It seems humans have a great deal of trouble learning from history. Either our memories are too short, or we feel history has nothing to offer.
As a Clinical Professor of Pediatrics I am given the honor of teaching residents. These young doctors are eager to learn, but at times are hampered by the same long-term history deficit. Having been in the practice of pediatrics since 1970 my long-term data bank is loaded. Too often my young colleagues forget that meaningful medical research has existed longer than the usual ten year computer generated search of the literature. There are still enough experienced teachers to remind them that useful medical knowledge does indeed extend beyond the 1980's.
The purpose of this article is to tell parents, Wake Up! Let's learn from the past. As a citizen of this planet, I have seen the ravages of polio stopped by the wide-spread use of polio vaccine. As a practicing pediatrician I have experienced the unbelievable impact of the H.influenza meningitis vaccine. This biologic product of medical research has all but obliterated H. influenza caused bacterial meningitis in appropriately immunized children. The lives and disabilities that have been saved by the nation-wide use of this inoculation are astounding.
Now, let us look at chicken pox. A report published in Vaccine Bulletin, #117, July 1998 should open parental eyes to the need of having their children vaccinated against varicella (chicken pox). The Center for Disease Control and Prevention reported that varicella is the leading cause of vaccine-preventable deaths in US children. In the first quarter of 1998 Texas and Iowa claimed the death of three children by varicella related causes. They were all unvaccinated boys, ages 21 months, 23 months and 5 years.
The same CDC report confirmed that between 1990 and 1994, chicken pox was the underlying cause of death for 43 unvaccinated children per year. In addition, between 1988 and 1995 as many as 10,000 children were hospitalized per year for similar related causes. Varicella is not the benign disease we erroneously believe it to be.
The current vaccine is good, free of bad side effects, and grants us long-lived immunity. Our experience with other viral vaccines such as MMR indicates that a booster will be needed. In the future it is conceivable that MMR and the varicella vaccine will be combined; thus, no extra shots will be needed to provide this booster.
Several parents have expressed the idea that they believe in the longevity of immunity granted by naturally acquired chicken pox. To this end they have exposed their young ones to known cases. In the past five years two children in my practice who were purposefully exposed in order to acquire immunity developed varicella encephalitis (brain infection). Fortunately, neither died nor sustained long-term brain damage. However, they spent four weeks in the hospital; 10 - 14 of those days were spent in an Intensive Care Unit. To underscore the severity of their illness, both received assisted ventilation due to nervous system failure and coma. Use of the vaccine could have provided protection against varicella without the severe price the children had to pay, or the guilt born by the parents, which was enormous.
Let us learn from history. Vaccines have saved lives and prevented severe disabilities by the millions all around the world. Put aside the media panic blurted over the air on the dangers of vaccinations. Even if boosters are needed in order to maintain immunity it is of little significance. Remember the sobering statistics previously stated. An average of 43 children per year have died of varicella related causes between 1990 and 1994. That is, 215 youngsters gone because of a now preventable disease. As I said earlier, Wake Up, Parents! Let's prevent needless suffering and death in our children.
(1) Vaccine Bulletin, #117, July 1998 (NCM Publishers, Inc.)
(2) MMWR, 1998; 47 (18): 365-368.