Why Vaccinate? For the Fragile

Too many of my friends have ailing children right now. One one end of the range is the simple, a child running a fever after his first day at school. On the other is the heartbreakingly complicated, a young autistic boy recovering from surgery to remove a cancerous tumor from his spine, who is now going to have to be strapped down for frequent MRIs because he can’t lay still that long. And of course, you know about Beatrix.

Those aren’t what have me fuming today, though. Let me tell you a little story.

A friend of mine is a writer. He doesn’t have a job outside the house, but he’s nothing like a full-time writer either. This is because he’s a stay-at-home dad to a severely disabled daughter. We’ll call them Matt and Carrie, although those aren’t their real names.

I won’t tell you what Carrie’s condition is called, either, because it falls just a little shy of being rare enough to identify her. Suffice it to say her brain didn’t develop normally in some very important ways. She was prone to seizures at a very young age, though I’m happy to say she’s been seizure-free for a while. She also has lots of problems with motor control, including swallowing. She has a feeding tube to deal with that last part.

For all that, Carrie is doing well. Her parents recently sent her off to start first grade. She’s in a school with a large number of other children who also need special care, but she’s got the same team assigned to her as she had last year, so she’s well looked after. She’s having a grand old time from what I understand. Well, she was.

Right now, Carrie’s sitting at home, and Matt isn’t getting a lot of writing done as he keeps her entertained and watches her carefully. Why? Because on Friday, one of the school families sent their two kids with pertussis to school.

That’s right. Pertussis. Whooping cough. This:

No, I couldn’t watch the whole thing either. But that’s what Matt is waiting for, afraid he’ll see in Carrie. Unlike almost all children, Carrie couldn’t be given the pertussis vaccine. It’s not recommended for her because, while the vaccine has been cleared in causing epilepsy in children with no previous history, it increases the risk of seizures among children already prone to them.

If Carrie has been infected with pertussis, what then? Here’s how it goes in the otherwise healthy:

  • The cough occurs in sudden, uncontrollable bursts where one cough follows the next without a break for breath.
  • Many children will make a high-pitched whooping sound when breathing in after a coughing episode. Whooping is less common in infants and adults.
  • During a coughing spell, the person may vomit.
  • The person’s face or lips may look blue from lack of oxygen.
  • The cough is often worse at night.
  • Between coughing spells, the person seems well, but the illness is exhausting over time.
  • Coughing episodes gradually become less frequent, but may continue for several weeks or months until the lungs heal.

Carrie, of course, is not otherwise healthy. She’s prone to seizures, one of the rare complications of pertussis. She also has that problem with swallowing.

Think back to the last time you had a bad coughing fit. It’s gross, but think about the saliva and the mucus. Think about the last time you threw up. Now imagine all that together, along with gasping for air–and not being able to swallow.

If Carrie gets pertussis, she’ll almost certainly get pneumonia. Well, she will if the doctors can keep her from choking to death first. There’s a very good reason that pneumonia is a common complication of pertussis, even without Carrie’s problems.

I don’t know whether she’s strong enough to survive it. Honestly, I’ve been too cowardly to ask. Matt and his wife will know, though. They’ll have been thinking these same things, trying not to let their worry show, as they try to keep her entertained while she’s home from school. Other parents at the school will have been thinking similar thoughts. As I mentioned earlier, Carrie’s school has a large population of medically fragile students. Some of them won’t have had the vaccine for sound medical reasons. How many of them could survive pertussis?

As for the family with two children who already have pertussis, I have to hope they’re selfish idiots, that they don’t have two kids in a situation like Carrie’s. The chances are good. Two such disabilities in one family are unlikely. If they’re not the selfish idiots, then it’s someone else whose child infected these kids. And the long line of parents before them who didn’t have their children vaccinated. I have to hope, as well, that the full impact of what they’ve done to their kids–and what they’ve risked, exposing children like Carrie–settles heavily on their shoulders.

