Maintaining Childhood Immunization Schedule Is Crucial During Pandemic
Question: I am an emergency room nurse. Last week, we had an eight-month-old baby coming in with severe diarrhoea and dehydration. It turned out that her parents didn’t bring her to receive her childhood vaccination, because they were terrified of the pandemic virus. She went to daycare a couple of times and got sick. Her parents treated her at home for several days because they didn’t want to go to the hospital, again afraid of catching the virus. Please advise your readers not to miss their children’s immunization, and to get help if they are sick.
Thank you for alerting everyone about the importance of childhood immunization in the midst of combating the pandemic. Hospitals have delayed or cancelled non-emergency surgeries; preventative screening for cancer is also delayed because of staff shortage or reassignment, putting many’s health at risk. These are the unexpected consequence of the Covid-19 pandemic.
I can understand why some parents are afraid of bringing their healthy children to public health clinics or family physician offices; they don’t want to expose them to others that may carry the pandemic virus. However, immunization of young children to prevent them from serious infections has to continue timely; it cannot wait until the pandemic is over. Otherwise, we run the risk of them getting sick with illnesses that are totally preventable through vaccination. This is a tragedy that we should try to avoid.
The infant that you saw most likely had Rotavirus infection. Not too many years ago, we used to have large outbreaks of severe diarrhoea and vomiting every fall and winter, in infants and children, from Rotavirus. It is easy to spread in play groups and daycare. With the introduction of Rotavirus vaccine, beginning at 2 months of age, large outbreaks have mostly disappeared. Without immunization and delayed treatment, Rotavirus gastroenteritis can be very serious, and sometimes fatal.
Childhood immunizations are scheduled at two, four, and six months of age, with additional vaccines between 12 to 18 months. The first three doses prevent diphtheria, tetanus, pertussis, and polio infections. Most of these are extremely rare in Canada, with the exception of pertussis, also called whooping cough.
There are several other infections that this “primary series” of vaccination prevents. One is against Hepatitis B, a virus that infects the liver, and can cause liver cancer later in life. They also prevent two bacterial infections: Haemophilus influenzae type b and Pneumococcus. Both of these bacteria can cause serious pneumonia, septicaemia (blood infection), and meningitis. These bacteria can be present in the throat of healthy individuals quietly, and pass onto young children without detection. Most adults have antibodies against these bacteria, so they don’t get sick. Mothers can pass on antibodies to their babies through the placenta during pregnancy. These antibodies, however, decline after birth, and become undetectable within months. As a result, these babies can get sick after the first few months of life; that is why it is important to immunize them early, and without delay.
In my decades of work as a paediatrician, I have seen many children with meningitis that died or suffered permanent brain damage from these two bacteria, before routine immunization against them became available. It would be a tragedy if it happens now because parents delay their immunization out of fear of the pandemic virus. We should follow all the public health recommendations to combat this pandemic, but maintaining childhood immunization schedule is crucial for the health and well being of infants and children. It should not be delayed or forgotten. Otherwise, tragedy can strike when we least expect.