A Thoughtful Choice

17 04 2014

I remember lining up at school in the ‘60s to get vaccinated against smallpox and a few other diseases for which there were vaccines.

I also remember the years when my brothers and I took turns at getting measles, mumps and other diseases for which there were no vaccines.

In the end, we three were fortunate—no permanent harm from our maladies.

Fast-forward 30 years. My daughter was four months old when she was diagnosed with hepatitis B. She had not been vaccinated and subsequently developed a chronic infection.

It all sounds mundane when read as words on a screen. But in those early years, the heartache and anger I felt at having my daughter’s life so affected by something that was preventable . . . well, it was almost more than I could bear.

But again, we were fortunate. After years of infection, her body turned around and got control of the disease. Although we have bloodwork done every year to keep an eye on things, she has a good chance of living the rest of her life free of complications from this infection.

Over the years, I’ve met other parents whose children were affected by vaccine-preventable diseases. Some, like Kelly and Shannon, chose not to vaccinate their kids and ended up with horrible consequences. Kelly’s son Matthew was hospitalized for Hib and they came within a breath of losing him. Shannon did lose her daughter Abigale to pneumococcal disease, and almost lost her son. He recovered and was released from the hospital, at which time they had a funeral for their daughter.

Because of my job, I talk to and hear from many families with similar stories. Some children have died, some remain permanently affected, and some have managed to recover.

Also because of my job, I hear from parents who believe vaccines are not safe, and that natural infections are the safer choice. I understand and have experienced the emotions we as parents feel when something happens to our children. In a way, I was lucky. I knew exactly what caused my daughter’s problems. A simple test provided a definite diagnosis.

If we can’t identify the cause of our children’s pain or suffering, we feel like we can’t fix it and we can’t rest until we know the truth. When the cause can’t be found, we latch onto if onlys. What could we have done differently to keep our kids safe? If only we hadn’t taken her to grandpa’s when she didn’t feel good. If only we hadn’t vaccinated him on that particular day. If only. The problem is, the if onlys are guesses and no more reliable routes to the facts than playing Eenie Meenie Miney Mo.

The deeper I go into the world of infections and disease prevention, the more obvious it is to me that the only way to find the facts is to follow the science. Now granted, one study will pop up that refutes another, but I’ve learned that when multiple, replicable studies all reach the same conclusion, then I can safely say I’ve found the facts.

In our family, we vaccinate because for us, it is the thoughtful choice.

By Trish Parnell

Originally posted on Parents Who Protect





Sports and Infectious Diseases – Part 3 of 3

17 04 2013

Guidelines for Before, During and After Each Sports Event

The NCAA and NATA and other sports organizations carefully spell out the standards athletic organizers, including coaches, teachers and others, should follow before, during and after an 558354119_c856022b30athletic event.

Before the Event Begins

As part of the “pre-game” education program, NATA encourages trainers to:

  • Educate athletes about bloodborne pathogens.
  • Discuss the ethical and social issues related to bloodborne pathogens.
  • Review the importance of prevention programs, including standard precautions and immunizations.
  • Educate athletes about the signs and symptoms of hepatitis B [and hepatitis C] and HIV.

Make sure the athletes know the rules concerning standard precautions, including reporting all wounds immediately if and when they occur.  This is part of the coach or trainer’s critical pre-game education.

Before the opening whistle, cover all wounds, abrasions, cuts or weeping wounds that may serve as a source of bleeding or as a port of entry for bloodborne pathogens.  Remember, protection is a two-way street.  No one wants germs entering or exiting these wounds or abrasions. The “cover” or bandages should be able to withstand the demands of competition.

Wear protective equipment over high-risk areas where bruising commonly occurs, such as elbows or hands.

Make sure the necessary equipment and supplies needed to comply with standard precautions are available, including latex [or other non-permeable] gloves, biohazard containers, disinfectants, bleach solutions, antiseptics, containers for soiled equipment and uniforms and sharps containers.

During the Event

Underscore the importance of early recognition and control of any cuts or bruises that bleed.  Coaches and athletes alike should be prepared for appropriate cleaning and covering procedures and changing of blood-saturated clothes.

Require all athletes to report all wounds immediately.  Players with active bleeding should be removed from the event as soon as practical.  Return to play should be determined by appropriate staff.

