Sunday, November 6, 2016

One pediatrician says vaccines are the most important thing she does; another says providers' recommendations are key

By Melissa Patrick
Kentucky Health News

One of the most important things a provider can do to get children vaccinated is to offer clear recommendations for their parents.

Dr. Ari Brown
So said Dr. Ari Brown, a pediatrician and author of the "411" parenting book series, in Lexington on Nov. 3, the second day of the 2016 Kentucky Immunization Conference.

"The number one reason why (vaccinators) chose to vaccinate is because they trusted their health-care provider," Brown said, citing a study that asked parents who chose to vaccinate why they did so.

Brown said parents need to depend on reliable sources for immunization information when they are making the decision to vaccinate their child, like;;;; or And that providers need to actively direct parents to these sources.

Brown listed several myths that are perpetuated on websites with unreliable sources.

"There is no link between vaccinations and autism," she said, noting that the study that is often cited linking the measles-mumps-rubella vaccine to autism has been proven false and "should have never been published." She noted that the study has been removed from medical literature and the author, Dr. Andrew Wakefield, has lost his medical license.

She also pointed out that thimerosal, a mercury-based preservative that some think causes autism, was removed from vaccines in 2001, but autism rates are still rising.

She said risk factors for autism include genetics, mature parents, closely spaced pregnancies, obesity in pregnancy, taking certain medications during pregnancy, having flu during pregnancy, not enough folic acid, and extreme prematurity.

Brown, who is also a spokeswoman for the American Academy of Pediatrics, said there is no "alternative" vaccination schedule; there is either a recommended schedule or a delayed schedule, and studies show there is no benefit to delay.

"You are delaying your child's vaccine protection. And when you delay shots, you are leaving the most vulnerable children at risk. If your child is under six months of age and they get whooping cough, that is pretty serious," she said. "You are not going to wait to put your child in a car seat for the first six months of life, so why would you wait to protect yourself against these diseases."

Infants are recommended to receive their first dose of pertussis vaccine, in combination with diphtheria and tetanus, at 2 months, 4 months ,6 months and 15 months of age. Another dose is recommended between 4 and 6 years of age. New recommendations call for mothers to get the vaccine during pregnancy, which offers protection to the child until it is old enough to be vaccinated.

Pertussis, or whooping cough, is a highly contagious respiratory disease caused by bacteria transmitted by droplets from sneezing, coughing or close contact. Infected people are most contagious up to about two weeks after the cough begins.

Margaret Jones, manager of the Kentucky Immunization Program, said the state has had 430 confirmed or probable cases of pertussis this year, 150 percent more than all of last year.

Dr. Rebecca Bakke
Also at the conference, Dr. Rebecca Bakke, a pediatrician at Sanford Health in Fargo, N.D., shared her story of infecting her 5-week-old daughter with whooping cough, and spoke of the fear she had for her child because she knew that between 1 and 2 percent of babies infected with the disease die. Her baby survived and is now six.

Bakke, who is also a member of the American Board of Pediatrics and a Fellow of the American Academy of Pediatrics, said she has taken care of a child that has almost died of chicken pox; cared for several children who now have severe brain damage from meningitis; bagged air into the exhausted bodies of babies with pertussis; and cared for many children in the ICU battling the flu. And said that though most children are resilient, "Not all stories have a happy ending."

"I vaccinate children every single day in my office and I know without a shadow of a doubt that it is the most important thing that I do at work. It has the most impact," Bakke said. "Vaccines matter."

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