Parents wonder whether to vaccinate or not


Awareness of the importance of vaccinations is increasing, but Dr. Cheryl Huffman still sees many parents who refuse vaccinating for their children against potentially life-threatening illnesses.

Huffman, a pediatrician at Caughman Health Center, said parents are often eager for some vaccines, but reject others.

“Everyone is clamoring for a Zika virus vaccine,” she said. If one existed, parents would be lined up from here to Toledo to get it, she said.

Still, “Influenza kills kids every single year,” she said. “And parents refuse the flu shot more than any other shot.”

At the time of her interview with The Courier, Ohio had already had four pediatric flu deaths this season. A fifth death was reported in late February.

And it isn’t just children with other medical issues who can die of the flu — otherwise healthy children can contract a serious case of influenza and be “here today and they’re gone tomorrow,” Huffman said.

Huffman had recently had a young couple come in, and encouraged them to get a flu shot for their child. They refused, even though she was sure to tell them there had already been four pediatric deaths in Ohio from flu. Huffman feels she did what she could, but cannot understand how strong the flu vaccine refusal is.

By contrast, fewer parents are refusing the measles, mumps and rubella vaccine.

Parents started refusing this vaccine after a 1998 paper which suggested a link to autism. That paper was completely retracted in 2010, and its researcher was found guilty of ethical violations and scientific misrepresentation.

The word is finally getting out that “Those guys made up all their data,” Huffman said.

She said she used to have to explain this at more length, but parents are no longer refusing it at the same rate.

One shot she always strives to get parents to approve is for pneumococcal bacteria, which can cause meningitis and pneumonia. While a resident, she saw a baby die of pneumococcal meningitis within 24 hours of getting sick.

“You do not forget those things,” she said. “Ever.”

Newly required in Ohio is the meningococcal vaccine, for a different bacteria which can also cause meningitis.

Meningococcal bacteria has a different kind of cell wall, which is part of what makes it so infectious and so quick to spread. It’s not very common but if someone does get sick with it, “It can be absolutely devastating,” causing loss of limbs or death. And if one person gets sick with it, everyone around them might get sick, too, Huffman said.

She said parents do generally comply with the requirement and she can’t recall anyone refusing the meningococcal vaccine.

Parents do tend to refuse Gardasil, a vaccine which prevents genital warts in both boys and girls — and in girls, can prevent forms of cervical cancer.

Huffman said it’s a sexually transmitted virus, and most parents don’t want to think about their children engaging in sexual activity. But the reason they start the vaccine at age 11 is because you need three doses of it. The idea is to make sure children have all three doses before they do become sexually active.

And Huffman said there are definitely times she can tell a child who is her patient wants the vaccine, but the parents are refusing it. It’s not something children want to talk to their parents about, she said.

Huffman said if you are exposed to an illness, your body recognizes the foreign object — such as virus or bacteria — and makes white blood cells to produce an antibody against it. Once you get that antibody, it tends to stay in your bloodstream. It’s your body’s “defense system” against a foreign invader, Huffman said.

Then when, say, “someone sneezes on you at Meijer,” your body already has the defense system built up and fights off the illness before it can overwhelm your body.

Vaccines are almost all made from killed virus, and in almost all cases there is “absolutely no way you could get the disease” from the vaccine, Huffman said.

Another reason the MMR vaccine is refused, Huffman said, is because it is a live virus vaccine, as is the chickenpox vaccine. Generally this is for technical reasons, such as that scientists have not been able to make an effective vaccine with the killed virus. However, even when it is the live virus, it is “this little, weeny dose,” not a dose that will cause illness, she said.

Huffman said every year, it seems like a few more parents are opting not to vaccinate. More common, though, are parents who are willing to vaccinate but would like to split up the shots, delaying the schedule and not having the child receive as many at the same time.

Caughman has available a book for parents to educate them about some of the illnesses preventable with vaccines, and true stories of children who have contracted them.

Huffman tries to educate parents and work with them. If a parent refuses a vaccine, she tries to be “very nonjudgmental.” They do not dismiss them as a patient. She tries to educate them, and said, “I don’t want to alienate the family” so that they never think about it again. Some parents do come around after talking about it, or may agree to get the shots, but say they will do so later.

Huffman has been in practice as a physician for about 18 or 20 years, and said more parents refuse vaccines now than when she started. With medicine in general, not just vaccines, parents are taking more interest in learning the information themselves. Now it’s possible to look things up on the internet, to access information there was no way to get before.

And there is huge attention when a celebrity like Jenny McCarthy speaks out against vaccines.
Parents may worry that it is a foreign body they are putting in their child’s system.

But you have to put “some faith in the system that has been doing these vaccines forever,” Huffman said.

If more than, say, 90 percent of people in a particular area are immunized against an organism, that organism is not prevalent in that area and will not spread. But if fewer people are immunized, there is a much higher chance that that virus or bacteria will take up residence there. This is why there ended up being more measles cases again a few years ago, as there were areas where parents were choosing not to immunize.

And if someone is severely immunocompromised — for example, if they are going through chemotherapy or on high doses of steroids for an illness — they cannot get the vaccine.

But she said she doesn’t think parents understand that if their child doesn’t get immunized, it’s only because their playmates’ parents got their children their shots that it’s less risky for their child.

“If everybody decided to not immunize, all of these things would be back” and would be killing children, she said.

Huffman said people aren’t afraid of things like measles, “but we don’t see it. So we don’t think about it.”

And people respond emotionally to, say, images in the media of babies with microcephaly from Zika. However, although children are dying of influenza, this isn’t as visible in most people’s minds.

She said HiB, in the 1950s, caused severe developmental delays. She hasn’t seen a case of HiB meningitis and prays she never does.

“I think if we could remind people the reason we did this in the first place. … These are the awful things that happened when we didn’t have the vaccine,” she said.

Huffman orders the shots, but it is her nurses who actually administer them. She said they do so very efficiently, and the goal is to get children “back in the arms of their parents to comfort them.”

It’s the 5-year-olds who are the most scared of the shots, but for kids of all ages, it’s “a very, very brief time they’re upset,” Huffman said.

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