← The Pediatrician Next Door - Simple Advice on Parenting and Family Health
The Pediatrician Next Door - Simple Advice on Parenting and Family Health
Vaccines: Now What? Answers to the Biggest Questions (Encore)
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- [00:01]
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New year Same extra value meals at McDonald's. So now get two snack wraps plus fries and a medium soft drink for just $8 for a limited time only. Prices and participation may vary. Prices may be higher in Hawaii, Alaska and California. And for delivery.
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Hey, it's Wendy. If you're a parent, you're probably confused right now. The CDC just updated their recommended vaccine schedule and. And when that happens, questions start flying. What exactly changed? Do you need to do anything differently for your children? So I'm re releasing this episode that I did about vaccines. It's not about politics. It just answers the same questions I hear every day in the exam room from parents who just want to make the best decisions they can. So if vaccines have ever made you pause even briefly, this episode is for you.
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I'm Dr. Wendy Hunter and I I'm.
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B
The pediatrician next door. I'm that doctor friend you call for practical advice about your kid's health. I mix the science of medicine with the reality of parenting. Vaccine hesitancy. That's what it's called when parents are unsure about vaccinating their kids. It's not the extreme anti vaxxers who believe in conspiracy theories about alien DNA and vaccines. That's not common. It's the very rare person who doesn't vaccinate. The majority of kids who aren't fully vaccinated have parents who just are a little bit hesitant. Maybe they delay shots, maybe they skip certain vaccines, or they just feel uneasy about the whole process. And I totally get that. But here's the problem. The loudest voices belong to this anti vax crowd. They spread fear. And fear is sticky. It's why you see social media posts with a million likes about a child who got their one year old vaccines and then had a developmental delay. Because that's dramatic and it's interesting. No one makes a post about their child getting the MMR vaccine and then not getting measles. That's a boring story and that's not going to go viral. No modern parent is out there bragging that all four of their kids made it to the age of eight. But if you go back 150 years, that wasn't a guarantee. Before vaccines, kids died all the time from things as simple as strep and smallpox. Modern medicine is like pretty badass. But we don't have the cure for everything. And there are parents out there who wish we had a cure or a vaccine for their child's illness. Think about that. This reminds me of a 17 year old girl I saw in the ER, she was beautiful and I think that that's why this is always going to be stuck in my mind. About 18 months before I met her, she had West Nile encephalitis. It was a super rare case. But she got a mosquito bite that carried the virus. That was how she got it. And she was completely neurologically brain dead since then. She still looked like a beautiful young teenager. I could picture that being my own daughter. It was devastating. It was really scary. This is the kind of case that makes you wish there were a vaccine for everything. We've wished for vaccines so many times throughout history and when they come along, they change everything. Think about polio. Before the vaccine, parents lived in fear of their child being paralyzed. Right now, polio is rare and some parents use that as a reason not to vaccinate. But polio is only rare because we vaccinate. That logic that a disease is not worth vaccinating for because it's uncommon, that logic is backwards. It's uncommon because we vaccinate. We are seeing that right now with measles. Some parents don't want to vaccinate because they don't trust the government or pharmaceutical companies. But in my experience, that's not usually parents primary concern. The truth is, most parents who hesitate about vaccines, they can't quite put their finger on why they feel uneasy. They've just heard that some people don't vaccinate and it makes them pause. If you want to be a thoughtful parent, you're going to think about this. I've heard so many parents ask me questions like are vaccines really necessary or can we delay some of them? And let me start by saying this, these are great questions. You're not alone and it's really fine to have concerns. Our job as pediatricians, and my job is to provide you with the facts so you can make informed decisions. Let's start with the simple truth. Vaccines save lives. Before vaccines, diseases like polio, measles, whooping cough, they caused widespread illness, disability and deaths as you're seeing now thanks to these vaccines. Though, these diseases are rare and some of them are eliminated in many parts of the world. But here's the thing, these diseases have not disappeared entirely. We've seen outbreaks of measles and whooping cough in recent years, usually in communities with lower vaccination rates. And why is that? Because these germs are still out there. They're waiting for an opportunity to spread. And vaccines are used to create a shield of protection for your child and for everyone in your Community. It's called herd immunity. The idea is that when enough people are vaccinated, or most of your herd, it's harder for a disease to spread throughout it. So