Transcription:
Vaccinate: Protect Your Child from Vaccine- Preventable Diseases

Melanie Cole (Host): Vaccination is one of the best ways parents can protect infants, children, and teens from potentially harmful diseases. Vaccine-preventable diseases can be very serious, may require hospitalization, or even be deadly, especially in infants and young children. My guest today is Dr. Tony Giaquinta. He's a pediatric hospitalist at Hendricks Regional Health. Welcome to the show, Dr. Giaquinta. So, tell us about vaccines. As our children are little and babies, what are the vaccines that you feel are most important for parents to know about and follow in the schedule?

Dr. Tony Giaquinta (Guest): Oh, gosh! That's like asking who my favorite child is! They are all so important and I like them all the same. You know, parents sometimes ask, "Is there any vaccine that I should forego, or that you think I should skip?" and the answer is “no”. You hit the nail on the head, Melanie. These are really dangerous illnesses and they, in fact, can be deadly. You know, it's interesting, this is such a case of out of sight, out of mind where we just don't see the devastating consequences of a lot of these vaccine-preventable illnesses. The easiest ones to think about are polio or tetanus. These are illnesses that you can certainly give a Google, and the images are worth probably more than a thousand words. Polio is still around and it's endemic in certain countries, but we don't see it anymore in the United States. Tetanus is the same thing; we very, very rarely see tetanus, but it is an incredibly dangerous illness. So, these are just a couple of the illnesses that we can totally prevent and, in fact, eliminate with appropriate use and administration of vaccinations.

Melanie: So, then, let's start with the first ones that the little babies receive, and then kind of work your way up into the toddlers and teens.

Dr. Giaquinta: Excellent. So, when the baby first comes to my hospital, before they go, they will get a Hepatitis B vaccine and a lot of you think, "Boy, Hepatitis B? Isn't that something that adults get and it causes terrible liver disease? Why are we giving this to babies?" Well, that's exactly right. This is usually an adult illness, but the thing is that about 90% of infected infants will get a chronic infection. The risk certainly goes down as the child gets older, but we do see that about 15-25% of chronic infections will turn into a serious liver disease like cirrhosis or even cancer. So, right off the bat, we are preventing illness. After you get to your doctor when they're two months old, they'll get another round of vaccines, and that will consist of a pneumococcal vaccination. Pneumococcus commonly causes ear infections and pneumonia and we're seeing now, now that we cover 13 strains of this, that we're seeing way less ear infections and pneumonias from pneumococcus. Along with that we will also give a Diphtheria shot. This is another one that we very rarely see nowadays, but it is, in fact, very dangerous. We see it usually as a sore throat, and then it can, in fact, block the entire airway. The toxin is incredibly dangerous. In areas where they don’t vaccinate for Diphtheria, the mortality rate is about 40-50% of those who get the illness. The other one that's very important that we start at about two months old is the haemophilus influenza vaccine. This is a very dangerous bacteria. About 1 in 200 kids would usually develop the invasive disease before they were five and 50% would have meningitis, which is a serious infection around the brain. Now that we vaccinate it, we very rarely see meningitis from haemophilus influenza. It's so interesting. When kids came to my hospital 20 years ago and they had a fever, and they were less than three months old, we would almost assume they had meningitis from one of these diseases. Now we very rarely have to actually work up from meningitis because we know that vaccines are incredibly effective and they are doing their jobs. The other ones that are very important that we give at one year of life is the measles vaccine. This has really hit the news a lot lately. Believe it or not, in 2001, the United States had declared victory over measles. We won. We had eliminated it from our country and yet, time and time again, in these last 15 years, measles rears its ugly head. Some people wonder "Well, how dangerous is it?" Well, again, we don't see it a lot, so we don't remember, but sure, ear infections, pneumonias--these are some of the more common effects of measles, but one in a thousand will get encephalitis. That's a brain infection, okay? About one to two out of a thousand will die from this. We don't see it very much in the United States. Two hundred thousand people in this world, every year, will die from measles, and so this is something that we don't see, but it certainly there, and it is certainly dangerous, and we can prevent it--we can eliminate it again from this country with appropriate use of vaccines. Varicellus, or otherwise known as chicken pox--that's the one that we, most of us in our 30s, probably had when we were younger, but again, we don't see it anymore. Victory to science! We have a vaccine for this. We remember that it itched and that it was annoying, but the truth is that about 11,000 kids got hospitalized from chicken pox and maybe about a hundred or so would die every year. And so, these are really the common vaccines that we think about. The other one that I certainly recommend for every parent that comes in is the influenza vaccine. This is a vaccination that we remember to get every year, and so we kind of wonder every year, "Boy, do we really need it?" Absolutely, the answer is “yes”. Every year we see kids hospitalized with influenza and they get incredibly, incredibly sick. They can get dehydrated, or they can get serious pneumonias, and, in fact, die from this. We have, all of the doctors in the health field have a case where we have seen a child die from influenza and it's devastating.