I don’t want them to hurt the way Carrie would. Most of them haven’t quite deserved that. They’ve been deceived by the promoters of infectious disease, the people who tell them that a jab in the arm is so much more dangerous than the disease, that disease is so rare that they shouldn’t worry about their child contracting it. They’ve been terrorized by Andrew Wakefield, Dr. Sears, Jenny McCarthy, people who claim to want to help.

Those are the people who should be put into Carrie’s situation and somehow infected with these diseases they’ve already been vaccinated against. They’re the ones who should be worrying about how they’re going to breathe, whether they’re strong enough to make it through the illness and all of its complications. Let them look up at the eyes that are trying very hard not to betray the seriousness of the situation.

Not Carrie. Carrie’s got much better things to do, like going back to school.

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18 Responses to “Why Vaccinate? For the Fragile”

  1. September 11th, 2009 at 7:29 am

    a daughter's mother says:

    How can any parent send their kids off to school so obviously sick? (Yeah, I know, if you don’t go to work you risk your job, etc., but….. !)

    How could any school – let alone this one – let them in the door, especially right now with the clinical symptoms of H1N1 on everybody’s mind and in the news with upsurges in the back-to-school and back-to-campus cases through the country?

    I know you don’t think it will help, but I’m sending a prayer for Carie and her parents. Whether it helps them or not, it helps me.

    I did watch the whole video, and it’s heartbreaking, especially coupled with a bit of imagination and the awareness of the consequences. I never saw or heard whooping cough before. Vaccinations were taken as a matter of course in our family, even before the school systems started to require them. How did these kids slip through that crack?

    Speaking of parents opting out of healthcare for their kids, the “chemo-kid” is back in the news, just finishing his court-ordered treatment for Hodgkins Lymphoma. Supposedly his mom protested on religious grounds. I never noted anyone pointing out that she was perfectly willing to let him go through the first round of chemotherapy, and only “found” her particular brand of religion after the kid complained to her about the side-effects. At least in his case, he wasn’t infectious.

  2. September 11th, 2009 at 10:05 am

    Barbara says:

    The concept of vaccines is not the core of the issue for those “parents opting out of healthcare for their kids” – it’s the execution that shakes up most non-vaxing, selectively-vaxing, or delayed-vaxing families. Why do we – and here I mean “we” in the collective sense, as parents, as human beings – overwhelm the developing (and yes, fragile) immune systems of our infants with cocktails of toxic substances? Read the package inserts to any of the childhood vaccines, specifically the ingredients, side effects and potential dangers. Look at the complete schedule of vaccines recommended for the first 2 years of life – and compare it to the schedule from our childhood, or compare it to the schedules of other developed countries (countries, ironically, which have much lower instances of chronic illness and automimmune disease). Vaccinate, don’t vaccinate, selectively vaccinate – my point is, make an informed decision.

    I am not convinced that this is a vaccine issue. I do think that the parents who sent their infected kids to school (knowing, as they must have, that they were sending their sick kids into a community of medically fragile kids) behaved reprehensibly. I don’t believe that parents trying to be cautious or sceptical of big pharma need be painted with the same brush.

  3. September 11th, 2009 at 10:33 am

    Monica says:

    As the parent of two children: one with cerebral palsy and a compromised immune system, and one with autism spectrum disorder (ASD), I can’t tell you how I poured over articles and books about vaccines in order to have an informed decision. I am not against researching vaccines to find out more about them and/or the THEORIZED links to autism or other health issues, but the benefits of vaccination far outweigh the risks. If those once common childhood illnesses like pertussis, polio, and measles make a comeback because of parents who chose (out of fear? ignorance? or celebrity anti-vaccine groups) to not have their kids vaccinated I’m guessing we’ll have greater epidemics on our hands than H1N1. I’m no scientist, but it seems that if we see these diseases become more prevalent they will undoubtedly develop strains that are resistant to the current vaccines we have on hand.

