The wars of the world: Saving lives through vaccination

Issue: August 2011

ByDavid W. Kimberlin, MD

It’s been a hard week. The infectious diseases ward of our hospital is so full that we have to put many children who normally would be in isolation wings on regular floors. The 3-year-old with smallpox died early this morning, and the three infants on the ventilator with measles pneumonia are not far behind.

Although there is not much more to do for them, the house staff is consistently over their duty hours because of the sheer number of other children in the hospital. The easiest way to tell the dozen children with bacterial meningitis apart is that the eight with Haemophilus influenza type b meningitis have seizures that are easier to control than the two with pneumococcal central nervous system infection. Of course, the two with meningococcus are easily distinguished by their amputations. The one bit of good news is that it is not summertime, so at least we do not have to deal with polio yet. You’d think that in the year 2011 something could be done to prevent this.

I doubt this intro has you as scared as the Americans who heard Orson Welles’ War of the Worlds in 1938, but make no mistake — this is a reality that did happen, albeit decades ago. This is being held at bay from occurring again by only one thing: vaccination.

Women and children in a mobile clinic waiting for and receiving vaccinations in 1972.

Without the safe and effective vaccines that we too often take for granted now, more than 300 million who lived full and rewarding lives during the 20th century would have died prematurely of a vaccine-preventable disease. Compare this with the 160 million estimated to have been killed in all wars combined during the same century. Stated another way, vaccines saved twice as many lives as were lost in war during the most destructive 100 years in human history.

Accurate information

With this as background, it is incredible to me that anyone would deliberately refuse the protections that previous generations would have given their eye teeth to have had. I am certain that today’s vaccine refusers love their children just as much as parents did in prior eras. So why would so many people willingly leave their children at real risk for lifelong disability or death when there is a way to prevent it?

I believe that in most situations, it comes down to a misperception of what the risks really are, and this misperception is aggravated by the onslaught of (mis)information that is available at the click of a mouse.

Measles vaccine does not cause autism, nor does it produce inflammatory bowel disease. In 2011, though, measles virus has killed 12 children in France and left six with permanent brain damage. Is it more dangerous to have your child vaccinated against measles or to take him to France for a wonderful family vacation?

Clearly, right now it is the latter, but I bet most Americans would not realize this. Instead, parents who love their children but hear on the soccer field scary (yet unfounded) stories about vaccines, go home and Google “measles vaccine.” They are presented with links to some very reputable sources of information, such as the AAP, CDC and the National Network for Immunization Information (NNii), but they also can be directed to media-savvy groups who perpetuate misinformation that sounds very scary. These parents likely have not ever seen measles, and they do not want to harm their children. They may, therefore, delay or refuse the vaccine, not realizing that the neighbor returning home tomorrow from a European vacation may be carrying the agent of their child’s death.

Parents trust their child’s pediatrician

This leaves us with the question of what can be done to change this situation. Studies have consistently shown that most parents trust their pediatrician to provide the most accurate information about protecting their child’s health. This is a great thing, and in it offers the best solution that we have right now. All of us should passionately advocate for all children to receive all their vaccinations at the appropriate schedule. When parents ask about what they should do, we should tell them that vaccines save lives, that we have protected our own children against these diseases, and that we would want nothing less than the same for their children. No hesitation, no wavering, no appeasement if they request an “alternative schedule” that leaves their child at risk. In this global world, all vaccine-preventable diseases, except smallpox, are only 18 hours away by plane.

These thoughts may sound harsh, or at least uncompromising. However, pediatricians just one generation older than I am regularly saw polio, and pediatricians one generation younger than me likely will never see the neurologic devastation wrought by Hib. To not strongly advocate for the continued suppression of these disease threats is a disservice to pediatricians’ experiences, just as it is a disservice to today’s children.

David W. Kimberlin, MD, is professor of pediatrics and the Sergio Stagno Endowed Chair in Pediatric Infectious Diseases. He is also co-director of the division of pediatric infectious diseases at the University of Alabama at Birmingham, and is the course director for the Infectious Diseases in Children New York Symposium. Disclosure: Dr. Kimberlin reports no relevant financial disclosures.

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