All personnel involved with sports should be trained in basic first aid and infection control, including standard precautions:

  • They should use sterile latex [or other non-permeable] gloves for direct contact with blood or body fluids containing blood.
  • Gloves should be changed after treating each individual participant.  After glove removal, hands should be washed.
  • Any surface or equipment contaminated with spilled blood should be cleaned with gloves on.  The spill should be contained in as small an area as possible.  After the blood is removed, the surface should be cleaned with a disinfectant or decontaminant.
  • Proper disposal procedures should be practiced to prevent injuries caused by needles, scalpels and other sharp devices.
  • Any equipment or uniforms soiled with blood should be laundered in accordance with hygienic methods.

Any life-saving equipment should be maintained in accordance with infection control guidelines.

After the Event

When the game is over, any wounds, cuts, and abrasions should be tended to.

Coaches and athletic personnel should constantly review the level of knowledge and implementation of standard precautions policies and recommend revisions and retraining where necessary.

Appropriate policy development with legal and administrative assistance of existing OSHA (Occupational Safety and Health Administration) and other legal guidelines and conference or school rules and regulations should be considered on an as needed basis.

Medical Records and Confidentiality

While many experts feel an athlete should not have to “disclose” an infection to a coach, trainer or teacher, some athletes may decide personally to share information about a bloodborne viral infection.

The security, record-keeping and confidentiality requirements and concerns that relate to athletes’ medical records generally apply equally to those portions of athletes’ medical records.

Because social stigma is sometimes attached to individuals infected with HIV or viral hepatitis, athletic officials should pay particular care to the security, record-keeping and confidentiality requirements that govern the medical records for which they have a professional obligation to see, use, keep, interpret, record, update or otherwise handle.

An Infected Trainer, Teacher or Coach

A coach, teacher or trainer infected with a bloodborne pathogen should practice his or her profession while taking into account all professionally, medically and legally relevant issues raised by the infection.

Depending on individual circumstances, the infected coach, trainer or official must take reasonable steps to avoid potential and identifiable risks to his or her own health and the health of his or her team.

More information may be found at PKIDs’ Infectious Disease Workshop

Image courtesy of PShanks





Sports and Infectious Disease – Part 1 of 3

6 04 2013

exeterIf you coach a little league team, parent an active athlete or are an avid sportsperson yourself, it is important to know what health risks may be present during athletic events other than shin splints and bruised egos.

Close physical contact and a heightened chance of bleeding present a chance for disease transmission unless appropriate precautions are taken.

Athletes, trainers, coaches, parents, and teachers alike must know how to prevent the transmission of bloodborne viruses such as HIV and hepatitis B or C, or even skin-to-skin infections.

These infectious diseases, and others, pose complex problems for athletes of all ages and everyone involved in sports activities.  But following standard precautions to prevent bloodborne, skin-to-skin, and respiratory infections simplifies and safeguards sports events and ensures that everyone can participate safely.

Sports and Standard Precautions

Universal use of standard precautions is critical because many children, adolescents, and adults who are infected with viruses, such as HIV and hepatitis B or C, may not even know they have these viruses.  Estimates vary, but some predict that more than half of those infected with these viruses do not know they’re infected.

Standard precautions protect everyone, from those whose diseases have been identified, to those that have not yet been diagnosed, to those not infected.  When everyone follows standard precautions, no one who has an infection needs to be treated differently.  Essentially, standard precautions are the great equalizer; when followed, they allow everyone to fully and safely participate in sporting events.

The more serious bloodborne viruses that athletes need to be aware of are: HIV (the virus that causes AIDS), hepatitis B, and hepatitis C.  There is no recommendation that people infected with these viruses not be allowed to participate in most sports.

Although HIV and hepatitis C are not vaccine-preventable, there is a safe and effective vaccine that prevents hepatitis B infection.

Skin-to-Skin Infections

According to the NCAA Injury Surveillance System, “skin infections accounted for almost one-third of the practice time loss events” in wrestling during the 2001-2002 season.  As a result, the NCAA recommends that coaches, teachers and other sports officials be able to identify symptoms of skin infections.  Symptoms may include:

  • Crusting
  • Scaliness
  • Oozing lesions

Skin infections may include:

  • Bacterial skin infections including impetigo, erysipelas, carbuncle, staphylococcal disease, folliculitis and hidradenitis suppurativa.
  • Parasitic skin infections including pediculosis and scabies.
  • Viral skin infections including herpes simplex, chickenpox and molluscum contagiosum.
  • Fungal skin infections including ringworm.

In some cases, such as fungal infections, the skin conditions can be covered with a securely attached bandage or non-permeable patch to allow participation in the sporting event.

