Amanda Wilde (Host): Today, Pediatrician Dr. Crystal Carney joins us to discuss the impact that immunizations have on our children's health and overall well being. Welcome to Hello Healthy! A Dignity Health Podcast. Thanks for joining us. I'm Amanda Wilde. Welcome, Dr. Carney.

Crystal Carney, MD (Guest): Hi, yeah, thanks for having me.

Host: I have so many questions. I know vaccination rates are high in the U.S., but right now, lower than they were worldwide before the pandemic. And there's also a trend of misconceptions about vaccinations, and we are going to address that as well. Let's start with immunizations, what they are, and how do they work.

Crystal Carney, MD (Guest): Yeah, so I think that's the most important fundamental thing to start with, because I think a lot of the fear comes from having absolutely no idea how these things work. And there's a lot of that misinformation that gets sent out. So they're actually this incredibly simple, but really amazing things that we can use to protect people from future disease.

What you have to understand is the way your immune system works, is anytime it sees a bacteria, or a virus, or even a fungal infection, really anything that could cause us harm, your immune system starts creating it's own immune sort of army specifically towards that one thing to try to kill it.

I like to use what we call a lock and key system. So every different bacteria has a lock on it and your body starts creating massive amounts of keys that just fit that one lock. But the idea between vaccines is what if we could create keys, before you ever got sick with that particular bacteria, with that particular lock, and that's where vaccines come in.

So what we do, we have different kinds of vaccines. The ones you might have heard of the most are what we call the killed vaccines and the live vaccines. The killed vaccines, those are the ones that most of the time kids get in the first year of life. Those are where instead of giving you an entire bacteria with the lock, we have found a way to just take the lock off.

So it's not even like we're giving someone a bacteria or we're giving them anything harmful. We're literally just isolating that lock, giving a small amount of it to the body and saying, Hey, make some keys. And your body starts making keys so the next time even one or two of those bacteria come in, you don't have to wait to have keys available to kill it.

You've got them ready and you can kill it before it ever gets a stronghold in your body and does anything to harm you. Now the live vaccines do involve giving and we say live, but it's not alive in that it's not active. Whatever we're giving, the virus or the bacteria, it is whole and it does have a lock, but it's in such a small quantity that it's not actually going to hurt you.

But it does allow for your body, again, to create those keys. And the reason we do live vaccines is because there are just some organisms that we can't isolate that key, that lock, from to make the key. So that's really the idea is just giving your body kind of heads up so that the minute it sees one of these bacteria, it already has everything that it needs to kill it so it can't actually harm you.

Host: So, immunizations help your immune system react effectively.

Crystal Carney, MD (Guest): Exactly.

Host: What are some of the common diseases that are prevented through immunization?

Crystal Carney, MD (Guest): You know what, I was actually just looking at the list because it's hard to remember off the top of my head all of them, but you're talking about over 20 things. But, you know, I think I can list off all of the different diseases, but I think what's most important to people is what those things cause.

So there's a lot of different conditions that cause meningitis. We've prevented so much meningitis, I mean, really, the amount of kids we see with meningitis now versus 30 or 40 years ago, I think on average it's gone down about 40 or 50 percent. Even little things like that we remember from our childhoods, like ear infections, they're almost unheard of now, as far as being due to a bacteria, we still have some viral ones. Epiglottitis, different forms of paralysis, like polio, birth defects, like congenital rubella. A lot of these things that we vaccinate for, cause pretty high mortality or death, especially in younger kids, and cancers. So there's a lot of things, a lot of conditions that a lot of us as parents are always worried about that we can prevent with vaccines.

Host: It sounds like advances have been made. Were you saying that advances have been made since even our childhood in vaccinations?

Crystal Carney, MD (Guest): Well, yeah, I mean, I'm going to age myself here, but, I'm turning 42 next week, and when I was a kid, I was one of the first kids to get the MMR vaccine. Even, my sister who is 10 years older than me, she had measles as a kid. Measles, mumps, rubella, I never received the chicken pox vaccine.

I very clearly remember having chicken pox. There was no rotavirus vaccine. There was no pneumococcal vaccine. I mean, we've pretty much doubled the number of vaccines that we have even in my lifetime.

Host:

Are there any risks associated with immunizations?

Crystal Carney, MD (Guest): There are risks associated with everything, with everything you do and that doesn't stop at immunizations. You know, if you go walking outside in the rain, you have a chance of getting struck by lightning. And if you get vaccinated, there is always a small risk that you're going to have an allergic reaction to that vaccine.

Now, the risks that are spoken about on the internet, I feel like they're a little overblown. The only true risks that we have found to the vaccines are either an allergic reaction to a component of the vaccine, or there is a delayed reaction called Guillain Barré, which is a paralysis that can occur.

Now, while these might sound really scary, you are more likely to get struck by lightning than you are to have any of these things happen. On the flip side though, the, all of the diseases that I just mentioned, the estimation is about two to four million deaths a year in the world are prevented because of these vaccines.

So if you weigh the chance your child would catch one of these conditions and have a severe either long term disability because of it, or even die because of that condition, versus the risk that they would have some negative reaction truly to the vaccines, you know, that risk of, getting sick with the vaccine is definitely outweighed by the risk of the conditions that, that vaccine is helping to prevent.

Host: So, in the benefit risk analysis, there's no competition there.

Crystal Carney, MD (Guest): Not even close. I mean, there is a organization that keeps track of all documented deaths and they research every documented death anytime that a hospital physician or a family reports a death due to vaccinations, they do a very deep dive. And I want to say that in 10 years, they had confirmed maybe 10 deaths that were due, and they were all either due to Guillain Barre or an allergic reaction. In all the other cases, they were able to find other reasons for that patient's, for that patient's death.

