Thursday, August 03, 2006


Okay, class. Everyone who has seen a case of Hemophilus influenza type B (HiB) infection in the last ten years, please raise your hand. No one? Good.

When I was a resident in pediatrics in the 1980's (I know, I'm getting pretty old), I spent a great deal of my time taking care of kids with HiB (a bacterial infection, not to be confused with "the flu", caused by influenza viruses). I saw kids with HiB cellulitis, HiB meningitis, HiB epiglottis, and just plain old HiB sepsis. It's not a pretty disease. The meningitis can cause brain damage and/or hearing loss, and some HiB infections cause the most feared complication: death. I saw so many HiB infections that I wonder what pediatric residents do all day now, since HiB took up a major part of my time.

Okay, class, second question. Do you know why no one in our class has seen HiB disease in the last ten years? Because we developed a vaccine for it that has nearly eradicated the disease from developed countries. It's been great to see; in my career, I've seen a vaccine developed and then stamp out a terrible disease, just like earlier generations of pediatricians saw vaccines wipe out terrible diseases like polio and small pox. When you've seen the scourge of a disease, you're especially grateful for the vaccine.

Maddeningly, there are still some people who are opposed to vaccinations, such as my ex-brother-in-law and Muslin Imams in Nigeria, where polio still kills kids because the Imams say polio vaccine is part of a plot by the U.S. to harm kids. It's crazy. People claim that vaccines are not safe, but that's not really the question. The question is, which is safer, vaccines or taking your chances with the diseases? Unquestionably, the vaccines are. Even if you believe a lot of the malarkey that anti-immunization folks say - most of which is not true - it would still be safer than getting, say, measles, or pertussis (yes, we still see these diseases) and certainly safer then getting HiB disease.

And if you don't believe me, I could probably find you some parents from my residency days who are still grieving their kid's death from HiB.


Anonymous Pen said...

Thanks for that.

Why do the Nigerian Imams see vacciantion as directly to do with the US and not the WHO or the UN?

8:24 PM  
Anonymous Anonymous said...

Nigerian imams are not the only ones, I have seen educated idiots right here in the US who impose their ridiculous beliefs on their children. Retards who blame their kids' autism on the MMR vaccine are pretty easy to find. Cults like scientology made popular by cheap actors adds to these misconceptions.

12:09 AM  
Blogger That Girl said...

Howling at the moon. Did you see the Villiage?

There are always a signifigant number of people who are willing to take risks on behalf of others, as long as they themselves dont have to pay the price.

While it's very sad for parents to watch their kids suffer through a disease that could have been prevented Im thinking it's harder on the kids - and they dont get a choice.

5:05 AM  
Blogger stockingup99 said...

I was a believer. I updated my shots before trying to concieve.

After a year of her getting very sick after every shot, and seeing two of her immunizations recalled, I woke up and started reading. One of her vaccines was recalled for overdosing newborn babies with mercury. That was the published reason. The other for bowel obstructions.

It was hard to watch my child suffer from the vaccinations. The doctors didn't report even one occurance to the VARS database. The doc made the call that it was unrelated, and didn't follow the rules. Vaccine incidents are 95% underreported.

The screaming, the rainbow poops, and the worry was only there for the 7-10 days after each shot.

How 'bout the way that SIDS peaks in two perfect bell curves centered around two and four months age. Same as immunization time.

The only polio seen in the US for more than a decade, is the vaccine strain, not the wild one. Most polio cases in the US recently were caused by the oral vaccine. The caregivers were catching it from the diapers.

And what about the nasty preservatives.

I will not vaccinate my son. It was hard enough watching my daughter suffer.

And before you get on your high horse, vaccines are contraindicated if siblings had bad reactions. It says so right on the manufacturers pamphlet. So even the medicos would agree not to vaccinate another.

I loved the line in the varicella vaccine pamphlet. "There is no evidence of sutained immunity in the absence of wild booosting." So if we vaccinate the kids, they may get chickepox as adults.

7:58 AM  
Anonymous Anonymous said...

Neo Doc,

I'm with you on this one. I worked in a NICU and I saw and heard a number of opinions on immunizations.

My wife and I have made sure that our son is up to date. I think that the benefits of avoiding a disease is greater than the risk involved if he catches something.

I have heard commentators express their guilt over the "reactions" their child had from the shots. I wonder about the depth of their guilt if their child comes down with whooping cough or (even worse) polio?

