I know it's been a while since I've posted (mea culpa!) but I haven't been on hospital wards for quite a while. So, I figured I'd kill 2 birds with one stone- here's a paper I just had to submit for our Commitment to Underserved People elective. I took out a quite a bit of it for blog-ability's sake, and it's filled with hyperbole, but there you go. By the way, I'm going to be a doctor in about 5 weeks. That blows my mind.
The cacophony was deafening. Kids of all ages were screaming, feeding off each others’ fears. Overwhelmed parents desperately tried to calm their children, all to no avail. One group, sensing an opening, bolted out the door, screams trailing down the hallway. A toddler was banging blocks on the ground, wailing at the top of his lungs. This was a madhouse. This was TotShots.
It all started when I mistakenly allowed a very nice couple to bring all 5 of their children into the vaccination room with them. By this point I had already been performing vaccinations all summer (although I vividly remember my hands trembling wildly on my first day) and I felt like the master of my domain. Vaccines organized – check. Band-aid prepped – check. Alcohol swab opened – check. Dad holding kid snugly on lap – check. Bare arm exposed, swabbed, stabbed, and bandaged. Clockwork.
There is always something new to learn in medicine, and on this day I learned never to allow children to see other children getting vaccinated. Perhaps more importantly, avoid at all costs allowing them to see the fear, pain, and abject horror in their siblings’ eyes. It was perhaps the most quickly apparent lesson that I have learned in the entirety of my medical education.
The screaming started immediately, which could have been contained in the small vaccines room, except that sister #1 ran out of the room, incoherently screaming, whites of her eyes wide and nostrils flaring. Sister #2 followed… and from that point on the waiting room erupted into ear-splitting wails. There was no containing it now. We had lost control.
I have always felt very strongly about vaccinations; the concept that the human race has eradicated smallpox from the face of the planet with something as simple as a vaccination campaign is staggering to me. This was a disease that caused horrific scarring, blindness, and death, which no longer exists except in laboratories. This is one of the best examples of the human race using science and a commitment to the greater good to better itself.
Significantly, vaccinations must be adopted by an entire population for eradication of disease to occur. In 2003, Nigeria issued the governmental opinion that the vaccine included estrogen; ostensibly as a plot by foreigners to sterilize their children. Vaccinations in small villages essentially stopped overnight, and a resurgence of polio occurred. This prevented the WHO from reaching its goal of eradicating polio by 2005 and cost the world $200 million to stem the rapid outbreak. News is good, however; Dr. William Foege, the senior medical fellow to the Bill and Melinda Gates Foundation and the former head of the CDC’s smallpox taskforce, said recently that he believes polio will be officially eradicated from the planet within the next two years.
The estrogen scare in Nigeria is only the latest of our problems with vaccinations. Perhaps the most recognizable controversy is the debate over the linkage between autism and vaccines. This controversy stems from an article in the 1998 journal of Lancet authored by Andrew Wakefield and 11 others, in which a link was suggested between the MMR vaccine and autism. However, upon the revelations that not only did he receive major funding from lawyers prosecuting an autism case, but also held a patent for a rival vaccine, 10 of his co-authors retracted their authorship. Essentially all of the research done since has refuted this link; however this association continues to plague us today. I cannot count the number of parents who refused vaccinations on my outpatient pediatrics rotation due to “that autism thing”.
In the end, all the kids quieted down after we distributed tons of stickers and lollipops. Thoughts that were fixated on the fears of gigantic needles quickly were distracted by the bright colors and delicious candy. I continued to vaccinate, chortling inwardly at the tears running down each victim’s face. I was their enemy at that moment, baleful looks begging the question, “Why? Why would you do this to me? What have I ever done to you?” Silently, I would respond, “Because one day you will thank me.”