Blog | Wednesday, November 23, 2016

The lives of your children are in your hands


I've never lost a patient to polio. Or tetanus. Or whooping cough, but to be honest, I have an unfair advantage on the whooping cough: only kids die of whooping cough, and I only treat adults. I have seen my fair share of pertussis cases (as whooping cough is more properly known). It's terrible; uncontrollable fits of coughing, so violent that people vomit, wet their pants, break ribs. But adults, at least, don't die.

Babies are another matter. About half of kids under a year old who get whooping cough end up in the hospital. About 1/100 die of it. And you and I are to blame. (This link will take you to a video of a baby with whooping cough. It's hard to watch, but do it anyway.)

We're to blame in two ways: first, we fail to vaccinate our babies against pertussis, even though it couldn't be easier. Second, we fail to vaccinate ourselves. Immunity from the vaccine doesn't last very long, but it lasts long enough to get a baby through that critical first year. By the time we're adults, though, our protection has often worn off, unless we get a booster shot.

Adults can walk around with whooping cough, thinking they have a nasty cold. They can then pass it to parents or babies. And watching a kid with pertussis try to breathe is terrifying.

It's so simple, really. We vaccinate parents before babies are born, and I try to make sure all my patients have their shots up to date. But there will always be people in whom the shot doesn't work well, and there will always be people who say “no” to it, either on their own behalf or their child's. And that's a tragedy.

As you, dear reader, know, whooping cough isn't the only disease we can prevent with vaccination. Thankfully, there are dozens of known killers that we have locked up with the help of medical science. Some of them, like polio, haven't yet returned to the U.S., thanks in large part to vaccination and to public health measures such as the delivery of clean water. Others, like measles, mumps and whooping cough are enjoying a resurgence, thanks in large part to adults who refuse to get vaccinated, and deny their children this simple life-saving treatment.

I know I'm asking a lot of you to keep reading a long piece on a nice fall day, but stick with me because this is important.

At the University of Wisconsin, Madison, health officials are scrambling to get meningitis shots to all students. Two have come down with meningitis type b, a somewhat uncommon brain infection. And while it is rare compared to, say, influenza, it's deadly. Over the last several years outbreaks have occurred on U.S. college campuses, often killing young adults. Until one woman in Michigan lost her daughter to this rapidly fatal disease, a vaccine wasn't available in the U.S. Alicia Stillman made it her mission to bring the vaccination here and promote its use so no child would die of a preventable disease and no parent will suffer the same loss. She's been incredibly successful in getting the word out, and the shot into people's arms.

And now it's flu season, a time when hundreds of thousands of Americans get very, very ill, and thousands die from a preventable disease. The flu is one of the most contagious human viruses, but also one of the most preventable. Flu shots protect millions every year from losing time at work, from ending up in the hospital, from getting pneumonia, and from death. Since there is not a single downside to the shot (at least not compared to the disease itself), it's a massive public health failure that so many Americans miss it each year.

Cancer. We have a vaccine against cancer. Not all of the hundreds of kinds of cancers that affect humans, but against a bunch of them. Human papilloma virus (HPV) causes cancers of the cervix, penis, head and neck (e.g. tonsils, back of the throat), and anus. As an astute reader you've caught on to the pattern here: some cancers are sexually transmitted.

Every time you go for your Pap smear that's what they are looking for: pre-cancerous changes, and cancer cells on the cervix. And now there is a shot that can prevent that callback from the gynecologist, that fear, the painful surgeries. It can prevent the radiation treatments to the neck that dry up your saliva and burn your throat while trying to save your life. This vaccine saves lives. The trick is, it's best to get it before any sexual activity, so basically, in pre-adolescence. Some parents are scared of the idea of their kids growing up and having healthy sex lives, but it's going to happen. There's no conceivable reason to deny your kids this life-saving shot. Other than the pain of the needle, there are no side-effects. Despite what you might read on facebook or anti-vaccine blogs, this shot is as safe as safe can be, and it prevents cancer from attacking your children.

And this is the frustration I face as a medical professional and as a father. There is a small but vocal subset of people who think they are public health experts despite the obvious fact that they are not. I have spent the last twenty-some-odd years studying and practicing medicine. I've learned how to read and interpret medical studies, how to sift through data to find the difference between tall tales and facts. This is not knowledge that is available to everyone, because it takes years to become an expert. Anyone can learn to be a good parent, but not everyone can learn to be a doctor. I spent the time, money, sweat, and sleepless nights learning this because I could. I have been given the responsibility to help care for my fellow human beings. And I take responsibility this very seriously.

While getting parenting advice from strangers online may be helpful, getting medical advice from the same “experts” isn't so smart. What we do is very hard. And what you do, and who you listen to, will make the difference between saving the lives of you and your children, or giving them up to an amoral microbial world that doesn't care what you read online.

Get your shots. Save your life, and the lives of your kids. I'd much rather hold my daughter's hand as she cries from a shot than hold it while she gets chemo.

Save a life. It's as easy as calling your doctor.