vaccinating most of the people in a group protects people who can't get vaccinated, like newborns, or for kids with cancer or weakened immune systems, they can't become immune even if they get a vaccine. Some of these kids, so for measles, for example, the magic number is 94%. When the percentage of kids who are vaccinated with MMR falls below this magic number, there are enough kids who can get the disease, then that is when we see outbreaks occur. That's what happened in New York City, and now it's happening in Texas. I'm sure you know that meningitis is relatively rare in kids, so I don't know what the chances are that this happened, but it did. When I was a second year pediatrics resident, I admitted two patients on the same night from the emergency room and they both had meningitis and they were both two years old. The big difference was they each were infected by a different disease. I went down to the ER to see the first kid. She was really sick and she had already had a spinal tap done. So the doctors knew it was meningitis based on the analysis of the cerebrospinal fluid. But what we didn't know was which bacteria she was infected with. So we started a really broad antibiotic that treats the most common causes of meningitis. And she got better over the course of like 48 hours. But unfortunately, the infection caused her to be permanently deaf. It turned out she had meningitis caused by a bacteria called Haemophilus influenza, which, which is also known as Hib. That's the infection that's prevented by the Hib vaccine that babies get at two months, four months and six months. And then kids get a booster sometime after age one. A lot of people hear the name of this bacteria and confuse it with influenza virus, but they're completely different infections. Hib bacteria, they cause ear infections, pneumonia, blood sepsis, and can cause meningitis. The second child I saw had a form of meningitis from the bacteria Neisseria. He had not been vaccinated because we don't vaccinate for this until about age 11. As you probably know, meningitis can be deadly very quickly. This is the one that can cause infections in college students. You've probably heard some stories. This kid did really well without any consequences. As far as I know, but only because it was caught within hours of his fever starting. Apparently he had been playing outside riding his tricycle and he was totally fine. But over the course of about 30 minutes, he started suddenly to act really, really sick. Then he vomited and he had a fever. And his parents probably wouldn't have done anything special except they noticed he had a weird rash starting, so they brought him directly to the er. The reason these cases are top of my mind right now is that that night was one of a few very specific experiences that I had during my residency training that made me committed to protecting children from diseases that can be prevented by vaccination. Both of those kids survived, but I have not seen many kids that sick in my career. It was, frankly, scary and extremely humbling. We don't spend a lot of time thinking about why we give immunizations, but it is the most effective thing we do to keep kids healthy. I know vaccines can feel scary. No one likes watching their baby get poked with a needle. No one likes getting poked with a needle themselves. But here's what I want to do. I want to make parents feel confident that vaccinating their child is the right thing to do. Because it is. There's nothing to be fearful of when it comes to vaccines. And I hope by the end of this episode you'll feel the same way.
- [09:27]
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Every year around this time, people talk about New Year's resolutions. But instead of resolutions, I make a list of my values and then I build simple rituals that support them. My best friend knows I do this, and this year she said her values are her home and her family, and that means new bedding.
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She's right for me.
- [09:46]
C
The rooms I spend the most time in and that really shape how I feel are my bed and my bath. That's why this year my reset started with Cozy Earth sheets and towels. I upgraded to Cozy Earth's Baja bedding set and transformed my bedroom. It's a complete matching set. Sheets, duvet, cover, quilt, coverlet with this beautiful, calm design inspired by the Baja California landscape. It feels elevated but inviting. Then there are Cozy Earth's luxe bath towels. They're plush, absorbent, and they dry you off quickly. It's a small ritual, but stepping out of the shower and using a towel that feels this good changes how I start my day. When the holidays wind down, I need rest and the feeling that I'm ready to take on the new year. And that's exactly what Cozy Earth delivers. Luxury, comfort that makes home my best part of life.
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Plus, it's completely risk free.
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Cozy earth offers a 100 night sleep trial so you can try it out and return it hassle free and everything comes with a 10 year warranty because once you've experienced this level of comfort, you'll want it to last. Start the new year off right and give your home the luxury it deserves and make home the best part of Life. Head to cozyearth.com and use my code Dr. Wendy D R W E N D Y for up to 20% off. And if you get a post purchase survey be sure to mention you heard about Cozy Earth right here. Refresh your routines with comfort that makes every day feel like a new year.
