The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Friday, September 15, 2006

Just Do It.

Although maybe not what you think.

Just vaccinate your damn kids already. I am so tired of having the same argument over and over with people who 'know someone whose friend had a niece who got autism from a vaccination'. Sure they did. But right now there is a young boy on the pediatrics floor with meningitis because his mother didn't believe in vaccinations. When questioned further about her beliefs, the mother admitted that she didn't have any concrete evidence or research to back up her decision, but a friend of hers suggested that vaccines were like 'putting poison into her child'. So she put it off. And refused it when her family doctor offered it. Repeatedly. She had been meaning to do the research herself, she said, but she just didn't have the time.

Hope you have the time to deal with a brain-injured child.

I have yet to come across anyone who can provide me with actual fact-based evidence to support a decision not to vaccinate. Particularly with the tried and true vaccinations-- MMR and DTaP-IPV. I am more likely to understand the hesitation to incorporate the 'new' vaccines with the (albeit misguided) reasoning that new vaccines have less safety data backing them up. But childhood vaccinations have changed the face of disease in the past 50 years. Smallpox has been eradicated. Polio has been eradicated in the western hemisphere, with the exception of some confined outbreaks in religious communities that are anti-vaccination. Diseases such as mumps, measles and whooping cough are so rare that when a child is admitted with one of them, medical trainees parade through the room at a constant pace to see how it presents.

And with the newer vaccines (Hib, Menjugate) even during my short medical career we've seen the impact. Meningitis used to be a much more common childhood killer. Since the advent of the Hib vaccine (hemophilus influenza B being one of the most common causes of meningitis in infants and young children) the incidence of meningitis has gone down dramatically (I think it's by about 90 percent, but don't quote me). Epiglottitis, an airway emergency that we're taught to be suspicious of in any child coming into the emergency room with stridor and drooling, is actually now more common in adults.

This topic infuriates me. If anyone out there in cyber-land can give me evidence (and by that I mean peer-reviewed trials, not the word of your next-door neighbour) that backs up the decision to avoid childhood vaccinations, I'd love to hear it. Because every time I see another kid come in suffering from a vaccine-preventable disease, I have to bite my tongue not to point out to the parents that their inaction was directly responsible for their child's suffering.

Judgemental? Sure. But YOU try treating a kid with meningitis who, up until admission, was a totally normal kid and is now deaf and brain-injured. And then find out that mom had opted out of vaccinating because she decided to take the word of her cousin's friend over her family doctor or pediatrician. And let's see how judgemental YOU become.

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Blogger Return Of Saturn said...

I work with kids with autism, and recently, several of my well-educated colleagues have had babies. And they have decided not to vaccinate until they are 5-6 years-old.
It blows my mind!! I'm just waiting for one of them to say, "Sorry, I have to take a few weeks off because [small unimunized child's name]is near death and facing the possibility of brain damage." Scary stuff...

5:02 AM

Blogger Couz said...

It's certainly not limited to people with less education. I remember back when I was doing grad studies I was on an e-mail listserve with a group of public health professionals. A pretty heated discussion broke out on the subject of vaccination, which surprised me. I didn't realize that people would even hesitate with their children's health when there is so much evidence out there showing the benefits.

6:40 AM

Blogger TheTundraPA said...

YOU GO!!! GIRL! ABSOLUTELY! I could foam at the mouth on this one... Fortunately in the population I work in (Yupik Eskimo) we have a very low rate of vaccine refusal. It was much more of a problem when I worked in a middle-class, predominately Caucasian population. I wanted to grab their collars and shake them and yell "WHAT are you thinking?!! This is YOUR CHILD that you are risking!"

Whew...OK, I feel better now...

1:34 PM

Anonymous Anonymous said...

I know physicians that don't immunize their children until later than the recommended schedule. Their contention is that the standard schedules are set up so that people won't forget their kids immunizations, but because they are well educated and on top of things they can make up their own schedule that they consider safer with no adverse effects.

What do you think of that?

4:55 PM

Blogger My Own Woman said...

Wellllllll...... I work the ER...and a friend of a friend of a cousin of an aunt whose uncle had children that were immunized told me to immunize my children, so I did.

I couldn't agree with you more. If you want to risk health care, let them do it on themselves... give the kids a fighting chance.

I've heard the argument... I didn't get my kids vaccinated because you never hear of those diseases anymore..... Well,,,,, duh.... guess why not?

