂補牙, 玻璃離子, 牙腳尖, 二手煙, 敏感牙齒, 吸煙, 手術, 鑽洞測試,水銀, 成功,牙齒氟化, 發炎, 淋巴核, 神
經, 牙齒過度長出酸鹼值, 維他命C, 智慧齒,華法林, 牙膏, 牙刷, 牙齒美白,牙齒漂白, 口氣, 失敗, 補牙, 牙線, 外觀, 咬合, 橋
體, 牙冠,口腔種植周邊炎 , 含氟漱口水, 漱口水, 硝酸鉀, 口腔黏膜發炎, 尼古丁, 口腔疾病, 口腔感染, 預防, 牙袋, 家庭主婦,
感冒, 象牙質, 牙齒創傷, 牙骨黏連, 牙周膜位置骨化, 磨蝕牙齒, 牙齒正畸, 氟素防蛀劑, 牙紋防蛀劑,鑲嵌物, 鑄造瓷貼片, 酸
蝕牙齒, 牙齒腫大, 漱口水, 肝素, 薄血藥, 維生素C,血栓栓塞, 國際標準化比值, 感染性心內膜炎, 琺瑯質, 局部麻醉劑, 三氯
沙, 空間固定器, 進食次數,用餐次數, 全口假牙托、琺瑯質形狀缺陷,馬利蘭牙橋, 咽喉炎, 食物與牙齒健康, 奶瓶齲齒, 鎮靜,
牙髓治療, 氟素凝膠, 牙腳斷裂, 牙腳吸收, 牙根整平術, 早期兒童蛀牙, 糖尿病, 效用, 測試, 牙齦, 牙齦組織, 牙齦出血, 雙氧
水, 免疫抑制劑, 嵌塞, 牙縫刷, 腎病, 致命,牙齒脫位, 膿, 退縮, 戒煙,骨質疏鬆, 腫脹, 四環素染色, 更薄的牙齒, 刮舌板, 牙齒
長出, 牙齒不可逆性牙髓炎, 水氟化X光對生育期內婦女的影響、什麼年紀最適合箍牙、假牙、傷口處理、公共衛生教育、
剝牙、副作用、口腔種植、成人矯齒成效如何、止血、正確刷牙及使用牙線方法、注意事項、洗牙流血點解、活動假牙托、
流血不止、滿口牙套可以箍牙嗎、漂牙、牙周病、牙周病患者是否可以箍牙. 透明牙箍有用嗎、牙柱、牙橋、牙痛、牙瘡、
牙肉流血、牙醫、牙骹、種牙、空姐接觸的宇宙射線會否影響胎兒、笑容、箍牙會唔會失敗、脫牙、蛀牙、關節, 常見的
牙患及預防方法, 蛀牙的成因及預防, 牙周病的成因及預防方法
甚麼是根管治療, 關於脫牙的事實, 銀汞合金安全嗎, 牙齒如何漂白, 需要矯齒的原因及準備, 牙齒創傷即時處理及治療, 懷
孕婦女需特別注重口腔健康, 如何除口氣, 骨質疏鬆與牙齒脫落的關係, 家長須助孩子護理乳齒, 牙周病─治療方法探究篇,
牙患可以致命, 鑲補牙齒方法知多少, 假牙扥 你們對我的期望合理嗎, 牙菌膜可以使種牙鬆脫, 糖尿病與牙周病互相影響, 必
先利其器 口腔衛生用品知多少, 脫牙前必須認真考慮, 預防蛀牙的方法氟素防蛀劑及牙紋防蛀劑, 漂白牙齒的各種方法, 細
數牙周病各種病徵, 用力刷牙≠清潔
使用漱口水是否好習慣, 吸煙與牙周病, 吸煙對治療牙周病的影響, 吸煙與口腔癌關係密切
戒煙為何與如何, 二手煙立法與自律, 乳齒對恆齒的影響, 公眾對洗牙的誤解調查, 兒童乳齒的根管治療, 第一隻長出的恆齒,
換牙時需注意事項, 護理口腔第一步正確刷牙方法, 敏感牙齒成因及預防, 公眾對洗牙的誤解應用篇, 如何保養活動假牙, 矯
齒點滴, 矯齒前應注意的事項, 木糖醇對人有害嗎, 口腔穿環的後遺問題, 牙周牙髓聯合症, 防敏感牙膏不適合長期使用, 頭
頸部放射治療前後的口腔護理, 幫助睡眠窒息症患者呼吸口腔矯治器, 根管治療時斷針是否失誤, 小朋友在牙科治療時不合
作, 嚴重蛀牙 幼兒一次被脫8隻乳齒(上)
嚴重蛀牙 幼兒一次被脫8隻乳齒(中), 嚴重蛀牙 幼兒一次被脫8隻乳齒(下), 香港牙膏並未含有「二甘醇」, 社會醫學研究電
話調查, 小朋友不肯見牙醫 怎辦？, 牙周病口瘡性潰痬與口腔癌 牙齒創傷幸與不幸, 智慧齒過度長出, 智慧齒過度長出引致
的其他牙患, 矯齒替代鑲假牙, 矯齒替代鑲假牙(二), 善用抗生素, 失去牙齒的其他後果, 一顆牙齒多個問題
根管治療後如何加上牙柱及牙套, 澳洲回顧研究 漱口水內的酒精致口腔癌, 牙齒美容
牙齒美容(二), 牙齒美容(三), 常見牙齒問題酸蝕, 牙科治療 為甚麼要磨蝕好的牙齒, 健康牙齒伴你一生, 淺談假牙的承扥問
題, 腎病患者的口腔問題, 抗凝血劑 抗血小板劑與脫牙

13. 感染性心內膜炎與牙科治療, 二手煙對兒童牙齒的影響, 失智症(老人痴呆症)與口腔健康
如何保持牙齒清潔, 防敏感牙膏新資訊, 牙套內會不會蛀牙, 探討牙科內常用的局部麻醉劑
孕婦及牙科常用藥物, 牙科病人與精神問題(上), 牙科病人與精神問題(下), 阻生智慧齒
殺菌劑三氯沙氾濫我們應否使用抗菌牙膏, 牙科病人的求診習慣, 診斷不同不知信那一個
什麼情況,什麼病人不宜脫牙, 關於植牙的種種迷恩, 如何處理長者的牙患, 預防牙患多角度孕婦與胎兒母親與嬰幼
兒, 牙周整形手術治敏感牙齒, 牙齦萎縮不能復原, 牙周組織再生法, 植骨與植牙手術 先植骨後植牙, 同時進行植骨