In addition to identification and treatment of individuals with skin infections, prevention can occur through proper routine cleaning of all equipment, including mats and shared common areas, such as locker rooms.

Respiratory Illnesses

Anyone with an infectious respiratory illness, such as flu, or whooping cough, or perhaps tuberculosis, should be prohibited from playing to prevent the spread of infections that are transmitted through respiratory routes.

Check back over the next couple of weeks for Parts 2 and 3 in this sports series. Part 2 gets into specifics on bloodborne pathogens, and Part 3 provides guidelines for sports teams to follow before, during, and after each event.

 

See PKIDs’ Infectious Disease Workshop for more information.

Photo courtesy of University of Exeter





Fifth Disease? What About Third or Fourth?

21 07 2011

Last summer, PKIDs’ advice nurse, Dr. Mary Beth, explained what fifth disease is: a viral rash that is tricky to contain because by the time you get the rash, you’re already through the contagious stage.

The rash itself is not painful and most children get through it without any problems, although adults may experience joint pain with this infection.

If a pregnant woman catches it, there is a small risk that the unborn baby will have severe anemia and the woman may have a miscarriage.

It’s also worse for people with sickle cell disease. Their red blood cells can get dangerously depleted during a bout with fifth disease.

Why is this condition known by a number instead of a real name? The vernacular term “slapped cheek syndrome” isn’t too endearing; neither is its scientific moniker, “erythema infectiosum,”  nor “parvovirus B19,” the name of the organism that causes it.

Even “variola” has a certain melodic ring to it, and that (smallpox) was the Chuck Norris of infectious disease.

It turns out that, by old tradition, several of the rashy illnesses of childhood were known by numbers:

  • First disease was measles
  • Second disease was scarlet fever, caused by the same bacterium that causes strep throat
  • Third disease was rubella
  • Fourth was Duke’s disease, which is not a defined disease today
  • Fifth, our friend erythema infectiosum
  • Sixth, roseola—which sounds a lot like rubella and rubeola—is actually caused by a couple of strains of herpes viruses

It seems that, just like squirrels are said to be rats with good PR, the names of the other diseases were relatively euphonious compared to “erythema infectiosum,” and so the rather anonymous “fifth disease” was the name that stuck.

Frankly, the whole rubella-rubeola-roseola conglomerate might be easier to keep straight if each of those diseases were still referred to by number. Maybe it’s time fifth disease got the charming name it’s never had. How about . . . slappacheeka? Rosella? Gwendolyn?

By Ms. Health Department

Image courtesy of http://healthpictures.in/





Why are Vaccines Mandated?

26 05 2011

Why does the government mandate that millions of children and adolescents receive certain immunizations for school entry?

The more people in a community who are vaccinated, the healthier that community is.  Here is how Dr. Samuel Katz, a renowned vaccine expert and a member of PKIDs’ Medical Advisory Board, explained it before Congress in 1999.

“We know too well that the level of [immunization] protection that we have now established in our children and our communities is a fragile one that depends on what we refer to as community or ‘herd’ immunity.  From the standpoint of effectiveness, modern childhood vaccines are approximately 90 to 95 percent effective.  What that means is that for every 20 children who are vaccinated one or two may not develop a sufficient immune response [or antibodies to fight an infection].

“It cannot be assured that these children will be protected from the virus or bacteria should they encounter it at school, at a playground, at a shopping mall, or at their church daycare.  However, if sufficient numbers of children in a community are immunized, the vaccinated ones protect the unprotected by effectively stopping the chain of transmission in its tracks and drastically lowering the probability that the susceptible child will encounter the bacteria or virus,” said Katz.

Community immunity also helps protect children and adults whose immune systems are compromised or weakened because of another illness or old age.

“As long as the great majority of children receive their vaccines, we will be able to maintain our current level of disease control,” Katz explained.  “However, should the level of community protection drop to the point where the viruses and bacteria travel unimpeded from person-to-person, from school-to-school, and from community-to-community, we instantly return to a past era when epidemics were an accepted part of life.”

America experienced such an outbreak in 1989-91 with the resurgence of measles.  There were 55,622 reported cases mainly in children less than 5 years of age, more than 11,000 hospitalizations and 125 deaths.  States do allow personal exemptions, so parents can choose not to vaccinate their children, but those exemptions carry risk to the child and the public’s health, emphasizing the importance of community immunity.