Recently, there has been an uprising in both adults and children. I wonder if that can possibly be related to the fact that less children are getting vaccinated. (Things that make you go hmmmmm)

5:52 PM

Blogger Nikki said...

I couldn't agree more. Not immunizing a child orders on child neglect, if you ask me.

10:35 PM

Anonymous Anonymous said...

Alright from one anonymous to another..(although I'm an academic center pediatrician), I am surprised at the MD's delaying immunization. I currently have a 6 week old on the wards who has been admitted for 3 weeks with apnea (stopping breathing) secondary to pertussis. It presents much differently in infants and is life threatening. Most vaccine preventable diseases are much more severe in children less than 1 year. Some aren't (eg. rubella), but that is not a justification for delaying the whole schedule. Couz mentioned HiB meningitis which is much worse in infants as well as both Strep pneumo and Meningococcal meningitis. Our infectious disease specialitists are mad at the MoH in my province since the meningococcal vaccine is only covered at 1 yr although the CPS (Can Peds Society) promotes the recommended schedule starting at 2 months.
As you can see - this is an important and HOT topic for pediatric specialists. I do International Child Health and have seen many many cases of rare vaccine-preventable diseases in developing countries. One of the best arguments TO vaccinate I explain to parents is that, do they think their child will ever travel to a foreign country where these diseases are endemic or can they guarantee that they won't sit beside someone on a plane who has been exposed or beside another immigrant child in the classroom?
Please check out for ways to discuss vaccination with families.
Thanks for the posting! Important topic.

11:50 AM

Anonymous Anonymous said...

Here, here! I TOTALLY agree with you! I know of two people that are deaf due to meng...there's no way in HELL I won't vaccinate my kid against everything possible. I rolled my eyes when a co-worker (very good mom, very involved) told me that I needed to special order mercury and thermisol free vaccines. BUT when my son had a 102+ deg fever for a damned week after his 6 mo shots, I began to think differently...then got a hold of myself! Which reminds me that I need to call the office to ask about HPV vaccine availability for my 14 yo daughter. Discussion with her was limited on this -> it's not about sex, it's about anti-cancer and...and as a parent, can I do anything less than provide the best protection (vacs) possible? I think not.

2:26 PM

Anonymous manitoba reader said...

I have an overly educated friend (as in she knows the answer to everything) who does not immunize. I get so irritated with her, yeah it is those of us who do "take that chance" who are making it easy for you to decide not to immunize. We don't have a pediatrician, so getting immunized is rather hard! Have to find PHN's who are willing to do them, which is not easy! Ask my youngest, she has only had two and she will be a year next month... PHN went on mat leave and I haven't found anyone else willing to do it in our area yet.
Yes, I've tried to get a pediatrician. No, I haven't found any willing to take three kids and are open in the evenings when I have a car and husband to transport them. Please don't give me any helpful hints on finding one. They aren't available when I need them.

6:15 PM

Anonymous Anonymous said...

To the academic center pediatrician thanks for your comments about delayed vaccination by physicians. (I'm the first "anonymous") I'm a medical student and this was a clinical instructor at my school who told us this (that she was delaying vaccinating her kids) and I was pretty shocked at the time!!

2:02 PM

Blogger sweet_de said...

I too work with children who have autism and it does bow my mind with every so called "new evidence of the cause of autism" the latest is men over 40 sperm no good causes autism.

Vacinate your child. I was hesitant to get the chicken pox vacine for my daughter but when my doc said "can you afford 1 week off work to take care of her?" no not really. I'd rather vacinate her and know shes safe, and if she gets anything It would not be as serious as if she wasn't vacinated.

10:51 AM

Anonymous Anonymous said...

I view it as neglect and mourn for children who battle preventable diseases while their properly vaccinated parents ineptly try to explain their (lack of) decision.
Carry on....

3:53 PM

Anonymous Anonymous said...

Families from Third World countries are pouring into our countries, and many of them have not been vaccinated, some of them already have communicable diseases, like wild polio and new strains of TB. How can our kindergartens and schools screen every child, make sure every one of them has/will get treatment/vaccinations? The risks unvaccinated kids face today are very great. Seems to me there needs to be a huge government PR education/effort to convince all parents to get those vaccinations early as possible.

2:09 AM

Anonymous Anonymous said...

I don't have a problem with vaccinations, I have a problem with vaccinating infants who are very young in age.