I also noticed that one of the studies that supposedly links immunizations with autism has so many holes in the methodology that a large university statistics department in England uses it as a "bad example" of how to construct a study.

This arguement comes from the proliferation of false information on the internet and the media. It make the education responsibilities of health care providers that much more important...

Thanks for listening...

Evan PA-S

1:09 PM  
Blogger Ex Utero said...

Neo Doc...

tag your it.

1:26 PM  
Blogger Flea said...

You preachin' to da choir, baby!

I have a large number of non-vaccinators in my practice. They know what the risks are and they barrel ahead anyway. Life takes risk... or something.



4:15 PM  
Blogger neonataldoc said...

Thanks, all. I don't know why the imams blame it on the U.S., but we are the great Satan. I haven't seen the Village, but it's supposed to be good. Stockingup99, there is no question that the world is a safer place with immunizations. If others didn't get immunized, your kids would be in great danger from things like polio and diphtheria. You can get away without immunizing only because so many other people do immunize.

12:11 PM  
Blogger Judy said...

I've seen HIB meningitis and epiglotitis - but not in the last 10 years. They used to float us from the NICU to the PICU. Ugly. Realy ugly.

The thing that scares me is the number of non-vaccinators who might not tell the ER doc that their kid hasn't been vaccinated in combination with younger pediatricians and ER docs who have NEVER seen HIB in all its glory.

As a homeschooling mom, I meet more than a few non-vaccinating parents. I don't bother to argue with them, but I do preach about making sure the ER doc knows your kid isn't vaccinated if you end up there.

1:38 PM  
Blogger Tassie_gal said...

As someone who had a reaction to the whooping cough vacc when I was younger, along with a mild triple antigen reaction...I will (if I ever have any) still vaccineate my kids...after having suspected whooping cough (unconfirmed) at 22, I would NEVER want to put my kids through that. Also my hypotetical kids being immunised will add to the herd immunity, and thus those few who aint, and might get something are much less likely to pass it on. (sorry that the epidemiologist in me).

4:44 PM  
Anonymous kim said...

I remember when the HiB vaccine came out and my kids were all immunized with it.

I was relieved that another disease was out of reach.

I don't even see epiglottitis anymore in the ER....

9:22 PM  
Blogger Clark Bartram said...

I'm going to pilfer this one for the PGR if you don't mind.

12:18 AM  
Blogger purple_kangaroo said...

You have some good points, but what a lot of people don't take into account (as stockingup99 mentioned) is that some vaccines ARE contraindicated for certain children. Even the vaccine inserts the manufacturers provide says this. Some children simply have a much greater risk of side effects or bad reactions than others do, or should not have the vaccine for other reasons.

I wish more time and research would be done to try to identify those children most at risk and those for whom the vaccines would be contraindicated. That might go a long way toward making vaccines safer overall.

I have a child who is extremely allergic to some of the vaccine components. She has had severe reactions to even trace amounts of these allergens supposedly processed to the extent that they are not allergenic even to highly allergic people. In such a case, it would be foolhardy to give her a vaccine with an ingredient we know she is so allergic to.

So far, it appears that all the vaccines contain ingredients that would be problematic for her. If we do give her any vaccines, I'll want to do a skin test first to see if she reacts to the vaccine before administering it. Once something has been injected, it can't be taken back out of the child's body if they have a bad reaction.

Yes, I've seen some of these diseases. We've been exposed to Pertussis several times (as most people probably have without knowing it). My nephew was extremely sick and had to be hospitalized with pertussis when he was just a few weeks old--too young for the vaccine.

I think it's very important that parents and doctors have the freedom to evaluate the benefits and risks and make the best decision in each individual circumstance.

3:30 AM  
Anonymous Anonymous said...

My son had open heart surgery at 6 weeks of age. On day 5 of his recovery in PICU, he acquired HiB. Somehow, my little 7 pounder managed to fight it off and is a healthy little boy, getting ready to turn 2.

I was told that because he was intubated he became more susceptible to such diseases. Is this accurate?

He had not been immunized yet.

6:34 PM  
Anonymous Anonymous said...

A friend (we're in England, by the way) has just had a 26-week premature baby. An injury caused partial rupture of her membranes - she didn't realise this, thinking it just discharge - and the baby contracted Hib.

Baby now has meningitis & septicaemia. I wish I knew what to tell her - she keeps asking me how likely it is that the baby will live, and live normally. Anyone know?

7:23 PM  
Blogger sexy said...







1:43 AM  

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