September 29th, 2016

Why I No Longer Tolerate Anti-Vaxxers

Emily F. Moore, RN, MSN, CPNP-PC, CCRN

Emily F. Moore, RN, MSN, CPNP-PC, CCRN practices pediatric cardiovascular care across the Pacific Northwest.

 

One may ask why I am all of a sudden fixated on vaccines. I have always been a pro-vaxxer. In graduate school, I once prided myself for talking a whole family into getting vaccines. And I certainly have always promoted vaccines when practicing.

But I used to think that the decision to vaccinate, although important, was not mine to make. Parents have their own reasoning, and my job as the clinician was to provide proper education but then support the decision made. Of course, vaccinating my own children was a no-brainer. (Why wouldn’t I choose to protect them from terrible diseases?)

Then my two-year-old was diagnosed with pertussis. The days following were a blur. I was 38 weeks pregnant and desperately trying to get my daughter the help she needed while also praying that my unborn baby didn’t make an early debut. I had always thought that my own children would be protected because they were vaccinated, and if for whatever reason something happened, the high percentage of vaccinated children would provide extra security.
sick_kid-154048047
Here is what happened. My daughter was coughed on while playing at the park. I shrugged it off; kids get sick, and we can’t protect them from everything. About a week later, she developed a terrible cough followed by a high fever. As the days progressed, she developed posttussive emesis and a cough that would stop anyone in their tracks. In the back of my mind, I thought, oh my gosh, she has whooping cough. How crazy would that be though? She’s fully vaccinated. So I chalked it up to a cold and ignored it.

Because I was busy getting my hours in before maternity leave, I had my husband take her to our pediatrician. Our pediatrician called me at work and more or less reassured me that pertussis was not within the differential. She said that our daughter had a bad cough and needed time to recover. I reminded her that I was 12 days away from having a baby and wanted to make sure all was well. So, we made a plan; if the cough wasn’t better in the next 5 days, we would test her.

Well, we didn’t make it 5 days. One day later in the middle of the night, the most heart-stopping cough woke me up. I ran to my daughter’s room and found her gasping (whooping) for air with intermittent bouts of apnea. I yelled to my husband to call 911. By the time he deciphered what I was yelling, my daughter had recovered. She slept with us that night and had two more episodes. The next day we went to urgent care. There, I was belittled and told that there was no way my vaccinated child had pertussis. I mean, after all, she looked perfect in the exam room (doesn’t this always happen?). I must not recognize what croup looks like in a “non-cardiac” baby (cardiology being my practice specialty). To say that this infuriated me is an understatement. Regardless, I was determined to get a diagnosis.

What finally convinced the urgent care providers to send a culture was my advanced pregnancy. However, this, too, was followed with patronizing comments. They wouldn’t even discuss treatment options, stating that they were 99.9% certain that she had croup. I left the appointment thinking I must be crazy.

Later that day I got the phone call — my daughter had pertussis.

A positive culture turned our worlds upside down. We were reported to public health, I couldn’t return to work, my daughter couldn’t leave the house, and everyone in our family needed to be treated. On top of that, the cough continued for weeks. They say pertussis is the 100-day cough, and I can see why.

My daughter catching pertussis, a preventable disease, has been one of the scariest experiences I have had as a parent. Watching her suffer from an absolutely paralyzing cough with apnea was indescribably horrible. This experience taught me two things: First, always listen to parents. They truly know their children best. Second, the decision to vaccinate should not be taken lightly. I will no longer sit quietly when caring for unvaccinated children. I will voice my bias. I once thought I didn’t support anti-vaxxers. Now I can state from experience: I do not tolerate them. If given the choice, I will not treat patients whose parents choose not to vaccinate them.pertussis_infant

 

 

 

44 Responses to “Why I No Longer Tolerate Anti-Vaxxers”

  1. Archie B. says:

    Seems to me that if your daughter was vaccinated properly she would have received her DTaPs, and be vaccinated against pertussis, yet still contracted it. You also speculate how she was infected, NOT knowing if the carrier was vaccinated or not.

