Thursday, April 14, 2011

View from the Exam Room: Baby's First Immunizations

Today my younger sister took her two-month-old daughter to get her first vaccinations. She asked me to be present. After we talked to the doctor about the baby's bowel movements, her tendency to spit up, her impressive head and neck strength, we got the vaccination question. At that point, my sister got tongue-tied, and she turned to me.

"Obviously you don't turn away unvaccinated children," I jumped in, "but I think what my sister is concerned about is exposure to infected unvaccinated children in your waiting room. We can't control the general population--who knows who is vaccinated and who isn't when we go to the mall. But several infants have been infected in waiting rooms and emergency rooms by unvaccinated children waiting for treatment." The doctor nodded and seemed grateful to hear from a couple of so-called "pro-vax" moms for once.

"You're right," she said. "We don't turn away unvaccinated children. We try to convince the parents to vaccinate, of course, and give them the facts." She continued. "We had a case of measles here on Friday." It was like the air was sucked out of the room. The doctor was pregnant herself. I mentioned that I thought that must have been a bit scary for her. "Luckily, I was on the other side of the clinic at the time," she said. "But we have very clear protocols for handling that."
"Do other parents have the right to be notified?" my sister asked.
"Yes, we notify anyone who might have been in the waiting room that day, and if we suspect the child has measles, we put him in a specific room in the clinic."

I looked at my sister. This didn't see like enough. And I agreed. "It's really refreshing to hear from this point of view," the doctor added. "Parents who are concerned about unvaccinated children." She told us that since the Twin Cities measles outbreak, some parents who had, to this point, left their children unvaccinated had relented and brought their kids in for vaccines. I found this a hugely positive step.

Then it was time for the vaccines. The physician's assistant had set down a piece of paper and said: "Here are the vaccines for this visit. She then said: "You'll be getting shots for these eight diseases," and went down the list. I cringed. As soon as she left, I turned to my sister. "This will actually consist of two injections." Her eyes had grown wide, because it sounded like this baby was going to get eight shots. Going down the laundry list of diseases a combo vaccine prevents has become rote, but health providers really need to give careful consideration to the way they present these vaccinations. "These PAs need to be trained in how to talk about vaccines in ways that don't mislead or scare parents," I said to my sister. "Geez!"

In the end, my baby niece got three injections (dTaP--Diptheria, Tetanus and Pertussis--protecting her against three of the most devastating diseases known to man; Pneumonococcal, which prevents a disease that can lead to meningitis; and her Hep B vaccine, since she hadn't gotten it at birth).

When my sister laid her baby on the exam table, she said, "Oh, look at her looking at me, all trusting and loving." I said: "She's trusting you to do what's best for her because you love her. And you are."

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