By, Rebecca Bakke MD, FAAP
As a pediatrician, I am often asked the question, “What would you do if she was your child?”
I always try to answer this question as honestly as I can. Sometimes, when the answer is not very straightforward, l can say sincerely, “I don’t know. “ Other times, such as when parents have concerns about immunizations, the answer is easy.
Vaccination is one of the most polarizing issues in our country, and because I immunize infants and children every single day at work, the controversy frequently makes its way into my office. Anxious first-time parents cradle their newborn babies while nervously reviewing the vaccine schedule, then look up at me and ask what I think about delaying vaccines, trying an alternate vaccine schedule or forgoing them all together.
“What would you do if she was your child?”
Parents are not usually surprised when I say that I vaccinate all three of my children according to the recommended CDC schedule. They expect that as a pediatrician, I have seen the horrors of vaccine-preventable disease and believe in the ability of vaccines to prevent these now rare illnesses. This is, of course, true. They are usually quite surprised, however, when I tell them that my most significant experience with vaccine preventable disease happened not while I was working as a doctor, but as a first-time parent.
My first pregnancy was gloriously uneventful, and I was full of the joyous anticipation and occasional irrational terror that most first-time mothers share. I followed all the rules. I took my prenatal vitamins, avoided sushi, cut back on caffeine and made a special effort to get adequate sleep and exercise. I spent hours online reading reviews on strollers, car seats and cribs. I was pregnant during the 2009-2010 H1N1 (“swine flu”) epidemic, and I was terrified of the toll the disease could take on my unborn baby and me. I even cared for babies in the NICU who were born far too early because their mothers became critically ill from influenza while pregnant. I spent months wearing a mask at work, and I stood in line at the Department of Health to get the H1N1 vaccine just one day before it was available from Employee Health at my hospital.
Claire Noelle was born on a snowy January morning, and I remember being overwhelmed by the instantaneous love and devotion I felt for this tiny baby I had only just met. We took her home the next day, and like most new parents, spent the first several weeks of her life gazing at her and relishing in every sweet newborn expression, sigh and sneeze.
When Claire was 5 weeks old and just starting to smile, she started coughing. Initially, it was only after I nursed her, and I thought it was reflux. But when the coughing worsened, I panicked. I reflected on the fact that I was recovering from a mild cold when Claire was born, and had been coughing ever since. My cough was nothing remarkable, but Claire’s cough was starting to sound an awful lot like pertussis (whooping cough). We took her to the pediatrician. The next day he called and confirmed my fear: Claire had pertussis.
The next three weeks were the darkest of my life. Antibiotic treatment for pertussis prevents the spread of the disease, but after the coughing starts no medication can alter the disease course. If you have ever seen a child with pertussis you know why it is called whooping cough. Infants and children have such long coughing spells that they cough until their lungs are completely out of breath, then they inhale desperately (“whoop”) before the coughing fits start again.
Claire would cough cough cough cough cough and whoop, cough cough cough cough cough and whoop for an hour straight several times per day.
She coughed until her lips turned blue.
She coughed until she vomited so many times that she lost weight.
The coughing completely and violently took over her precious 9 pound body.
Infants with pertussis, especially infants as young as Claire was, are at high risk for complications.
The coughing fits can lead to bleeding in the brain.
They can get pneumonia.
They can have periods of apnea, where they stop breathing.
Many end up on a ventilator.
One to two percent of infants with pertussis die.
I knew these things, and I was terrified. But nobody could stop the coughing.
Claire was fortunate. We were fortunate. She recovered without any complications. But dozens of infants born in 2010, including at least one infant in our community, died of whooping cough. Many of these babies were too young to be vaccinated. So was Claire.
But I was not. While I was pregnant, I spent a whole lot of time researching strollers, but failed to take any time to get a vaccine that could have prevented my baby from getting a life threatening illness. And I am a pediatrician. I, of all people, should have known better. Because of this, it is now part of my mission to make sure that the families that I take care of do know better.
Today, all expectant women should be vaccinated with Tdap during every pregnancy, preferably in the third trimester (between the 27th and 36th week). By getting vaccinated during pregnancy, mothers build antibodies that are transferred to the newborn, providing protection against pertussis before the baby can get their first dose of DTaP vaccine at 2 months old. Tdap vaccine also protects mothers during delivery, which makes them less likely to transmit pertussis to their babies. This recommendation is not only supported by The American College of Obstetricians and Gynecologists, but also by the Centers for Disease Control and Prevention (CDC).
