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





Pneumo – It’s All About the Numbers

3 03 2014

DDWhen we are immunized, we usually have to get several shots, or doses, before we’re protected against a disease.

Nearly all vaccine-preventable diseases require more than one dose of vaccine to provide us with a strong immune response. It’s not fun, but it’s better than fighting all those infections.

Last summer, an article in Pediatrics described a study which looked at the cost-effectiveness of removing a primary dose of 13-valent pneumococcal conjugate vaccine (PCV13).

This vaccine helps to prevent pneumococcal infections, which can mean anything from an ear infection to pneumonia to meningitis. It can be a dangerous and deadly infection.

Right now, this vaccine is a four-dose series. The first three doses are primary doses, and the fourth dose is a booster.

A primary dose “primes” the immune system, allowing our bodies to develop stronger immunity with each primary dose we receive. The booster dose is the last shove to get us over the top, helping our bodies to develop long-lasting immunity against a particular disease.

The study in Pediatrics was the topic of conversation at PKIDs for several weeks, and, while we were surprised that removing a dose was up for consideration (and you’ll see why in a minute), we thought it was probably more of an intellectual exercise than a course of action that our public health leaders in the US would take.

After all, our tradition in the US is to use all of the tools we have to protect our citizens and prevent infections.

Come to find out, this is more than an exercise in “what if.”

In February, I attended the Advisory Committee on Immunization Practices (ACIP) meeting in Atlanta.

(As noted on their website, the ACIP “is a group of medical and public health experts that develops recommendations on how to use vaccines to control diseases in the United States. The recommendations stand as public health advice that will lead to a reduction in the incidence of vaccine preventable diseases and an increase in the safe use of vaccines and related biological products.”)

Based on that meeting, it sounds like they’re looking at removing a primary dose as a real option.

This may give us an opportunity to save money—$400 to $500 million—but it’s not a risk-free deal. In order to save that money, we have to be willing to see harm come to a lot of people.

This flies in the face of what we, as health advocates, say every day to the folks we meet, which is: Get immunized! Use the safe and effective prevention tools available to protect yourself and your family from unnecessary infections.

It’s easier to make this kind of money-saving decision if the conversation is all about the numbers: the dollar amount saved, the numbers of increased cases of disease, the numbers of hospitalizations and deaths.

Numbers are easy to talk about because they’re not personal.

But this decision to remove a primary dose of vaccine is personal. The consequences will be felt by our people, our loved ones, our friends, and our neighbors. We can’t dehumanize this process by just talking about the numbers.

If the third primary dose is removed, an average of 2.5 more people will die each year. Who are those people? One could be my niece, Millie, who’s just learning to crawl. Another could be your grandson, who loves cheerios and bananas.

Forty-four more people will get invasive pneumococcal disease. My daughter could get meningitis, and your son could get a bloodstream infection.

Fifteen hundred more people will be hospitalized for pneumonia. When my oldest was a toddler, she was hospitalized for pneumonia. It’s a terrifying experience and one that I would not have anyone else go through, if possible.

An additional 10,000 of our friends and neighbors and loved ones will have to be treated for pneumonia as outpatients.

Twenty-three hundred more ear tubes will have to be inserted into the tiny ears of children that we know.

A staggering 261,000 more children will get earaches, fevers, and possibly ruptured eardrums.

All of this happens if we decide to save money and remove a primary dose of PCV13.

It’s all about the numbers. We just have to decide which numbers are more important to us as a nation—the dollar amounts or our people?

by Trish Parnell





Adults Young and Old Need Vaccines

21 05 2012

Adults know to wash hands and wear condoms to prevent infections. And we try to eat fruits and veggies to stay healthy. Some days, we even exercise.

One thing we don’t do enough of is get vaccinated.

Other than the flu vaccine in the autumn, I seldom think about vaccines for myself. I bet I’m not alone.

But, we should remember to vaccinate.

We make sure our kids wear seatbelts and helmets, cross the street at the light and keep a weather eye on the ocean for sneaker waves, and get all the vaccines they need.

For the most part, we follow the same safety rules, except for that one about vaccines.

I am determined to get myself fully vaccinated and to nag encourage friends to do the same. I don’t want to get sick and think “if only.”

If you’re like-minded, I’ve listed the diseases for which there are vaccines for adults 19 years of age and older. Not every adult will need every vaccine, so print out this post and take it to your provider, find out what vaccines you need, and realize that you may need more vaccines if you’re traveling outside the US:

  • Flu is a respiratory illness. It can cause fever, chills, sore throat, cough, muscle or body aches, headaches, tiredness, and a runny or stuffy nose. You get over it after several miserable days, unless you develop complications, some of which can be life-threatening.
  • Tetanus, diphtheria, and pertussis vaccines are combined for adults. Tetanus is caused by certain bacteria entering the body through a break in the skin. It’s the one that causes lockjaw, and can cause spasms and seizures. It has a surprisingly high death rate of 10 – 20% of cases. Diphtheria is caused by bacteria spread person-to-person and can damage the heart, kidneys and nerves. Pertussis, also called whooping cough, is a very contagious disease caused by bacteria. In some parts of the world, it’s called the 100-day cough. The “whoop” is most often heard from babies, for whom it can be a lethal infection.
  • Varicella, also called chickenpox, is a virus that spreads easily and causes a blistery rash, itching and fever. For some, it can cause severe complications including pneumonia or sepsis.
  • Human papillomavirus (HPV) is a sexually transmitted infection that is very common in the population. Most people get it and get over it, but some will develop genital warts or cervical or other types of cancers.
  • Zoster or shingles is caused by once having had chickenpox. The virus stays in the body after the chickenpox clears up and goes away, and years later can reactivate, causing pain and itching, followed by a rash.
  • Measles, mumps, rubella vaccines are also combined for adults. Measles is caused by a virus that makes you feel like you have a bad cold, along with a rash on the body and white spots in the mouth. It can develop into pneumonia or ear infections, sometimes requiring hospitalization. Rubella is also caused by a virus and brings with it a rash and fever. This infection can be devastating to the fetus if a woman is pregnant when infected. Mumps is caused by a virus with symptoms of fever, fatigue and muscle aches followed by the swelling of the salivary glands. Rarely it will cause fertility problems in men, meningitis or deafness.
  • Pneumococcal disease is caused by bacteria and can appear as pneumonia, meningitis, or a bloodstream infection, all of which can be dangerous.
  • Meningococcal disease is caused by various bacteria, and the available vaccines prevent many of these infections. The symptoms are varied and include nausea, vomiting, sensitivity to light and mental confusion. This disease can lead to brain damage, hearing loss, or learning disabilities.
  • Hepatitis A is caused by a virus. It’s generally a mild liver disease, but can rarely severely damage the liver.
  • Hepatitis B is also caused by a virus that damages the liver. Most adults are infected for a short time, but some become chronically infected. The infection can cause jaundice, cirrhosis or even liver cancer.

More information on these infections can be found on the CDC website.

Talk to your provider about these vaccines. Who can afford to get sick these days?

By Trish Parnell

Image courtesy of Lancaster Homes