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- [11:44]
E
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- [12:11]
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- [12:46]
B
We have a patient in our clinic over the past few months who has whooping cough which is also known as pertussis. That's the P and the DTAP vaccine and I say we have a patient in our clinic over the past few months because the mother brought this baby in so many times. Mom chose not to vaccinate her baby with the routine schedule and her 4 month old got sick with pertussis. She was a little on the older side like four months is older, so she did fine. And babies who are under two months who get whooping cough, they tend to be extremely ill, often needing to stay in the intensive care unit. Anyway, this baby was not terribly ill, but I will tell you her mother was exhausted because the baby coughed all the time. She was vomiting from coughing and she's up all night. No one in the house was sleeping. And let me also tell you the other name for whooping cough. Do you know what it is? We call it the hundred day cough because literally it lasts for 100 days. And on day 90 of this baby's illness, her mom came into the clinic wanting to know why her baby was still coughing and what we could do about it. And I was very happy to inform her that she only had another week or so of the illness and it would start to go away. 100 days. This baby's mother was worried about the safety of the vaccines. But let me say again, vaccines are safe. They are far safer than the disease they're preventing. And I'm going to get into that. But first I want to focus on why there is so much talk by politicians, on social media and among parents that they say vaccines aren't safe. How did these rumors get started? Here's what I see. Concerns about vaccine safety usually follow a specific pattern. First, someone suggests that a health problem like autism, for example, might be linked to vaccines. Okay, whatever the health problem is, autism, Crohn's disease, seizures, it's always a condition that is becoming more common and, and always one that doesn't have a known cause. So someone suggests it might be caused by vaccines. Then the next thing that happens is that there are a few research studies, early, tentative, preliminary research studies that show there might be a link to the disease. But these are not well designed studies, and they might just be a few cases, or in some cases, they may be completely made up. Like the first study that linked autism with the mmr, it was completely made up. These early reports grab attention, especially from people that are affected by the condition. And then they're reported in the media because they're dramatic and they attract viewers or they attract social media attention, which means more advertising dollars or more followers. Then finally, we will have larger, better studies that come along and they don't find the same results. But by then, fear has taken root. It can take years to undo the damage of this misinformation. The other thing that can help you see that information you hear on tv, social media, or from friends is unreliable is that people's fears about vaccines are different depending on where they live. That means fear is based on a social context and not on actual scientific data or on reality. For example, some English speaking communities worry about vaccines and autism, as you know. While in other places like France, people worry about vaccines causing other conditions like multiple sclerosis and not about autism. In Nigeria, people worry that vaccines cause infertility. These fears don't have any solid evidence, but they still make parents hesitant to get the vaccines for their kids. It's fascinating to me that vaccine concerns are different in different parts of the world because that is a clear indication that our fears are culturally based. They are not based on. In fact, these are rumors and myths. It's not that different from believing in ghosts. I mean, I admit I do sometimes believe in magic or have fears that someone tells me a creepy story and then I think there's a ghost and it seems like it could be real, but I'll still go into a dark room or sleep alone at night because I know it's not true. What I find interesting about parents who hesitate to vaccinate is that their fears come from so many different places. At the core of it, it does all come down to fear. But the specific worries are very different. To me, that means there isn't a solid reason not to vaccinate. If there was a reason not to vaccinate, every hesitant parent would have the same concern. Many parents don't even realize that part of their hesitation comes from something as simple as not wanting to see their child cry during an injection. And that's fair. Yes, kids do react to vaccines. That's kind of the point. If a child gets redness at the injection site or feels a little off, or has a brief fever, that's a sign their immune system is doing exactly what it's supposed to do. It's building protection. So don't be fearful of this. If your biggest fear is the discomfort of the vaccine, go back and listen to episode 87 that I recorded. It's called Stress Free how to make vaccines easy for your child. I list the specific steps you can take to make getting a shot not hurt, including using topical lidocaine. There are ways to do this. Okay. Aside from that, these are the most common concerns that I hear parents say to me regularly in clinic. The first is the idea that vaccines are overwhelming for a baby's immune system. This is a myth. Babies encounter