An Unexpected Gesture

I have several families in my practice who have delayed vaccinating their children.  (Don’t get me started!)

One such family came in today for the final vaccination of the childhood series.  The little boy is 4 years old and he was receiving his second dose of MMR and varicella (conveniently packaged in a single dose vaccine called MMRV).  He was a little scared, of course and asked me a question as I was preparing the vaccine.

“Can you put it right here?”

I turned to look at him as he pointed to the inside aspect of his forearm.

“Well, the needle has to go in the fatty bit of your arm and there isn’t enough fat there.  How about we put it up higher on the back of your arm?”

He agreed with a nod of his head.

I cleaned the back of his arm with a swab of alcohol and gave him the needle. There was not a whimper.  He took it like a man.

As I was back at the desk, finishing up the clinical note and completing his immunization record he walked over to me and said “Thank you, Doctor” and gave me a hug.

A hug! For giving him a vaccine.

Well, I’ll be damned.  He just made my day.

Too Close For Comfort

Day 21. National Blog Posting Month.

Every now and then, I get an email from my son’s preschool about an outbreak of Hand, Foot and Mouth disease, or Fifth’s disease.  These are viral infections that are generally self-limiting and not a whole lot to worry about.  Except if you’re a pregnant woman exposed to Fifth’s disease.  In that case, there is an increased risk of miscarriage if exposure occurs in the first trimester and if exposed after 20 weeks there are certain biological effects to the fetus, in particular a life-threatening form of anemia.

Last night, around 1am, while I was nursing the baby, I decided to check my email.  In my Inbox is a note from the preschool announcing that there has been one confirmed case of Chicken Pox.

And so it begins ….

At this point, my son has already been exposed and has likely exposed all of us, including the baby.  Thankfully, both my husband and I have had the infection in childhood, our daughter was immunized and got a booster last year, and the toddler was immunized at 15 months.  My first thought was to get my son his second dose immediately, if for any other reason than to protect the baby.

Where I live, children are given one dose of the Varicella vaccine at 15 months of age and again at age 4.  According to the CDC, one dose of the vaccine is “85% effective against any form of varicella and close to 100% effective against severe varicella.” However, two doses of the vaccine is 88%-98% effective at preventing all varicella disease.

Don’t get me wrong, 85% effectiveness is pretty darn good, but is it good enough for me?  Especially having a 2 month old in the house?  My instinct as I mentioned was to bring my son (the toddler) to his pediatrician today for the booster.  Instead, rational heads prevailed and I called instead.  Our pediatrician assured me that my son’s immunity should still be strong enough to protect not only himself, but his little brother as well.

Phew.

Still, I can’t help but be pretty pissed off at those parents.  Given the type of preschool my son attends (okay, it’s a Montessori school in an affluent area of the city and quite frankly, not cheap), I have to assume these parents are well-educated and probably know that a vaccine against Chicken Pox exists.  But, I’m also quite sure they’ve heard all the “horror stories” on the Internet or from Ms. McCarthy herself and decided it was best for their child to skip the vaccine.  Right.  

Ugh.  I’m sorry if this offends any of my readers, but these kinds of parents are putting other children at risk.  As a mother, I’m not okay with that, but there is zero I can do about it.

As a doctor?  Well, you know where I stand on that.

End rant.