Vaccine hesitancy & the return of dangerous diseases
As difficult as it is to see children suffer from vaccine-preventable illnesses, it’s so much more so when the disease was once considered eliminated. The United States was declared measles-free in 2000, yet we have seen 1,172 confirmed cases of the disease this year as of August 1. Most cases have been among unvaccinated individuals.
Some families don’t realize how dangerous the virus can be, or they are exposed to misinformation about vaccines. Some skip immunization in favor of holding "measles parties" in an effort to immunize their children naturally, rather than through a vaccination. I do my best to explain to parents that it is not wise after all to “just let the children have the disease first-hand,” because doing so could cost them their health or lives.
I tell them about what I saw during medical school, which I attended in a country where like most of the developing world, not every child has access to vaccines. I describe an 11-year-old patient’s struggle with subacute sclerosing panencephalitis, one of the most devastating consequence of measles. It develops years later in children who had measles, causing them to lose mental capacities, get refractory seizures, become vegetative and then die.
I also tell them other vaccine-preventable diseases I saw children suffer and die from: the 4-year-old who developed diphtheritic myocarditis, a devastating complication of diphtheria that leads to heart failure; the five-year-old with paralytic polio, and the three-year-old child who developed fatal tetanus spasms.
In the United States, I explain, we don’t see such devastating consequences of vaccine preventable diseases today is because vaccines have been around to prevent them. And we certainly don’t want to invite these monsters back!
| “The
parents watched in despair as the toddler struggled with this
life-threatening infection. Feeling totally helpless about the child’s
prognosis and realizing how easily it could have been prevented with
vaccination, they broke down into tears.” |
Grassroots efforts to promote immunization
I practice in Iowa, where I work to promote immunization in underserved rural as well as urban pediatric populations. I educate not only my patients and families, but future physicians and the public. I stress the importance of building community immunity with high vaccination rates, and how important this is to immunocompromised children, especially. I explain how many infectious diseases are only a plane ride away, and the importance of full immunization prior to traveling.
Within the American Academy of Pediatrics (AAP) Iowa chapter, we are working and collaborating with other stakeholders to create a parent information network for addressing vaccine hesitancy, emphasizing the proven fact that vaccines save lives. As pediatricians and pediatric sub-specialists, we are dedicated to advancing AAP’s goal of eliminating barriers for vaccination, promoting adherence to evidence-based recommendations, and providing accurate, high-quality scientific information about immunization.
The World Health Organization has rated vaccine hesitancy as one of the top 10 threats for 2019. I firmly believe that enthusiastic pediatricians who take the time to educate parents play the biggest role in sustaining high immunization rates. We need to help parents understand that vaccines are the greatest life-saving tools that medicine can offer. They have protected millions of children from these diseases and their horrible complications. We cannot stress this enough.
* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.
Ashlesha Kaushik MBBS, MD, FAAP, is the 2019 recipient of the Centers for Disease Control and Prevention Childhood Immunization Champion Award for Iowa. She is the AAP Iowa Chapter’s Immunization Representative and serves on its Committee on Immunization. Dr. Kaushik is Chief of Pediatric Infectious Diseases and Director of Antimicrobial Stewardship Program at Unity Point Health, and Pediatrics instructor at the University of Iowa Carver College of Medicine. She was honored at the Iowa Immunization Summit 2019 and frequently appears in the media educating communities about immunization.