    Your article speaks to the “evils” of not vaccinating, but nothing of it’s limitations or risks. That is the issue with much of this conversation about vaccinations. The risks and limitations tend to be downplayed if not totally ignored.

    Please, do NOT take my position as anti-vaccine, I am NOTanti-vaccine. I am PRO-CHOICE. (This is another problem with the discussion as well.)

    One can only how the author frames the discussion about vaccinations; Vaccinate or leave??? Is that really informed consent?

    • Emily Moore says:

      Archie,
      Thank you for your response. You are correct, I am merely speculating how my daughter contracted the disease. Due to the shift to DTaP, it is possible the other child had been vaccinated and was due for his next booster shot. My daughter however being only 2.5, was not due for a booster. This is where herd immunity would have protected her, being in the small percent of children who still get ill despite vaccines.

      My post was more to discuss my own incident with a preventable disease and exactly how disruptive it can be to ones life. Let it be pertussis, mumps or even measles, these contagious disease if contracted have the potential to turn ones life upside down. My daughter is still coughing, taking close to 30 seconds to recover at times.

      I too used to be pro choice. As I stated, my responsibility was to provide the education and support the choice made. Being specialized in cardiology, I do not have the ability to refuse to see a non vaccinated patient. I will however, share my story and ask parents why they have chosen not to vaccinate. If I ever move to a clinic where treating non vaccinated children is a choice, that is where I will enforce my bias.

      Emily

    • Doctor says:

      So you are “pro choice” when the choice is weather or not to expose your own child and someone elses to a potentially life threatening, but preventable disease, but you are “anti choice” when the question is should somebody offering a service be allowed to deny it to somebody who’s putting childrens lives in jeopardy out of sheer stupidity? Do I understand you correctly?

      • Archie B says:

        Human dignity gives all human beings the right to self direct their lives in every situation. There are however consequences. The same is true of the physician, any physician may refuse an unvaccinated patient. That does not mean that they will not face consequences (censure, law suit, loss of license, etc.).

        You may try to argue that being fired from a practice is a consequence of not vaccinating, but that does NOT apply to this situation. First, medicine is suppose to be compassionate, respectful of human dignity, and put the patient first. Would you deny care to someone who injured themselves doing something stupid (like backyard wrestling) or illegal (like running from the police in a car)?

        Furthermore, physicians have a fiduciary duty to the patient. That requires them putting the patient first even at a cost to them. One could argue that firing unvaccinated patients is a breach of that fiduciary duty.

        There is also the issue of liability. If a physician is speaking from a position of expertise, then one would expect that the physician be accountable for those recommendations. Yet, that is NOT so with vaccines.

        Today, with narrowing networks and so many practices closed to new patients, it may NOT be possible for a person to find another provider.

        The sentiment that you are expressing is the AMA’s backdoor to paternalism. In their most recent code of ethics (Principles of Medical Ethics section) ( source:http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/principles-medical-ethics.page ), note numbers:

        VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.

        VII. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.

        These 2 sections allow a physician to ignore patient centered care, informed consent, and shared decision making. (I should not have to explain how this occurs, if I do, then we have a whole set of different problems.)

        The second to last principle is:

        VIII. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.

        If the patient is paramount, then why is this not the first principle?

        Even more than with patients, paternalism gave physicians absolute power free of accountability in society. These are the very words of the AMA (source: http://journalofethics.ama-assn.org/2004/04/msoc1-0404.html ). They want to go back to the days of a self-regulated monopoly.

        What it comes down to is that if physicians want to create policies that exclude unvaccinated patients, they should take responsibility for the side effects of vaccinations.

        Just for the record, I have received all my major vaccines in childhood (polio, MMR, etc.) and 2 years ago got a tetanus. I will not do influenza, pneumococcal pneumonia, or anything that my body can fight off.

