Total Health Radio

Childhood Vaccinations

Podcast published: January 22, 2014



Three kids laughing and playing with a wagon in a park

As a parent, there is nothing we feel so strongly as the need to keep our children safe; not knowing how to best do that can be challenging.  On the topic of childhood vaccinations, there are countless articles to be found on the Web – and for every recommendation for a certain vaccine, there also seems to be a warning.  Today’s show explores the myths and realities of childhood vaccines and presents what should be considered as you make your decision on vaccinating your kids.

About the Guest
Matthew Daley is a pediatric health services researcher with the Kaiser Permanente Institute for Health Research and a practicing pediatrician for Kaiser Permanente in Denver.

Episode Host
Joyce Gottesfeld, MD, is an OB/GYN with Kaiser Permanente Colorado, where she’s worked 17 years. She’s a wife, proud mother of three girls, runner and blogger. Read more about Dr. Gottesfeld.

Learn More
Additional information on childhood vaccines can be found at the following links:


Transcript
DR. GOTTESFELD:  Welcome to Total Health Radio. I’m your host, Dr. Joyce Gottesfeld. Every year thousands of children are affected by illnesses that could be avoided, but for many parents the decision of whether or not to get their child vaccinated is a challenging one. We’re joined by Dr. Matthew Daley. Dr. Daley is a researcher with the Kaiser Permanente Institute for Health Research and a practicing pediatrician. He is an expert in the field of immunization safety. He’s here to talk about the myths and realities of childhood vaccinations. Thanks for joining us today, Dr. Daley.

DR. DALEY:  Thanks for having me.

DR. GOTTESFELD:  Are vaccines beneficial?

DR. DALEY:  Vaccines certainly are beneficial, and often in the conversation that I have with parents, we talk about the benefits and the risks at the same time. But in terms of the benefits of vaccinations, the diseases they prevent are very severe, life threatening, and in an era before vaccination they caused a lot of childhood deaths. So the benefits are certainly there for each of the recommended vaccinations on the schedule.

DR. GOTTESFELD:  Like what are some diseases that we’re now safe from that we were victims of not that long ago?

DR. DALEY:  Well, you know, the list of diseases that are vaccine preventable grows every year, and that’s a great achievement. But ones that come to mind for me, as a pediatrician, are things like HIB, which is Hemophilus type B. That’s kind of a mouthful, but it causes meningitis, pneumonia, blood stream infections, and we just don’t see HIB causing those things at all anymore. Another is pneumococcal disease; pneumococcus is another type of infection that also causes meningitis and blood stream infections and pneumonias, and we also don’t see that very much. There are other types, but we don’t see the ones caused by HIB or caused by pneumacoccus. But the list is pretty long. Pertussis we see less of, although we’re seeing a resurgence in pertussis now. Diphtheria, tetanus—so many of these diseases that were quite common are really quite rare in the United States now.

DR. GOTTESFELD:  I think back to a teacher I had in—for seventh grade English, and he had been injured by polio, and that was really common when he was a kid growing up. And I mean, you never even hear about that anymore.

DR. DALEY:  Yeah, and polio’s almost eradicated from the world; there’s just a few hundred cases a year. But that’s really due to vaccination. And in the pre-vaccination era, every summer kids would be permanently paralyzed from polio here in the United States.

DR. GOTTESFELD:  Well, let me ask you this, Dr. Daley. Are vaccines safe?

DR. DALEY:  Well, that’s a great question, but that’s a complicated question. Vaccines are one of the safest things that I do in my day, and they’re also one of the most well-studied. So because we give vaccines to the whole population, we give it—we certainly try to give it to every child born in the United States. Then it has to be incredibly safe because everybody gets it. And you’re giving it to healthy people, so it really has to be that safe. So vaccines can cause serious side effects; they can cause serious allergic reactions. But fortunately, that happens very rarely—less than one in a million for most vaccines.

DR. GOTTESFELD:  So why are people afraid or hesitant to vaccinate their kids?

DR. DALEY:  Well, I think there’s a—there’s a lot of reasons. And the reasons probably differ from family to family. But I think at its heart, these families want to do what’s best for their child. And they see a child who’s perfectly healthy, and so then they think, is there any harm that I could do to my child by giving them vaccines? So they’re really concerned about the potential harm of vaccinating.

DR. GOTTESFELD:  Right.

DR. DALEY:  And then there’s been a lot of misinformation that suggests that the risks of vaccines are quite a bit higher than they really are. So, I think parents’ biggest concern about vaccines is about their safety.

DR. GOTTESFELD:  You hear about that vaccines cause autism; I think that’s out there in the media a lot. Is that true? Do vaccines cause autism?

DR. DALEY:  Vaccines don’t cause autism, and fortunately, we have a lot of information that supports that point. There’s been more than a dozen studies done in a dozen different countries that come to the same conclusion. But boy, that’s a complicated thing, cause once that seed of fear is planted in parents’ minds, it’s hard to remove that as a fear. And it’s partially because autism is great concern that parents have, understandably. Autism’s diagnosed often between 12 months of age and 36 months of age, and that’s at a time where children are certainly receiving vaccines. And so then to have this diagnosis happen after somebody’s received vaccines, then it’s understandable that the parents would think, “I wonder if there’s some connection.” And one addition point is that the original study that showed a relationship between MMR and autism was found to be fraudulent in all ways, shapes and forms.