與植牙, 口腔植體周邊組織炎, 牙冠增長手術(上). 牙冠增長手術(下), 中小學教師與中學生對牙齒創傷認識不足, 牙
齒各類創傷與處理, 牙齒各類創傷與處理(2), 牙齒創傷當牙周膜死了, 牙齒創傷日後可能顯現的問題
牙齒創傷後的治療個案, 假牙可以戴多久, 即時性假牙托, 假牙的種類和設計, 假牙的種類和設計--種牙, 假牙的種
類和設計--牙橋, 假牙的種類和設計--活動假牙托, 我的牙齒為什麼不好, 由牙齒所引致的感染看似小事的牙瘡, 由
牙齒所引致的感染看似皮膚問題的牙瘡
由牙齒所引致的感染細菌進入眼部, 由牙齒所引致的感染細菌入腦, 由牙齒所引致的感染Ludwig氏咽峽炎阻塞氣道,
漱口水過酸易蛀牙, 食物與牙齒健康, 錯誤使用奶瓶餵飼幼兒奶瓶齲齒, 兒童嚴重蛀牙的治療方法, 兒童嚴重蛀牙的
治療方法--牙套, 牙齒咬合與移位(上), 牙齒咬合與移位(下), 智障人士的牙患, 智障人士如何預防牙患, 正確使用氨
素
氟素以外牙紋防蛀劑填補牙紋縫隙, 牙齒重疊最需要徹底清潔, 牙齒磨損, 對牙菌膜的監測
簡介牙髓的各種測試, 淺談口腔以外的牙科X光, 口腔以內的牙科X光, 牙髓死亡, 淺析咬合垂直距離, 牙痛, 到底哪
裡痛, 能不能忍一時之痛, 活動假牙托下不應有壞牙腳, 氟斑齒的處理方法 注意有否刷蝕牙齒, 牙齒消炎丸到底是
甚麼., 正確使用抗生素, 處理接近神經線的阻生智慧齒, 脫牙流血不止, 正確清潔牙齒及牙肉邊緣, 牙科手術儀器的
消毒程序, 牙科用具其他消毒程序, 黏液囊腫, 看見和看不見的蛀牙, 切除部分牙腳手術, 切除部分牙腳手術 2, 如何
清潔牙腳分岔位 上, 如何清潔牙腳分岔位 下, 牙線功能成疑, 美白牙膏去牙漬, 洗牙真的很痛嗎, 清刮牙腳, 再談清
刮牙腳, 洗牙流血只因牙肉發炎 口腔腫塊--牙齦瘤
口腔腫塊--乳突瘤, 口腔內的黑色素---牙齦的黑色素沉澱,G6PD缺乏症與牙科治療
頭頸癌放化治後牙科問題, 關愛基金改善政策使長者更受惠, 關愛基金改善政策使長者更受惠, 磨去蛀牙

14. Dr. Cecilia Young Yau Yau Oral Health Education series key words
mellitus, diagnosis, early childhood caries, effectiveness, electric pulp test, enamel, erosion,
esthetics, examination, extraction, failure, fever, fillings, fissure sealant, flight attendant, flossing,
fluoride gel, fluorosis, gaps, gingiva, Gingival hypertrophy, gingival tissue, glass ionomer, gum
bleeding, gum disease, halitosis, Heparin, housewife, hydrogen peroxide, hypoplasia,
immunosuppressant, impaction, implant, infective endocarditis, inflammation, inlay, interdental
brushing, international normalizing ratio INR, Kidney disease, lethal, local anaesthesia, look,
luxation, lymph node, mechanical cleansing, mercury, mouthrinse, mucositis, nerve, nicotine,
number of meals, nursing bottle syndrome, occlusion, onlay, oral disease, Oral Health Education,
oral infection, orthodontic treatment, osteoporosis, overeruption, peri-implantitis, periodontal
disease, periodontal membrane, pH value, plaque, pocket, pontic, porcelain veneer, post, post
and core, potassium nitrate, prevention, abrasion、abrasives、abscess、abutment tooth、