        • Doctor says:

          I agree, human dignity gives us the freedom to make our own choices and that freedom does have a price. If an individual decides to act contrary to the interests of society, society is well within its moral right to excomunicate that person. Hence the only logical reaction of society to unvaccinated children is to refuse them anything from daycare and schooling to healthcare. Acting in any other way is in fact condoning this behaviour. Now what the real ethical conundrum here is in the fact that the children are actually the greatest victims of the antivax movement and in refusing them healthcare you are victimizing them all over again, so I would prefer this be settled through termination of custody in the same way it would be if you refused to feed it or treat its illness.

    • Maggie S says:

      Well – you do have the choice of leaving and finding another doctor, right?

    • Dr. B says:

      Unfortunately you have the misguided thinking that vaccines are like any other medication. When a doctor recommends a patient to take an aspirin for primary prevention of a heart attack, the patient is at risk for many complications from the aspirin alone. I dont spend the 15-20 minutes explaining all those risks. Why? Because the benefits outweigh them.
      When a doctor recommends a vaccine (pediatric vaccine), that child and family have a civil duty to get that vaccine. There is a greater risk of a side effect from aspirin as compared to a vaccine. If you think the vaccine schedule is incorrect then set up an experiment and test it. There should be no choice about this issue. Vaccines should be mandatory and I am happy that states are starting to make them mandatory.

      If a patient is not going to believe the evidence regarding vaccines, then why should they believe the evidence behind aspirin or anything else I say? There is more evidence on vaccines. I 100% agree with firing patients who think they know better. As a physician, my practice is evidence-based, so if you don’t follow the evidence I don’t follow you.

    • Frank Baudino says:

      We physicians should recognize that no vaccine is 100% protective. (Consider “efficacy” vs “effectiveness” of the influenza vaccine.) Herd immunity is important.

  2. Max Voysey says:

    Anti-vaxxers are a sure sign of free choice – uninformed, unjustified, with no feedback or consequences – hey, just like voting, smoking, drinking and driving etc etc. Until something happens. Then some people get angry at other’s irresponsibility.
    I might have thought that you would tell this story to every anti-vaxxer and convert them permanently!!??
    .

  3. Nic Weedle says:

    Yes, i agree with the above comment. It is fairly well known of the ineffectiveness of the pertussis vaccine, and that vaccinated children, although asymptomatic, can spread the virus. As a result, an unvaccinated child is no more ‘dangerous’ than a vaccinated child.

    Any ‘protection’ offered by the vaccine only makes them asymptomatic, not protected from carrying and spreading the virus.

    So, in regard to an ‘outbreak’ at an elementary school, for instance, if they really wanted to stop the spread/contain it, ALL children, not simply the unvaccinated should be blocked from attending school, cause the vaccinated children can spread it just as easily as the unvaxxed kids. The main difference is the an unvaxxed kid will be symptomatic if they have the whoop, while a vaccinated child can spread it without anyone being the wiser.

    There is no need to fear or ostracize a family choosing not to vaccinate. As the research shows, most who actively choose not to vaccinate are wealthy, college-educated people, who are more pro-active at chosing a healthy lifestyle, and less prone to having weakened immune systems.

    • David D says:

      Dude, you’re a chiropractor. Why are you even on Journal Watch if you think that getting pertussis is better than the vaccine? People who think like you say getting polio naturally is better than the vaccine too. Oh, and that vaccines haven’t done anything to lower illness rates, it’s just better sanitation.

    • Matt says:

      “As research shows, most who actively choose not to vaccinate are wealthy, college-educated people, who are more pro-active at chosing a healthy lifestyle, and less prone to having weakened immune systems”

      Sources?

  4. James Bogash says:

    You did not mention if you were aware of the research on the pertussis vaccination actually greatly increasing the risk of parapertussis infection (animal study). Was you daughter screened for parapertussis as well?

    It is possible and likely that the pertussis vaccination actually INCREASED her risk of developing whooping cough.

    In addition, the efficacy of the pertussis vaccine has been called into question in all of the recent research, suggesting that vaccination is not even close to as efficacious as we once thought.

    Unlike the vaccine, your daughter is now truly protected against pertussis for many years to come, which was not the case (obviously) with the vaccine.