    In the end, my decision to vaccinate both of my children in spite of a myriad of health issues including hydrocephalus and early seizures in my daughter, and all signs pointing to ASD in my son, was the right choice. And, one that I stand by. If my daughter caught pertussis, she would most certainly contract pneumonia, and she would most certainly need to be hospitalized because she has a hyper-active gag reflex and has difficulty swallowing under the best of circumstances. Coughing sends her into spasms she cannot control. Also, she cannot talk, and can only sign “yes” and “no” so she cannot ask for help. When she gets sick we have to maintain constant vigilance, if she were to get something as severe as pertussis or measles, she would be in grave danger.

    Good luck to Carrie and her family. I hope she makes it back to school soon!

  4. September 11th, 2009 at 11:24 am

    Greg Laden says:

    I remember whooping cough as a kid (a couple of neighbors getting it) and until a few years ago I had assumed that the vaccine had simply not been developed yet, but of course it had been. Pertussis is one of the most common causes of death in children that could be prevented by regular vaccinations.

  5. September 11th, 2009 at 11:36 am

    Greg Laden says:

    Barbara: But what is the specific evidence that makes a vaccine delayer or avoider think (guess? believe? whatever it is) that the US health system is doing it wrong and the European is not, other than a general sense of ickiness (which is quite reasonable) at seeing the list of chemicals, a seemingly aggressive schedule of vaccination, and a concern for the welfare of the child?

    I hate to say this, but I don’t think you or Monica for that matter are going to get to the level of informed choice that you really may want to in terms of technical details. (Or anyone who is not a specialist, of course.) Isn’t this one of those areas that requires that you trust the experts? A rough analogy (that we probably want to avoid over using) would be air flight. Not even the pilot understand the plane as the level the technitians do, and the average passenger implicitly (at least) trusts the pilot and the mechanics and so on to get the thing working.

    An airplane’s maintenance and the knowledge to fly one does not exceed the complexity and knowledge required to truly get vaccines.

    If anyone thinks I’m wrong about that, try the following test. Without looking at the internet or any other source of information, write down a list of twenty distinctly different molecules that exist inside every cell. There are thousands. You only need to know 20 to pass this little quiz, and they don’t even have to be the ones that are involved in the immune system.

    Most people can name more airplane parts than they can cell parts. Those same people will tell you that you don’t need to vaccinate … just eat right and that’s enough … but are totally willing to put their lives and their family’s lives at risk in an aireplane in virtual ignorance.

  6. September 11th, 2009 at 11:41 am

    D. C. Sessions says:

    If they’re not the selfish idiots, then it’s someone else whose child infected these kids.

    No.

    It could easily be (and by the odds, likely was) an adult. Pertussis immunity isn’t terribly long-lasting, and it’s only recently that pertussis immunization was approved for adults [1]. Pertussis, being a bacterium, is going to be with us pretty much forever because unlike human-specific viruses like measles and polio it has other places to live.

    That’s the bad news: kids can get pertussis from Aunt Agatha.

    The good news is that it’s sensitive to antibiotics if it’s caught early enough. The endotoxin that does the damage is actually a rather late-stage symptom. For kids like “Carrie,” it might be appropriate to either have an early culture to check for the bug before it gets symptomatic or put her on precautionary antibiotics. Warning: I am not a physician. This is a fer-sher case of talk to a real professional.

    Segue: it’s early preventive moves like that, though, that all too often don’t happen in the USA’s health-care “system.” Which leads to spending major fortunes on what should have been handled by inexpensive precautions.

    [1] I’m religious about my DT boosters, and haven’t had the DTaP yet because it’s less than the regular interval since the last DT.

  7. September 11th, 2009 at 12:01 pm

    Matt Taylor says:

    A couple of quick points for Barbara…

    1- When we were kids, infants rode in the front of cars in people’s arms. I would like to think that we know a bit more about child safety since then.

    2- As for all of the vaccinations coming in the first two year, that’s due to the fact that most of these diseases have the greatest repercussions on infants (death and disability).

    3- I’m not going to defend big Pharma, but I will mention that I’ve worked with numerous pediatric doctors. All of them only wanted to keep kids healthy, and all of them supported immunizations. The current schedule of immunizations comes from the American Academy of Pediatrics, the Advisory Committee on Immunizations Practices of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians. The vaccines themselves have been studied by the FDA, CDC, and many other medical researchers, Do we really believe that there’s this massive conspiracy of people who want to circumvent all of their training and ethics in order to hurt our children?