What would I do if she was my child?
I would vaccinate.
For more information, visit these special CDC webpages dedicated to whooping cough information for pregnant women and healthcare providers here.
About the author: Rebecca Bakke MD, FAAP is a pediatrician at Sanford Health and a clinical assistant professor of pediatrics at the University of North Dakota School of Medicine. She lives in Fargo, ND with her husband and three young children.
Being a mom to Molly and Frankie is, without a doubt, the most rewarding role I’ve ever had. As we prepared to welcome another baby into our home this fall, I was reminded of just how fragile and precious a newborn can be.
In recent interviews with Fox News and CNN, I shared my concerns over the growing number of unvaccinated children in the area where we live. It frightens me to think that my baby may possibly be exposed to a dangerous and life-threatening disease before he is old enough to be vaccinated himself. It seems unfair that while I do everything in my power to protect this delicate new life, others are making a choice that puts my child at serious risk.
I have real reason to worry. When my second daughter Molly was just 10 months old she contracted whooping cough (also known as pertussis). As any parent can relate, it’s scary when your child gets sick, but it’s especially upsetting when you realize that your child is part of the largest outbreak of whooping cough in over fifty years. As an advocate for Every Child By Two’s Vaccinate Your Baby initiative, I was all too aware of the fact that whooping cough can be deadly for infants, and yet here we were facing that terrible diagnosis. We were incredibly fortunate that Molly fully recovered, but I’ll admit that I was completely rattled by the experience.
Fortunately, since that time, scientists have been closely examining the possible causes for the large number of whooping cough cases over the past few years and have made recommendations aimed at curbing the outbreaks. Part of the problem is that the immunity against the disease is wearing off so that people throughout the U.S. are less immune to whooping cough. Therefore, it’s more important than ever for infants to receive all five recommended doses of the DTaP (diphtheria, tetanus and pertussis) vaccine, followed by the booster shot of the adult version of the pertussis vaccine (Tdap) at 11 or 12 years old. It’s staggering to note that 83% of infants who are diagnosed with whooping cough got it from a family member, most often their own parents. Therefore, adults need to make sure they get a Tdap booster before a new baby arrives to protect themselves and to stop the spread of the disease to infants, who are most likely to become seriously ill from the disease.
Most important for newborns, the CDC’s Advisory Committee on Immunization Practices took a good hard look at the pertussis research and concluded that we can best protect newborns by ensuring that pregnant women receive an adult Tdap booster in their last trimester of each pregnancy. By getting vaccinated during pregnancy, not only was I protected, but antibodies were transferred to my baby through the placenta, providing my baby with protection against pertussis before he could start getting DTaP vaccine at two months of age. So I followed my doctor’s advice and not only received the Tdap vaccine during my last trimester, but I also got a flu shot.
Just as I have the ability to protect my newborn from pertussis, I also have the ability to protect him and other members of my family from influenza. I’ve learned that due to changes in a pregnant woman’s immune system, heart and lungs, I was more prone to serious complications from the flu such as pre-term labor and delivery, hospitalization and even death. And, since children can’t be vaccinated against the flu before six months of age, everyone in our family must do all we can to protect our baby boy. With my child being born in the midst of flu season, I wanted to do everything I could to protect him from a disease that causes more than 20,000 children under the age of five to be hospitalized each year. I find it upsetting to learn that with all the medical resources available to us here in the U.S., last year’s flu season claimed the lives of 109 precious children.
I’ll admit that as a parent I’m concerned about the threat of vaccine-preventable diseases, especially as a result of people choosing not to vaccinate. But I refuse to stand by and watch as others put my children’s health at risk. By getting the flu and pertussis vaccines during my pregnancy, I felt empowered that I could do something positive to protect my child. And you can too.
Talk to your doctor if you have questions about vaccines. In addition, encourage your friends and family to utilize the resources provided by reputable organizations, such as Every Child By Two and the American College of Obstetricians and Gynecologists. And be sure to immunize yourself and your entire family.
