Category Archives: Vaccines

KatieCouricBodyCount.com

In case you missed it (I never do), here’s the opening line to Katie Couric’s syndicated talk show last week:

(spooky voice, eerie music) The HPV vaccine is considered a life-saving cancer preventer… but is it a potentially deadly dose for girls?

Ugh.

I used roll my eyes at such irresponsible attempts at sensationalism, but I can’t anymore, not after Jenny McCarthy took to daytime TV to spout her unproven theories blaming autism on vaccines. Like Katie Couric, the TV shows that invited Jenny McCarthy (‘Larry King Live,’ ‘The Doctors’), supported the topic under the innocent banner of a ‘conversation.’

The problem, however, is when in one corner you have two teary eyed mothers (or the pretty, charismatic Jenny McCarthy), and in the other, a scientist giving objective data, science loses EVERY TIME.

The consequences of losing these talk-show ‘conversations,’ unfortunately, are not inconsequential. We are still reeling from the effects of Jenny McCarthy’s media campaign, in which kids unnecessarily got sick, and important dollars were diverted from meaningful autism research.

For the record, we are talking about a medicine that prevents cancer. For all the research, money, and media attention that go towards cancer research and treatment, nothing comes close to the holy grail of medicine, that is prevention.

Here’s the boring objective stuff. HPV isn’t just an unsightly wart. Annually, it is estimate to cause1:

  • 2,100 vulvar cancers,
  • 500 vaginal cancers,
  • 600 penile cancers,
  • 2,800 anal cancers in women,
  • 1,500 anal cancers in men,
  • 1,700 oropharyngeal cancers in women, and
  • 6,700 oropharyngeal cancers in men

And, by the way, its safe: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6229a4.htm?s_cid=mm6229a4_e

As a whole, we pediatricians were embarrassingly silent as we watched Jenny McCarthy’s deadly escapade unfold. I don’t think we will let that happen again. Katie Couric, what you did is shameful and dangerous. I hope you use your platform as a respected journalist to refocus the image you created for the HPV vaccine. If not, you may see yourself the recipient of a similar dubious honor, as seen here:

http://www.jennymccarthybodycount.com

 

  1. http://www.cdc.gov/std/HPV/STDFact-HPV.htm

Musings on Measles

For some reason, there are more kids with peanut allergies than beforemeasles.

Peanut allergy, which can cause life-threatening anaphylaxis, is very serious. The community, in response, has adjusted their way of life to protect this minority, knowing the impact even a tiny particle of peanut can have on those that are allergic. We now have peanut free schools, peanut free airplanes, peanut free Halloween. Perhaps begrudgingly, but always understandably, we did this to protect those that can’t always protect themselves.

And now, according to this report in the journal Pediatrics,  we are seeing ‘pockets’ of communities where the decision to not vaccinate is more prevalent than most of the United States. Without vaccination rates somewhere in the 90% range, the community loses the powerful effect of ‘herd’ immunity, where even the unvaccinated are unlikely to get a potentially life threatening disease.

There are kids with cancer and autoimmune diseases that can’t receive vaccines because they are immunosuppressed. There are children under 4 that are incompletely immunized. In the midst of this growing measles outbreak, how does the community respond to protect these kids? Is your right not to vaccinate your child, the same as my right to eat peanuts next to a child with a peanut allergy? I would never do that, by the way.

I’m struggling with this one. Can someone help me out?

Why you (Yes, you) still need the flu shot

Why you (Yes, you) still need the flu shot.

  1. 45% > 0%.

Before every Flu season, a group of scientists, smarter than me and with hard to pronounce titles, meet up to try to figure out which strains of the flu will be rearing its ugly head. I honestly don’t know exactly how they do it, but suffice to say it’s more sophisticated than drawing a name from a hat or throwing darts at a board. Usually they do a good job. So far, this year they didn’t. In particular, they did not predict a “rogue” strain of flu H3N2 which seems to be wreaking the most havoc (about 45% of the H3 strains), and is not included in the vaccine. Rats! The good news: the vaccine does provide protection against some of our most popular, and deadly, strains which can pop up as quickly as this H3N2 strain. Remember “swine flu?” We got you covered.

  1. You can get sick. Real sick.

Last year, the flu caused an estimated 400,000 individuals to get sick. Annually, about 20,000 die. Who can get sick from the flu? Anyone. Yes, the elderly, very young, and those with chronic diseases like asthma, seem to get hit the hardest. But, I’ve also watched healthy teenagers die in the pediatric ICU from the flu. So far 11 children have died this season, the number will certainly climb into 100’s, like every other year.

