Conan Gasque (Host): Welcome to Inside Pediatrics, a podcast brought to you by Children's Hospital of Alabama in Birmingham. I'm Conan Gasque. Thanks so much for your time today. We're talking about vaccinations for kids and how important it is for you to get your kids vaccinated, taking a look at three specific diseases or conditions that you really want to make extra sure that your kids are vaccinated against. We're talking to Dr. Peily Soong, a pediatrician at Pediatrics East, part of Children's of Alabama. Thanks so much for your time today.

Dr. Peily Soong: Good to be here.

Host: So again, we're taking a look at three specific ones that have really been major points of focus, particularly on the news lately. Let's jump right in here and talk about measles. I think, you know, measles, it's a case that everybody's heard this. What is measles? When you have that, what does it mean?

Dr. Peily Soong: So, measles is a viral respiratory illness. So, it can be spread by sneezing, coughing; highly contagious. If you're in a room with somebody that has measles and you're unvaccinated, you have a 90 plus percent chance of actually contracting measles. The symptoms of measles are cough, runny nose fever, pink eye, typically. So, all sounding like regular kind of cold symptoms.

Host: Innocuous type stuff, right?

Dr. Peily Soong: Yeah. So, you may or may not think about measles to start with. But you can also get these little white little spots on inside the cheeks of the mouth. That's one of the kind of unusual signs of a difference between measles and a regular cold. But then, after a few days of the start of the illness, then you get the rash that spreads from the head down to the toes, which is what people kind of, in general, think about with measles as a measles rash.

Host: So, it can present like a common cold, but it can also get pretty severe, right?

Dr. Peily Soong: Correct. About one in three kids, one to three kids out of a thousand can actually die from the measles, usually typically from pneumonia. One in a thousand people that contract measles can get something called encephalitis, which is an inflammation in the brain. So, it can be very serious. Last year, about 40% of the cases of measles ended up in the hospital for either breathing trouble or just, you know, making sure that they didn't need more supportive care with measles.

Host: And this is one of those things that you used to never hear about, right, and then, all of a sudden spreading now.

Dr. Peily Soong: Yeah. And the year 2000, the CDC actually declared measles eradicated from the United States. So, it was completely gone, didn't have any cases of the measles, but then has slowly crept back in our society. And so far, right now in, in the US, there's been over 800 cases with several kids dying from it as well too.

Host: How concerning is that for you as a pediatrician to see that? You know, there's this disease that it was non-existent in the United States for a while. And now, it's starting to spread and it's highly contagious. How concerning is it?

Dr. Peily Soong: It's very concerning to us. Because as a pediatrician, I've been in practice 21 years. I've never seen a case of measles. Most of the people out that are in practice have never seen cases of measles, unless they're much older physicians. And so, this is something that's new to us, that we are trying to educate ourselves about what to look for and how to test for it as well too. And so, you know, we've seen this coming about because of the decline in people getting their kids vaccinated.

Host: And the good news is there is a vaccine for it and it's highly effective, right?

Dr. Peily Soong: Yes. It's one of our more effective vaccines. It's two shots, called MMR, which is the measles, mumps, and rubella vaccine. There's also one that adds a combination with the chickenpox vaccine too, called MMRV.

Host: It's one of the newer ones, right?

Dr. Peily Soong: It's been out for about 20.

Host:  Mid-'90s, I think is when they started.

Dr. Peily Soong: Yeah. Yeah. If you get your first dose, which is usually about between 12 to 18 months of age, it's about 93% effective at preventing a kid from getting really sick from the measles. A booster dose is given between four to six years of age, usually before kindergarten, and it puts you at about 97% effective at preventing you from getting really sick from the measles, and it protects you the rest of your life.

Host: Yeah. Yeah. Good to know that there's a such an effective vaccine out there, especially when you're talking about the fact that this is so contagious and so potentially severe.

Dr. Peily Soong: Correct. Yeah.

Host: Yeah. So, that's a look at measles and, you know, the latest information we have on that, the importance of the MMR vaccine to guard against that.

Let's take a look now at whooping cough. You may say whooping cough, pertussis is the actual medical term, correct? What can you tell us about this?

