Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand.

And today I'm going to be joined by Dr. Rosvida San Gabriel, Pediatrician at Riverside Medical Group's Pediatric Specialist Bradley office to discuss all that you need to know about childhood immunizations.

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Host: And we're back with Dr. San Gabriel. Thanks for being here today.

Rosvida San Gabriel, MD: Hi.

Host: We're glad to have you. So could you start by just telling us a little bit about yourself?

Rosvida San Gabriel, MD: All right. Well, I'm one of the new kids in the block, I guess. Not the newest one because we have another one. So I've been here at Riverside since June and I'm the new pediatrician also at Bradley, joining Dr. Batista. And we've got our new member also, Dr. Herrera. So there's three pediatricians in our practice right now. So, yeah.

Host: Awesome. And jumping into the basics of this topic, can you tell us from the start, like, what is immunization?

Rosvida San Gabriel, MD: Well, immunization really, in general terms, only means that it's, it's actually a process where your body, and we're talking about like basically for this topic right now, is able to resist, and also protect you when you're faced and exposed to an infection.

So that's basically immunization, which sometimes gets, sometimes it can be interchangeable with immunization and vaccination, but for basically for this talk, we'll just say immunization and vaccination are basically the same for now.

Host: Okay. So why is it so important to get your immunizations rather than just building up like your immune system naturally?

Rosvida San Gabriel, MD: Okay. That, I hear that a lot. I mean, back in the days, like, when they can actually feel, and we're talking about like 1700s, 1800s, where you actually see people, well, they're miserable. And of course, the ones who are affected much are the children. So, natural immunity is not even considered like a treatment, because for you to have natural immunity, you have to go through the illness.

You have to be sick first, and who knows what side effects you're going to get. So you have to go through the illness first. But your immune system starts developing antibodies to it, so that's your natural immunity. So you have to be miserable first before you get the antibodies. Now with the vaccine though, what the vaccine actually does is also simulate that.

And that's, I think, where a lot of confusion goes because I think people think of vaccines as a medicine, something foreign, that it's the vaccine that's actually doing the work. In reality, it's actually our immune system doing the work. It's just the vaccine is trying to simulate, to take part of that organism or that bacteria where it will not give an infection. So when you have, say for example, you have chicken pox, so you got the chicken pox, but it has entered now your body and it's like a big dose think of it like you got the blast of chicken pox. So do you have like a higher response to that one there and that's why you are miserable you have symptoms. You're itchy, you have a high fever. Although they said that natural immunity is actually better, the problem about that is, is that you're going to be sick, you're going to be ill.

So who wants to take that risk? Like, I'm going to get immunity, but I have to be sick first. So the vaccination actually came up because they want to do that. And what they did is that, we'll just get a sample of this bacteria. And all these scientists actually, and this is controlled, this is all scientific.

They're going to give a little dose first, where you don't have to be infected. And that's why a lot of these immunizations, they're just one big blast, like when you're sick. So say for example, chickenpox, you're going to get one now. And then once they found out like, oh, okay, well, it's kind of waning a little bit.

So we have to boost them. So that's another topic, but this is very controlled and it's like little doses where you don't get sick, but you also have the same effect of protection, like the natural immunity. So that's basically what we would prefer to get the vaccine than being sick.

Host: That makes sense. I think the chickenpox is such an interesting example because I was talking to some of my friends and we were all like, none of us have ever had the chickenpox. That's so weird. I feel like everybody always used to talk about it and then we looked up when the vaccine came out and it was right when we were, like, right when we were born.

So it's like, well. I know, I know. Something's working.

Rosvida San Gabriel, MD: I know, actually, I remember this because I just got out of residency and when it came out that it's recommended for the school, a lot, a lot of parents are not really happy because they really think like chickenpox is no big deal, so that's why they have this like, I'm thinking like, the what?

You have chickenpox parties? I'm thinking like, where I grew up, there's no such thing. Right. Because you get sick, you're sick. But the thing about this is with the chickenpox parties, they only see like, okay, well you get sick, you're going to be miserable, you're good, you're fine, now you've got immunity, but they don't realize the ones who did not get chicken pox when they're an adult, that's the one that they have it really bad.

So they really are not aware of the full scope of what chicken pox does. Because when all these scientists pick, okay, what vaccine are we going to develop right now? They're just not going to get something out of the hat. They have to get something that's very significant to the population that will protect them.

So, and that's why they picked up chickenpox, because, people are not aware, but people can die from this.

Host: Yeah, definitely, definitely. So is there a set timeline, like schedule, to get these immunizations? I know there's like a lot of different ones.

Rosvida San Gabriel, MD: It depends on what it is. And since I mentioned about like, you give like many doses of that one depending on how you respond.

