GUEST ESSAY: Vaccines have given children future they deserve

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By Dr. Kathleen Braico

I’m a retired pediatrician. I have wonderful memories of sweet children, families, smiles, triumphs and tragedies throughout my career, but there are experiences that still haunt me.

I remember sitting by a child’s bedside with a drug designed to reduce the swelling in the brain. I was an intern, fresh out of medical school. She was an infant from the Amish community who didn’t get their children immunized.

She had measles encephalitis.

The virus invaded her brain and the resulting swelling threatened to kill her. Although we used the drug repeatedly, it failed, and before dawn appeared that beautiful little girl was dead.

She was dead from a disease that even then in the 1970s could easily have been prevented with the MMR vaccine.

In the same hospital at the same time another Amish child was dying from measles pneumonia. My husband sat by that bedside and watched him die in spite of all that medical technology could do. Although those events occurred 50 years ago, medicine would not be able to save those children today either, only vaccines can do that.

Representatives from drug companies visited my office regularly, usually trying to get us to try their latest medication. One day a new rep visited offering a vaccine against a bacteria called “HIB” which caused multiple dangerous infections such as meningitis, pneumonias, bone and soft tissue infections and another called epiglottitis.

It is a disease which causes the epiglottis—the flap that covers the vocal cords when you swallow—to swell and obstruct the airway. Airway occlusion happens suddenly and irreversibly. Victims need emergency placement of a tube placed in their airway or a tracheostomy opening cut into their trachea in order to breathe.

I was particularly interested in this young drug rep, as she had a telltale scar in her neck. Indeed, she had had epiglottitis as a child and the scar was from the emergency tracheotomy that saved her life. When the “HIB” vaccine became available in the 1980s. it saved countless children’s lives. In fact, on the Glens Falls Medical Mission trips I went on to Guatemala we brought the "HIB" vaccine with us to give to children there, and the young drug rep came along and saw first hand how that new vaccine was saving lives.

Meningitis is a serious infection of the covering of the brain and spinal cord and is almost invariably fatal if not treated at the first sign of infection. Treatment involves painful spinal taps and IV antibiotics. Even those patients who are successfully treated can have residual deficits like deafness or neurological damage.

The infection was common enough that more than once I went into my waiting room to get the next patient and realize that the mother was holding a child with the telltale stiff spine of meningitis. A rush to the ER followed, a spinal tap and a serious, scary talk with the parents about their child, who seemed OK at breakfast that morning, may die or be disabled even with our best care.

Pediatricians take the long view. Like the parents, we want to help children be healthy for life. That is why we even embrace vaccines that can prevent illnesses that don’t occur until adulthood. Vaccines against cancer are on the top of our list. Cervical cancer was once a killer of adult women until the pap smear allowed for early detection — but that was still cancer, albeit cancer that could be treated.

Better yet, we now have the HPV vaccine that prevents acquisition of the virus that causes cervical, penile, throat, and other cancers, so that those kids may never hear the “C word” as adults. The vaccine against Hepatitis B can also prevent the liver cancer that can result from Hepatitis.

The DPT vaccine is one of our older vaccines and protects against tetanus, whooping cough (pertussis) and diphtheria. In my training, I had a beautiful little six-week-old baby with whooping cough. Too young to receive the pertussis vaccine, she got the disease. She coughed so violently and for so long she stopped breathing and needed resuscitation multiple times a day, for weeks!

The force of the coughing actually can cause bleeding into the brain. Pertussis “starts in one season and ends in the next,” with the cough typically lasting three months. We now urge pregnant women to get vaccinated so the antibodies she makes are passed through the placenta protecting the baby in those first weeks and months until the infant vaccines can take over.

The polio vaccine came out in the 1950’s, allowing me to go to the pool and play with other kids in the summer without my parents being terrified I would get polio.

Other vaccines didn’t come out until my teen years or later (I’m very old…!) so I had measles, mumps, chicken pox, “German” measles (rubella) and scarlet fever.

Obviously, I survived those “childhood diseases” but that doesn’t mean they are benign for everyone. Measles still puts 40 percent of its victims in the hospital. I have seen teen boy patients with mumps that caused testicular swelling which is not only painful but can also cause sterility.

Rubella was once a major cause of mental retardation, heart defects and deafness in children infected in utero when the mother was not immune to the disease.

Chicken pox can cause local skin infection from the child’s scratching which put some of my patients in the hospital with cellulitis.

The ”age of vaccines” has freed children and families (and their pediatricians!) from the fear of early death. In the early 1900s one in five children never reached adulthood, and almost all of those deaths were from infectious diseases. We so rarely see those diseases now, thanks to these vaccines, that people think that they have somehow just disappeared. In fact, the only disease that has actually disappeared from the earth is smallpox, and that only happened because the first ever vaccine against an infectious disease actually eliminated it!

We can eliminate diseases for which we have vaccines when that disease is unique to humans. Measles and polio are two diseases for which this dream exists, but only if we get every human immunized to them. We achieved that goal with smallpox, won’t you help us achieve it once again?

Dr. Kathleen Braico

Dr. Kathleen Braico is a retired pediatrician who founded Adirondack Pediatrics with her husband in 1978. She has spent most of her career working on international child health and growth issues. She has regularly volunteered in Guatemala with the Glens Falls Medical Mission and has worked in Jamaica, Haiti and Bangladesh. She served as medical director of Double H Ranch for its first 29 years before retiring. She currently works with the Adirondack Welcome Circle helping legal refugees settle in the region area.