Dr. Peily Soong: Yeah. So, pertussis is a bacterial illness. It's a bacteria that causes whooping cough, right? It is a bacteria that kind of spreads respiratory as well. It causes really bad coughing fits. So, the people that get whooping cough really just cough, cough, cough, cough, cough, to where they sometimes have trouble breathing, because they're just coughing so much. And then, once the coughing starts, it gives kind of a whoop sound, which is where the term whooping cough comes from.

And the little babies is usually what we really worry about with whooping cough. Also, it can affect elderly people as well. But as pediatricians, we worry more about the babies. And in babies, it can cause something called apnea, which is where they stop breathing because they're coughing so much.

Host: Kinda like sleep apnea.

Dr. Peily Soong: Exactly. Yeah. And it can also lead to pneumonia as well too.

Host: So again, you know, a very frightening situation. And you know, like measles, it's one that. You didn't hear about it a whole lot until recently.

Dr. Peily Soong: Yeah. And this one, we're seeing lots of cases in the United States right now. Last year, there were about 35,000 cases that were diagnosed of whooping cough. And that's 15 times more than we saw in 2023. So in 2023, there were about 3000 or so cases. And it's risen exponentially. And this year, we're already in 2025. We're probably on pace to hit that mark again as we saw in 2024.

Host: So, it's out there and it's growing and it's something that you need to be aware of as a parent. And you also need to be aware of the fact that there is a vaccine.

Dr. Peily Soong: Yes. So, the vaccine is DTaP, which is the vaccine we give in kids, usually starting at two months old. And then, you go all the way up to between four to six years old. You get your last childhood booster of the DTaP. And then, there's the Tdap, where the Tdap, which is given to teenagers and adults as well too. Both these, the DTaP and the Tdap also include the tetanus booster, right? Or the tetanus shot in it. So, it is your tetanus booster essentially.

Host: So, how effective is this vaccine?

Dr. Peily Soong: It's really effective at the start of when you first get it, the first five years of protection are pretty good with it. But unlike the measles and the polio vaccine, we're going to talk about later, it does wear off in protection after about five years. So, it is important to get a booster shot for it. The Tdap booster shot, like I said, is given to teenagers and adults. You're supposed to get that every 10 years to keep you protected from both tetanus and from whooping cough.

Host: We like to, you know, come on here to talk about advice for parents, for the benefit of their kids, but sometimes that advice is good for the parents as well.

Dr. Peily Soong: Right, exactly. And it's also maybe why we're starting to see a little bit more of pertussis is because adults can spread it to the younger kids, to babies as well. And again, with whooping cough as an adult, it could just be a really bad cough and cold. And you may not know that's what you've got. And most adults aren't really great about getting their vaccines. And so, there's lots of adults that are susceptible to getting a whooping cough.

Host: So, that is a look at whooping cough and the latest information on that. We're going to shift gears now, as you mentioned to polio, which I think of as, you know, kind of very similar to measles in the fact that you used to never hear about it, you think of it as a historical disease. But now, all of a sudden, here it is.

Dr. Peily Soong: And so, fortunately, unlike whooping cough and measles, we aren't seeing large outbreaks of polio. But in 2022, there was a case of something called poliomyelitis, which is where you get the paralysis from having polio. that's what we kind of commonly think of with the complications of polio, is the paralysis.

You think of FDR having polio as a kid and being paralyzed from it. But there was a case of an American in New York that ended up with polio myelitis. Yand over the last two to three years, there have been detections of The polio virus in wastewater. And so, since COVID we've started testing our wastewater in the sewer systems for different viruses to kind of be able to see what viruses are circulating. That was also a way they kind of kept track of COVID as well too. But they've been able to pick it up polio virus in wastewater in the United States and in Europe as well. Because in developing countries, polio actually is still readily seen. And so, with international travel, there can be cases of polio just kind of spreading all over the world.

Host: The fact that it's showing up in wastewater, is that an indication that we might start to see it spread?

Dr. Peily Soong: We might see it if we start to see drops in vaccinations, because polio vaccine does prevent you from getting sick from polio, prevents you from getting the complications from polio. It doesn't necessarily prevent you from actually contracting polio, right? Just like the flu vaccine doesn't necessarily fully prevent you from getting the flu. It just prevents you from getting really sick from the flu.

