Faculty voice:

Kimberly Mitcham: A pediatrician’s view on vaccines

Feb. 11, 2015

Kimberly Mitcham is an assistant professor of health programs in the College of Osteopathic Medicine and a practicing pediatrician who has been treating and vaccinating children for more than 20 years. Prior to becoming a physician, she was a registered nurse at the Mayo Clinic.

You can’t open a newspaper or a social media site today without seeing some story about vaccinations. As a pediatrician, I’m sure this topic is hotly debated in every clinic across the country where providers care for children. As a mother, I have made the decision to vaccinate my own three children, and as a provider I have encouraged other parents to do the same (a question I frequently get asked by parents).

Our dilemma as providers is to encourage families to do research on immunizations from trusted websites. Unfortunately, there is a significant amount of fear mongering and untruths being shared on the Internet from individuals with little or no medical background – the Jenny McCarthys of the world.

Most vaccine misconception originated from a provider named Dr. Andrew Wakefield, a British doctor who claimed there was a link between autism and the MMR (measles, mumps, rubella) vaccine. While this claim has been debunked and he has since acknowledged that this is not true, the damage has been done. Globally, doctors are fighting the information age. While WebMD and other sites help to educate our patients, we are also encountering people who get “untruths” from the Internet, which makes our job becomes significantly harder.

This is no more evident than in the current repercussions of the anti-vaccination movement. I believe this will go down as one of the biggest public health disasters of my time. As providers, we quash one misconception about vaccines, only to see another one pop up. Take for instance vaccine ingredients. We are debating about thiomerisol in vaccinations and the other components of the vaccine being harmful. While the anti-vaccinators argue about the ingredients of the vaccine being detrimental to a child, I ask this question, what about the harm caused by the actual infection?

In a discussion with a family member about the flu vaccine she told me she did not want to put anything harmful in her body. Interestingly, her husband contracted influenza and required steroids, breathing treatments and Tamiflu. I would argue that steroids have adverse effects, and much more documented serious effects, as compared to the flu shot. I chose to get the flu shot for myself.

It sometimes feels like I am on the front lines of a losing war. My personal favorite is the opinion that I get a kickback off the vaccine industry. While I am trying to encourage what I believe to be the very most essential way to keep one’s child healthy, my ethics and character are being called in to play.

Ironically, most people do not know that pediatricians are the lowest-paid physicians in all spheres of medicine. We get no kickback from vaccine sales. We choose this profession because we love kids and want what is best for them. While we may be the lowest-paid physicians, we also have the highest job satisfaction rate across medicine. We advocate vaccines for the simple reason that we know they can protect your child. That is it. There’s no secret agenda behind vaccinating your children. We just want them safe and healthy.

Despite significant medical research behind immunizations and long-term evidence promoting their safety and efficacy, we are seeing record numbers of measles in this country today, despite it being eradicated from the United States in 2000 (a mere 15 years ago!).

The most important piece of information that is most often overlooked is our limitations in the vaccine schedule. MMR is timed to be given at 12 months of age. What happens to the six-month-old who travels with her family to Disneyworld and is now exposed to an incredibly infectious illness like the measles? That baby is now at higher risk of complications from measles. Both that six-month-old and her parents now have no choice in illness. The decision was made for them by someone who did not vaccinate their child and subsequently put others at risk.

This is the whole argument behind herd immunity. Of further concern is the child on chemotherapy. This child is also immune-compromised and at risk for illnesses exposed to him/her by the general public who wish not to vaccinate.

As a mother and as a pediatrician my job is to advocate for children – my children and yours. There is nothing more tragic to me than caring for a child with a vaccine-preventable disease. In my time I have cared for children with whooping cough whose parents opted not to vaccinate and subsequently required ventilator support, as well as children who contracted meningitis. Let me ask you, what is more invasive – an injection of Dtap or a tube being put down a four-month-old’s airway to keep him breathing as he battles pertussis infection?

We will see a continued rise in these diseases if we continue to see vaccine refusals. It is as simple as that. There is a much smaller subset of individuals who CANNOT get vaccinated, either due to allergy in the component of the vaccine or additional medical conditions that make vaccinating contraindicated. This population counts on herd immunity to keep them from being exposed to the very illnesses that they cannot get vaccinated against. This much smaller subset of population is not why we are seeing massive increases in vaccine-preventable diseases, as evidenced by the populations currently getting infected.

I urge families to talk with their doctors about vaccinations. Think about it this way, would you get mechanical advice or plumbing advice from celebrities on the Internet? Of course not, you would take advice from someone trained in repairing your car or your pipes. Then let us reconsider taking advice from Jenny McCarthy about how to keep the most precious thing in your life healthy.

 

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