Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and joining me today is Dr. Neela Sethi. She's a Pediatrician on staff at Henry Mayo Newhall Hospital and she's here to highlight the importance of childhood vaccinations for us today. You are a great guest as always. I'd like you to start by telling us about some of the vaccine preventable diseases that we've seen. How have we with vaccines, eradicated some of the worst diseases we have ever known?

Neela Sethi, MD: Absolutely, it's a pleasure to be here. And let me just tell you, this is one of my favorite topics because there are just so many vaccine preventable diseases that we have come such a long way with. So first and foremost, let's start with newborns, because that is really the most important place to begin.

Newborns have a blood brain barrier that is like Swiss cheese. So if you can imagine what's circulating through their body is also circulating through their brain, which makes them very susceptible to meningitis. Us, we have a closed blood brain barrier. So what goes through our blood, stays in our body and what goes through our head stays in our head for the most part.

So vaccine preventable diseases that are most important in newborns are pneumonia and meningitis. Meningitis for the reasons that we've talked about and pneumonia because they don't have the strongest lungs at birth. So strep pneumococcus, Prevnar vaccine, and any other name that it goes by is strep pneumococcus.

It's a bacteria that loves the lungs and it loves the brain. Just having one dose gives you around 70 percent coverage, having all four doses gives you close to 99 percent prevention rate for Strep pneumonemonia and Strep pneumomeningitis. Huge! In that category is something called Haemophilus influenza or HIB, Haemophilus influenzae B. It's also a four vaccine series. We start it at two months and go all the way to 15 to 18 months. It also prevents a very nasty form of meningitis and a very nasty form of pneumonia. Those two vaccines just themselves prevent with all four vaccines in that series, up to 99 percent protection for pneumonia and meningitis in newborns.

It's so effective, even just with one dose, that if you have your first set of either of those vaccines and your baby gets a fever, you do not automatically buy yourself an admission to the hospital. It is that effective. If you do not have those vaccines on board, and your baby gets a fever, you will be sent to an ER and get what's called a rule out sepsis workup to make sure that your baby does not have meningitis and pneumonia because of what we talked about with the sensitive lungs and the kind of Swiss cheese blood brain barrier.

This is how I pitch it to patients. So, those are the two, I think, most important things to think about when you've had that baby and then we can go on as the kids get older to other vaccine preventable diseases, but those are really the most important and, frankly, the most life threatening at that young age.

Host: That was quite an education you just gave us. You're an excellent teacher, and the fact is that you explained it in such an understandable way. And listeners, I want you to rewind and listen to what she just answered for that first question. If you ever have questions about why these are so important. Now, Dr. Sethi, the percentage of children receiving some of the vaccinations has been declining. What are some of the reasons that you see for vaccine hesitancy? Are you seeing some of those vaccine preventable diseases coming back? Because I know my pediatrician was furious when she saw measles coming back and she's like, there's no reason for it.

And I know that there is media and propaganda and things going around the country that are making these look and sound bad. Tell us your opinion on this decline that we're seeing.

Neela Sethi, MD: I always start by saying, I always come from a place of empathy and understanding being a physician. I think that's very important to have communication and just back and forth dialogue with your patient. I understand with the fact that we survived a global pandemic, and all the back and forth data that we received when it came to the COVID vaccine.

It made people vaccine scared and it really did make people sort of question just modern medicine and were they getting the right information and who to trust and where to get your source of information from because everybody was a medical expert during COVID, if you don't remember. And it really led people to feel kind of unseen, unheard, and just to have a lot of fear.

And I completely understand that. I had fear when it came to COVID. I really researched the COVID vaccine and chose the right one for our family. So I totally understand that. I believe that's the reason that people are where they are right now, where they're just distrusting. They're distrusting of their doctor, they're distrusting of the hospital system, and frankly, they're distrusting of the CDC and the AAP and all of the big organizations.

What I tell patients is, is I understand that. I understand that you're frustrated, that you received a lot of medical information in a short amount of time, and frankly, that we were living and learning as we lived through the pandemic because it a global first. We had never seen it before. What we're talking about today is not that.

