The Partial Observer by Dr. Brandon Greene and Dr. Chris Kjolhede
Vaccines: Let’s Talk
Over the last 30+ years here in our area of rural upstate New York, the prevalence of childhood infections has been reduced significantly. There has been no bacterial meningitis beyond the newborn period. There have been rare episodes of whooping cough. There have been no children sick with measles or mumps. The biggest impact on lifespan in the last 100 years is not curing cancer or fixing clogged cardiac arteries. The most important factor for the length of life has been vaccinations.
There are some retirees who may remember getting their first polio shot or sugar cube; few actually remember being vaccinated for smallpox (a disease that is now totally eliminated) since it was given during infancy. Name the infectious diseases common until World War II and today these are rare—so rare, in fact, that they make the news. We now almost never see the withered legs of polio unless it is in a foreign country and, even there, it is increasingly uncommon.
Pediatricians have worked for decades to improve the lives of their patients, the children of our community, our country, and the world. Along with clean water and promotion of breastfeeding, immunizations are the defense against many infectious diseases that could result in an early death or a lifetime of chronic illness. We who are alive today can speak with appreciation for all those childhood shots; those who did not get them, who died or who are severely impaired, may not be able to talk.
Questioning healthcare providers about vaccine schedules, shots’ contents, and the efficacy of immunizations is legitimate. But when people deny the value of very extensively studied childhood vaccines or recommended timeframes for giving these shots, it is hard for many students of science and believers in evidence-based policies to understand. Data and statistics are the basis for truth and trust amongst most practicing child healthcare providers. Without science as the foundation for how we attempt to improve the lives of children, we are nothing but “influencers,” modern day sellers of snake oil.
Vaccines have had a huge effect on the health of children in the United States. Polio went from infecting more than 50,000 Americans every year pre-1950s to a few hundred within a decade, and to zero by 1979. It was the vaccine. Mumps went from infecting 200,000 every year in the U.S. pre-vaccine to a few hundred, and just 226 so far this year. Rubella went from infecting 60,000 every year in the U.S. (and killing thousands of infants) to infecting less than 10 per year. Measles went from infecting hundreds of thousands in the U.S. every year to less than 100 in 2000, when it was declared “eliminated.” (There have now been 1,454 confirmed U.S. measles cases as of September 9 this year due to decreasing vaccination rates and loss of herd immunity.) Haemophilus flu, type b, formerly the major cause of bacterial meningitis in children, is all but eliminated. One study estimated that 150 million lives have been saved by vaccines in just the last 50 years. Smallpox, which accounted for 7-10 percent of all deaths in London every year before the vaccine, has been eliminated from the planet. Few things in medicine could be safer and avert more suffering than preventing a disease before it ever happens. Healthy kids miss less school, learn more, get better-paying jobs, lead healthier lives with fewer chronic diseases, and contribute more to their communities.
This we believe. We are pediatricians, your children’s pediatricians and, in many cases, we were your pediatricians. We write this letter to inform you, based on what we learned, based on our training, based on what we have experienced over the decades, that we have delivered the best healthcare we know. If you have questions about vaccines, we encourage you to raise them when next you see a pediatrician. When we say, “Johnny is scheduled for his shot today,” do not be afraid to say, “Could we talk about that?” Next to a child’s parents, we are among the best advocates that that child has. Talk to us! It is a privilege to care for your family and this community.
Dr. Brandon Greene is chief of pediatrics for Bassett Healthcare Network. He oversees and guides each of the pediatric providers across the network’s eight-county service area, including its hospitals, outpatient clinics, and the Bassett School-Based Health Program.
Dr. Chris Kjolhede is a pediatrician emeritus for Bassett Healthcare Network. He was formerly co-director of the Bassett School-Based Health Program.
