>> ARE VACCINATIONS REALLY NECESSARY?
>> I I THINK THAT VACCINES ARE STILL NECESSARY FOR THREE REASONS:
THE FIRST REASON THAT VACCINES ARE NECESSARY IS THAT FOR COMMON
DISEASES LIKE, FOR EXAMPLE, CHICKEN POX,
A CHOICE NOT TO GET A VACCINE, IS A CHOICE TO GET THE DISEASE.
>> IN MOST CASES, IT'S A MILD DISEASE.
IN SOME CASES, IT'S NOT.
AND IT'S IN THAT--IN THIS SETTING IN THE EMERGENCY DEPARTMENT
THAT WE MIGHT SEE PATIENTS WHO HAVE MORE SEVERE CASES
OF CHICKEN POX.
>> MY HUSBAND AND I DIDN'T REALLY KNOW.
SUNDAY WE JUST KNEW THAT JONATHAN DIDN'T FEEL WELL.
YOU KNOW, HE COULD MAYBE WALK ABOUT THREE OR FOUR STEPS,
AND THEN HE WOULD JUST DOUBLE OVER IN PAIN GOING,
"MOMMA MY BELLY HURTS.
I JUST CAN'T WALK ANYMORE."
>> THESE ARE ALL CHILDREN WHO VERY QUICKLY WENT FROM BEING
WELL TO ILL WITH COMPLICATIONS FROM CHICKEN POX,
COMPLICATIONS OF PNEUMONIA, OF SERIOUS SKIN INFECTIONS,
OF ATAXIA, AND IMBALANCE, FROM AN INFLAMMATION OF THE BRAIN,
FROM A SERIOUS SEPSIS SYNDROME WHERE THEY REQUIRE
INTENSIVE CARE UNIT.
>> THE DOCTORS HAD SAID WHAT HAPPENED TO JOHN WAS HE WAS
BASICALLY INVADED.
HIS BODY WAS INVADED.
THE REASON--ONE OF THE REASONS WHY HE COULDN'T WALK WAS BECAUSE
HIS COLON WAS LINED WITH THE CHICKEN POX.
AT THE HOSPITAL WHEN THEY PUT A BREATHING TUBE DOWN HIM,
BLOOD WAS COMING OUT AND THEY COULDN'T FIGURE OUT WHY.
WHEN DOCTORS SAID, BASICALLY, JONATHAN BLED TO DEATH BECAUSE
NOTHING WOULD, YOU KNOW, NOTHING WOULD STOP THE BLEEDING.
>> THIS IS A MILD DISEASE, IN GENERAL.
BUT FOR A SMALL GROUP OF CHILDREN, IT CAN BE A DEVASTATING DISEASE.
>> I WENT IN AND SEEN HIM AFTER HE HAD DIED.
AND I JUST TOLD HIM TO SAVE ME A SEAT, YOU KNOW.
I DON'T GET TO KISS HIM GOOD NIGHT.
I DON'T GET TO GIVE HIM A HUG.
CHILDREN ARE SUPPOSED TO BURY THEIR PARENTS.
IT'S NOT SUPPOSED TO BE THE OTHER WAY AROUND.
>> WHEN I SEE PARENTS COME INTO THE EMERGENCY DEPARTMENT WITH
THESE COMPLICATIONS IN THIS ERA, WHEN THERE'S A VACCINE AVAILABLE,
IT'S SAD IN SOME WAYS, AND IT ALSO MAKES ME THINK
THAT WE MISSED THE BOAT AS PEDIATRICIANS.
>> BEFORE THE CHICKEN POX VACCINE WAS FIRST AVAILABLE
IN 1995, CHICKEN POX KILLED 50 AMERICAN CHILDREN
AND HOSPITALIZED OVER 7,000 EVERY YEAR.
>> THE SECOND REASON THAT VACCINES ARE NECESSARY IS THAT
SOME DISEASES KIND OF SMOLDER BELOW THE SURFACE LIKE MEASLES
OR MUMPS OR GERMAN MEASLES OR HAEMOPHILUS.
AND IF WE CHOOSE TO LOWER IMMUNIZATION RATES,
EVEN BY JUST A LITTLE, WE RUN THE RISK THAT THERE WILL BE,
AGAIN, OUTBREAKS OF THOSE DISEASES IN OUR COUNTRY.
AND WE NEED ONLY LOOK BACK ABOUT 10 YEARS AGO WHEN BETWEEN 1989
AND 1991 WHEN WE HAD IMMUNIZATION RATES AGAINST
MEASLES OF ABOUT 70%, WE HAD SWEEPING OUTBREAKS OF MEASLES
ACROSS THIS COUNTRY.
>> PHILADELPHIA WAS NOT ONE OF THE FIRST CITIES TO HAVE A MAJOR
MEASLES EPIDEMIC.