Host: Mm hmm. Well, I think we're touching on the fact that there has been a trend toward misconceptions about immunizations, and I'm wondering why has that hung on? Why have those misconceptions really taken hold with some people?

Crystal Carney, MD (Guest): I think it makes perfect sense. I'm a mom of two children and, I think that our first reaction is to take everybody who doesn't vaccinate their kids and disparage them in some way, but I don't see it that way. I completely understand. It is so much easier to not make a reversible decision. Once you vaccinate your kid, you can't take that vaccine back, than to just kind of sit and wait.

And I think that on top of that, vaccinations have sort of become their own worst enemy because so many of these diseases just don't happen anymore. We forget why it is that they don't happen anymore. So as a parent, you sit there and think to yourself well, the internet or this one random relative of mine, or this one friend that I met at the schoolyard told me this horrible story about vaccines, and really I don't know anyone who's had diphtheria. You know, It makes more sense for me to just not get my child vaccinated and really rely on the fact, honestly, that everyone else is getting their children vaccinated.

Host: So I was just going to ask, why is it important for children to be immunized?

Crystal Carney, MD (Guest): Well, the truth is, is that estimations are when we are above 90 percent vaccinations for any particular vaccine, then we can pretty much guarantee what we call herd immunity. But when we start falling below that 95 percent mark, you don't get that herd immunity. So I can tell you from a do the right thing for your society standpoint, it's good to get your kids vaccinated, but no one really cares about that.

What people care about is their own child, which is fair, it's not selfish, it's the way we are. And when you think about it, your own child, these diseases, everything we're vaccinating for, they still exist in other parts of the world. And as we become a more globalized nation, people are coming from all parts of the world.

People are vacationing everywhere. They might be picking these things up. Even if you're vaccinated, as I told you, it's a lock and key system. It doesn't mean you don't carry that particular condition. You just won't necessarily get sick with it. So people could be fully vaccinated going to other countries and still carry some of these things back.

And then you or your child, if you're not vaccinated, even, if your child doesn't get sick with one of those particular things, if you have anyone in your house that has a low immune system, they could then spread it to them. And that's how these diseases come over, like we hear about the measles outbreak. All these different things that come from other countries, that's usually where we see them now is they come over from somewhere else and then somebody gets sick and especially if they're part of an unvaccinated community, then you'll have an outbreak amongst people who are unvaccinated.

Host: That is the strongest possible argument for how immunizations impact a child's health and well being. How can parents and guardians ensure that their children are up to date on their immunizations?

Crystal Carney, MD (Guest): So, the best way to do that is to go to your pediatrician. Your pediatrician should be keeping records, although I do highly suggest keeping your own record of when your child got their immunizations. If we cannot prove that your child has received a vaccine, we can always re give it, and there are catch up schedules and all kinds of things that we can do.

But, you know, nobody wants their child to get poked more than they have to be poked. So, I usually suggest keeping a personal record or keeping a record on a card that your pediatrician signs. But they should also be keeping it as well. If getting to a pediatrician is hard, there are a lot of mobile clinics and you can look them up through the public health websites that will also do mobile vaccines and they will stamp those cards the same, but that's why it's important for, I think, each parent to have their own, because sometimes you're getting your vaccinations at different places or different clinics.

Host: That's perfect. Are there any other resources that come to mind that parents can go to regarding information about immunizations?

Crystal Carney, MD (Guest): Actually, yes. There is a great website. I tried to see if I could find the actual website itself, and it's such a long website that what I really suggest putting in is just CHOP, which is Children's Hospital of Philadelphia. CHOP, and you put vaccine education center. So the CHOP vaccine education center, if you search that, it'll, it's the first thing that'll come up on Google. That website, even as a pediatrician, that's what we go to when we want to reference things. I know there's a lot of concern amongst parents. You know, what I hear, from concern is now about the additives in vaccines and that website will break down every single additive in each vaccine. It will tell you the amount that's in every vaccine and gives you some perspective.

So, for instance, formaldehyde is one that people are always really concerned about. Because, you know, that's the one that touts like, oh, what they preserve dead bodies in is what they put in your vaccines. This is so bad for your children. And what people don't realize is that formaldehyde is actually within your own body. It's a really important chemical that you produce yourself that helps in making DNA and amino acids. So, at any given time, you're going to have a certain concentration in your blood. So, for instance, a two month old, and I got this from their website, and I use this with families all the time, a two month old has 1.1 milligrams of formaldehyde in their blood at all times, and most vaccinations have less than 0.1 milligram of formaldehyde in them. So, I think that it's a really great place to go if you've been on the internet and you've heard these stories and you've seen some of these concerning headlines, just to give you some perspective.

It gives you some nice scientific numbers to look at that might make you more comfortable or it might just help you make a more informed decision.

Host: Exactly. I think a more informed decision for me, hearing that these diseases are still all around us, we haven't eradicated them; makes me understand much more clearly how immunizations protect our children.

Crystal Carney, MD (Guest): Yes, it's incredibly important. Because, you know, as time goes on, I think we're seeing more and more of these little outbreaks and they're not all getting reported to be honest, you know, because if it's only one or two kids, it's not enough that it's going to make global news, but one or two kids in every state, and that ends up adding up.

Host: Yeah. It can be become a trend. So thank you so much for being here today, Dr. Carney, to educate us on vaccinations.

Crystal Carney, MD (Guest): Well, thank you so much for having me. I really appreciate being able to take this time and hopefully help people make a good informed decision about vaccines.

Host: Dr. Crystal Carney is a Pediatrician and Chair of Pediatrics at Bakersfield Memorial Hospital. For more information, please visit dignityhealth.org/Bakersfield/pediatrics. If you found this podcast helpful, please share it on your social media. Thanks for listening to Hello Healthy, a Dignity Health podcast.