    It’s great to look at vaccination on the surface, but few are able to articulate the nuances that go along with vaccination from the medical research. I find that few pediatricians actually understand ALL of the research that goes along with the vaccinations they are promoting.

  5. Berta says:

    What’s the last picture supposed to say?!…
    Also can you please share how do you know the other kid on the playard was unvaxxed?… And carrying pertussis?…
    When was you daughter vaccinated agsinst whopping cough?
    Hum… So many unresolved (ignored?…) questions…

  6. John says:

    The more I learn about vaccines and the vaccine business the less I trust them.

    Pertussis vaccines fail all the time.

    Learning about the dangers and perverse financial incentives to providers has made me increasingly distrustful of the medical system and MDs in general.

    • David D says:

      Pertussis vaccine is not one of the most effective ones we have, no. However, it protects a large portion of our children. There aren’t any “perverse” financial incentives to give vaccines.

    • Richard says:

      Spot on!

  7. heather says:

    I will assume you know that the pertussis vaccine is well known by the CDC to be failing in effectiveness
    http://www.foxnews.com/health/2016/01/13/citing-2013-outbreak-in-florida-cdc-says-strength-whooping-cough-vaccine-may-be-waning.html

    http://well.blogs.nytimes.com/2016/02/05/whooping-cough-booster-shot-vaccine/?_r=0
    “Researchers looked at 1,207 pertussis cases among children who had had the acellular vaccine in childhood. The study, in Pediatrics, found that when these children got the Tdap booster, it was 69 percent effective after the first year, then dropped to less than 9 percent two to three years later.”

    it is also known by most Dr.’s who inject people with this vaccine that the virus is live. Most people who catch Pertussis are catching it from nonsymptomatic carriers who were vaccinated. I think your obvious refusal to believe the vaccine could have failed, injured your child.. If your Dr and yourself had instead tested for Pertussis right away your child may have been treated sooner.
    I was born in the 70’s so I had the DTAP does that mean I don’t need more boosters for the acellular Pertussis vaccine? no one seems to care, just inject everyone.

    • Matt says:

      “Most people who catch Pertussis are catching it from nonsymptomatic carriers who were vaccinated.”

      Source please. Otherwise this is just hearsay.

  8. Stephen Campbell says:

    Herd immunity. I vaccinate myself for two reasons: I am less likely to contract the illness and I hope it will be more mild if I do AND I decrease the chances I will infect someone around me. There are real reasons a few can not be vaccinated, for the rest of us: let’s all do our part to protect them. After all, one person driving 60 mph is a school zone is unlikely to be a problem, if we all did it someone would get hurt.

  9. Jennifer says:

    Is it a possibility that the vaccination is no longer working? Why are you blaming anti vaxxers for getting you child sick, when she was fully immunized?
    I am not sure of the logic here

  10. David D says:

    Archie,
    If you don’t agree with vaccination for all (other than true medical exemptions), then are you are anti-vaxxer. Maybe a different degree of one, but one nonetheless.

  11. kristina nadreau says:

    I am 78. I nearly died from pertussis when I was 8 years old. I was starving from the constant coughing and emesis. I can still vividly recall gasping futilely for breath during episodes of paroxysmal coughing. I was an only child in an affluent, highly educated family who were doing all possible for my recovery..

    I am waiting to hear the data, real confirmed data, not anecdotal speculation, about the the adverse effects of vaccines. I know of none that support any part of the stance of the anti-vaxxers.

    This is not about choice because the children who get these diseases do not make the choice to vaccinate or not. The vaccinated parents decide that vaccines are not right for their child(children). In my own anecdotal experience I have noticed that the adult antivaxers have all been vaccinated and thus are able to minimize the incidence and consequences of the “childhood diseases”.

    I also have zero tolerance for antivaxer rants and practices.