  1. You can get others sick.

Christmas season is the season of charity and giving. But don’t give the gift of flu. That’s mean, and down-right Grinch-y.  My Pediatric Unit at Hendricks Regional Hospital is currently full of sick children and infants with the flu, some of them too young to receive the vaccine. By protecting yourself, you are protecting your community, which includes the most vulnerable.

  1. You can’t get the flu from the flu shot.

Let’s stop with this nonsense. The flu “shot” only contains part of the virus to help your body develop a natural immunity. This means creating an immune response that sometimes involves soreness around the injection shot, mild body aches, and low-grade fevers. Unlike the flu, these side-effects are well tolerated, and compared to the actual flu, will not hospitalize you or make you miss even a day of work. The nasal spray contains weakened strains that also will not cause true influenza infection, but you may short-lived mild symptoms. Again, ask anyone who has had the flu, this isn’t it. Finally, immunity takes a few weeks to develop, so it is possible to get infected after vaccination, but before immunity develops fully.

  1. It’s not too late!

As mentioned before, several viruses circulate every season, which lasts until spring time. Get vaccinated, protect yourself, your friends, and your community.

 

Merry Christmas and Happy Holidays!!!

Dr. Tony GiaQuinta, MD FAAP

More Musings on Measles

Does this ring a bell for anyone?

“Texas Megachurch at Center of Measles Outbreak?”

This happened only about a year ago in September, 2013, when 21 members were infected, a majority of whom were unvaccinated children.  I remember at the time thinking it was a big deal. Yet, I haven’t heard it referenced at all in the midst of our current measles outbreak.

I’m guessing its omission is partly because an outbreak of 21 cases is chump change compared to the now 121 cases throughout 17 states, as of February 2015. But perhaps it highlights another issue at play: Why isn’t there much, if any, heat on the religious exemption for childhood vaccinations?

This isn’t the first time unvaccinated communities, in the name of religious exemption, have gotten themselves (and others) in trouble.

Turn back the clock way back to 1991, and some (not me… only in 2nd grade at the time) will remember the measles outbreak that infected more than 1400 people in Philadelphia, which included 9 dead children. About 33% of those infected belonged to one of two large churches, which emphasized prayer over medicine (and vaccines, for that matter).

Dr. Paul Offit, now an infectious disease specialist, witnessed the outbreak firsthand. He talks about his experience in this recentNew York Times article.  Since the disease has become so ‘out-of-sight, out-of mind’ to many, I’ll quote his experience:

“Children would come in, covered in rashes, squinting in the bright light (a side effect caused by eye irritation), struggling to breathe, and often dehydrated. It was like being in a war zone.”

200 kids came through his ER, 40 needing hospitalization, and with a handful of deaths.

It required this bucket of cold-water reality for something remarkable, and probably unthinkable for many of us: a court order to vaccinate children against their parents will.

So what would the ACLU (American Civil Liberties Union) have to say about that? Would they decry this sacrilege on individual freedom and the first amendment?

Nope. As Deborah Levy, of the Philadelphia ACLU chapter defaulted, “…parents don’t have the right to martyr their children.”

Or, to get downright Libertarian, “the only purpose for which power can by rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.” That’s John Stuart Mill. On Liberty. Boom.

So what happened? Well, kids got vaccinated against their parents’ wishes, outbreak ended, and kids didn’t get sick.

I wish I could also report that we remembered the dangers of measles and other vaccine preventable illnesses, and when we beat measles into submission and eliminated it from this country in 2001, it stayed down. But that, of course, didn’t happen.

Which brings me back to the topic at hand. Currently, most people are hung up on states (currently 19) that allow personal belief or philosophical exemptions from vaccines. Some of them are thinking this wasn’t such a good idea (I’m looking at you, California). 

But what about the 48 states, sans Mississippi and West Virginia, that allow religious exemptions?  Look, freedom of religion and separation of church and state are foundational tenets for this country.  My parents have always instilled in me the importance of the right to believe (or not to believe), and the right to express one’s religion freely. But when the rubber hits the road, and kids are being harmed in the name of martyrdom, we begin to recognize there are more important rules at play.

Truly, I believe that with what we are witnessing in these last two months, mandating vaccinations for all children bears more attention and consideration.

-Tony GiaQuinta, MD FAAP

@IndyPedsDoc