“Selective Vaccination”

Photo by Max Felner on Unsplash

As Zak heads to the pediatrician for another round of vaccines, I thought I’d type another atypical Slishman angle on the topic. I’ve touched on vaccines a few times previously.

For the antivax community, I feel your pain and anxiety, and I hate every single injection into my kids too. Here’s what you may not realize. Even after studying the past 6 months for my ER board recert exam a couple weeks back, I’m actually not sure if I’d recognize measles if it hit me square in the head. Never seen it. “Koplik spots + cough, coryza, conjunctivitis”… in theory for board exams anyways. I’ll keep waiting. Have no cases entered my world in 20ish years, or have I missed every single one?

I had a patient with a swollen parotid gland and sore testicle a couple weeks back. Mumps? Coulda been. They were referred to public health, but then never got tested. I haven’t seen a chicken poc (What’s singular for pox?) since a cruise in 2011 when three of five unvaccinated filipino band members got hit hard. Diphtheria “pseudomembrane”? Never seen it. H.flu epiglotittis? Maybe saw a case in residency. Maybe. Rose spots? Opisthotonus? Risus sardonicus? Blank. I know what a “whoop” sounds like from Youtube anyways.

I type this because in the past few days I’ve had a variety of calls from worried parents with sick kids who have opted not to vaccinate. One used the phrase “selective vaccination.” I said I hope she selected right.

As a doc I feel like I have a good idea how sick and not sick kids look, and how they’re likely to progress. It’s from seeing hundreds of kids over 20ish years. But for all the maladies typically covered by vaccines, all my data really just comes from books and photos. Meds students may actually be better at picking out these illnesses than me now, because it takes a residency to learn about probabilities vs. possibilities. In med school zebras are just striped horses.

So choose your path and I’ll still love you. Just realize when you call me with an unvaccinated kid, you may actually get better advice from a nervous med student, or a salty doc who may still remember talking into the mirrors of iron lungs.

To summarize:
– These diseases are bad.
– Your doc, or at least this doc, probably hasn’t seen or treated any of them in a very long time.
– Roll your dice.

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