These are vaccine preventable diseases that are not the novel COVID-19 vaccine. These are vaccines that are tried and true and tested for decades. These are bugs that we know. They've been around the block and the block and the block and we've studied them. We know how they operate and we have proven over and over that these vaccines are effective.

We have also proven over and over that the side effect profile for these vaccines is amazingly good. We have also proven that it is well tolerated amongst these young kids and it prevents the disease that we're going after. And we're not claiming that it's going to prevent every disease and we're not claiming that your child isn't going to catch the common cold or flu or other things.

But what we are saying is, we are going for life threatening illnesses, and I'm going to repeat that. We are going for life threatening diseases as Pediatricians. All we want is for your child to live. That is it. That is our entire reason for being and why we operate the way we operate. Do we care if your child gets a cold?

Yeah, we're empathetic. We are sensitive to that. We don't want your child to get a cold. Is that going to keep us up at night? Absolutely not. Is meningitis going to keep us up at night? Absolutely. Is a terrible pneumonia that can turn into sepsis, keep us up at night? Absolutely. So what we tell patients is this, do your research, find a Pediatrician that you can have open dialogue with, and really understand that we're not coming in with new vaccines.

I've been in practice about 18 years. I have used these same vaccines for the last 18 years, and knock on wood, I have had so few really terrible infections and deep seated illnesses because I really and truly believe that my vaccine rate is very high, but I take the time to explain it to each and every patient the why and have them understand why they're putting this into their baby and what that vaccine does and just how effective it is.

Host: Beautifully said. Now, there are a lot of myths. And as you said, everybody was a medical professional during COVID. I even remember someone putting on Facebook that if you ate something with COVID, then your mouth would kill it. And, oh my God, I was like, are you kidding? It was nuts, really. But, there are a lot of myths and someswirling information about those myths. I'd like you to clear it up right now about vaccines and autism, because that one's still floating around.

Neela Sethi, MD: I was just going to say, let's go there, because you know what, if you don't provide truth, and we don't have conversations like this, we're never going to be able to make progress. First and foremost, it has been proven over and over and over again that vaccines do not cause autism. I repeat, vaccines do not cause autism.

Meaning, there is not a cause and effect relationship there. You get the vaccine, and then you get autism. That has been debunked over and over and over again. So the other thing that has been debunked is the idea that the heavy metals in the vaccine caused autism. There was a circulating myth that something called thimerosal which is a metal that is used for binding in the vaccine led to autism.

That was also debunked, but that was removed from vaccines in a just in case fashion because vaccination companies and pediatricians in general are so wanting to debunk all these myths and so wanting to calm fears, that that was removed from vaccines completely. So first and foremost, vaccines don't cause autism.

Generally speaking, there are a lot of reasons why kids get autism, and we are still figuring that out. The reason that there's so much fear is and what's very sad about the whole situation is we don't really know what causes autism completely.

We're still working on that and because there is that fear and that unknown, it's very easy to blame the vaccine and that has been proven to be true. Kids generally present with early autism type symptoms in that first year or two, and it progresses. And because you are getting vaccines so heavily from zero months to 18 months or two years old, they were an easy target and they were wrongfully blamed for autism symptoms and again just to reiterate, vaccines do not cause autism. There is also a myth that if you delay the series or you delay vaccines that we're doing too many at once and I hear this every day. There's just too many and the body can't handle it. That's not true. The body's actually able to handle several vaccines at once. And sometimes that's even better for the baby because once you've mounted the response to the vaccine, you're just mounting the response to everything that's in your body at a given time.

And you're just going to rev up the immune system, create all those antibodies. And then you're going to level off. Now again, some people like a delayed schedule. I just like them getting the vaccines. Do I like the delayed schedule? Not really. It just makes the baby hate me more and them come in more often and them get poked all the time and babies hate that.

And that part of the vaccines I detest. I hate the poking part of it. I hate the pain part of it. And I wish there was a way we didn't do that, but we haven't gotten there yet. But if the parent is willing to at least be on a schedule, that makes me happy, knowing that eventually they're going to get all the vaccines.

But spreading the vaccines out has not been proven to be more effective or less effective or decrease your autism rate at all.