An article in the Journal of the American Medical Association found that, on average, those children who were exempted from immunizations ran a 35-fold greater risk of contracting measles compared to those who were nonexemptors.

Not only are these children at greater risk of disease, their infections can be the spark that ignites a disease outbreak in a community.

According to Dr. Katz, in the late 1960s and early 1970s, despite the availability of a safe and effective measles vaccine, the United States continued to experience regular epidemics of measles.  Left to individual choice (as opposed to government mandates), only 60 to 70 percent of the community was immunized.

That coverage failed to provide adequate community immunity to prevent an outbreak.

“States without school immunization requirements had incidence rates for measles significantly higher than states with these requirements,” noted Dr. Katz.  “Recognizing these data, other states (not the federal government), quickly adopted similar requirements.  These requirements are supported by the American Academy of Pediatrics.

“The results are striking,” he added.  “Before we had a measles vaccine, an estimated 500,000 cases of measles were reported each year.  In 1998, there were 89 cases of measles in the United States with no measles-associated deaths.  Most counties in the United States were free of measles.  However, we have learned that nearly all of the cases of measles that did occur in the United States were imported from other countries.  This would not have been possible without the “school exclusion” statutes that now exist in every state.  While we hear dramatic stories of exotic diseases that are just a plane ride away, the importation of vaccine preventable diseases into a susceptible population is much more frightening.  Should we allow our community immunity to wane, we will negate all the progress we have made and allow our communities to be at risk from threats that are easily prevented.”

Compulsory vaccination laws in the United States have repeatedly been upheld as a reasonable exercise of the state’s compelling interest even in the absence of an epidemic or a single case.  As the U.S. Supreme Court held in 1905 in the case Jacobson vs. Massachusetts:

“ …in every well-ordered society charged with the duty of conserving the safety of its members, the rights of the individuals in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations as the safety of the general public may demand.”

The Supreme Court makes clear that “the liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint.  There are manifold restraints to which every person is necessarily subject for the common good.   [Liberty] is only freedom from restraint under conditions essential to the equal enjoyment of the same right by others.”

This is one in a series of excerpts from PKIDs’ Infectious Disease Workshop. We hope you find the materials useful – the instructor’s text and activities are all free downloads.

Photo credit: lawtonjm





Vaccine Education Center

28 04 2011

Dr. Paul Offit, Director, VEC

The science of vaccines can be . . . daunting. The lists of ingredients and potential side effects make us want to second guess ourselves and our children’s providers. We need to be sure we’re making safe choices.

And the complicated schedules! They’re enough to make sane people pound their heads.

The folks at the Vaccine Education Center (VEC) at Children’s Hospital of Philadelphia have a gift for presenting the complexities of vaccines and attending issues in a way that’s easy to understand yet comprehensive in scope.

The VEC website has a special section for parents and adults of all ages.  While there, you can sign up for the Parents PACK newsletter to get monthly immunization updates.  In the March issue, there’s a timely post on measles and the dangers of rubella parties.

You’ll also find age-specific information on vaccines and the diseases they prevent. There are FAQs, but if you can’t find your question, you can send it in via a form provided on the site.

The VEC has created a library of educational materials on specific vaccines and commonly asked questions. These resources range from information sheets to more consumer-friendly bookmarks and brochures.

They also maintain essential tools, including vaccine schedules, facts about vaccine preventable diseases, and the latest in vaccine science.

To keep information fresh, the VEC pens a monthly “Ask the VEC” on a myriad of topics.

Starting in 2011, the VEC will present three or four webinars a year addressing evolving issues, recent ACIP meetings, new science and media reports.

There are layers and layers of information available on the website, for those of us who feel more is better.  And what parent doesn’t?

The VEC staff constantly works at sifting vaccine fact from fiction and explaining the difference in ways we can all understand.  If you have questions, they’re worth checking out.





Sand, Surf, and What?!

25 04 2011

Kids love to dig in the sand and build castles. They’ll work for hours, crafting structures of dizzying heights, sculpting the turrets and drawbridges just so with their hands.

Oh, and getting buried in the sand? Even better.

Turns out, all that digging and getting buried can expose kids to lots of germs.  Researchers found “… evidence of gastrointestinal illnesses, upper respiratory illnesses, rash, eye ailments, earache and infected cuts. Diarrhea and other gastrointestinal illnesses were more common in about 13 percent of people who reported digging in sand, and in about 23 percent of those who reported being buried in sand.”