countless bacteria and viruses every day. Every time they touch something or put their hands in their mouth, like they are literally exposed to thousands of pathogens every day. And Vaccines use a tiny fraction of their immune system's capacity. It's like if you ask an Olympic athlete who trains for hours every day to do just one sit up. It's a tiny task compared to what their body is already handling. Another question I hear is about the vaccine schedule. Why do we have to give so many vaccines so early? Or parents ask me, can I use my own schedule? I mean, okay, yeah, you can follow your own schedule. That's fine. But this schedule is not random. It's carefully designed based on when children are the most vulnerable to a specific disease and when their immune system is going to respond best. Unfortunately, for my second patient with meningitis that I talked about at the beginning of the show, Neisseria meningitis infections, they peak around age 16 to 20. And the immunity to the vaccine doesn't last forever. So in the United States, the vaccine is given at age 11, and a booster is given at age 16, so that we protect kids in the time in life when they are most likely to get the disease. It was just super unlucky that this kid got exposed at age 2 before he was vaccinated. It's just really uncommon in the US to get meningococcal meningitis that young. So some other countries do give this vaccine to infants and toddlers in their routine schedule. Another example of why we have a particular schedule is whooping cough or pertussis, which, as I said before, it can be very dangerous or even deadly for young B. That's why we give the vaccine as early as two, four, and six months, because we need to protect them during those critical first months. When experts design the schedule, they take into consideration how much immune protection a baby will get from their mother before they're born. This is exactly why we give the measles vaccine after a year of age, because they have protection from their mother that can interfere with the vaccine before age 1. The other thing about creating your own schedule is that who has tested your schedule? The schedule that is recommended has been extensively tested for safety with the combination of vaccines that are given at a certain time, and they're also tested for effectiveness. Your own schedule or random combination of vaccines isn't tested. So we just don't know what effects could happen. It's a little bit dangerous. Which brings me to concerns about side effects. What about side effects? Are vaccines really safe? I hear this from parents, too, and this is a great question. The truth is, vaccines are among the most tested medical products we have. They undergo years of research and many clinical trials before they're approved. And if you compare this to over the counter supplements, they do not get any testing. That's why we sometimes hear about strange side effects to supplements, like kids developing breast tissue from being exposed to lavender oil. They're not tested, but vaccines are. So, yes, like any medication, vaccines can have side effects, but they're usually mild. Like you've seen it a sore arm, low fever. Serious side effects are extraordinarily rare. It's far more common to see a bad outcome from getting a disease than to see a side effect. For example, the chance of having a severe allergic reaction to a vaccine is one in a million. Compare that to the risk of the diseases that vaccines prevent. For example, measles can cause pneumonia, brain swelling, and, as you know now, even death. And when you look at the bigger picture, it's safer to get the vaccine and face the tiny risk of an allergic reaction than to take the chance of getting whooping cough because you're not up to date on your TDAP vaccine. All right, the other thing I hear a lot of parents worry about are the preservatives and the ingredients in vaccines. So let me clear that up. Many vaccines contain tiny amounts of things like aluminum salts, which enhance their effectiveness. Aluminum has been used safely in vaccines for decades, and it's actually present in much smaller amounts in vaccines than what we get daily through our food and water. As for mercury, the preservative thimerosal has been removed from all vaccines. The only exception I'm aware of is the multi dose vials of the flu vaccine, but I highly doubt any pediatric practice is using that. They're mostly used in settings where healthcare workers are vaccinating large groups of people at once. I've probably gotten it myself, honestly, and I'm not worried. Many studies have shown that thimerosal is totally safe. In fact, it was only removed to address parental concerns, not because it was dangerous. So today, all childhood vaccines are thimerosal free. So don't worry about this, all right now, are you thoroughly confused or do you feel reassured that vaccinating your child is the right choice? If you found this episode helpful, please share it with parents, with friends, or anyone who feels the need to share their opinions about vaccines. Because the more people who understand the nuances here, the better. For more from the pediatrician next door, find me on the web@ pediatric pediatriciannextdoorpodcast.com if you've got a question about the weird things kids do, send an email to helloediatriciannextdoorpodcast.com for a chance to hear your voice on the show. I'm Dr. Wendy Hunter. And I'm the pediatrician next door. This show is produced by Red rock Music. Make sure to subscribe and leave a review wherever it is you're listening. I'll be back next time with more.