AAP Voices Blog

Editor’s note: This is one of a series of “AAP Voices” posts timed with National Immunization Awareness Month to highlight the importance of vaccination to protect against life-threatening diseases.

On one of those busy on-call days during my residency training in New Jersey, I received a call from the emergency department. We were admitting an 18-month-old with meningitis, etiology identified as Hemophilus influenzae type B (Hib).

Wait, what? Yes, my colleague repeated, the diagnosis was Hib meningitis. Most U.S. children are immunized against Hib between 2 and 15 months of age. This patient had not received any vaccines at all, so had no protection against this disease that once killed about 1,000 American children each year.

The parents watched in despair as the toddler struggled with this life-threatening infection. Feeling totally helpless about the child’s prognosis and realizing how easily it could have been prevented with vaccination, they broke down into tears. The pain of watching their child suffer like this was palpable, and my heart ached for the young family.

I saw that same look of helplessness and despair in parents’ eyes a few years ago during my fellowship in Texas. A 3-year-old patient with leukemia, who couldn’t be immunized because of that disease, got chicken pox (varicella) and developed severe complications from the viral infection. The child was now on a ventilator and fighting for life.

Cases like these are the reason I encourage parents to vaccinate their children whenever possible.

Vaccine hesitancy & the return of dangerous diseases

As difficult as it is to see children suffer from vaccine-preventable illnesses, it’s so much more so when the disease was once considered eliminated. The United States was declared measles-free in 2000, yet we have seen 1,172 confirmed cases of the disease this year as of August 1. Most cases have been among unvaccinated individuals.

Some families don’t realize how dangerous the virus can be, or they are exposed to misinformation about vaccines. Some skip immunization in favor of holding "measles parties" in an effort to immunize their children naturally, rather than through a vaccination. I do my best to explain to parents that it is not wise after all to “just let the children have the disease first-hand,” because doing so could cost them their health or lives.

I tell them about what I saw during medical school, which I attended in a country where like most of the developing world, not every child has access to vaccines. I describe an 11-year-old patient’s struggle with subacute sclerosing panencephalitis, one of the most devastating consequence of measles. It develops years later in children who had measles, causing them to lose mental capacities, get refractory seizures, become vegetative and then die.

I also tell them other vaccine-preventable diseases I saw children suffer and die from: the 4-year-old who developed diphtheritic myocarditis, a devastating complication of diphtheria that leads to heart failure; the five-year-old with paralytic polio, and the three-year-old child who developed fatal tetanus spasms.

In the United States, I explain, we don’t see such devastating consequences of vaccine preventable diseases today is because vaccines have been around to prevent them. And we certainly don’t want to invite these monsters back!

“The parents watched in despair as the toddler struggled with this life-threatening infection. Feeling totally helpless about the child’s prognosis and realizing how easily it could have been prevented with vaccination, they broke down into tears.”

Grassroots efforts to promote immunization

I practice in Iowa, where I work to promote immunization in underserved rural as well as urban pediatric populations. I educate not only my patients and families, but future physicians and the public. I stress the importance of building community immunity with high vaccination rates, and how important this is to immunocompromised children, especially. I explain how many infectious diseases are only a plane ride away, and the importance of full immunization prior to traveling.

Within the American Academy of Pediatrics (AAP) Iowa chapter, we are working and collaborating with other stakeholders to create a parent information network for addressing vaccine hesitancy, emphasizing the proven fact that vaccines save lives. As pediatricians and pediatric sub-specialists, we are dedicated to advancing AAP’s goal of eliminating barriers for vaccination, promoting adherence to evidence-based recommendations, and providing accurate, high-quality scientific information about immunization.

The World Health Organization has rated vaccine hesitancy as one of the top 10 threats for 2019. I firmly believe that enthusiastic pediatricians who take the time to educate parents play the biggest role in sustaining high immunization rates. We need to help parents understand that vaccines are the greatest life-saving tools that medicine can offer. They have protected millions of children from these diseases and their horrible complications. We cannot stress this enough.