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Fred Leonard, STAT
Fred Leonard, STAT
I was 1 year old in 1949 when polio struck my mother. As I got older and could understand why she was in a wheelchair, she told me about her time in the hospital — more than a year — most of it an iron lung. Late at night she would lie awake, listening to the rhythmic pumping of the iron lungs on her polio ward and to the whooping cries of babies with pertussis that echoed down the hospital’s corridors.
That scene of polio patients in iron lungs and babies with pertussis struggling to breathe was played out in hospitals across the country. In 1949, 42,000 cases of polio were reported in the U.S., along with nearly 70,000 cases of pertussis. There were also more than 600,000 cases of measles reported, though the actual number was probably more than 3 million since most measles cases were never reported to health departments.
In some ways my mother was one of the lucky ones from her polio ward: She left the hospital alive. And though she had reduced breathing capacity and permanent paralysis of both legs and one arm, she could still breathe on her own. Some of her ward mates went home in iron lungs; others died.
When the Salk polio vaccine became available in 1955, my mother made sure my brother and I lined up to get it. And when the Sabin oral polio vaccine came along, we got that one, too. It’s not that my mother rushed us to the doctor for all the latest treatments. We were rarely in a doctor’s office. But she knew all too well the value of immunization.
I was 18 when my mother died from complications of polio. A year later, I was in an immunization line at boot camp. The military didn’t waste time trying to figure out what immunizations we recruits had previously received. We just got them all. When it came to immunization, the military and Mom saw eye to eye.
After leaving the military, I used my GI Bill benefits to go to college and medical school. By that time, widespread immunization had all but eliminated polio and pertussis in the United States, and the measles vaccine had been almost as effective. The authors of a 1985 article in the medical journal Pediatrics estimated that in the 20-year period since the measles vaccine had been introduced in the United States, it had prevented 52 million cases of measles; 17,400 cases of what was then called mental retardation, a complication of measles; and 5,200 deaths.
But other severe infections were still common. Doctors routinely saw children with bacterial meningitis and with epiglottitis, a frightening infection that can rapidly result in closure of the airway and suffocation. Thanks again to new vaccines, bacterial meningitis is rare in childhood and many recently trained doctors have never seen a case of childhood epiglottitis.
But the success of immunizations in the U.S., as well as in other developed countries, has had unintended consequences. Having never seen someone with polio or pertussis or meningitis, or had a loved one die from these diseases, many people no longer understand the value of vaccines, and some have even come to view them with suspicion. At best, such individuals see vaccines as having significant risk and little benefit. At worst, they regard them as a sinister plot forced on a naive public by misguided doctors and greedy drug companies. While it is true that everything we do in medicine has risk, including administering vaccines, there is nothing else we do that provides such an overwhelming benefit with so little harm.
I continue to be saddened when I see or read about a child who suffers or dies from a disease that could easily have been prevented by a routine immunization. I understand that in most cases their parents were just trying to do what they thought was best for their child. But with no personal experience with vaccine-preventable diseases, and exposed to ongoing misinformation campaigns by small groups of vaccine opponents who spread their erroneous claims on the internet and social media, they made the wrong choice.
I also understand what propels parents to blame immunizations for other conditions that strike their children, such as autism. In 1998, the Lancet published the now-infamous Wakefield study that claimed to have identified a link between the measles, mumps, and rubella (MMR) vaccine and autism. The study was subsequently determined to be fraudulent and based upon falsified data, and was eventually retracted by the journal. But the damage was done. And even though multiple subsequent studies have shown no link between autism and vaccines, and the Institute of Medicine and Centers for Disease Control and Prevention have both gone on record stating that the evidence does not support such a link, some parents desperately searching for the cause of their child’s autism still blame vaccines. The connection seems to make sense: their child is vaccinated, and then later develops autism.
But autism and other conditions also emerge after a child has had breast milk or formula; after a child has ridden in a car seat; after a child has been exposed to televisions, smartphones, video games, and other electrical devices; and after a child has had a whole host of other experiences common to early childhood.
No matter how well-intentioned, blaming vaccines for autism and other unrelated conditions is like convicting the wrong person of a crime. Not only does it unfairly condemn the innocent, it hinders attempts to find the true culprit. As parents shy away from vaccination, they aid the reemergence of multiple potentially devastating and life-threatening infectious diseases like measles, pertussis, polio, meningitis, and encephalitis. And that puts at risk and harms the most vulnerable among us — babies too young to be vaccinated, children who don’t have a choice about vaccination, and those with conditions such as leukemia and other disorders that suppress the immune system.
I do my best to explain to parents the true value of vaccines and why immunizing their children is so important. But too often the message doesn’t get through. At those times, I wish my mother was with me. Maybe she could help them understand.
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