A Crack in the Armor


I remember back in 1985, when I was a brand new pediatric nurse, I encountered my first patient with bacterial meningitis.    The little boy was wheeled into the Pediatric Ward on a gurney, such a tiny boy with brown curls, and long lashes that dusted his round cheeks.  He was so sick, rigid and unresponsive.  Despite intensive treatment, he never really recovered.  He was never the same.  He never walked again, nor did he ever talk, his development stopped that day.  Even now, 30 years later, I still remember that boy.  Because the most shocking thing was, 24 hours before he arrived on our Pediatric Ward, he was a completely normal, exuberant little 2 year old.  Bacterial meningitis can hit hard and it can hit fast.  And as sad a story as this is, it becomes even sadder because he wasn’t the only one,  there were many more.   November was the month we feared, that was the month we saw a surge in bacterial meningitis each year. Some of the children recovered, but because of how quickly bacterial meningitis took hold of a small child, not many of them did.  And even if they did, they sometimes had hearing deficits because of the large amounts of ototoxic antibiotics we administered.

The Haemophilus influenza (Hib) vaccine was licensed in 1987.  Prior to the availability of this vaccine 20,000 children a year came down with bacterial meningitis caused by Haemophilus influenza (the leading cause of meningitis in children under 5 years of age), and a 1,000 of these children would die. The majority that did survive had permanent disabilities.

Before the Hib vaccine was available we saw epiglottitis.  This was a scary, scary illness that caused the epiglottis to swell.  The child would present with drooling and if not treated promptly with steroids and antibiotics  his breathing would become stridorous (high-pitched breathing) and eventually if left untreated the epiglottis would block off the airway. These patients were brought to the Pediatric ward, sitting up in the gurney, leaning forward and they were frightened and their eyes were wide, pleading silently for help  as every breath was a struggle.  We taped emergency airway equipment to their crib just in case.  According to the Mayo clinic website, epiglottitis is rare today.

Several years ago, I contracted Pertussis.  This is another horrible illness.  The coughing is so intense and painful, ribs can be broken.  According to the CDC website, Pertussis in young children and infants can be fatal.  Cases of pertussis are on the rise.

Finally, another illness which is kept at bay is Rubella (the ‘R’ component of MMR) with vaccinations.  For children, this illness is benign.  For adults, it is not.  Rubella can make adults very ill, with arthralgias and arthritis.  In severe cases it can cause encephalitis.  The scariest thing about Rubella is the effect it can have on the unborn child of a pregnant women in the first trimester of pregnancy.  If a pregnant woman is exposed to Rubella in her first 3 months of pregnancy her child could potentially be born with hearing, vision or developmental disabilities.  This used to be a huge concern when the MMR vaccination was not available, but no one seemed to remember this, when the vaccination rates were high. Unfortunately now it might be something we need to keep in the back of our minds.

With daily updates on the news about additional cases of measles, it is really upsetting to know that much of this could have been prevented. I think back to the children and parents whose lives were forever changed because of bacterial meningitis.  If  the Hib vaccine had been available to their children 30 years ago, those children would have grown up and probably had children of their own, their parents would be grandparents.  But they didn’t have that particular vaccine available to them.

I have been watching the news closely regarding the measles outbreak.   I have also watched the videos of the parents explaining why they have chosen not to vaccinate their children.  I have seen a number of videos where they do they air quotes in reference to these illnesses being so rare.  Illnesses such as Rubella, Pertussis, the cyclical outbreaks of meningitis we used to see starting in November are rare, but not gone.  They are successfully controlled because the majority of the population chooses to vaccinate their children. These diseases are just waiting, hiding on the sidelines, waiting for a crack in the armor.  Measles has found a crack, an entry point, and if more and more parents opt not to vaccinate, those other devastating illnesses that most people are too young to remember will also find a way through – and that will be a crying shame.

22 replies »

  1. I really do not understand the anti-vaccine crowd. Why would anyone knowingly risk their child coming down with a serious illness when there are easy, safe ways to prevent it? I understand there is a remote chance that there may be a reaction to the vaccine, but the symptoms prevalent in diseases that can be prevent by vaccines are serious and can even kill, as you note.

    Not to mention the impact it has on the rest of society. A couple of years back, my wife caught pertussis while in a movie theater, likely from a child behind her who coughed nonstop during the movie. We surmised that the child hadn’t been vaccinated. Unfortunately, my wife hadn’t been vaccinated for many, many years and she was out of action – and miserable – for quite some time.

    • Oh your poor wife, Pertussis is so miserable. The problem with so many of these illnesses is that children just don’t to be that greatly troubled by them, and periods of being contagious are generally during the febrile stage. So parents just assume their children have a viral illness and don’t quarantine them and before you know it everyone has been exposed. I wonder if a MMR booster will be needed for adults, with everything that is going on.
      My Dad grew up during WW II – he said when the children got these illnesses, Diptheria, Measles, etc, they either got better or the blue Hospital Vans would come collect them and take them away. Sometimes they would come back and sometimes they wouldn’t. How scary would that be as a child seeing the blue Hospital Van come up to your house? But no one remembers all of this, but if they continue to not vaccinate, we will all get a reminder of what these illnesses are really about.
      Thanks for coming to visit my blog.

