Prevention
I spent this past week in Washington DC at a medical conference for all Infectious Disease physicians in our country. It was attended by thousands of us in addition to physicians from countries across the world that gathered to learn about the cutting-edge research and issues facing us at this very critical time.
Now my particular interest in infectious disease is regarding prevention of these diseases for children.
Prevention = Vaccines.
I have spent the greater part of the last two years researching and studying vaccines. This is an amazing and exciting area to research, especially when you think about how much has been accomplished in the past few decades. Let’s discuss in detail.
Vaccines have literally transformed the landscape of medicine over the course of the 20th century.
Before vaccines, parents in the United States could expect that EVERY YEAR:
- Polio would paralyze 10,000 children.
- Rubella (German measles) would cause birth defects and mental retardation in as many as 20,000 newborns.
- Measles would infect about 4 million children, killing 3,000.
- Diphtheria would be one of the most common causes of death in school-aged children.
- A bacteria called Haemophilus influenzae type b (Hib) would cause meningitis in 15,000 children, leaving many with permanent brain damage.
- Pertussis (whooping cough) would kill thousands of infants.
- Rotavirus would infect half a million children, causing severe diarrhea and dehydration.
- A bacteria called Streptococcus Pneumonia would cause thousands of cases of pneumonia, meningitis, and bloodstream infections.
I hope people agree that the decrease in disease is remarkable. I am extremely grateful that my 6-month-old daughter has now recieved all of her primary immunizations and that she lives in a country where vaccines are available to all children. It is a great relief to know she is protected from such debilitating and deadly diseases.
I have studied the disturbing anti-vaccine trend for about a year now. Most people who prescribe to this trend are concerned that vaccines cause Autism.
Vaccines do not cause Autism.
The studies have been done and millions of dollars have been spent to investigate this, and the science is clear. I think people need to understand that a paper in The Lancet years ago by a Dr. Wakefield brought up a theory that the Measles vaccine infected the intestine and somehow caused Autism. The paper got a lot of attention, and his findings could never be replicated and most of the authors who wrote that paper actually retracted it. It is a huge embarrassment as a scientist when you have to retract your paper because the science is so poorly done. So at the end of the day Dr. Wakefield’s theory is debunked.
Then there is my favorite- the thimerasol in vaccines causes Autism. Well, the proof is in the pudding with this one. There has been no thimerasol in vaccines for 8 years now, and the Autism rates have skyrocketed. Thimerasol does not cause Autism.
The argument that I internally roll my eyes at is, “Jenny Mcarthy said vaccines caused her son’s Autism.” Not to belittle a personal experience, but it is a common thing that vaccines are given in the first two years of life and Autism is usually diagnosed in that same period. This does not mean that one thing causes another. We all know things that are temporally related usually do not cause each other. For example children often eat peanut butter sandwiches – often near the time Autism is diagnosed, but the peanut butter sandwich did not cause the Autism.
Now will I ever be able to absolutely prove that nothing in a vaccine will never cause Autism? No, that is a scientific impossibilty. You can never prove a negative. I can tell you the true statement that I have never been to Russia. You will never prove that I have never been to Russia, but I can show you all the pictures of me on all my vacations and none of them are in Russia.
One of the most concerning things to me is the trend that everyone is concerned only about themselves. Vaccines save individual lives! They also decrease disease for society in general. Polio is a great example of this. The generations before me vaccinated for Polio religiously and vaccination has eradicated this disease. I am grateful I was never exposed to Polio and that the people before me chose what is good for society. Our current generation makes choices based on the ‘me’ factor instead of the ‘we’ factor. People have studied if an appeal to vaccinate for the good of society would increase vaccination rates, and it won’t. Sad commentary on how little we care for those around us.
At the end of the day please vaccinate your children and keep your own vaccinations up to date. Please do it. Go to the CDC website to investigate about vaccines and not some garbage website. You don’t want to be THAT parent in the ER or office with a very sick baby and the docs can’t get the diagnosis or treat your baby until they remember to ask the question- “did he receive his vaccines?” When you say ‘no’, we groan inside. When your child is critically ill from a disease that was totally prevetable, we feel as if we have failed in our job – to protect children. So vaccinate! I know that vaccines can cause fever and soreness-it is better than the alternative- so trust me; vaccines save children’s lives.
Dr.C
I agree with you 100%. I think those who choose not to vaccinate their children are riding for free on the backs of everyone else who does, and I believe this is incredibly selfish of them. Would you ever think of not vaccinating your child against smallpox if it were widespread? No. But since most people do vaccinate, people think they can get away with it at no cost to their own child. A fine theory until enough people become selfish in this way and all of a sudden the disease starts to make a comeback. So, so sad.
I’m completely supportive of vaccines, vaccinate on-time, complete with a yearly flu shot, etc. I’ve read all the articles I’ve been able to find on vaccines and autism, and just haven’t found anything other than interesting theories to support a link, in spite of the MANY attempts that have been made to establish such a link (this in contrast to the effort to link early DPT shots to increased risk of asthma, which took ONE study, recently published in Immunology….which is more what you expect when an actual linkage exists).
