Monday, August 09, 2010

I vaccinate

I may be opening a can of worms here, but I vaccinate my kids. For everything.

I just watched the PBS documentary Frontline: The Vaccination Wars (you can stream it on Netflix) and it's a subject that is close to me. I didn't really realize why until I watched it.

They made the distinction that the vast majority of parents of young children today don't have personal experience with the devastation of polio, small pox, mumps, measles, or pertussis. Previous generations didn't have to be sold on vaccines - they saw the proof growing up. Our generation grew up without most of these diseases and it's easier to be concerned about what the vaccines are doing than what they are preventing. When you don't see it, it's more like the boogey-man - it just doesn't seem real.

These diseases are real. My grandmother had polio as a child. Her life was severely shortened, and she had a huge hump on one shoulder, affecting her gait, her height, everything. Her body was destroyed by the disease. I saw first-hand what polio can do to a person. Polio has lived endemically for centuries, but began to become epidemic in the late 1800s in Europe and was the most feared childhood illness of the 20th Century in America, as it is highly contagious through basic contact. Factors affecting the severity of the disease include tonsillectomy and pregnancy. 90% of those infected show no symptoms at all, but the remaining 10% of cases can have the virus attacking motor neurons which causes paralysis and the deformities we see in pictures. Polio is one of two diseases marked for global eradication through vaccination, but there continues to be around 1000 infections per year worldwide. Polio survivors are one of the largest disabled groups in the world.

A friend of mine recently told me that she would not be vaccinating her child because the diseases we vaccinate for don't occur in the US. But people in the US travel abroad all the time and anyone can bring something home. The Hammer's daycare center recently had to report that a child in the center, who chose to remain anonymous, had a case of Pertussis, or whooping cough. In fact, there was an outbreak in MN. Frontline had a video of a 6 week old baby with Pertussis and it was horrifying - she literally could not get a breath in because of the fluid in her lungs and you can see the panic in her face. It's human instinct to fight for air when you can't breathe, even when you're 6 weeks old.

Most parents today had chicken pox as children - I did. It was seen as a rite of passage, something your parents exposed you to so you could get it out of the way. I was very sick when I had mine, lethargic, feverish, barely ate. Apparently, most children who die from chicken pox, however, die from an infection that enters where lesions have been scratched, usually staph or strep. Chicken pox infections are severe for adult males and pregnant women, and the virus can reactivate at any time, causing shingles. Shingles causes an extremely painful rash resulting from the toxin becoming active again in the nerve tissues it continues to inhabit for the rest of your life if you have had chickenpox.

Many of us don't know what happens when some of these diseases take hold. We know that the mumps will make your throat huge and sore, but it can also make a child deaf or cause nerve damage. If adolescent or adult males are infected with the mumps virus, about 30% will see their testicles infected, which is extremely painful and can cause atrophy or infertility. Pregnant women in the first trimester who contract mumps will miscarry around 27% of the time. There was an outbreak of over 6000 cases of mumps in 2006 attributed largely to young university students.

Measles is actually a respiratory infection that also causes a rash and it's highly infectious - 90% of people with no immunity will contract it if they are in regular contact with someone who has it. One of the reasons it is so contagious is that it can be transmitted days before the rash appears. Although usually not fatal, complications are common and can be severe. Indiana experienced an outbreak in 2005.

Rubella, or German Measles, is relatively benign, unless contracted by pregnant women. Rubella in pregnant women can kill the fetus, or, if it survives, will cause many severe and irreversible defects. There was a pandemic of Rubella in 1964-65 that affected 1% of all births in New York alone. The vaccine was created in the 1970s and the CDC declared this disease eradicated from the US in 2004, but continue to vaccinate for it due to foreign travel.

Diphtheria can make you seriously ill and cause death. Cardiomyopathy occurs in 20% of cases and peripheral neuropathy in 10%. It can also cause paralysis. Swelling in the lymph nodes during the acute illness can necessitate intubation. It has been nearly eradicated in the US but continues to infect hundreds of thousands every year overseas. The Guinness Book of World Records has named Diphtheria the "Most Resurgent Disease."

Tetanus can cause extremely painful muscle spasms and 11% of cases are fatal in the US. Complete recovery can take months. There are no blood tests to diagnose a tetanus infection - diagnosis is based on the symptoms alone. Tetanus is widely known to come from contact with metal puncturing or slicing the skin, but any cut, wound, or injury that opens the skin can become infected with Tetanus. There are approximately 100 cases of Tetanus in the US annually. Tetanus infects around a million people worldwide each year and kills approximately 30-50% of those who contract it.

Meningitis comes in many forms, it's a name given to inflammation of the meninges, the protective tissues covering the brain and spinal cord, usually due to infection. Four vaccines are given to prevent various causes. Diagnosis of the condition is done by lumbar puncture (they stick a needle into the fluid around your spinal cord and extract some for testing). The doctor's usually won't know exactly what infection caused it, though, so they'll just throw everything they have at you - antibacterials, antivirals, and maybe a corticosteroid to reduce the inflammation. The infection may cause sepsis in the body. The swelling may damage brain or spinal tissue. Mortality is high for infants, low for older children, and oddly, highest of all for adults. In survivors, deafness and cognitive impairment occur in more than 10% of victims.

And finally, the Hepatitis vaccines. Hepatitis is basically an inflammation of the liver caused by a virus. About a third of the world's population has been infected with the HepB virus, including the approximately 350 million chronic carriers that can spread the disease at any time through bodily fluids. Infection can either be chronic or self-limiting, meaning it goes away on it's own. Only 30% of young children will be able to clear the infection and the rate drops to 5% of newborns infected by their mothers at birth. Those with chronic infections have a 40% chance of death due to cirrhosis of the liver or liver cancer.

Hepatitis A is spread fecal-to-oral. It also causes inflammation of the liver and although it is rarely fatal in the US, the illness is severe (vomiting, diarrhea, abdominal pain, fever, fatigue) and can last 1-3 weeks in children and much longer in adults. Up to 10% of people can experience relapses up to 40 weeks after the initial illness. The most widespread US outbreak occurred in 2003, when over 600 people were infected from tainted green onions served in a restaurant in Pennsylvania.

Growing up watching my grandmother struggle with the after-effects of polio formed my opinions on vaccines. Not everyone has the personal experience I had with her and it's easy to think these diseases don't exist here or aren't dangerous. They do. They are. Consider your choice to vaccinate carefully.