    4- Which brings me to my last point. It is in the best interest of insurance companies to keep our children healthy. Why? That’s where they make all of their money.

  8. September 11th, 2009 at 12:07 pm

    Matt Taylor says:

    Hi. I just wanted to thank everybody for the thoughts and prayers.

    Carrie is doing well. I just found out from the school that none of the other students or staff members contracted pertussis. She’ll be back at school on Monday.

    D.C,-
    Since Carrie wasn’t in direct contact with the sick kids, we just kept an eye on and consulted with her medical team. Had she even developed a sniffle, we would have started the antibiotics.

  9. September 11th, 2009 at 2:08 pm

    catgirl says:

    It’s one thing to risk your own children by not vaccinating them (and that’s bad enough!), but why would anyone be stupid enough to send the sick kids to school?

  10. September 11th, 2009 at 3:31 pm

    qetzal says:

    Barbara, re:

    Read the package inserts to any of the childhood vaccines, specifically the ingredients….

    The problem with this is that there is so much deliberate misinformation and scare tactics regarding vaccine ingredients. For example, claims that vaccines contain antifreeze (ethylene glycol). They don’t, but they do contain polyethylene glycol. It sounds really similar, and there is a chemical relationship between them. But from a toxicological standpoint, they are completely incomparable.

    This comes back to Greg’s point on airplanes. Unless you know a lot of chemistry, biochemistry, and/or toxicology, simply reading the ingredients in a vaccine can’t help you make an informed decision. Nor can you easily learn on your own via the web. Too many people tell deliberate lies about vaccines. If you don’t already know enough to distinguish the truth from the lies, it’s nearly hopeless.

  11. September 11th, 2009 at 6:59 pm

    DuWayne says:

    I don’t believe that parents trying to be cautious or sceptical of big pharma need be painted with the same brush.

    That really depends on whether or not their children are vaccinated or not. If they are, then the parents needn’t be. If they aren’t and don’t have a medically legitimate reason for not being vaccinated, I will happily not paint them with the same brush, as long as they keep their children out of public schools. And preferably public parks and other places they might pick something up or pass something along.

    I am sure that you believe that it is best to ignore the evidence and ignore the experts. I am sure that you believe this is the best for your child/ren, if you have any. But let me ask you this; If your child fell out of a tree and broke his or her leg, would you not rely on the same experts who are recommending you vaccinate your child to take care of that broken leg before deciding you would set it and bind it, hoping for the best? If horribly, your child fell ill with pertussis, would you not rely on that expert who recommended you vaccinate your child against it, to help make him or her better? Do you actually believe you understand this better than your child’s pediatrician – you who presumably didn’t spend nearly a decade in school studying the art of medicine? Do you actually believe that every single study that has been done and failed completely to find links between vaccines and autism is bullshit? Do you actually believe it is better not to listen to your child’s pediatrician, because of an infinitesimal risk that your child is going to be that one in several hundred thousand, to have an adverse reaction? Because while there are certainly still risks, evidence based medicine marches on and doctors now know that children with a variety of congenital conditions are significantly more likely to have an adverse reaction.

    As a parent, I understand and empathize with the fear that something bad might happen to my children. Indeed, I am so very concerned about my children’s well being, that I could not even consider not having them vaccinated. While most kids do survive pertussis, kids who get whooping cough are exponentially more likely to die horribly, literally coughing themselves to death – choking on their own phlegm, than they are of having a significant reaction to the pertussis vaccine. While most kids come through the mumps ok, it is far more likely that a child who contracts mumps is going to end up either blind or dead, than it is they are going to have a significant reaction to the vaccine.

    So Barbara, if you have kids who have not been vaccinated and could have been, please do them a favor, do the kids who simply didn’t develop anti-bodies a favor and most importantly, do the medically fragile children a favor – homeschool. Don’t send them to one of those damned Waldorf schools or other schools packed with kids who aren’t vaccinated – they are likely to get sick there. And don’t send them to public schools, where they might get sick or be the one who gets other kids sick. It really is best if you just keep them at home where they will be safe and everyone else will be safe from them.

