A few months ago, I became aware of the ongoing measles outbreak that has been traced back to visits to Disneyland in Anaheim, CA, which began in December 2014. I remember reading the news reports, including the defense of those who did not believe that vaccines are safe, and witnessed the pleas from physicians, who are also parents, expressing the frustration and anxiety they faced because their own children, immunocompromised due to various medical conditions, were exposed to measles unnecessarily.
Needless to say, these events alarmed me. I could attribute my concerns to my being an oncologist who was concerned for my patients, who, due to treatments, are always at risk for infection. And yes, I feared that they could be exposed to measles, which could be serious and even life-threatening, in addition to the risk that they, in turn, could expose others.
But, if I am to be honest, the outbreak has brought back memories I would rather leave buried in the past. My partner, Henry, and I are the proud parents of three beautiful children—our oldest, Isabelle, is 12, and our twins, Harrison and Sophia, are seven, all of them born by surrogacy. Our surrogate’s pregnancy with the twins was complicated, and we risked losing them in the early second trimester.
But, they made it to 29 weeks and six days, and although we live in Boston, they were delivered at the University of California, San Francisco. Fortunately, after a relatively uneventful seven weeks at the Neonatal Intensive Care Unit, we left with our newborn babies. They were so tiny and vulnerable, though, that we had to stay in an apartment with them until the time came when we were cleared to fly home to Boston.
I still remember boarding that flight to Boston. There were a few people sniffling and coughing, and I worried the twins would catch a cold. We sat in the back of a relatively uncrowded plane, and fortunately, they slept through the flight. Ultimately, we landed home—our family larger and intact. We thought we were in the clear.
About two weeks later, though, Harrison developed a cough. He didn’t have a fever, so I didn’t think too much of it. When it did not clear over several days, my partner began to worry. It became more pronounced, and his paroxysms were so severe that he would vomit (posttussive emesis, it’s called) and struggle to breathe. We went to the pediatrician, and she was sufficiently concerned that we were referred to the emergency room for further evaluation where our boy was admitted with a tentative diagnosis of a viral upper respiratory infection. He was deemed stable the next day and was discharged, even though his symptoms had not abated.
That night, while holding him, he turned blue. I thought it was the lighting, but quickly I realized that he wasn’t breathing. Instinctively, I gave him a few breaths (yes, mouth-to-mouth resuscitation), and he woke up, cried a little, and then fell back asleep. I called out for my partner, and he came running. He took Harrison out of my arms and soon realized Harrison had stopped breathing again. He started CPR at home while I called 911.
Harrison was taken to a local emergency department and then transferred to a Children’s Intensive Care Unit in Boston. The intensive care team evaluated him and immediately made a diagnosis—“your son has pertussis, likely infected during the plane trip.” For the second time in his weeks’ old life, he was in the ICU, monitored for a disease I had thought had been eradicated.
My son recovered, but not all children do. According to the Centers for Disease Control, there were approximately 17,000 cases of pertussis between January and August 2014, and most of these cases affected those too young to be immunized or were otherwise immunocompromised. Of these, 20 have died, and mostly, these were infants.
This is inexcusable because diseases such as measles, polio, and pertussis should not be seen in resource-rich countries like ours. Decisions not to vaccinate are not made by children; those decisions are made by their parents who refuse to believe the science and/or are deeply skeptical of government and pharmaceutical companies.
But the lack of vaccination puts others at risk, like my son, and for this reason, clinicians must be aware that diseases that they might have only read about in medical textbooks are very much out there.
In addition, we must speak out about the importance of childhood vaccinations. We have certainly done this in oncology and other parts of medicine, and we have done this in the best interests of the children. Whether it is ensuring access to chemotherapy for a child with a curable cancer or the use of transfusion for the children over the religious objections of their parents, we have taken these stands. One can reasonably argue that measles and other infectious illnesses are not the same as cancer or severe anemia. However, all of them are serious and can kill.
I read recently that Andrew Wakefield, the author who provided “scientific evidence” of the link between vaccines and autism, has lost his UK license to practice medicine. His research has been discredited and that seminal paper retracted from The Lancet. To Mr. Wakefield, I will say—you will never understand the harm you have caused to society. Bad science is bad for everyone. There should not be a body count to prove it.