It feels just like yesterday that I was sitting in room #2 in the Pediatric Intensive Care Unit with my then 2-year-old daughter, a chest tube draining the pus from her left lung. Outpatient antibiotics failed to help her recover from what appeared to be a pneumococcal pneumonia. It was that same intensive care unit where I trained just 3 years earlier.
The doctor taking care of my daughter at the time had been one of my attendings.
“Just think about it this way,” he said. “Before the pneumococcal vaccine, we would see 10-15 of these pneumonias a month here. Now we see about 5-10 a year. Isn't that great?”
It is great, I thought, except when your child is one of the 5 to 10 children.
I remember looking at my daughter, simply miserable with that chest tube in her side restricting her movements. I’d done all I could to protect her, getting her immunized on time, but she was one of the unfortunate few who catch the disease anyway. How could any parent knowingly put their child at risk for this? Or an even worse disease, like meningitis? It is unfathomable to me.
One of my patients had pneumococcal meningitis just last year. He came from a country where the vaccine against it is not routine, though he had all his other vaccines. He received his first pneumococcal vaccine in my office just a few weeks prior. He was due to come in for his second just a few days after he ended up catching the disease. Imagine how many children could have caught it sitting in the same waiting room as him, had I not insisted all my patients vaccinate. Then those children would expose other kids in their homes, schools or daycares.
So, I tell the couple about my daughter’s experience, and the patient with pneumococcal meningitis.
"Vaccines have so successfully reduced the number of infectious diseases striking U.S. children, people often forget how serious they can be. As we talk with parents about the sound science behind vaccines and the immunization schedule, we also need also to share our stories about children who’ve caught these dangerous illnesses."
I also tell them about one flu season when I witnessed 2 healthy teenagers die from the flu after several weeks on a ventilator. Neither had been vaccinated.
I tell them about the 1-year-old patient who barely survived the flu having to go on ECMO. He was not fully vaccinated.
And I tell them about an 8-week-old boy with pertussis I treated a few years ago. The baby was too young to be vaccinated, and likely caught pertussis from an unimmunized family member. With each of the baby’s violent coughing spells, which left him exhaustedly gasping for air, we would all gather--doctors, nurses, respiratory therapists—to debate whether we should intubate or not.
“This is why it's so important for both of you to get you TdaP shot,” I tell the parents. “Oh, and so should any grandparents or other close family members, as well.”
After an awkward pause, the mom shows me a copy of a delayed vaccination schedule circulating on the internet.
“So, you don’t think we shouldn't separate vaccines as suggested in this popular schedule and instead get everything on time?”
Yes, I replied.
“And please remember to get your Tdap vaccine and ask all family members to get it. You can get it here in our office, the pharmacy across the street, your doctor's office or the health department. Oh, and since your due date is in September, make sure y’all get the flu shot as soon as it comes out.”
Vaccines have so successfully reduced the number of infectious diseases striking children in the United States, people often forget how serious they can be. As we talk with parents about the sound science behind vaccines and the immunization schedule, we also need also to share our stories about children who’ve caught these dangerous illnesses. In this way, we help immunize parents against the epidemic of misinformation circulating on the internet.
I guess you could say that is my vaccine philosophy.
* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.
Eliza Agrest Varadi, MD IBCLC, FAAP, a 2018 recipient of the Centers for Disease Control and Prevention Immunization Champion Award, is the
American Academy of Pediatrics (AAP) Section on Early Career Physicians District IV Representative. Dr. Varadi is also a 2017 President’s Award recipient from the South Carolina chapter of AAP and
Pelican Pediatrics in Charleston, SC.