After being notified that he and his family were exposed to measles, Dr. Tim Jacks signed on to the family’s online CaringBridge journal to vent his frustration. His 3 year old daughter Maggie is fighting acute lymphoblastic leukemia (blood cancer) and as a result has a compromised immune system. His 10 month old son Eli received all his recommended vaccines, but is too young for his first dose of MMR (measles, mumps and rubella) vaccine. The children were with their mother at a Phoenix Children’s Hospital clinic when they were exposed to measles. Frustrated and concerned, Dr. Jacks wrote a journal entry as though he was speaking directly to the person who was responsible for putting his family at risk. The next day, Kid Nurse reprinted the story and Dr. Jacks and his wife were soon being interviewed by various national news outlets, to include CNN, FoxNews as seen here:
Dr. Tim Jacks, DO, FAAP is board certified by the American Board of Pediatrics and a fellow of the American Academy of Pediatrics.
As an Every Child By Two Immunization Champion, he has given us permission to share his story here on Shot of Prevention, as well as on our Vaccinate Your Baby website. Every Child By Two has also invited him to present testimony in front of the U.S. Senate Health, Education, Labor and Pensions Committee on The Reemergence of Vaccine-Preventable Disease: Exploring the Public Health Successes and Challenges at 10am on Tuesday, February 10, 2015.
We hope that his personal experiences will help educate Congress about the plight of those who depend on herd immunity and the importance of protecting those who are most vulnerable to vaccine preventable diseases.
To the parent of the unvaccinated child who exposed my family to measles:
I have a number of strong feelings surging through my body right now. Towards my family, I am feeling extra protective like a papa bear. Towards you, unvaccinating parent, I feel anger and frustration at your choices. Read more…
Rafiki, the wise old mandrill in Disney’s Lion King movie, made a profound statement that is extremely relevant to the current U.S. measles outbreak that began in Disneyland in December, 2014:
Yes, the past can hurt. Infectious diseases have a history of being dangerous and deadly.
All you have to do is look at history to see how many millions of lives have been lost, or how many people have been permanently disabled, by infectious diseases. It’s no small number. And, there’s a long list of diseases that we can now prevent that have been leading killers in the past. Today, vaccination greatly reduces disease, disability, death and inequity worldwide. Vaccines given to infants and young children in the U.S. over the past two decades will prevent 322 million illnesses, 21 million hospitalizations and 732,000 deaths over the course of their lifetimes. While it’s hard to see what doesn’t occur, the fact remains that vaccines save lives and prevent suffering.
Some people will choose to run from the past. They’re called vaccine refusers.
No matter how much scientific evidence there is to prove vaccines are responsible for the incredible reduction of disease worldwide, there will always be some people who will run from the truth. They either debate it, or simply ignore it. These are the people who purposely refuse vaccines. Sometimes they focus their efforts on trying to pin every possible ailment known to man (from SIDS, asthma, allergies, autism, etc.) on vaccines. Other times they focus on the risk associated with vaccines. In the case of the MMR vaccine, they prefer to focus on the less than a one in one million chance of a serious adverse reaction rather than the fact that one or two of every 1,000 children who have measles will likely die. What is particularly frustrating is their tendency to ignore the present reality as well as the past. In cases when the scientific community has investigated their concerns, they ignore the findings because they fail to support their previously held beliefs.
Most people have learned from the past, but remain at risk from those who haven’t.
Thankfully, the overwhelming majority of people vaccinate. These are the people who actively try to protect themselves, their families, and others in their community, by contributing to the benefits of herd immunity and trying to reduce the transmission of vaccine preventable diseases. Unfortunately, the minority can sometimes jeopardize the herd.
Take the Van Tornhout family for instance. Today mark’s the fifth anniversary of their daughter Callie’s death. Callie was exposed to pertussis before she was old enough to begin her DTaP (diphtheria, tetanus and pertussis) vaccination series. Her story was featured on CNN last week, as an example of how concerning the current measles outbreak is. Unfortunately, there are many children under the age of one who are too young to receive the regularly scheduled MMR (measles, mumps, rubella) vaccine who are at increased risk of complications of measles as a direct result of this outbreak.
Sadly, the Van Tornhout’s can’t run from the past. Every day without their daughter Callie is a reminder of why they must continue to educate people on the importance of vaccines.
Stories like Callie’s are shared repeatedly. On the national news. On various social media sites. On websites and blogs. And even around the family dinner table. We share these stories so people will realize that these diseases still pose a threat to our children, especially those too young to be fully vaccinated. Unfortunately, some people remain conflicted about the lessons of the past. On the one hand, they consider vaccinating to protect themselves and their children from these preventable diseases because they hear stories about children like Callie. But on the other hand, they’re frightened by prolific misinformation that reinforces their suspicions that vaccines may be harmful. For fear of making the wrong decision, they fail to make the responsible decision to vaccinate, which then results in a decision which jeopardizes the health of everyone else in their communities.