Melanie: Dr. Giaquinta, as kids get into their teen years, there are some new, specific vaccines that you're recommending. Speak about HPV and the meningitis vaccine for before they go to college.
Dr. Giaquinta: Boy, what would say if I told you that we have a medicine that can prevent cancer? I mean this is the Holy Grail that we're talking about. A medicine that prevents cancer. We have so much research and dollars going into treating cancer. What if we could prevent cancer? That is exactly what the HPV vaccine can accomplish. HPV, the strains that we protect against, against HPV, are the strains that predispose a woman or a male to very serious forms of cancer. For women, that's cervical cancer; and for men, less commonly, it's penile cancer. But, importantly, both sexes need to be vaccinated for this because it is a sexually transmitted disease and half of the group will be spreading it to the other half, so it makes sense to certainly vaccinate both men and females, especially in their teenage years against HPV. Certainly, we are not endorsing promiscuity by administering an HPV vaccine. We're simply acknowledging that at one point, when they are old enough to have sexual intercourse, that they will be protected from this very dangerous disease. The other one that's really hit the streets lately is the meningococcal vaccine that you mentioned. Again, every year there will be an outbreak at a college; the most recent one was the deadly case in Princeton--I'm sorry, I don't think it was deadly--but the very serious case in Princeton is when several, I believe 7 or 8 students, contracted meningitis due to the meningococcal bacterial. And what we know is that there have been no reported outbreaks where there was an appropriate level of vaccination of the meningitis vaccine.

Melanie: So, what do you tell parents that ask you about the safety and the efficacy and the schedule, and they have questions about getting more than one at a time or the combinations like Dtap. What do you tell them every day, Doctor?

Dr. Giaquinta: Well, every case is a little different because, like you just said, a lot of people have many different questions about vaccinations and every question deserves a personal answer. You brought up a lot of different issues about vaccine safety, too many at once, and so every one of those questions really deserves a specific answer and we have very well-known, scientific answers to all of those that will make parents feel safe about giving their child vaccinations. What I really always just encourage parents to know is that I care and love their child and that I want them to thrive and be healthy and with my scientific and medical background, this is absolutely the safest, most effective form of medicine that I could offer your child. We think of antibiotics as kind of our, again, maybe our Holy Grail of medicine; something that can kill the bacteria. Vaccines are so much better. They have a much lower risk side effect profile and, importantly, they prevent a disease from even occurring. That is fantastic. So, it's really that close relationship to the family and that level of trust that is most important between me and my patients to help encourage them to vaccinate their child. If they have questions, I encourage them to go look up their own and bring their resources in and then we'll talk about it. The more that we can have an open dialogue and build that relationship with trust, the more that they will understand that all I really want is for their child to be healthy and thrive.

Melanie: Wow. Thank you so much. Your passion certainly shows, doctor, and what a great wrap up. It's such important information and thank you so much for being with us today. You're listening to Health Talks with HRH, Hendricks Regional Health and for more information, you can go to www.hendricks.org. That's www.hendricks.org. This is Melanie Cole. Thanks so much for listening.