LOS ANGELES, CHICAGO, AND OTHER MAJOR CITIES HAD IT A YEAR BEFORE.
SO WE KNEW IT WAS COMING.
WE WERE ACTUALLY ADVISING PARENTS BEFORE MEASLES HAD
ENTERED PHILADELPHIA THAT IT WAS COMING AND THAT CHILDREN,
ESPECIALLY PRESCHOOL CHILDREN, NEEDED TO BE IMMUNIZED.
THE MESSAGE WENT TOTALLY UNHEEDED; TOTALLY.
>> MEASLES DOESN'T JUST HIT THE SKIN.
IT, BASICALLY, HITS EVERY ORGAN SYSTEM.
SO THERE'S VOMITING, DIARRHEA, AND DEHYDRATION AS WELL.
AND THEN THE COMPLICATIONS OF THE MEASLES, THE EAR INFECTIONS,
THE PNEUMONIA, THE SEIZURES
>> EVERY DAY WE WERE GETTING 30, 40, 50 CASES OF MEASLES CALLED INTO US.
AND EVERY CASE REQUIRED THAT WE INVESTIGATE TO CONFIRM
THE DIAGNOSIS TO IDENTIFY SUSCEPTIBLE PEOPLE AROUND
THE CASE AND TO WORK TO TRY AND GET THEM PROTECTED.
I GOT A CALL AT 2:00 O'CLOCK IN THE MORNING FROM
THE MEDICAL EXAMINER TELLING ME THAT A CHILD DIED FROM MEASLES.
AND THEN AT 5:00 O'CLOCK IN THE MORNING I GOT A SECOND CALL
TELLING ME A CHILD DIED FROM MEASLES.
AND I SAID, WELL, I ACTUALLY GOT THAT CALL 3 HOURS AGO.
AND THE MEDICAL EXAMINER TOLD ME, "NO, THIS IS A SECOND CHILD WHO DIED."
>> IT WAS LIKE, "WHY IS THIS HAPPENING?
HOW COULD A DEVELOPED COUNTRY THAT HAS THE FACILITIES,
HAS THE EXPERTISE, HAS THE MONEY TO PREVENT THESE DEATHS.
HOW COULD THIS POSSIBLY BE HAPPENING HERE IN PHILADELPHIA?"
>> WHEN THE MEASLES EPIDEMIC WANED IN THE SPRING OF 1991,
WE WERE ABLE TO DOCUMENT OVER 1550 CASES OF MEASLES IN THE CITY,
AND THERE WERE 9 CHILDREN WHO DIED FROM THE MEASLES.
>> THE THIRD REASON THAT VACCINES ARE NECESSARY IS THAT
FOR DISEASES LIKE POLIO OR DIPHTHERIA,
WHICH HAVE BEEN EITHER COMPLETELY OR VIRTUALLY
ELIMINATED FROM THIS COUNTRY, THEY HAVEN'T BEEN ELIMINATED
FROM THE REST OF THE WORLD.
>> BEFORE GOING TO INDIA, I WAS UNDER THE IMPRESSION THAT POLIO
WAS BASICALLY NO LONGER A PROBLEM IN THE WORLD.
AFTER GETTING OFF THE PLANE IN DELHI AND TAKING A TAXICAB INTO
THE HOTEL, POLIO WAS APPARENT ON THE STREETS.
WE COULD SEE WHAT ARE KNOWN IN INDIA AS "CRAWLERS,"
PEOPLE WITH POLIO HAVING NO WHEELCHAIRS,
NO CRUTCHES, PULLING THEMSELVES ALONG THE GROUND AND BEGGING.
SO PARENTS IN INDIA ARE VERY EAGER TO GET THEIR KIDS VACCINATED.
BY CONTRAST, PARENTS IN THE UNITED STATES HAVE FORGOTTEN
THAT POLIO IS A PROBLEM.
>> AND LET'S FACE IT, THE WORLD'S JUST NOT THAT BIG ANYMORE.
INTERNATIONAL TRAVEL IS COMMON, AND WHEN PEOPLE TRAVEL,
THE GERMS THAT INFECT THEM, TRAVEL WITH THEM.
RECENTLY, THERE WAS A LITTLE GIRL WHO CAME INTO CANADA WHO
WAS INFECTED WITH POLIO.
SHE WAS INFECTED WITH POLIO BECAUSE SHE'D RECENTLY BEEN
IN A PLACE WHERE POLIO INFECTIONS WERE OCCURRING.
NOW, SHE WAS VERY CONTAGIOUS TO THOSE PEOPLE IN CANADA.
BUT THE PEOPLE IN CANADA DIDN'T GET INFECTED BECAUSE THEY WERE
VACCINATED WITH THE POLIO VACCINE.
BUT IF THEY HADN'T BEEN, THE POTENTIAL FOR AN OUTBREAK
OF POLIO WAS THERE.