We delay introduction of solid foods because the GI system of infants is less developed. Why subject their immnature immune systems to the dozens of vaccines given in the 1st 12-18 months?

We know that the early introduction of solids increases the risk of allergy, asthma and eczema. Isn't it within the realm of possibility that vaccinating (which bypasses our natural immune defenses - mucus membranes, etc.)could cause a reaction?

I will vaccinate, but not before 18-24 months.

8:32 AM

Anonymous Anonymous said...

Yeah well, being the mother of a child who DIED from her vaccinations, I think what you are saying is misguided.

You are pretty presumptious ma'am.

5:43 PM

Anonymous Anonymous said...

Yes, kids do sometimes die as a result of adverse reactions to vaccines and that sucks. I don't think anybody would disagree with that. However, when look at on the basis of a population, vaccinations are an invaluable preventive measure against even worse odds of adverse outcomes.

Everything in life has a risk. Sometimes the risk work in your favor and sometimes they don't.

9:50 PM

Blogger A girl said...

Yap, I spend day in Resp clinic today and had same "I am not sure if I want to vaccinate my child with asthma" conversation several times. This is were 5 minutes spent building a raport become handy.

2:40 AM

Anonymous Anonymous said...

I have four children and all are vaccinated. As a nurse I know there are risks and side effects with everything and anything (imagine my horror as a nursing student reviewing the drug books!)

I figure whatever risk I am taking doing what millions of parents have done before me is small compared to the situation you are blogging about.

9:57 PM

Blogger The MSILF said...

Hi, I just (re) found your blog and really like it.

It seems like one of the curses of the vaccine age is that the general public no longer has any idea of how horrible these diseases actually are. On my first day in peds in medical school, there was a baby with whooping cough which ended up with her intubated, leukemoid blood reaction and later HUS, seizures, a long stay in the PICU. Until I had actually seen it, I had no idea what a horrible disease it was. That baby hadn't been vaccinated yet because she was too young. But who was the source? Another mildly ill, older, nonvaccinated kid in a community that has a traditionally high refusal rate.

Every time a new vaccine comes out, I'm first in line.

12:21 PM

Anonymous RDoc said...

Good hygiene and vaccines extended average life span much more than any other medical achivement.

1:46 PM

Anonymous Anonymous said...

as a parent you carefully weigh all the pros and cons before you make any decicions regarding your children, especially those that effect their health and well being, and that is why there is nothing surprising in the fact that a lot of parents are patrefied of immunisations, with all the contrevercial information that they can find on the web. The very problem is that there are claims and no hard evidence, no official clinical studies were done, to ease our minds. Why? I believe that it's because all those parents that claim that their children became victims of immunisations are not just looking for someone to blame but really are awear of what happened to their children. After reading or hearing this who would wand to experiment on their own child. Also after hearing the health officials and some physitions say to the public that small amounts of mercury are not harmfull for tiny babies makes it hard to trust our health care, because any somewhat educated or intellegent parent will know that they are being lied to by people who are in charge of our health. I followed the recomended schedual vaccinating my son, deciding that not vaccinating might be even scarier than vaccinating. Now I am expecting a second child and I am considering that vaccination schedual again and I don't see why a newborn has to get a HBV on the day they are born while this vacciene is still optional for health care workers who are the ones that really needed. Where whoud a neonate contract Hep B? Or Varicella, why not limit vaccinating in the first years of life to only necessary immunisations instead of bomburding those immature immune systems with more and more vaccinations.

4:33 PM

Anonymous Anonymous said...

I have both my kids vaccinated and one has autism (the older one) and you know what she appears deaf and brain injured but it's autism and it fucking sucks. So I understand when parents question vaccines because I never questioned them until I found out my 2 yr old has autism. I still vaccinated my younger baby and I hope to fucking god she doesn't develop autism after 18 months like her sister did. Do you have kids? Do you love someone who has autism? What is the harm when a parents ask for a thermisol free vaccine or question vaccines? Give them the answers to their questions and have them read for themselves about vaccines. They are just doing their job as a parent and love their child. I would hate to have a dr or friend like you who thinks of the general population instead of your own child. When I got my children vaccinated I did not think about the health of the next child to us but my child..I want to protect my child and that is why I chose to get them. There is no research now to support vaccines or MMR vaccine = autism. I hope we don't see any research to support it or I will hate myself as a parent and nurse for vaccinating my children. It is natural to want to protect your child from this fucking hell world caused autism.