  12. frank says:

    what’s interesting about this article is how the nurse commands us to “listen” to the parents at all times, except when they disagree with her

    I am 100% supportive of vaccination, but appeals to emotion like this (i only changed my mind because i went through a stressful experience) risk inviting similar stories from angst ridden anti vaxxers

  13. Arthur says:

    I am a retired Infectious Disease sub-specialist who also practiced Internal Medicine in a major metropolitan area.
    We know about the limitations of vaccines and can understand your frustration at physicians who don’t understand that vaccines are very rarely 100% effective.
    However I must chide you for shirking your responsibility as a health professional: you don’t have the luxury to get to decide who you are going to treat or not treat.
    Your professional obligation is to serve those who need our services, without regard to their politics, beliefs, lack of knowledge or prejudices.
    Please reconsider your last sentence, ” If given the choice, I will not treat patients whose parents choose not to vaccinate them.”

    • Holly H. says:

      I support the decision to “fire” anti-vaxxers. Let me explain why.

      I have a duty, no only to my own children, but to other patients in my practice who are either too young to be vaccinated or who have illnesses and/or are on medications that contraindicate receiving vaccines. While no vaccine is 100%, they are better than no protection at all. Since the majority of my patients DO choose to vaccinate, why would I ask them to increase the risk of disease by forcing them to share waiting room space with non-vaxxers? I should reward the desirable behavior by accepting my responsibility to make my office environment safe.

      Enter also the new-ish field of behavioral economics (https://www.behavioraleconomics.com/behavioural-economics-and-healthcare-a-match-made-in-heaven/ , https://obssr.od.nih.gov/a-healthcare-revolution-behavioral-economics-for-behavior-change-and-preventive-medicine/) ….the basic tenet is that “People are irrational, but in predictable ways.” If you have any understanding of data and statistics, you know that the choice not to vaccinate is irrational. But there are predictable ways to modify that choice…. putting in place the threat of having to change providers unless their child is vaccinated caused the vast majority of non-vaxxers n our practice to change their minds… they are now getting vaccines! The 20+ years that I struggled to educate people on risks did not “convert” anyone! It was only when the negative consequence became immediate that people were willing to make a better choice.

      So oddly enough, the threat of excluding non-vaxxers actually IMPROVED medical care and vaccination rates.

      (PS I will not even dignify pseudo-data about the risks of vaccines or conspiracy theories about monetary kickbacks with my time. Some stuff is so patently ludicrous that I can’t waste my time one it.)

  14. Frank says:

    As other readers have pointed out, you do not know how your daughter was exposed to the pathogen that caused her pertussis. However, given that pertussis is a highly contagious illness, it seems likely that, due to the initial failures of the physicians that you consulted to diagnose your daughter’s pertussis, your vaccinated daughter a) was likely responsible for infecting several other people (who then blamed unvaccinated children?), and b) experienced more severe symptoms than if she had been treated in the first two weeks after symptoms appeared (according to the CDC).

    We experienced a similar problem; my (fully vaccinated) son developed a highly unusual cough, for which we repeatedly sought help from his doctor and called 911 twice. The doctor said he couldn’t have pertussis since he was vaccinated. By the time he was finally diagnosed, a visiting out of town (fully vaccinated) relative had developed the cough and had boarded a plane to return home. I wonder how many people were infected in that scenario due to the failure to diagnose?

    Given that failure to initially diagnose has been cited as a problem in pertussis outbreaks, maybe a robust nationwide physician education program encompassing differential diagnosis of pertussis (eliminating vaccination status as a consideration in diagnosis) and noting the variable effectiveness of vaccines would help reduce pertussis outbreaks?

    • Emily Moore says:

      Frank,
      I agree, if it is common knowledge the pertussis vaccine is not effective, providers should move this diagnosis to the forefront of their differential. Failure to diagnose was a clear issue here. Without advocating for my daughter, I question how long she would have gone untreated and exposing multiple people to the bacteria.

