"Intentionally Unvaccinated"

I came across a story on the Parents Who Protect blog that sent a chill down my spine. It was about a Hib meningitis outbreak here in Minnesota in 2009, which killed an infant and sickened four others. Hib is short for Haemophilus influenza type B. It's one of the basic childhood vaccinations. 

It's a terrible disease, and it's an unbearable story. But there's something about this story that makes it even more unbearable. The child who died, and two who were hospitalized, were intentionally unvaccinated. Parents of two of these children objected to vaccines; the parents of the third had delayed the vaccine until the child would be five years old. The news reports do not tell us who is who, and it really doesn't matter. The story made my heart bleed. I think about what it must feel like to be in those parents' shoes today and can only be in that place for moments. I don't wish this kind of grief on anyone. "We had a death from a child who was unvaccinated," Kristen Ehresmann, RN, MPH, of the Minnesota Department of Health said.  "We want to encourage parents who have delayed or refused vaccination to reconsider." 

It was stories like these--true stories--that transformed me from a vaccine-hesitant parent to one who is pro-vax. The true weight of my decision making process was laid bare, and I had to reexamine why I had come to my conclusions, what resources I'd consulted, and whether I was operating on fact or fear. We make these decisions for our children, because they can't; and we owe it to ourselves to base those decisions on the facts. I didn't want to be in the position of these heartbroken parents, wondering if I should have done things differently.  


If you are looking for more reassurance that the anti-vax claims are without merit, please consider reading Seth Mnookin's piece in The Huffington Post that ran recently. 

Moms Who Vax: Dr. Kate O'Brien's Story

Editor's Note: To mark World Pneumonia Day, Moms Who Vax, along with a number of other blogs, will run this commentary by pediatrician Kate O'Brien from Johns Hopkins on her experience with her own child's bout of pneumonia. 

By Dr. Kate O'Brien

I’m a pediatrician, an infectious disease pediatrician at that.  We’re supposed to know what to do when a baby has pneumonia---apparently that’s not always true.  I’ve treated hundreds of such cases --- but this time was different.   When it’s your own infant none of that experience matters.  Jack looked at me with what seemed like panic in his eyes.  Coughing, crying, breathing fast, sleeping in fits and spurts.  Babies aren’t supposed to breath that fast.  He lay beside me in bed. It was the day before Christmas and I just kept telling myself that we’d be better soon---apparently that’s not true either.    We both had influenza, I’m sure of that.  If you’ve had it you’ll know what I mean---I felt like hell, exhausted, muscle aches, every time I coughed it felt like sandpaper scraping over my trachea.  But since I’m an infectious disease doc, of course we were vaccinated!---well, apparently that wasn’t true this year.  I had every intention of getting that done weeks earlier, but life got in the way.

The middle of the night always makes things worse, or at least things seem worse.  So, we became ‘that family’, calling our neighbors in the middle of the night to care for our two-year old while we drove to the hospital with Jack.  So many times I was that doctor we were about to meet in the emergency room, scratching my head wondering, “Why did they wait the whole day at home and decide to finally come in at 2 in the morning?”  Well, now I knew.  Sometimes it doesn’t get better.  He had pneumonia on the chest x-ray and needed antibiotics.  

Every day, of every year, millions of children get pneumonia and struggle to breath; more than a million of them don’t get the treatment they need and die.  

Every day of every year something unimaginable to the mothers we are, happens to mothers we don’t know, over 90% of them living in poor countries in Africa and Asia ---their child dies in front of their eyes from pneumonia.  It’s senseless.   It’s inhuman. Vaccines against the biggest pneumonia causing bacteria, Hib and pneumococcus, along with other simple strategies can prevent these deaths.   

So, this year on World Pneumonia Day, look at your kids and remember to get them vaccinated, remember to get yourself vaccinated and remember that not every mother is so lucky….yet.  The GAVI Alliance is helping give those mothers the same opportunity for their kids, faster than ever before for any vaccine.  At a time when the world seems to be more complicated than ever, this seems like a pretty sensible thing to do.

