Pediatricians for Vaccines: A Call to Action to Vaccinate Children

AUTHOR:
John W. Harrington, MD
Director, Division of General Academic Pediatrics, Children’s Hospital of The King’s Daughters, Norfolk, VA

CITATION:
Harrington JW. Pediatricians for vaccines: a call to action to vaccinate children. Consultant360. Published online September 29, 2021.

DISCLAIMER:
This commentary is based on a compilation of many patients.

I know there are no words that can ease the loss of a child to measles, COVID-19, or another vaccine-preventable disease. In a recent case, a young girl presented to our pediatrics department, and we were successfully treating her chronic illnesses, including cancer and severe asthma, as well as overseeing her recovery from an organ transplant. However, we could not avert her from being exposed to a vaccine-preventable disease transmitted in our office. Her immune system could not fight off this vaccine-preventable disease because we were not able to keep her out of harm’s way in our practice. In the last hours of her life, her parents asked us to promise this never would happen again to another child.

It has indeed been a wake-up call and has forced our practice to rethink our policy concerning parents/guardians who persistently refuse to vaccinate their children. As a practice, we have tried to follow the policy that the American Academy of Pediatrics (AAP) has suggested. We have tried to convince parents/guardians who are vaccine-hesitant and strongly resistant to all vaccines to vaccinate their children. Casting them out of our practice may mean they congregate in only 1 or 2 other practices, and it would be better to try to persuade them to vaccinate while maintaining them in our practice.

However, changing a belief system or undoing Internet misinformation is exceptionally challenging during our 15- to 20-minute visits. Many of the doctors believe when a parent/guardian flatly refuses vaccines, we should be able to reframe this decision into an action that is harmful to their child and the children around them. Unfortunately, the 4-year-old boy who entered our office with a fever and cough 3 weeks ago and subsequently developed COVID-19 infection is not responsible for the young girl’s death. However, he will now live with the unbearable knowledge that his parents could have prevented him from the consequences of their actions.

One life lost and one life changed irreparably forever. What should we have done differently?

There are no religions known in the modern-day that profess against vaccines, and therefore, providing religious exemptions seems as arbitrary as allowing philosophical exemptions. New York’s current refusal to allow religious exemptions has started us down a path of sanity and embraced evidence-based public health. Still, further, it would make sense to make vaccines the lawful duty for those who can be vaccinated. We know that seat belts save lives, and we know that vaccines save lives, so why shouldn’t we make it mandatory? People cannot drive around without their seatbelt on, so why can they roam around without vaccines if they are required? We also have rules about drinking and driving because it is unsafe for those around us. Isn’t that the same argument and public health issue with vaccines? Why should people be allowed to let their children be unvaccinated when they could very well injure those around them?

Parents/guardians need to realize they are being duped into believing vaccines are unsafe. We need some mandate that supports the universal use of vaccines with some penalty or consequence for making that actionable decision. Perhaps if not as a law, as an additional fee or indemnification for parents/guardians to pay if their child infects another or becomes hospitalized with a vaccine-preventable disease. We could start with the most prevalent vaccine refused, the influenza vaccine. Only 40% to 50% of eligible children are vaccinated every year, thus exposing vulnerable populations. As we move toward population health, which is public health, the system will likely need to consider these actionable decisions of nonvaccination as a costly one and impart that cost onto the parent/guardian or patient.

I realize this essay will not return a child to a parent, but I am hopeful it will create a call to action for the people who can affect change in our institutions to make it unacceptable to allow the misinformed public to make irrational medical decisions that can directly injure and kill others by their inaction.

About 150 years ago, 20% of children born did not make it to age 5 years. Do we have to learn our lessons about vaccines all over again?