      Thank you,
      Emily

  15. Joe says:

    The AAP has addressed this issue and recommends that we do not dismiss patients from our practice who do not vaccinate. The AAP(and I personally) strongly believes in the benefits of vaccines. If we do not see a patient who’s parents choose not to vaccinate then we loose an opportunity to develop a relationship and then over time educate them and help them understand the benefits. If we refuse to see/”fire them” then we may feel like we are taking a stand, but really all we have done is let them go to another provider who may not be as interested in taking the time to build that relationship and educate about the benefits of vaccines. We are not seeing an innocent patent, who needs care, because of the parents choice. We are that child’s advocate, and as long as we can keep that relationship going there will be future opportunities for understanding and dialogue.

  16. Bryan Cebuliak says:

    http://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1004138
    A Change in Vaccine Efficacy and Duration of Protection Explains Recent Rises in Pertussis Incidence in the United States

    This paper confirms my anecdotal observation over 35 years of general practice that since the change from whole cell to acellular pertussis vaccine there has been a dramatic increase in whooping cough. Third trimester vaccination in all pregnancies is now recommended by authorities here in Australia. Due to their poorly effective product there is more sales for the vaccine manufacturers.

  17. Elizabeth Smith says:

    While I truly feel sorry for the experience you & your daughter endured, vaccination is NOT the issue here. Pertussis has been a cylic disease in the US for decades, and the rate of disease has actually been rising since the 1970s. There are many factors at play here, but the biggest factor is that there is a substantial reservoir of disease in adolescents & adults, who may develop subclinical disease despite vaccination. And as previously mentioned, the effacacy of the acellular pertussis vaccine is just not that good. Bottom line, there is a lot of Pertussis around. I fully support vaccinations, but we have to understand the science behind their use. Your child was likely infected by an unsuspecting adult with a cold, not an unvaccinated child.

  18. Anne Arikian says:

    I agree with you 100% Emily. I’m so sorry for what your daughter and family had to endure. Parents who don’t vaccinate their children readily admit to their own selfishness and are just hoping enough of the rest of us will do the right thing so they don’t have to worry about their kids dying. I have no tolerance for these families in my practice either.

  19. Jesse says:

    As other commentators have noted, appeals to emotion are not useful. While I can sympathize with how difficult the situation you experienced must have been, the evidence suggests that the rise in pertussis cases has nothing to do with children not being vaccinated and mostly to do with the switch from whole cell vaccines to acellular vaccines. No one should take my word for that, of course. Feel free to read up on this matter from the CDC:

    “As long as currently available acellular pertussis vaccines are in use, it is likely that the “new normal” will be higher disease incidence throughout pertussis cycles.”
    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6348a2.htms_cid=mm6348a2_x

    “There are several reasons that help explain why we’re seeing more cases as of late. These include: increased awareness, improved diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity… When it comes to waning immunity, it seems that the acellular pertussis vaccines (DTaP and Tdap) we use now may not protect for as long as the whole cell vaccine (DTP) we used to use. Throughout the 1990s, the United States switched from using DTP to using DTaP for babies and children.”
    http://www.cdc.gov/pertussis/about/faqs.html#increasing

    “Even though children who haven’t received DTaP vaccines are at least 8 times more likely to get pertussis than children who received all 5 recommended doses of DTaP, they are not the driving force behind the large scale outbreaks or epidemics.”
    http://www.cdc.gov/pertussis/about/faqs.html#travelers

    “Since pertussis spreads so easily, vaccine protection decreases over time, and acellular pertussis vaccines may not prevent colonization (carrying the bacteria in your body without getting sick) or spread of the bacteria, we can’t rely on herd immunity to protect people from pertussis.”
    http://www.cdc.gov/pertussis/about/faqs.html#immunity

  20. Penny says:

    Congrats on publishing this very personal story. When I was a baby I contacted pertussis even though I was vaccinated and my parents experienced the same horrific experience during my illness. No intervention is 100% foolproof and a small minority of children may not respond to a vaccine thus herd immunity by vaccinating all children is very critical! I am now a physician and even though I am practicing an adult subspecialty I always take the time to educate patients and their families of all ages on the importance of vaccines. Ignorance is dangerous for all of us. A habit that endangers the rest of society should not be encourages and frankly yes, tolerance should not be an option. This is not a personal decision for each family. It is not choosing the color of your child’s bathing suit in the swimming pool. Freedom’s limit is where the other person’s rights start.