DR. GOTTESFELD:  Yeah, I read that. I heard about that. So why do we have to give all the vaccines to kids who are so young?

DR. DALEY:  I mean, that’s another great question, Joyce. And you know, you see a little baby who’s two months old, looks perfectly healthy, and there’s a couple things as a parent that you feel—and I have kids of my own, and so I can sympathize with this. One is, you don’t want any harm to come to them right now, and you know that the needles are gonna hurt, so there’s that. And then also there’s just this general perception—they’re pretty vulnerable. And you’re there to protect them about everything; every decision you make is about your child’s wellbeing and safety. You’re putting them in their car seat, you’re making sure they’re buckled in, you’re making them sleep on their back—all those things are about their safety. And so then, as a parent you think, you know, “Is this really necessary, and is it really safe?” So, very understandable questions. But, the timing of the vaccines is critical, and it’s critical because infants’ immune systems are immature. They’re immature for a couple reasons. One is that they’re not fully developed, and the second is that they haven’t had a lot of practice. They haven’t been exposed to a lot of things. And so because of that, many of the diseases that we vaccinate against are worst in the first 12 months of age. Pertussis is an excellent example of that. Pertussis in an adolescent or an adult is a very bad cough, but an adolescent or an adult wouldn’t die form pertussis, in most circumstance. But an infant, a one-month old that gets pertussis can die from it.

DR. GOTTESFELD:  One of our physician partners, as well as maternal medical medicine doctor, a high-risk pregnancy doctor, they both had kids who got pertussis before two months of age-within, I think, a week of life, and almost died. It was very, very scary.

DR. DALEY:  Yeah, I mean, it’s very scary. And I, you know, just hearing you say that story gives me chills, cause I’ve seen babies like that who I’ve been taking care of, and I’ve watched them stop breathing, and we need to resuscitate them. It’s entirely understandable and appropriate for parents to ask, do we need to give vaccines to infants? Because they appear so vulnerable, and we don’t want to do any harm to them. But these diseases are at their worst at those ages. Pertussis is just one example. Pneumacoccus causes quite a bit of meningitis in the first year of life. HIB causes quite a bit of meningitis in the first year of life. And infants who get meningitis often don’t fully recover, ever, for the rest of their life they’re left with deafness or developmental disabilities, or they may die from meningitis. And so the timing is really critical, cause we’re trying to protect these infants when they’re at most risk.

DR. GOTTESFELD:  So you make a very good case, but can you talk me through a conversation you might have with a family who might come in initially, and they’re opposed to vaccinating their children? Tell me about the kind of conversation you would have with them about this.

DR. DALEY:  It’s critically important to have that conversation with parents who are hesitant. And what I try to do is understand where they’re coming from. Really, in my mind, we’re not trying to scare as much as to inform. And to collaborate, really. And so if a parent comes in and says, “I have concerns about vaccines,” then what I want to do is I want to hear from them why—why are they concerned? What are they concerned about? Where are they getting their information from? And then I’ll just try to provide as factual information as I can about whatever their question or concern is. And I also try, in that context, to not pretend that there aren’t potential side effects with vaccines; I just want to help them understand how rare those side effects are. Based on all the information we have, the benefits strongly outweigh the risks.

DR. GOTTESFELD:  Can you just mention something about being part of a family and maybe you have other young kids at home, or maybe the mom’s pregnant—how does the discussion about immunizing a child change when there are those factors to consider, the other kids or being around a pregnant woman or something like that?

DR. DALEY:  So immunizing a child doesn’t just protect them, but it protects the community around them. Immunizing a child will protect a pregnant mom in the house; it’ll protect maybe the elderly in the house. Interestingly, the rates of pneumococcal disease in the elderly have gone down since we’ve been immunizing infants and young children.

DR. GOTTESFELD:  Wow!

DR. DALEY:  And so it’s really the community—it’s their grandparents that they’re protecting. And then in the case of a pregnant mom in the house, immunizing a child can potentially protect her from getting something during pregnancy that could infect the baby in utero and cause some pretty significant problems.

DR. GOTTESFELD:  That’s really interesting. Anything else you want to add on this? It seems like we could talk about this for a really long time.

DR. DALEY:  Well, it’s a complicated issue, but I think it’s pretty understandable. If I didn’t have the medical training that I do, I think I’d have some concerns about vaccines, just like many parents do. And I think my suggestion to both parents and doctors is that they kind of need to meet each other half way. And I think the parents need to really bring up their questions and concerns, but also we, as doctors, need to be clear in our message, that we think vaccines are safe, and we think they’re very beneficial, and we think that the benefits strongly outweigh the risks.

DR. GOTTESFELD:  Well, thank you, Dr. Daley, so much.  It’s really nice to talk to you about this topic, and I really appreciate all of your good information.

DR. DALEY:  Well, thanks so much for having me.

 

This show is for educational purposes only. If you have specific health concerns, you are encouraged to address those with your personal doctor. And as always, if you’re having a health emergency, please call 9-1-1 or go to the nearest emergency department.