    At the very least, I hope you inform the parents of children that you kids interact with socially of your children’s unvaccinated status. Some of us really do prefer that our kids be as far away from yours as possible – especially parents of kids who for whatever reason, aren’t protected by vaccines.

  12. September 11th, 2009 at 8:19 pm

    Barbara says:

    DuWayne – Both of my children are vaccinated, with the exception of the age 5 MMR booster for my oldest. I did my homework, and had titers run on my daughter to determine immunity. I continue to learn from the mindful parents that have been put in my path, both those who vaccinate and those who do not.

    As parents, we are entrusted with the care of our children. We owe it to them to make thoughtful decisions. The human body is an awe-inspiring complex thing – why would one patently discount opposing views, as they almost always lead to something previoiusly unknown? Vaccines carry risks and benefits. Who are you to judge the choices a parent makes as invalid simply because they are different than your own?

    Greg – that general sense of ickiness to which you refer is a powerful indicator that this is a question that should continue to come under literal and figurative microscopic scrutiny.

    Matt – I am relieved to hear that Carrie is doing well. Please know that even though we’re strangers, I am thinking of your family and wishing you all well.

    And to your comment, “Do we really believe that there’s this massive conspiracy of people who want to circumvent all of their training and ethics in order to hurt our children?” I say, no. I don’t believe that. I do think that they are human, and as such are imperfect. There’s a lot that even they do not know, regardless of their best intentions and education. We cannot hold them to unreasonable standards and empower them to have a disproportionate responsibility for our health and well-being. We do have the right, and should execute the privelege, of asking questions, of pushing them to learn more, of challenging them to calm our fears before they shoot us up with whatever they currently deem necessary in a syringe.

  13. September 11th, 2009 at 8:50 pm

    Greg Laden says:

    opposing views, as they almost always lead to something previoiusly unknown?

    That is actually a falsehood based, I guess, on confirmation bias.

    Who are you to judge the choices a parent makes as invalid simply because they are different than your own?

    I think DuWayne is making a judgment on the basis of best practices in medicine, not his own opinion. That’s what I would do, anyway. And given that, no, a random parent does not measure up to best practices for general advice. A reasonably well informed parent does not measure up to best practices, for that matter.

  14. September 12th, 2009 at 12:38 am

    qetzal says:

    Vaccines carry risks and benefits. Who are you to judge the choices a parent makes as invalid simply because they are different than your own?

    Barbara,

    With all due respect, you’re making a strawman argument here. This isn’t about criticizing choices simply because they’re different. It’s about reaching conclusions based on data.

    I certainly don’t dispute your right to question how the conclusions were reached and the data on which they’re based, especially when it comes to your own children. But to dismiss them as nothing more than than a demand for conformity is a gross mischaracterization. Not to mention a poor way to make decisions that could be critical a child’s health.

  15. September 12th, 2009 at 8:45 am

    DuWayne says:

    Barbara -

    I am really glad to hear that your children are vaccinated. But I want you to keep a few things in mind, first and foremost being that vaccines aren’t absolute protection. The only way that vaccines can work is by the vast majority of a given population being vaccinated. When larger and larger portions of the population are not vaccinated, it leaves room for diseases that have been all but eradicated to come back. This in turn leaves people who didn’t develop antibodies, people who only developed a small percentage fo the antibodies needed to fight off disease and those who could not be safely vaccinated in danger.

    There are, per the subject of this post, a great many medically fragile children out there. Kids for whom diseases like the mumps, pertussis and many other infections are a death sentence. The way that we protect these kids is through herd immunity. Again, the more people who choose not to vaccinate, the more than immunity breaks down.

    And there are also a lot of elderly persons who are in the same boat as the medically fragile children. It just takes one kid visiting a grandparent in the nursing home,who hasn’t started exhibiting symptoms to infect a large swath of the residents in that home with, say, pertussis. It is not inconceivable that exposure to that one sick child could kill several of those residents, including grandma.