Host: You got to all of my questions and myths right there, because I know that there are questions about delaying and the alternative schedule and herd immunity. Can you mention just that, as people are asking about delaying their vaccines or getting too many at once? Some people are just not getting the vaccine, like the flu vaccine, because they say, I'm just going to wait for herd immunity.

Neela Sethi, MD: I think that that is a somewhat selfish place to be and live in. And I mean, we're all humans and there's a world called humanitarian for a reason. And I think if you operate in this selfish mindset of like, I'm going to do what's good for me, but I'm going to expect everyone else to take the risk and everyone else do the right thing to protect me.

That's not how human nature and humankind works. That's not how we progress as a society and how we can show each other empathy and love and to try and conquer the world together. That's divisive. Now, are we going to have herd immunity eventually? Yeah. That's what happened with COVID is that eventually everybody was exposed and it decreased the sort of virality of the virus. What people don't want to admit is that a lot of that had to do with the vaccine and the fact that that virus hit so many people with the vaccine and was unable to replicate and it decreased that virus's power and by doing that it made it less and less serious and that's what vaccines do. The only issue is is that you have to have many people get the vaccine in order for that to happen and I just don't like the idea of I'm going to have everyone else do something so that I can be protected. Because honestly, I just don't, from a moral code and a moral compass standpoint, it irks me. It's like, we are humans. We are all homosapiens. We all have the same biology in our body. And we should be able to have empathy and to go in this together and bond together to fight these diseases.

And frankly, if we did do that, a lot of these diseases would be completely eradicated. We saw it with smallpox. We were at such a great place with polio. We were at such a great place with measles. And, you know, we're seeing those numbers climb because people are becoming vaccine scared. What more data do we need that vaccines are effective, that having decreased the vaccination rate is making these viruses come back and these bacteria come back? To me, it's like what more do you need, people?

Host: Wow. I couldn't have said it better myself. I feel exactly the same way. And I know we don't want these episodes to be too long, but I still have three things because you're such a good guest, that I want to discuss with you. So let's start with chicken pox, because another thing that we hear is, oh, just let them get it.

I got it as a kid. You know, it wasn't that bad. Let our kids get chicken pox. But the fact is you get chicken pox. Now you're at risk for shingles when you're about my age. You're younger than I am, but I'm telling you. So then I got the shingles vaccine. However, chickenpox, speak about that one.

Neela Sethi, MD: Chicken pox is one of my favorite topics because what people don't understand with the Varicella vaccine is we don't care about pox. Do you really think that we care if your child gets pox and is itchy for a few days and then you use some calamine lotion and they dry up and the baby goes back to school or back to daycare? No. The reason that we care about Varicella vaccine is it prevents Varicella hepatitis and Varicella meningitis, and Varicella pneumonia and I'm going to repeat that. It prevents Varicella meningitis, Varicella hepatitis which is liver and Varicella pneumonia. Those are life threatening diseases. That's what the vaccine does. It may not prevent you from getting a pox or two, or even poxs, but it prevents invasive disseminated disease by decreasing viral load and preventing that virus from replicating in your body.

That is the point of the vaccine. The vaccine goes in your body and tells your system that you've already had this, creates antibodies so that when you get into contact with that virus, you already have a first line defense to fight it. And what that means is that virus isn't going to go into the deeper parts of your body, create a little colony and spread.

So what we're trying to do, and I repeat, we are trying to prevent life threatening diseases. We're not just saying, oh, pox are annoying and they're itchy and we don't want kids to suffer from that. No, we're preventing disseminated disease and death. That is the point.

Host: Okay, next one, HPV. Another thing that floats around about that one is that if you give your child, tween, your teen, your tween, the HPV vaccine, that you are encouraging sexual activity. But this is, and blows me away really, one of the first cancer preventable vaccines that we have ever known.

Neela Sethi, MD: HPV is a modern miracle and because of some misinformation that was circulating online, it got a bad rap. And it's truly kind of devastating for doctors that HPV is considered dangerous. HPV is a sexually transmitted disease. It's human papilloma virus, which causes viral warts in women. That's why we get pap smears, to look for those because those warts that end up on your cervix can basically grow into a cancer. And that cancer is very hard to detect. If you imagine it's in the inside of your body that you're not seeing all the time. Also, HPV is carried with men. They carry it on their penis and when they have sexual activity, they transfer it to females.