Just makes your skin crawl, doesn’t it?  Before you give up on the beach, know that there are things we can do to combat the germs.

Tell the kids they can play in the sand, but not to touch their faces with sandy hands, and make sure they clean their hands with soap or sanitizer when they’re done playing.  Also, send them to scrub down in a shower as soon as possible after play.  There’s no guarantee they’ll avoid an infection, but it’ll help.

Kids (and adults) love to swim in pools, lakes, and oceans. We’re usually swimming in urine,  garbage, or who knows what contaminants.  Due to the reality of raw sewage runoff, we could come down with all sorts of infections, including E. coli, after practicing the backstroke.

Blech, but hey, everything carries a risk. There’s no guarantee we’ll get sick or we won’t get sick from swimming.

So go. Swim. Enjoy and shower when you’re done.

Life is too short not to have fun on vaca!

(Photo from dMap Travel Guide)





Life On a Blog

24 03 2011

image by inju

Blogging is therapeutic. For those living with or affected by infectious diseases, it can be a way to connect with those whose lives mirror their own.

Brooke Davidoff, diagnosed HIV positive in January 2010, blogs about her life as a newlywed and a first-time mom. Brooke’s life turned upside down during her pregnancy, when she had a routine blood test for HIV and discovered she was positive. “If there was no baby, I’d still have no idea,” she blogged. 

Brooke started blogging “. . . to express myself, I don’t know how not to. When I was diagnosed, I searched for stuff written by other HIV positive females to relate to, and I had a very hard time finding what I was looking for. So I began to write it for other women like me who needed to know they are not alone.”

Sabina is a 15-year-old girl who loves volleyball and dancing. She’s slogging through a year of treatment for hepatitis C and blogs about it “. . .  to share my experience of HCV treatment for children or adults who are starting or already started their treatment. I know that treatment can be difficult and painful, I would just like to give another perspective. I just want to help out and be there for other kids or adults.”

Elizabeth Boskey, PhD, MPH, calls on her education and research experience each time she blogs about STDs. Ever the teacher, Elizabeth says, “There is a lot of secrecy and stigma surrounding STDs. I blog about STDs not only to address the misconceptions about them, but to make them a topic of discussion.

“Some people think that having an STD means that they’re dirty or ruined, that infection marks them as a slut or somehow undesirable—all of which is ridiculous. Still, these feelings are common in people who have had bad experiences disclosing an STD to a partner, or who have simply internalized the stigma that is widely present in American society.

“People make jokes, and not kind ones, about STD infection, but the truth is that STDs are just diseases like any other. Yes, they are often preventable, and people should do their best to prevent them, but acquiring an STD doesn’t make you a bad person.”

Are you ready to blog?
It’s easy to get started. There’s no cost, other than your time, and, if you’re speaking from personal experience, what it costs you to speak from your heart.

Brooke blogs to share with women like herself, and to let her friends and family know that she’s OK. “I think I’m helping other people feel more normal…the stigma hopefully will diminish in time.”

Blogging can be a positive experience, but there are emotional risks.

“I think that if more people blogged about STDs it might help reduce some of the stigma associated with them,” says Elizabeth. “However, I think it’s important to acknowledge that doing so is not without risks. Publicly acknowledging an STD infection may change the way that people around you treat you. It may even affect your employment—although it shouldn’t.”

Boundaries
It’s OK to not share every single thing in your life. Write honestly, but don’t fret about keeping some details private. It is your life, so you define the boundaries beyond which you’re not comfortable sharing.

Readers
If you write about it, they will come, but be prepared for the readers’ thoughts that may cascade upon you. Some comments you’ll treasure and some, well, let’s just say they’ll raise the eyebrows.

“I check daily for new comments and emails,” says Brooke. “The ones that touch me the most are people who found out the same way I did, or the ones who decided to have a baby after reading my story.”

There’s a yin yang to blogging, as there is elsewhere in life. Be prepared for the nasties you’ll find in the comments section of your blog.

“Although blogging can be a wonderful way to gather personal support, it may also have less positive results,” explains Elizabeth. “Comments can be negative, or even cruel and vindictive. It may be worth blogging anonymously if you are concerned about your privacy and the ramifications for exposure in your daily life; however, it is very difficult to ‘guarantee’ that your identity will not become known. This is particularly true if you are discussing sensitive issues such as those involving your sexuality.”

Last words
Bloggers always get the last word, and that’s no less true for our guests today.