    Who are you to judge the choices a parent makes as invalid simply because they are different than your own?

    It has nothing to do with their choice being different than my own and everything to do with putting the lives of others in danger. And I am not judging them invalid, though I certainly think they are. I am merely pointing out that those children should not be allowed in a position where they are a potential danger to others. I accept that, as distasteful as it is, parents have a right to not vaccinate their children. But given that acceptance, those parents should accept that they do not, or at least should not have a right to endanger others with their bad decisions. I should have a right to send my kids to school, secure in the knowledge that even if something didn’t work out just right in regards to their vaccines, they’re not in any significant risk of contracting an illness that could endanger their lives. Or that they are going to carry an illness home with them, that might make it’s way to my grandmother who would be unlikely to survive a bout of whooping cough and who also requires a great deal of care from the family. Chicken pox – while she might survive, it would certainly reduce the time she has left with us.

    I can accept their right not to vaccinate their children. I cannot accept that they have an inherent right to put anyone else at risk. I do not base this on my own opinion either. Science based medicine and the evidence accrued through the scientific study of disease and vaccines supports every assertion I have made here. My position is not informed by discredited quacks who have nothing and shift the burden of proof, whenever a position they take has been compromised. It is not informed by something I saw on Oprah, or espoused by some celebrity who hasn’t the least bit of medical or even science training. My position is based on study after study that has indicated the quacks are wrong, Oprah and those other celebrities are wrong and that parents who choose not to vaccinate are wrong. A simple perusal of the CDC website, will allow you to search for outbreaks of diseases here in the U.S. that were all but eradicated. It will also make it clear that those outbreaks center around areas with substantially large percentages of vaccine exemptions.

    I am sorry to be so blunt and harsh about it, but I have a right to protect my children and their friends from irresponsible parents and their children, who are the unfortunate victims of their parent’s ignorance.

  16. September 13th, 2009 at 4:48 pm

    red rabbit says:

    I had pertussis as an adult. My immunity waned and I got exposed a couple of weeks before getting the booster. I am otherwise healthy, a nonsmoker. That was five or six years ago and I still remember it as hellish. I would cough until I vomited several times a day.

    Even now, when I catch cold, I get echoes of that cough, and people look at me funny.

    I also got shingles in medical school. The pain was appalling, like someone putting out a cigarette on my skin. I had mild case. I would have given anything for the chicken pox vaccine to have been current when I was a kid, because maybe if I hadn’t been primarily infected I might not have been able to get shingles.

    People putting their kids in line for that (and worse) out of being afraid of the ingredients of vaccines are pure unadulterated morons. The reason we have such an “aggressive” vaccination schedule in the first place is due to the fact that we want to prevent infants from getting the infections that used to kill kids as infants. The reason we have 5-valent vaccines is to cut down the number of needles to poor GP has to poke into the infant.

    I hate poking babies! But I hate seeing them get preventable diseases WAY more.

  17. September 14th, 2009 at 3:25 pm

    Zan says:

    Another reason to vaccinate is that sometimes in other children who have been vaccinated full immunity does not ensue.

    When I was a child my mother was religious about making sure my little brother and I were vaccinated with everything age appropriate. Even so, my little brother caught a brutal round of pertussis from someone at school. He was out for two or three months with a cough worse than anything I had heard before, regularly coughing to the point of vomiting.

    Don’t put other people at risk just because you don’t want to immunize, that’s fucked up and wrong. Even if they have been vaccinated there is still a chance that a person could contract the diseases they’ve been immunized against.

  18. September 15th, 2009 at 8:52 pm

    khan says:

    I got all vaccines as a child (born 1950). Am working on all needed as an adult.

    Am really disgusted by ignorant mommies who listen to lying assholes and who think they are more knowledgeable than 50+ years of science/research and really think it is a good idea that their children suffer all the avoidable versions of ‘whatever ‘creepy crawly crud’.

    “Oh look, little Johnny is blind deaf sterile …dead; at least he didn’t have a sore arm from a vaccine.”

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