So say, for example, chickenpox is two, you get one when you're one year old and then now you have another booster at four, the DTAP, polio, hepatitis B, because of how that organism is to protect how you're going to produce their antibodies; they've studied that you have to give a timing of like two doses or three doses to meet that complete immunity.

So that's why it's not the same for every vaccine. It really depends how you respond to that one. So yeah, so it depends.

Host: Got it. Yeah, and that was kind of going to be my next question about, you know, if there's a rhyme or reason for the schedule that there is and why different boosters you need and not others. But I think you kind of answered that in saying that, you know, different, just vaccines work differently and so making sure that people are up to date on the timeline in which it is most effective, I would say, right?

Rosvida San Gabriel, MD: That's right.

Host: Yeah. Cool. We're going to take a quick break to talk about finding a primary care provider. Riverside knows that health is your greatest asset and that your primary care provider is your partner in health. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare. So I have heard people talk about vaccinations and saying by getting vaccinated, you're protecting those kids and the people unable to get vaccinated. Do you hear that in your practice as well?

Rosvida San Gabriel, MD: That's the thing, because a lot of patients are not aware that they have a direct effect for the people that they're around them for, especially for the ones who cannot get those vaccines. If they're able to get the vaccines themselves, they're actually protecting other people too. That's what we call the herd immunity. We kind of want to call it now the community immunity, because people don't want to be identified as cattle, I guess. So yeah, with the herd immunity, if you're just going to think it this way, if you're in a room and there's 10 of you and there's one person there, for some reason, cannot get the vaccine, either he's immunodeficient or he's just not scheduled to get the vaccine, by him being surrounded by these people who are immunized from that one, that illness, that medical condition is not able to penetrate that room because it's not able to spread in that room because everybody already has antibodies to it. So it's kind of like a fringe benefit. You're actually helping the other ones who cannot get it and that's why it's called a herd immunity.

Host: That makes sense. What happens if a child gets behind on their scheduled vaccines? Like maybe they were sick or unable to get it or traveling. Is there a way that you can kind of make them up if it's not on time?

Rosvida San Gabriel, MD: Oh, yeah. That's actually the least of their worries because we have ways how to do that. We don't repeat, unless of course there's some mistake on how the intervals are. But basically, yeah, the parents should not be worried about how we're going to schedule to make sure that they're updated with the shots.

So, but yeah, but it's not the same because it's not the one size fits all because it depends on what their age is, what they need. But we know how to do that. There's ways how to do that. So, yeah, it shouldn't be a problem.

Host: You would just reach out to your provider.

Rosvida San Gabriel, MD: Mm hmm.

Host: Got it. Are there any trusted sources that you tend to send parents to if they're kind of on the fence about vaccinating?

Rosvida San Gabriel, MD: Oh, okay. I like giving handouts. So when I have patients who like handouts, I like to pick specifically for them because I don't want to give them like a, like a journal where it's going to do a snooze, so usually just pick one. The one that's really, really quick, but me personally, the ones that I like a lot, where I always go back when I need resources, one is the immunize.org, that I look it up all the time. They're the forefront of information. CDC, of course, but unfortunately, it's getting a bad rap right now, being politicized and all, but CDC actually has a wealth of information about anything, really. So, CDC, immunize.org. Now, also other websites that I check are the ones from hospitals or children's hospitals who are also very well known when it comes to immunizations and one comes to mind is the Children's Hospital of Philadelphia and there's Dr. Offit. He's very well known with immunizations and I also look at their website and they are also, back then they would give like free materials for immunizations and he is how would I say this? He's like the master when it comes to immunization. And then Texas Children's also too.

I remember that they would hand, they would give out like some books about real life people who actually had the disease itself. So those are the ones that I usually look into because, well, they've been always reliable and they're easy to understand, easy to read if I'm going to recommend it to my patients.

Host: Yeah, that's great. That sounds like you have a lot of different resources for people to check out. So that's awesome. Is there anything else that you want people to know about these immunizations? If they're on the fence or something like that, can they do you have to call to talk to somebody about it?

Rosvida San Gabriel, MD: Oh yeah, oh yeah. I mean, the most important thing is just to open up and because when, when they come to the office, and if I notice that there's certain immunizations that are missing, I usually want to ask what their thoughts are, what they think about this vaccine, why did they held off, and then that way we can have a conversation. Then hopefully I can help them if they're willing, if I can give them whatever information they need, but just start the conversation, basically.

Host: That's awesome. Well, we're so thankful that you were here today with us. And thank you so much listeners for tuning into the Well Within Reach podcast brought to you by Riverside HealthCare. For more information, visit riversidehealthcare.org.