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Another Reason Why It’s Important to Vaccinate Your Child

by Sue Hubbard, M.D.

I was in the office yesterday on a busy pre-holiday Monday. I went into an examining room late in the afternoon to see a two-year-old who looked “pretty sick”. Her mother told me that her daughter had developed a fever and a swollen eye over the last 8 hours and that “she had never seen her this sick.” She thought that her daughter had had a mosquito bite the week before and that maybe that was why her eyelid and the area beneath her eye was swollen and red. But the bite had gone away days ago, and now she had a fever.

I glanced at her chart and had one of those “ah-ha” moments when I realized that the little girl had never been immunized. Not one vaccine, never!! This made me put on my thinking cap from days gone by. It used to be a fairly common occurrence to see a child in the one- to three-year-old age range in the office with a swollen eyelid and area around the eye, who also had a fever and looked ill. The infection is called peri-orbital cellulitis (an infection of the soft tissue surrounding the eye), and is typically caused by a bacteria named Haemophilus Influenza (H. Flu). This bacteria was renowned for causing meningitis, epiglottitis, periorbital cellulitis and blood infections. A vaccine was developed in the late 80’s (our office participated in the clinical trials) and since that time when children began routinely receiving HIB vaccine it had become quite uncommon to see infections due to this bacteria.

But today, I was reminded of the risk of developing diseases that could be prevented with vaccines. The mother was very concerned and kept asking me how her daughter might have “gotten sick with this bacteria?” Just because there is an immunization, does not mean that the bacteria is no longer lurking in our nasal passages, on surfaces and all sorts of places. We often forget that kids may still get sick with these illnesses that we “had forgotten” about. I had to return to my first days of practice to remember that I wanted to get a blood culture on her to make sure that the bacteria had not invaded her blood stream, and to watch her in the office as we got her fever down and looked at her lab results. I was trying to decide if she needed to be admitted or could be treated as an outpatient.

Thankfully, after lowering her temperature and getting back her lab work, she looked a little better. She was treated with an injection (ouch) of a broad-spectrum antibiotic and will be seen again in the morning to make sure her eye has improved and that she is also feeling better.

In the meantime the reality of vaccine preventable diseases is still on my mind. Why would a parent not want to prevent any illness in their child that they possibly could? The reality that these infections may still occur became too close today. I think these parents may be re-thinking vaccines. If they are not, I am thankful that the frequency of these infections is rare, as the majority of my patients are immunized and will continue to be!! We have not eradicated these diseases; they have just been prevented by immunizations.

That’s your daily dose, we’ll chat again tomorrow.

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