aligners、amalgam、ankylosis、antibiotics、anticoagulation、antiplatelet、aspirin、attitude、
attrition、avulsion、baby teeth、bacteria、bad breath、biting、bleaching、bleeding、
bracing.., brain abscess、bridge、brushing、buffering effect、carbamide peroxide、caries、
check-up、chewing、chlorhexidine、composite、crown、crown lengthening、cyclosporine A、
dementia、Dental、dental bridge、dental decay、dental disesase. dental extraction、dental
problem、dental pulp、dental scaling、dental trauma、dentine、denture、diabetes mellitus、
diagnosis、early childhood caries、effectiveness、electric pulp test、enamel、erosion、
esthetics、examination、extraction.. failure、fever、fillings、fissure sealant、flight attendant、
flossing、fluoride gel、fluorosis、gaps、gingiva、Gingival hypertrophy、gingival tissue、glass
ionomer、gum bleeding、gum disease、halitosis、Heparin、housewife、hydrogen peroxide..
hypoplasia、immunosuppressant、impaction、implant、infective endocarditis、inflammation、
inlay、interdental brushing、international normalizing ratio INR、Kidney disease、lethal、local
anaesthesia、look、luxation、lymph node、mechanical cleansing.. periodontal membrane、pH
value、plaque、pocket、pontic、porcelain veneer、post、post and core、potassium nitrate、
prevention、preventive resin restoration、pus、recession、removable appliance、removable
denture、root apex.. Root Canal Treatment、root fracture、root planning、root resorption、
scaling、second hand smoking、sensitive teeth、side effect、smile、smoking、smoking
cessation、successful、surgery、swelling、test cavity、tetracycline staining、thinner teeth.
thromboembolism、tongue scrapper、tooth bleaching、Tooth bracing、tooth decay、tooth
eruption、tooth whitening、tooth. Irreversible pulpitis、toothache、toothbrush、toothpaste、
triclosan、vitamin C、warfarin、washing effect、water fluoridation.. wisdom tooth、wound
handling ,complete Denture, space maintainer, Maryland Bridge ,pharyngitis, sedation ,
Pulpotomy. Small tooth, black tooth, damage tooth.

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