Females are more likely to get cancer from it, but men can get cancer from it too. What HPV does is it prevents that transmission and when you get in contact with that virus, the virus can't replicate and make those abnormal cells, which turns into cancer. The studies have suggested over and over again that giving kids an HPV vaccine does not then encourage them to have sex.

What it does is prevent cancer and it's so effective, that over the course of my career it was a three vaccine series and now it's a two vaccine series for kids 14 and under because it's just that effective. It is so effective of a vaccine that they're saying, and I've heard from OBs in the future, that kids and tweens that get it now literally may not need as aggressive pap smears as an adult.

They won't have to go and get their pap smear so aggressively like we do every year because that HPV vaccine is so effective. And it's one of the first times that we've ever been able to prevent cancer with a vaccine. It's tolerated exceptionally well. What you read about it is absolutely untrue. I have been giving it for over a decade, and I would not say by any means that any of my teens in my population say, Oh, well, now I can go have sex.

It's actually the opposite. I think they say thank you for preventing me and having a conversation about sex and sexually transmitted diseases and equipping them with all that they can get in their body before they have sex to make sure that they're ready. And it opens up the conversation about what safe sex practices are and what sexually transmitted diseases are.

And I think that's a great starting point from a tween standpoint to even bring up those conversations, which a lot of times parents are really fearful and scared to even do.

Host: Not me, honey. I started having those talks with my kids when they were very young and it's so important. Everything you've said today is so important for parents to hear and for caregivers and even for teens and tweens to hear about these things. And as a last question, and you can wrap up with the importance of vaccinating our children, but speak about what we're seeing now with the flu.

We've got this tripledemic, everything's rising, COVID. We're seeing RSV, you and I have talked about that, and flu. Getting our flu vaccine, is it too late? Can we still get our kids the flu vaccine? What are we seeing now? Wrap it up for us with your best advice.

Neela Sethi, MD: We are in an absolute tripledemic. We've got rising rates of flu A, we've got rising rates of RSV in record numbers, and we're seeing a rise in COVID-19. What I recommend is it's not too late to get your influenza vaccine. It is not too late to get your RSV vaccine as an adult, and it's not too late to get your RSV antibody vaccine if you have a baby, if you can get your hands on it.

The flu vaccine, it prevents disseminated flu. The RSV vaccine prevents disseminated RSV and the COVID vaccine prevents you from getting into a hospital landing on a ventilator. Vaccines decrease just the severity of the disease and wouldn't we all rather have a flu vaccine on board and get better in two days versus have the flu vaccine not on board and hopefully get better in seven to ten days but maybe not and suffer the consequences of a potential flu pneumonia or flu meningitis or other things that we see and don't even ever really want to talk about.

So once again I think the take home point and what people need to understand is that vaccines don't prevent you from getting the disease completely, it prevents the disease from spreading in your body and making you very, very sick and unfortunately death. Our job is to prevent death. That is why we are doctors.

That is why we went to medical school. It is for the benefit of mankind, each and every one of us. And the more that we can think about that, the more likely we're going to make good decisions when it comes to vaccines. No one is forcing you. Be an informed parent, have open communication, but make your decisions based on science and on truth and not just what you're hearing or reading a blog or at a party.

Host: I want to give you an applause because that was just absolutely so good. Parents listening, please share this show with your friends and your family on your social channels. We're learning from the experts at Henry Mayo Newhall Hospital together, but when you hear a show like this, where the information is laid out so concisely and so clearly that you can't help but know that this is trusted information and to believe it is to know that that's what our Pediatricians are out there doing.

They are trying to give our kids as healthy a start as they possibly can and they're doing it with knowledge and information. And to learn more about vaccines, you can visit library.henrymayo.com and search for vaccines in the free health information library at Henry Mayo Newhall Hospital. That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital.

I'm Melanie Cole. Thanks so much for joining us today.