Dr. Kate O’Brien, pediatrician, epidemiologist, Deputy Director of the International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, USA,

Winner of the 2011 US Presidential Early Career Award for Scientists and Engineers

My Beautiful Boy: A Mom's Story

Editor's Note: One of the most important immunizations on the childhood schedule is the Hib and meningococcal vaccines. Few of us have seen firsthand the horrors of this brutal, quick-moving, and merciless disease, and yet we hear of cases in children and young people year after year after year. That this completely preventable disease still shows up in children is heartbreaking. That some parents still refuse to vaccinate their children against it is even more so. We are deeply grateful to Frankie Milley, mother and founder of Meningitis Angels, a nonprofit organization founded after the death of Frankie's son, Ryan. Below is her story. 

It is the end of yet another long day. It is once again midnight and I am at my computer working. I have had 13 years of these same days: Years of days without my precious son: Years without his laugh, his voice, his smile, his wit, his hugs, and his love. 

Ryan was my only child. He was eighteen, just graduated from high school, preparing for college and planning a pro golf career. He was a healthy young man one day and the next day meningococcal meningitis struck.  Within hours he lay dying on an emergency room table, with blood coming from every orifice of his body. 

I stood there helpless as I watch the life and blood leave my beautiful boy. His father reaching for him repeating the words, Daddy loves you baby boy over and over again.  The last words we would hear Ryan say were to his dad. They were: “I know.”

In the days that followed I found there was a vaccine that could have prevented Ryan’s death.  No one ever told me about it. I was in the medical field for over twenty-five years. How could I have not known that meningococcal disease not only kills but leaves its victims with severe disabilities?  Had I known Ryan would have been vaccinated.

The medical examiner told me Ryan would have lost all four extremities, been blind and deaf, had no kidney or adrenal function, severe brain damage, and more.  This disease had come from nowhere right out of the pits of hell. In just a few hours it took away his dad’s and my rights to ever be called dad and mom again, to dance with my son at his wedding, to ever hold a grandchild, to have his comfort in our old age when one has to leave the other. In just a few hours this preventable disease would forever change our life. It would leave a void and a grief that would never disappear.

In the days, weeks, months, years to follow I founded Meningitis Angels and what has become a lifelong work of advocacy. I began to realize there were many kids out there who were dying or being debilitated  with not only meningococcal disease/meningitis but also pneumococcal meningitis and even a few with Hib. Hib had been eradicated for the most part in the US due to recommended vaccination.  However, we have seen it resurface in areas where vaccine refusal was present. 

A few years later we would see pneumococcal on the decline due to new vaccine and more recommendations and in the last five years we have seen a decline in adolescent and young adult meningococcal disease.  I have fought hard, participated in and even led the fight at times for the recommendations and mandates around the country. 

The meningococcal vaccines are indicated for ages 2-55 and thanks to CDC recommendations they are now recommended for those kids age 11-18 and all who enter college.  Recently one of the vaccines’ indications changed and is now recommended for infants down to 9 months with compromised immune systems. 

Infants under one year now remain the most vulnerable of all for meningococcal disease.  Among our Angels are several infants and toddlers who have died or have been left with severe debilitations including brain damage, severe seizure disorders which lead to brain surgery, organ failure leading to transplants, the loss of arms, legs and even their little faces. Parents watch helplessly as their precious children literally rot away and body parts self-amputate and still die.

Two vaccines are being reviewed by FDA for approval of usage down to age 2 months.  CDC is gathering public opinion in four regional meetings on whether or not to recommend these vaccines when available. Though I praise them for this effort I feel in my heart that meetings in Seattle Washington, Denver Colorado, Concord New Hampshire and Chicago Illinois do not give a fair representation and voice of the whole country. This is why we have started our campaign Protect Infants Now which includes an online petition. 

Meningitis Survivor Helen Keller said, ““Alone we can do so little; together we can do so much.” I say if infants and children had a voice and a choice between deadly diseases or a vaccine to prevent it they would choose vaccination. But they don’t so we have to be that voice: One of fact, science and choice of health and life.

You can sign our petition at Protect Infants Now . They can learn more about meningitis and contact me though our Angels at www.meningitis-angels.org 

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."