Brooke on HIV: I live a normal life other than taking pills every day. I’m waiting to see what the disease does to me. I think all of us sit and wonder when it’s going to kick in, and what it’s going to do.
If you’re having unprotected sex, get tested. You never know. There are really no symptoms that would lead you to get the test, it’s better to know and get on meds now than find out when it’s too late and you’re really sick.

Sabina on HCV: [I want people to know] that we’re not harmful to others as long as we don’t share blood transferring items, such as razors, and toothbrushes. And that having HCV [hepatitis C virus] doesn’t set you apart from others even though it’s a serious virus.

Elizabeth on STDs: I don’t think you have to blog about STDs to help destigmatize them. Make a point of having open and honest discussions of sexuality with your partners and your family. Don’t allow people to get away with making cruel comments about infectious diseases or even “cute” jokes. And, finally, remember that a lot of the stigma surrounding STDs has to do with ignorance. Educate yourself—about how common STDs are, about testing, and about prevention—so that you can educate the people around you.





HCV+ Teen Tells It

24 02 2011

My name is Sabina, I live in San Diego, and I’m 15 years old. I have had hepatitis C (HCV) for about 13 years now and I have just recently decided to get rid of it and started treatment.

On MLK day I’m happy to say that I celebrated my first full week of being on the treatment. And let me tell you it wasn’t as bad as I thought it would be.

I started the treatment on January 10, 2011, and now I take two drugs. Every Monday I have to give myself a shot at night. When I was about to get my first shot, I was so nervous and scared. I thought the needle was going to be inches big but it wasn’t. The needle was an inch if not half an inch big. And it didn’t hurt one bit. But still I’m scared for every Monday to come.

Every morning I take pills after breakfast, and in the evening I take another dose after dinner. And so far I haven’t gotten any serious symptoms. Though everyday I get headaches in the evening that really hurt, but as I was doing some research I found out that it’s better that you don’t take medicine to try to make it better. Instead you should eat and drink lots of water, and it really does help.

From talking to people that have gone through the process before, some tips I learned were carrying a water bottle around with you is smart so you can always have water to drink, to not overreact if something happens because its happens to everyone, and to make sure you tell your parents everything from itchiness to headaches to how you’re feeling.

Something that I’m always concerned about is forgetting to take my pills every morning and evening. But you don’t need to worry about that. You should know that if you forget to take your pills in the morning you should never take 4 that night at once. All of that medicine at once can put a dent into your body.

Another thing that I’m worried about is my sports. But I was told from the doctor that after a few months I should be ready to go back to my everyday activities and sports. I’m a volleyball player and club season is coming up, and the doctor says I should be healthy enough to play. Great news, huh? So if you are a sports person don’t stress about not playing.





Two Risks

31 01 2011

Courtesy of NOAA's People Collection

Ben Franklin chose not to inoculate his little boy against smallpox, fearing the inoculation more than the disease.  In 1736, Ben’s son died at the age of four — from smallpox infection.

Was Ben right to choose the “common way” of infection? Well, no, he wasn’t, although inoculation was nasty.  First, a string was drawn through a pustule of someone infected with smallpox.  The string was then left to dry, and later drawn through a cut made on an uninfected person.  The resulting infection was milder in form and about two percent of those inoculated died from infection versus 15 percent of those who became infected the common way.

Ben Franklin was a brilliant man, but in this case, he failed to look at the science.  Some years after losing his son, he said:

“In 1736 I lost one of my Sons, a fine Boy of 4 Years old, taken by the Smallpox in the common way. I long regretted that I had not given it to him by Inoculation, which I mention for the Sake of Parents, who omit that Operation on the Supposition that they should never forgive themselves if a Child died under it; my Example showing that the Regret may be the same either way, and that therefore the safer should be chosen.”

After his son’s death, Franklin became a big believer in inoculation, considering it the safer choice.  He wrote an introduction to English physician William Heberden’s pamphlet on the subject, which promoted the act and even explained how parents could inoculate their children themselves.  Ben then distributed the document in America.

Nearly 300 years after Ben Franklin chose between two risks and lost, parents face the same choices. No vaccine is 100 percent safe, and no disease is 100 percent benign.  There’s a risk when vaccinating and a risk when choosing natural infection.

The fact is, our kids don’t live in bubbles, and we can’t keep them safe from exposure to germs.  Although the vaccines today are not perfectly risk-free, they are much safer than the infections they prevent.

All we can do as parents is look at the science, talk to our pediatricians, and make the safest choices for our kids.