      • Sounds like our dads are the same age; mine survived polio when he was 5 and I imagine he saw some of the same scenes. The last thing we need are children falling victim to preventable diseases.

  2. I found your blog. 🙂 You are very knowledgeable about health. Liked the post about ghosts, too. Thanks for coming over to my blog.

    • Thanks Lori, I finally figured out how to eradicate the defunct gardening blog, now if I could just get rid of my weeds in the garden with one keystroke, how cool would that be?

  3. I finally tracked you down via an Internet search which led me to Lori’s blog, so thanks for visiting Detective Roughseas. Shame you’ve deleted your gardening blog, I was hoping I wasn’t too late to put in a plea to save it. C’est la vie.

  4. Thanks so much for this informative article. Most of us have very little familiarity with most of the illnesses for which we have vaccines, if any at all, health care pros included. I have posted some links to updates on Measles cases etc. I mostly get feedback that blames illegal immigrants and the POTUS, cites evidence of vaccine risks, dismisses their benefits, and so one. Much of such feedback comes from professional nurses. If only Americans had at least a little historical memory and familiarity with interpreting scientific and other reports, especially regarding public health. Again, thanks – Greg

    P.S. Oh, and welcome to my blog, and thanks for following!

    • Greg, thank-you for the welcome.
      I agree, you can’t lay the blame for the recent measles outbreak on immigrants.
      I read that one of the highest areas of non-vaccinated children in the United States is in the affluent areas in and around San Francisco.
      Guess where the highest rates of childhood vaccinations are? Mississippi.
      Hmmm. It makes one ponder.

    • Wow, karlspain – thank-you so much for reblogging this. It makes my blood boil when I hear people say they aren’t vaccinating their children because of information they read on the internet. And amazingly it seems more often than not it is the families who are highly educated and have the means to do so. I get that they want to have control over what goes into their child’s body, but couldn’t they focus on something like BPAs, antibiotics etc? Playing Russian Roulette with your child’s health doesn’t make any sense. Thank-you again.

  5. Hear, hear. This should be required reading for the antivaccination “movement.” I can see the fear in the child’s eyes and body posture (with epiglottitis) that you describe, not to mention the downy eyelashes of the child with bacterial meningitis (my son has lashes like those, so my mind struggled to not see him in that position as I read your harrowing words). It is more than just a shame, it’s a bona fide tragedy that children and adults die or are forever harmed by vaccine-preventable illness. With all the media attention on measles of late, however, I feel quite a bit of hope, oddly. I think the tide is really turning against antivaxxers; their footholds are being lost and their talking points flouted outright. The otherwise “educated” people who were against vaccination, I believe, are being given pause, at least, if not altogether changing their thinking. Bravo for the post and definitely for your work as a pediatric nurse; I cannot imagine your courage in the battle against compassion fatigue, for one thing.

    • Leigh – thank-you. The thing that gets me, is most of the people who are against vaccines have never seen this diseases, and if by some horrible chance their child did contract one of them, there is no going back, no saying – Oops I changed my mind, I want to vaccinate now. What’s done is done.
      And being a pediatric nurse is the best, every day that I spend with the children gives me great hope there is a lot of good in the world. It is true, you never forget the sad stories, those children’s faces flash through your mind like a slide show, they are always with you.

  6. Reblogged this on sassafrass20's Blog and commented:
    This is why idiocy is rampant among Americans-because they don’t do their fucking homework and only use the first two or three “articles” on Google as their research. I’d rather have my children vaccinated and friendless than not vaccinated and lose them because of idiocy. There’s always a chink in the armor. Why do people believe that a vaccination is a cure all, end all, not a tool used to keep illness under control? Oh yeah-BECAUSE WE ARE IDIOTS THAT DON’T RESEARCH. Bloody hell, common sense isn’t so common anymore. Times like these, I hate being “American”. I just want to be me.

    • Thanks for the comment. There is one statement I feared most of all when doing Primary Care, above all others – “I read it on the Internet.” EEK! You are so right about some people only taking the information that fits their beliefs and thinking all the other stuff is just frivolous and nonsensical and doesn’t apply to them. The internet is a great thing, but I think in the end it might be our undoing.

      • The Internet I think was a great idea in planning and infancy, but has become out of control like a rebellious teenager. This is where idiocy abounds in my opinion. What would happen if Google unplugged for a week?? I miss a real research hunt for information, that leads to real and in-depth education on the topic being researched. We’ve fallen down the rabbit hole.

      • Read “Back in the Day” . I reminisce in that post about going to the library, card files and typing with White-Out. Such fun. I miss those days.

      • Me too. I pulled out the “when I was your age” schpeel for my son..even “before the Internet” shocker. I miss the sound of a typewriter, the card catalog, and looking for something that may or may not have been on microfiche!

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