But what do you do to try to persuade people who are already convinced that vaccine-promoting pediatricians are just in it for the money? Or that they are blind sheep, so cognitively challenged or uninterested in evidence-based medicine that they simply promote their own dogma, generation after generation, to the detriment of children. I feel like I encounter this perspective a fair amount. (Ob’s are the other primary victim of this hatred). I obviously think this characterization is unfair, but what do you do?
I actually also don’t think that people who don’t vaccinate are being ridiculously selfish. For the most part I think they do have a deep conviction that vaccines cause autism….and frankly if vaccines did cause autism, I think we would want to alter the vaccine schedule somehow or prune out some of the less critical vaccines, because obviously, autism really, really sucks. But I don’t know how to discuss the issue with someone who coming in to the situation already sees me as evil and unthinking. Is part of the problem that both parties here approach the other in this manner, resulting in a breakdown of communication? And what is the solution? How can the bridge be rebuilt so that kids can receive the vaccinations they need, and parents can feel comfortable that their own concerns have been fully addressed?
Can someone delete my previous comment, please? I feel like there is always the possibility of something coming across the wrong way….and I would feel better just deleting my questions.
Japan has substantially more relaxed vaccination guidelines than the USA — the USA guidelines are very aggressive by comparison. Are the Japanese being selfish or reckless?
There are several things that bug me about vaccinations.
First of all, pediatrician offices are a racket. They want to see the kid 10 times in the first year. I didn’t go to the doctors 10 times before I was 8 — and I cut off my finger, swallowed lighter fluid, and had a cinderblock dropped on my head from a tree fort. But insurance pays for my children’s visits, and the doctors insist on them, so they must be a great idea.
Second, doctors take a glib and paternalistic attitude about vaccinations. Most of the pediatricians I’ve dealt with aren’t really interested in answering questions about the direction of my child’s health care. If you ask them anything about vaccinations, they tend to simply tell you that they won’t follow your child’s care unless you get them vaccinated on their schedule. At that point, I walk out and find another pediatrician for my health insurance to fund.
Third, if you think that Lancet isn’t motivated by political considerations, then you should look at their articles estimating civilian deaths in Iraq in excess of 100,000, which didn’t even pass the laugh test and were transparent political.
Health care in the US is primarily a wealth-transfer mechanism between healthy people and the medical community via insurance companies. Young healthy people get treated like they’re made of gold, but if you get old and need real health care, you get trapped in an underfunded hospital system with overworked staff.
Andrea E, I really appreciate your comments. I would be more than happy to delete them if you feel uncomfortable. Some thoughts were deleted in a previous post secondary to some miscommunication and I couldn’t figure out a way to repost them…so, anyway, I just wanted to make sure you really wanted them deleted. I actually think what you wrote is very insightful and you ask some really great questions and still remain sensitive to people. I don’t think you come across the wrong way at all.
When I make recommendations to parents, I emphasize that they are recommendations. I encourage parents to feel comfortable about the decisions they are making for their children since they are ultimately held responsible for those decisions. I do feel strongly that parents understand the consequences that can arise. Often, in the course of our conversations, it becomes apparent that the information I provide does have a positive impact in helping parents with their decision to vaccinate their child.
And DKL – Danithew warns me that you’re an excellent debater, so I’m not even going to start. 
Di,
Your approach sounds great. My pediatrician is really the same way–fantastic about discussing any concerns. You can leave the other comment, I just don’t want to be taken to mean that all pediatricians, or all parents, are dismissive.
For what it’s worth, we were only recommended to visit the pediatrician 6 times in the first year (though we ended up going in for a couple sick visits too). For me, these visits have been tremendously educational, giving me everything from hands-on breastfeeding help (which I did NOT get from my lactation consultant) to understanding the difference between a spider bulls-eye rash and a lyme bulls-eye rash, to allaying various concerns, and receiving extensive help understanding how to recognize and manage my daughter’s emerging asthma on my own.
It is true that pediatrics is one of the few medical fields that focuses on *preventative* medicine, rather than focusing on highly lucrative treatments and dramatic interventions for health problems that have already reached catastrophic proportion. And maybe it’s normal to feel disgruntled with that. It’s not so sexy, pays poorly, and it does increase non-tv-drama-worthy time-consuming visits (it’s a little hard to prevent if you never see someone until something is terribly wrong) but I think prevention is a really good thing, not a money-making racket.
Thank you so much for writing this. There is so much misinformation out there that people believe because they heard it from a friend or a family member. I teach Microbiology, and so many of my students are clueless when it comes to the benefits of vaccines. I anguish to think of all the children would could die of very serious and preventable diseases because their parents refused to vaccinate them. I hope your blog post will spread the correct information.