Today, in honor of Callie’s fifth angel-versary, I urge everyone to do what you can to help ensure no other child dies as a result of a vaccine preventable disease. Don’t be reluctant to engage in a conversation about vaccines with friends or family. Don’t refrain from sharing scientifically accurate vaccine information on social media. Don’t be afraid to ask a non-vaccinator what their objections are. And please don’t let the past repeat itself. Sign up to receive notifications from Every Child By Two so you can stay informed of relevant immunization news, now and into the future.
When the Timehop app was introduced to Facebook not everyone was thrilled. While most people loved being reminded of photos and updates shared on Facebook in years past, others complained that there were some events they would prefer not to be reminded of; the loss of a job, the details of a difficult divorce, or the pain of losing someone we love.
Almost three years ago, shortly after Jonathan and Kathryn lost their infant son Brady to pertussis, they reached out to Every Child By Two and expressed an interest in advocating for pertussis vaccinations. They hoped that by sharing their son’s story they could help educate people on the dangers of pertussis and the importance of vaccination, especially in preventing exposure among children, like Brady, who are too young to be vaccinated themselves.
Being tasked to help them write their story was a challenge. How could I ever hope to do it justice?
Then it occurred to me… Kathryn had been recording Brady’s story all along as she continuously updated her friends and family of his condition on Facebook. I read her posts and could immediately empathize with the emotional roller coaster they were on. The hope. The fear. The unimaginable sorrow of watching their beautiful baby suffer, and ultimately lose his life as a result of a preventable disease.
Brady’s story was originally shared here on Shot of Prevention. We then worked to also get it posted to a site called Shot By Shot, which serves as a virtual library of personal stories of vaccine preventable diseases. From there, Brady’s story went viral.
Today we honor all our Every Child By Two parent advocates who continue to help us raise pertussis vaccine awareness. This day not only marks Brady’s third angel-versary, but also the fifth angel-versary of Carter Dube, and later this week the fifth angel-versary of Callie Van Tornhout.
While Timehop may be reminding you of a fun winter outing, a delicious dinner shared among friends, or an exciting new promotion, Brady’s mom Kathryn has been using Timehop with Facebook to remind us of how precious life is. Brady may not be here with us physically, but his battle was not entirely lost. Brady continues to fight today, as his family and friends share his story, in hopes that no more children are lost to pertussis.
💕 my bubba it was the calm before the storm
Ugh I hate this disease!! No family should have to endure this pain vaccination is so important
Our life turned upside down. I remember the ambulance ride and the rushing of the doctors when we reached Boston. We felt like we were dropped in the middle of a tornado everything happening so fast. We entered Boston with our son and left without him. I will also stand by what I advocate. Vaccines are important and save lives. Too many like Brady die because someone chooses not to vaccinate, and he was too young to receive his vaccines.
— feeling heartbroken.
This was my last update of Brady’s health. It was the worst pain to endure. Kissing your baby on the forehead and saying goodbye for the last time is something a parent should never have to do. These communicable diseases are nothing to take lightly. They take babies from there parents, siblings and families. The best line of protection we as parents can give to your own baby as well as other babies like Brady, is vaccination. Another parent should not be planning their child’s funeral because of these diseases. Or anything for that matter. Please light a candle for our bubba and tell his story to at least one other person today 💕
— feeling emotional.
We thank Kathryn for allowing us to share her personal posts, and we continue to thank all the strong and courageous parents who continue to share their personal sorrows in a public way in hopes of a better tomorrow.
As we prepare for the challenges of 2015, we want to thank everyone who has contributed to our success in 2014. Once again, the past year has been one of tremendous growth. We’ve seen a record number of views and shares on a variety of Shot of Prevention blog posts, and we’re especially grateful to our blog contributors and many new subscribers.
In looking back over our efforts from this past year, we would like to share a list of some of our most popular blog posts from 2014. We hope that you will revisit these posts and share them with others so that we can continue to engage more people in these important immunization discussions.
This blog post was written by Joe Lastinger, Board Member of Families Fighting Flu, who lost his young daughter Emily to flu. He explains that guilt and regret are often the hidden forces behind a lot of the good that is done in the world. And he explains the guilt and regret that he feels in his failure to adequately protect his daughter from influenza. To here more about Emily’s story, click here.
