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We’ve never met. You just had a baby named Angelese with my cousin’s son George. I guess that makes us family. You had your baby at home. I am glad things went well for you with no complications. She’s beautiful. I’ve seen pictures of her on my cousin Christina’s FB page. Christina says you’re going all-organic as far as the baby goes. That’s the way to go. She doesn’t need all those antibiotics and hormones in commercial meat and milk. She also says you’re not planning on vaccinating your baby. Ever. Against anything. No vaccines.
And that’s where we have a problem. Or at least I have a problem. You see, I’m a pediatrician. I vaccinate for a living. I’ve been around a while and have seen children die of diseases that have largely been eradicated due to vaccines. Vaccines I believe in.
The truth is Angelese will probably be just fine. She is afforded a certain amount of protection—called herd immunity—because most parents do vaccinate their children. That may not always be true. In fact if enough parents en masse refuse all vaccinations, herd immunity will evaporate and we will all be at risk, not just Angelese.
And that’s the thing. You have only your daughter to take care of. I have to keep all the other children in mind. If Angelese gets chicken pox, besides a few pox scars, she will likely do just fine. She’s strong with a healthy immune system. She can fight viruses just fine. But some children are not strong or fine and do not have healthy immune systems. My niece Emma just underwent chemotherapy and a stem cell transplant for neuroblastoma. For her, varicella could be deadly. Those are the children I need to think about. For me, there is also this is the ethical reason to vaccinate.
In my community there are some pediatricians who won’t accept you into the practice if you don’t go along with the immunization schedule as recommended by the American Academy of Pediatrics. In my practice, you’re welcome. (In fact, one solo practitioner’s, to me, over-the-top response is to threaten you with a call to DCF. He believes with-holding vaccines from your child amounts to child abuse.) I don’t believe that. I do believe deep in my heart, that all parents loves their children and no matter what decision they make, they are making the decision that they truly believe is in the best interest of their kids. I don’t believe in cutting those parents off from health care just because they disagree with me. But I do believe it’s my job to continue to defend and recommend vaccines.
We have parents in our practice who, for whatever reason, want to space out their children’s vaccinations, give just one at a time, delay some and defer others altogether. I take care of all of them.
When pregnant women come to the office to interview me as a possible pediatrician for their babies, the most frequently asked questions involve the vaccine schedule. I make it clear that they should not interpret my willingness to give them their shots on an alternative schedule to mean that I agree with them that it isn’t safe to give three shots at once. I don’t agree with them. And it is. One of the most compelling pieces of evidence for this was a June 2010 study in the medical journal Pediatrics that found no adverse neuropsychological outcomes in children who received on-time vaccines in their first year of life. These parents also need to understand that their children are at risk for whatever disease they’ve not vaccinated them against for as long as they’ve put off that vaccine. I also tell them up front that I’ll be hawking them at every visit to pony up and get vaccinated. I even email my patients news stories about disease outbreaks and clinical studies on vaccine safety and efficacy.
It was easier to convince parents about the efficacy of vaccination when their biggest worry was autism. The relationships between the MMR vaccine, thimerisol and autism have been roundly debunked for some time now. Parents’ concerns nowadays seem more to have to do with the necessity of vaccines at all. The vaccine program is in some ways a victim of its own success. Parents who have never seen encephalitis from measles, amputations after meningococcal infection or a seizure during a case of pertussis may not fully appreciate how aggressive some vaccine-preventable diseases can be.
No decision is easy when it comes to our children. There is always something to worry about. (My 28-year-old son announced recently that he is taking up sky-diving. Believe me. There will always be things to worry about.) You’d feel terrible if something happened to Angelese because you vaccinated her. You’d never forgive yourself if something happened because you didn’t. As parents, we all just do the best we can with the information we have. I hope you’ll consider listening to the information regarding vaccines.
We were having a staff luncheon yesterday: me, Dr. Moran, Jennifer and Heather. This is Heather’s last week before her maternity leave. We were having a surprise shower for her. She thought it was just one of our usual monthly staff meetings until we started putting gift bags with onesies, hats and baby blankets in front of her.
“You guys ambushed me!” Heather stammered.
Over lunch, we discussed the newest member of our practice, a newborn baby whom Dr. Moran had rounded on at the hospital that morning.
“He’s from your side of the family,” he told me. Apparently I had been the baby’s father’s pediatrician since he was a little boy.
He smiled, then corrected himself. “I mean your side of the practice.”
But he wasn’t so far off the mark. We have been doctors in this community for almost twenty years now. Children we have known since birth are now having children of their own. In another reference to family, we refer to these children as our “grand-patients.”
So today, it was my turn to round on this new baby from “my side of the family.” I introduced myself to the mother, congratulating her on her beautiful new daughter.
“So, how are we related?” I asked her, as I examined the infant in her bassinette at the mother’s bedside.
She knew exactly what I meant. She didn’t miss a beat.
“Oh, Janice is my mother-in-law,” she told me.
There was no need for last names. I knew exactly who she meant. After all, we’re family.
Carolyn Roy-Bornstein MD
Earlier this month I spent a week at Disney World on a family vacation. It was a very special trip. My 5-year-old niece Emma, after a brutal year of chemotherapy and stem cell transplants for her neuroblastoma, was finally cancer-free. This was Emma’s big Make-a-Wish trip and since Auntie was there at her bedside in Minneapolis for the beginning of her chemo, I was darn sure I was going to be there at the end of it.
I was the early riser of the family so every morning, before the rest of the group awoke, I’d head to the lobby in the pre-dawn. There, I’d check my email, grab a cup of coffee and talk politics with the night staff of the hotel. It was a pleasant enough routine.
One morning, in the middle of our political discussion, a fierce riot scene played out on the lobby TV, muted in the background. My debate-mate immediately launched into his views of the Occupy Wall Street movement and the 99%. But we soon learned that it wasn’t an Occupy movement at all. Rather, it was some students from Penn State protesting the firing of their beloved football coach Joe Paterno, let go for not doing enough to help the alleged sexual abuse victims of former assistant coach, Jerry Sandusky. Now all these mornings in our political deliberations, my front-desk-man and I had not seen eye-to-eye on many things: Herman Cain’s alleged sexual dalliances, Mitt Romney’s waffliness, the future of Obama-care. But on this point we were aligned: where was the moral outrage at the predatory behavior of persons in positions of trust and authority in children’s lives? Why were these students placing the importance of college athletics over the care and protection of children? Did these students really understand the facts of the case or were they merely going along for the ride?
On the last night of Emma’s Make-a-Wish trip, we were standing in line at Santa’s village so Emma could have a turn on the big man’s lap. The line was snaking slowly but surely through the aisles of an auditorium. At one point two young children started swinging from the railings which were decorated with Christmas lights. The tiny white lights shook and clinked under their weight. I watched as a pair of brothers spied the burgeoning mayhem. With a gleam in their eyes, they, too, reached for the top railing, ready to swing with their friends. Their mother, who had been deep in conversation with me, turned toward her boys ever-so-slightly. With a roll of her eyes and a dismissive wave of her hands she said in her deep Southern accent, “You just followers. You know that? You nothin’ but a pair of followers.” The two boys looked at each other. They got a very sheepish look in their eyes. Finally they let go of the decorated railing and resumed their place in line with their mom.
Maybe those Penn State students could take a lesson.