With polio there, a lot of cases that have no symptoms with it. And so, there could be people that have been exposed to polio that potentially could be spreading polio, but they're not sick at all, have no symptoms. And so, it could be, you know, potentially spreading it to people that are not protected.

Host: But I guess the biggest part of that is making sure that you get vaccinated. So, you prevent that poliomyelitis that you're talking about.

Dr. Peily Soong: Yes. So with measles, polio, whooping cough. If you get these vaccines, then you kind of feel like your kid's protected and you don't really necessarily have to worry about it.

Host: So, what do we know about the polio vaccine, and when a kid can take it?

Dr. Peily Soong: Yeah. So, it is a highly effective vaccine, about 99% effective, once you've gotten all the doses of it. Start at two months of age, you get your last dose between four to six years of age. Again, right before kindergarten typically is when you get your last dose. And then, it protects you the rest of your life, kind of like the measles.

Host: Yeah. So, it's scary to know that it's out there, but it's good to know that there is something parents can do.

Dr. Peily Soong: Right. Yeah.

Host: Alright. And that's really the case for, for all three of these diseases we've been talking about. You know, it's out there and it is something to be mindful about as a parent. And, you know, it's certainly important to make sure that your kid gets vaccinated. Let's talk about vaccines in general now. I know that a lot of people do have concerns about vaccines. You as a pediatrician, you see parents who express some of these concerns. What is your advice to that parent?

Dr. Peily Soong: So, I like to say that we have the same shared goals as parents. As pediatricians, we go into this field because we care about kids. We want to keep kids healthy. We want to keep kids safe. And our goal as a pediatrician, if you come into my office with your child, my goal is to keep your kid healthy as much as we can. And one of the biggest ways that we do that as pediatricians is vaccinations. That's our biggest tool to prevent your child from getting really sick from these vaccine-preventable illnesses.

And so, I like to come out with that as kind of the first thing, that we share the same goal. My goal is to keep your kid healthy. Your goal is to keep your kid healthy. And we kind of start from there and kind of explain how these vaccines work.

Host: But then, we also know about the historical effectiveness of this vaccine, correct?

Dr. Peily Soong: Yes. Right. And these are all highly effective vaccines. They've been out for decades. The polio vaccines been out since the 1960s. The measles vaccines been out since the 1970s. Chickenpox has been out since the 1990s. Even some of the newer vaccines that we think about, such as the HPV, which is the human papilloma virus vaccine,the meningitis vaccine have been out for almost 20 years now.

Host: Yeah. Newer ones, right?

Dr. Peily Soong: Newer ones, yeah. They have all been studied for, you know, various complications from it. And they've been studied here in the United States. And other parts of the world have also studied these vaccines too. And there's been no link to any developmental concerns, autism, any sort of common complications from these vaccines. So, they're all very, very safe to give.

Host: It's like you said there, it's backed up by historical effectiveness, but also backed up by research as well.

Dr. Peily Soong: Correct, yeah.

Host: So, any final thoughts about vaccinations and the importance of parents making sure that their kids are vaccinated?

Dr. Peily Soong: Yeah. So again, the goal of us pediatricians is to keep your kids healthy. And that's the same goal as parents do with their kids. And so, if you have concerns about your kid getting vaccinated, talk to your pediatrician. Get some advice from them, and learn a little bit about the vaccines too.

If you're completely pro-vaccine and that you're worried about other people in the community, not vaccinating their kids, kind of talk to your friends about things. And it can be kind of a hot topic. And you can do it kind of subtly where you're saying like, "Oh, I just got my kid their second dose of measles. I'm so relieved now I don't have to worry about traveling, I don't have to worry about getting on an airplane, and potentially getting exposed—my kid—to measles. And just kind of doing in a positive light and that encourages other people to kind of think about, "Well, hey, Susie got the vaccine. Maybe we should think about getting it too to not have to worry about traveling and being around other people."

Host: Certainly important to do everything you can to protect your kids from many illnesses that might be out there in the community. Once again, Dr. Peily Soong from Pediatrics East and Children's of Alabama. Thanks so much for your time.

Dr. Peily Soong: You're welcome.

Host: Thanks for listening to Inside Pediatrics. For more podcasts like this one, go to childrensal.org or wherever you download podcasts.