Infants don’t get begin getting immunized against pertussis until they are two months old. Prior to that, they remain vulnerable to this highly contagious disease at a time when they’re most fragile. In this post, Kathy shares the story of her son Brady’s battle with pertussis in the same way that she did with her closest friends and family; through her Facebook status updates. This small glimpse into one family’s heartbreak reminds us of how fragile a young life can be, and highlights how important adult pertussis boosters are in preventing pertussis in infants. Read the story for yourself here.
After five years and four miscarriages, Katie and Craig Van Tornhout celebrated the birth of their miracle baby, Callie. But their joy quickly turned to grief when Callie contracted pertussis and lost her life at just 38 days old. This story, which you can read here, talks about Callie’s struggle, but also highlights the important work the Van Tornhout’s have done to try to save the lives of other children by advocating for adult Tdap boosters in their community and across the country.
The U.S. is experiencing a record number of measles cases, with 610 cases in 24 states so far this year. This is the highest number of cases since measles elimination was documented in the U.S. in 2000. This may also explain why our fourth most popular blog post of the year was one that explained why measles outbreaks are concerning even to the vaccinated. To find out why everyone should be concerned about measles outbreaks, read the blog post here.
Dr. Dorit Reiss, is a Professor of Law, at the University of California Hastings College of Law. She has contributed several guest posts throughout the year, utilizing her legal expertise to examine the social policies of immunization. This particular post, which ranked as our fifth most popular blog post of the year, highlights the cost of vaccine misinformation. In this post, Dr. Reiss explores who may be liable when harm occurs as a result of a parent’s decision not to vaccinate – a decision often based on misinformation from a third-party. Read the details of Dr. Reiss’ explanations here.
If you have suggestions for topics you would like us to address in 2015, or you would like to contribute a guest post for publication, please feel free to let us know by commenting below or emailing us at firstname.lastname@example.org.
If you want to ensure you don’t miss any of our new posts in 2015, simply subscribe to Shot of Prevention by clicking the link at the top right of this page. You can also “Like” our Vaccinate Your Baby Facebook page to receive updates on important immunization news and join in on group discussions.
Thanks again for your continued support and best wishes for a happy and healthy new year!
This guest post was written by Denise Olson, a mother of four who connected with The Arizona Partnership for Immunization (TAPI) in her efforts to learn more about the HPV vaccination.
Like all good moms, I want my kids to grow up safe and healthy. I want to make decisions that will benefit them right now, but I also need to think about things that could help them in the future. I feel like it’s a big job and a lot is depending on me. That is why I wanted to learn more about the HPV vaccine before my children were old enough to get it. I wanted to make an informed choice, and I had all kinds of questions.
What is HPV, anyway? Could a vaccine actually protect my children from cancer? Are there side effects? What about the scary rumors I heard on the internet? Why is the vaccine given at age 11? Are my kids really at risk for HPV, or is this unnecessary medicine?
I wrote this article to share the answers I found to my questions, and to hopefully convince other parents to think about how they can protect their own children, not only now, but in the future.
What is HPV anyway?
HPV stands for human papilloma virus. HPV lives on soft mucous membranes and skin. Usually, it can be found on the genitals of an infected person, but it can also infect the anus, mouth and throat.
Some strains of HPV viruses cause genital warts, while others can cause tumors or cancers to grow. While there are many different types of HPV, there are several different HPV vaccines licensed by the Food and Drug Administration (FDA). The bivalent HPV vaccine (Cervarix) prevents the two HPV types, 16 and 18, which cause 70% of cervical cancers. There is also a quadrivalent HPV vaccine (Gardasil) which prevents against four HPV types: HPV 16 and 18, as well as HPV 6 and 11, which cause 90% of genital warts. The quadrivalent vaccine has also been shown to protect against cancers of the anus, vagina and vulva and is the only HPV vaccine licensed for use in males. And just last week, the FDA approved a new HPV vaccine (Gardasil 9) which will protect against nine different strains has the potential to prevent approximately 90 percent of cervical, vulvar, vaginal and anal cancers.
Can the HPV vaccine actually protect my child from cancer?
The primary cancer the HPV vaccine is designed to protect against is cervical cancer, the same cancer that is checked for when women go in for a pap smear. However, because the vaccine stops dangerous HPV viruses anywhere in the body, it may help protect against some cancers of the penis, throat, mouth, and anus. This is one reason it is recommended for boys as well as for girls. (The other reason is to protect future partners from cervical cancer.) Read more…