Monday, August 08, 2011

Immunization 411 | DEAR PARENTS: WHY VACCINES ARE VITAL - Dr. Steve Dudley tries to persuade parents to get their children immunized.

By Steve Dudley, Special to the Los Angeles Times |

Tdap vaccine

Students at Huntington Park high school get whooping cough shots last month. A recent outbreak in California has led to new school requirements for teenagers. (Irfan Khan, Los Angeles Times / August 8, 2011)


August 8, 2011

Dear Parents,

I'm afraid we have some work to do. The Centers for Disease Control and Prevention recently published a report on childhood immunizations and our own state of Washington had the highest proportion of kindergartners who hadn't been vaccinated, at 6.2%. At the other end of the spectrum, Mississippi had the best performance with fewer than 1% of kids unvaccinated. That's right, Mississippi. Maybe we could learn a thing or two from the parents down there.

I know we've discussed this before, but please indulge me because it's really important. You've come up with all sorts of reasons to avoid vaccinating your children. There's the dad who says he doesn't want any junk from Big Pharma put into his kids. (Meanwhile, he loads them up with "natural" supplements like kelp and mega doses of vitamin C — as if that'll do any good against whooping cough.) There are the Chicken Littles of the world who believe there is a connection between vaccines and autism. Forgive me for being so politically incorrect, but that's absolute hogwash. This "theory" is based on a fraudulent paper that appeared in the British medical journal Lancet in 1998 and has since been retracted.

Time and again, vaccines have been shown to be safe and effective in preventing debilitating diseases. Smallpox has been eradicated from the general population thanks to vaccines. Likewise, polio, mumps, rubella, measles and other maladies have been relegated to the back burners of our healthcare minds because vaccines are so effective. But there are ugly stirrings of these diseases making a comeback, with outbreaks that have been deadly.

California recently endured the largest whooping cough outbreak in 65 years, sickening almost 9,500 people and killing 10 infants. So far this year, there have been more cases of measles in the United States than any year since 1996. This is not a harmless disease — 40% of people who get it need to be hospitalized.

You may think your children seem just fine without their vaccinations, but that's because of a phenomenon called "herd immunity." Let's say you live in a neighborhood where every kid has been immunized except yours. There's hardly any chance little Billy will contract whooping cough when he's out with his buddies because all of them are immune. In essence, this is immunization-by-proxy, and it takes advantage of everyone else's immunity. Rather than taking the high ground, you're sponging off the other parents on the block who chose to do the responsible thing. If, on the other hand, all the parents behaved like you and Susie came down with whooping cough, it would spread like wildfire through the playground.

You need to understand that your child does not live in a vacuum. He or she interacts with others everywhere. Unvaccinated children can be the vehicles for introducing deadly diseases into communities. Children with compromised immune systems who cannot be vaccinated are especially vulnerable.

I know, you think I'm biased. Guilty as charged. I believe prevention is the key to good health. It is far easier to prevent polio than to treat it, and the same goes for all the other diseases I've mentioned.

You may also suspect I'm in Big Pharma's pocket or that I am simply repeating the party line foisted upon me as a gullible medical student when in actual fact I should have been getting my information from that unbiased source of all good information, the Internet. Let me be clear: I am proud of my education at the University of Washington, a leading institution that is on the cutting edge of research.

If you want an unbiased view, I can direct you to a whole bunch of people who would be happy to fill you in: our senior citizens. They lived with the fear of these dread diseases (one octogenarian told me his dad took a 1,000-mile detour around Chicago when he heard there was a polio outbreak there in the 1930s). They rallied around a president stricken with polio (for those who need a history refresher, it was Franklin D. Roosevelt). They lost children and other loved ones to the diseases you are so nonchalant about. These are the ones who line up for their annual flu shots and ask when they are due for any other immunizations they may need. Yes, they have a healthy respect for these diseases. I wish you could catch some of their fear.

Those of you who know me may recall that I used to be a veterinarian. Vaccination is hugely important in the animal world as well. You wouldn't dream of allowing your dog to skip his rabies shot, on the off chance that he gets into a tussle with an infected bat. All I am asking is that you treat your children as well as your pets.

If you keep bringing your children to me, you must think I'm at least an OK doctor. So why won't you listen to me? I have toyed with the idea of asking you to find another doctor, but I prefer to keep you in my practice in the hopes that over time I will whittle down your resolve and get you to see that vaccination is about the single best advance in medicine — ever. That's why the Gates Foundation is pouring hundreds of millions of dollars into global immunization and disease eradication.

Now, how about if you put down that flyer on the evils of vaccination and pay me a visit. Let's talk.


Your doctor

Dudley is a family physician practicing in Seattle.

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