  21. Emily Moore says:

    Thank you all for your insightful responses.
    In regards to my knowledge of the DTaP vaccine being acellular, herd immunity, my speculation as to how my daughter contracted the virus and her age, please see my previous comment.
    Similarly, please refer to my first comment in regards to why I decided to share this story.

    I appreciate the comments and discussions this post has generated.

    Emily

  22. Jim Keffer says:

    I’m sorry your daughter went through that experience with pertussis. Sadly, pertussis is one of the least well performing of all the vaccines we give. In my practice, many of our doctors and nurses have had to take post-exposure prophylactic medicine after being exposed to our patients when they get pertussis. This despite the fact that we are all immunized.

    Regarding not tolerating those who don’t vaccinate, how does that look in your practice? Do you ask parents to leave? Do you have them sign something saying that they’ve declined a vaccinating their child against a potentially disabling or deadly infection?

    If so, do you do that when they turn down flu vaccines, the HPV vaccines, or just the primary infant/young child series?

    Take care.

    • Emily Moore says:

      Jim,
      Thank you for your response. Please see my first comment regarding anti-vaxxers in my clinic. It is only the primary infant and young child vaccines that I am concerned about. Although I promote the seasonal flu vaccine as well as HPV vaccines, I do not feel the same about receiving them.

      Emily

  23. Dr. John says:

    This story and the subsequent comments underline many of the increasing difficulties vaccines face. After 35 years as a public health physician, I now try to resist joining these fruitless discussions (you will probably notice I failed in this case).

    Vaccine deniers must not be ostracized. They will congregate in self-selected groups where infection more frequently and spreads to the larger community. See the outbreak history of Waldorf (Steiner) schools, and small religious sects who oppose vaccine for many contemporary examples.

    They will also, at the individual level, seek alternative practitioners, rather than allopathic clinicians, for other care. This will occasionally lead to hideous, avoidable tragedies, as happened in Alberta, Canada, where the well-meaning, misguided parents of a toddler were recently convicted of failing to provide the necessities of life to their son dying of meningitis.

  24. Paul Terrill says:

    I’ve had the experience of following a pregnancy to term, delivering the infant, and then being on duty in the ER 10 weeks later when the infant arrived DOI from H. flu sepsis. That child did not have the choice of whether or not to be immunized. Res ipsa loquitur.

  25. Alex says:

    “Primum non Nocere.”

    Any physician that tolerates anti-vaxxers communicates to anti-vaxxers that it’s ok to not vaccinate, and is no physician at all.

  26. James Costello, PA says:

    Our practice has decided to continue providing care to children regardless of the position of their parents regarding vaccination. These children still need medical care. Also

    • James Costello, PA says:

      Continuing comment: also, some parents will change their minds after continued discussion of vaccines. Removing them from the practice cuts off any further discussions and possible change.

  27. Catherine says:

    The CDC’s own pertussis FAQ page states that pertussis vaccine cannot produce herd immunity. The FDA released a study in 2013 showing that vaccine recipients of the acellular pertussis vaccine were still susceptible to infection with pertussis when exposed in the community. After exposure and infection, these fully vaccinated, silent carriers harbored the bacteria in their throats for up to six weeks and spread the infection to vulnerable populations.

    Whooping cough is a horrible illness and I’m so sorry your daughter was infected at such an untimely season in your life. It seems to me that your being a clinician, you should know what the latest research about pertussis vaccine says. And it does not prevent infection or transmission of the bacteria, unfortunately. Your daughter’s case cannot be blamed on people who choose not to vaccinate.

    From the CDC link: “Since pertussis spreads so easily, vaccine protection decreases over time, and acellular pertussis vaccines may not prevent colonization (carrying the bacteria in your body without getting sick) or spread of the bacteria, we can’t rely on herd immunity to protect people from pertussis.”

    https://www.cdc.gov/pertussis/about/faqs.html

    https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376937.htm

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