9:14 PM

Anonymous Anonymous said...

YOU miss are a fucking moron. Sit up on your hidey high horse if you want to, your education was paid for and funded by medical companies...the same ones that make the vaccine, the same ones who tell its okay and won't do any studies on vaccinated versus unvaccinated people. Personally I would rather listen to the hundreds of parents that KNOW there children were affected, some braindamaged, some much worse, by the shot. My sister in law got meningitis from the shot to prevent meningitis. Yeah some kids dying 'sucks'. What an idiot you are too. Take care of your kids and mind your businesses you hoity bitches.

3:45 AM

Anonymous Anonymous said...

I have to laugh at you white robed priests of the medicine cult. Your vaccine technology is hardly more advanced than those of your predecessors' potions containing wing of bat and eye of newt, anachronistic and undifferentiated in no way from the enchanted magical elixirs of middle age witchcraft promising to ward off the devil and as absurd. You take a pinch of aborted fetal tissue, two drops of embryonic or fetal fluid from monkey or chick (take your pick), a dash of mercury, a dab of formaldehyde, and a little of the hair of the virus that might bite (blow your nose into it and you could label it "new and IMPROVED"), stir it up in your sanitized (Why bother? They could be mixed in my backyard cesspool with no danger of additional contamination.) industrial cauldrons, employ the political power of the state to impose at gunpoint the points of your needles in administering your communion cup to the general population, and yet, are not content to have enrolled within the ranks of the faithful and believing nearly all, but desire in the inquisition tradition absolutely all without exception to believe in the name of Vaccine and to be saved, here do cry aloud, lambasting, lifting up your voices in indignation at those few who have some small remnant of the atavistic instinctual revulsion to the obscene, filthy, and unclean. These few don't need to wait around for a pharmaceutical industry funded controlled study, to connect the dots over thirty, forty, and fifty years of cause and effect, to tell them what they already know deep inside. Besides, the study is already taking place, in your home with you and your children. I think I'll just sit back and watch to see if you get cancer, Alzheimer's, Lou Gehrig's, birth defects, autism, etc. Oh, Wait! The results are already coming in! Excuse me, while I learn from your experiences and save my own life and those of my children by not repeating your mistakes.

8:09 PM

Anonymous Anonymous said...

Doctors aren't always right when it comes to the best thing for your children. (I have a hard experince with my baby being misdiginosed by 3 different doctors) Your instincts are what you should go by. If you don't feel okay about vaccinating then don't. My Grandma & my mother wasn't vaccinated, I'm not vaccinated, my kids won't be. We are as healthy as anyone else.

9:35 PM

Anonymous Anonymous said...

My 6 yr. old daughter was just dx'd w/ MUMPS & has had her 15 mth & 4 yr MMR vaccine. Ticks me off that those of us who do the right thing have our children compromised for the ignorance & flippant nature of other parents on this issue. How does our gov't send men off to Iraq to die to save us from a possible "threat", but will allow anyone to come in from another country w/o proof of vaccination & allow unimmunized children to go to public schools?????????? For those of you who say you are healthy & haven't been immunized, grow up & realize the world does not revolve around just you. You are putting EVERYONE @ risk for these diseases to mutate & become stronger that the medicines we have will no longer be effective. Thank you!

10:50 AM

Anonymous Anonymous said...

I'm a couple years late here, I know.

But: I'm officially diagnosed with Asperger's Syndrome (also known as high-functioning autism, this week; I think next week, we're supposed to be calling it pervasive developmental disorder again. :P)

I've gone through all the research I can find (and stay awake through, or not get bogged down in citations while reading) and you know what?

There are a few cases where the vaccinations probably were the cause behind the kid developing autism.

In every case, these were the kids whose parents decided to have their kids get six or seven or even, in one case, fifteen vaccinations at one time.
So to my mind, while vaccinations might have a role to play in some rare instances, it seems to have more to do with the number of vaccinations in one sitting, rather than the specific vaccine or the solution the vaccine was made up out of.

So: I am planning on having kids one day. I am going to get them vaccinated, on schedule. They are not having more than three vaccinations at one time if I can possibly avoid it. (I'm basing this on the fact that the largest one I've heard of is the MMR and, from what I recall of my own vaccination table, those are all given at the same time. If I'm wrong, please do let me know. I like to learn new things :) )

4:57 AM


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