No such notes exist for the period after our son was born. By the time we showed up for his two-month checkup, I barely had enough energy to brush my teeth. That was when, in the midst of a 15-minute “wellness” appointment, our son was scheduled to receive vaccines that would protect him against rotavirus, pneumococcal disease, diphtheria, tetanus, pertussis, Haemophilus influenzae type b, polio and hepatitis B. It’s true that there were signs in our pediatricians’ office stressing the importance of vaccines — but at no point did anyone broach the topic or offer to answer any concerns.
If, on the other hand, we had had a scheduled appointment before our son was born to discuss issues of infant health — such as the dangers of infectious diseases and the importance of vaccines — we would have written that information down and reviewed it when we got home. If we’d had questions, we could have discussed them at a time when we were able to actually process the answers.
At a prenatal appointment, with no baby to distract or soothe, parents could ask how vaccines work. They could digest the fact that, contrary to some rumors, vaccines are not injected directly into the bloodstream, they do not contain antifreeze, and there is no evidence that children receive “too many too soon.” They could discuss early warning signs for developmental disabilities and review the studies showing that there is no connection between vaccines and autism. They could hear about the dozens of infants who have recently been hospitalized with measles or have died of whooping cough. And they could learn about “herd immunity” — what occurs when enough people in a population are immune to a disease to prohibit it from being spread in the first place.
There are logistical hurdles to setting up this type of system, including the fact that for the most part, the obstetricians who treat pregnant women are not trained in pediatric care. But squabbling over treatment turf instead of looking for new ways to tackle the problem is short-sighted.
As we’ve been discovering, the costs of getting vaccine education wrong are potentially enormous. It’s too early to tabulate the costs of this year’s outbreaks, but recent studies have looked at two small-scale outbreaks in early 2008: one in Tucson in which 14 people were infected and one in San Diego in which 12children were infected. (All of those cases occurred in unvaccinated children or adults of unknown vaccine status.) Arizona’s outbreak ended up costing $800,000 to contain, and San Diego’s $200,000, figures that were obtained by adding up hospital and quarantine costs, among other expenses.
As recent history has shown, these figures can explode in an incredibly short time. In 2006 and 2007, France had an average of 40 measles cases per year. In the first five months of 2011, the country has recorded more than 10,000 infections, including 360 cases of severe measles pneumonia, 12 cases of encephalitis and six deaths. In 2008, Britain declared that the number of unvaccinated children was large enough to sustain the “continuous spread” of the disease — which means the victory that was celebrated 15 years earlier had essentially been reversed.
We have not yet reached that point in the United States. And talking about vaccines before a baby is born might be all it takes to ensure we never do.
Seth Mnookin
, a lecturer in MIT’s Graduate Program in Science Writing, is the author of “The Panic Virus: A True Story of Medicine, Science, and Fear.” You can follow him on Twitter or read his blog at the Public Library of Science.
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