June Visits the Doctor

 In mid-April my granddaughter June had a two-month check-up with her pediatrician.  At that visit, she received her first vaccinations.  The midwife that helped with June’s delivery and the pediatrician had both briefed June’s parents about these shots, and they were prepared.  June was not.  Here are the vaccines June was given.

·       ACT/HIB by Sanofi Pasteur - an injection to prevent a range of infections caused by haemophilous bacteria including meningitis.

·       Pediatrix by Glaxo - First of three injections given at 2,4, and 6 months.  The first injection prevents Diptheria, Pertussis, and Tetanus (DPT).  Later shots address all known forms of Hepatitis B and Polio.

·       Prevnar by Pfizer - an injection to prevent pneumococcal pneumonia and more.

·       Rotovirus by Merck – an oral vaccine given to prevent severe diarrhea in infants.

Before the procedure, the nurse prepared them thoroughly.  June’s Mom, my daughter Moe, described the conversation this way.

“OK, here’s how we’ve learned to do this.  We know it’s not easy for you or the baby, but it’s over quickly.  We give her the Rotavirus first.  It’s a gel given by mouth.  As she swallows it, we quickly give her three injections in her thighs.  After the first injection, she’ll likely open her eyes wide, inhale deeply, so much that you think she won’t breathe again.  But don’t be scared.  She’s just getting ready to scream.  Maybe louder than you’ve heard her cry ever before.  It’s what happens. While she screams, we give her two more quick shots.”

“When it’s over I pass June to you, Mom.  You hold her, she settles down, and we’re done.  She may have a little redness or hardening at the injection sites tomorrow, but as the doctor told you, these are notoriously safe drugs with few adverse reactions ever.” 

Moe looked at Don.  He looked worried.  Moe was too.  June was content and relaxed, oblivious to what was about to happen.  Three syringes and a little cup were laid out on a table beside her.  

It went exactly as the nurse predicted.  It was not the nurse’s first rodeo.  It was, however, definitely June’s first.  Here is a picture of June on the ride home.

She doesn’t look happy, does she?  Her Mom and Dad told me later they were pretty sure June was, for the first time, mad at them.

“Get used to it,” I said. ”That won’t be the last time.”

Soon after June’s mom became pregnant, she and June, in a prenatal kind of way, became patients of a group of professionals from West Suburban Midwife Associates, a practice based in Oak Park that works closely with West Suburban Medical Center, a hospital with a birthing center attached. 

Moe came to know a team of midwives that provided all her necessary care.  Later she added a doula, something like a birthing coach for parents, and a pediatrician.  That completed her prenatal, birthing, and postnatal care.  Included was a solid health assessment, vitamins, regular checkups, sonograms, and an amniocentesis, lots of education, and preparation-all while June was in the womb.  And although there was a pandemic and the hospital was wary of people going in and out, Don, June’s father, was also involved at key appointments like ultrasounds, in birthing classes via Zoom, and was there when June was born.  It was a family affair, a family of two becoming three.  With two cats thrown in for good measure.

June has so far been extremely healthy and happy.  The goal is to keep her that way.  She’s now seven months old.  Her preventative care continues.  At her four-month check-up, she received more vaccinations. 

We can only wish everyone in our country had access to such care.  It wasn’t easy to find a birthing center and a practice that would accept Moe and June.  She had insurance, but not a great policy.  Moe is co-owner of a small business that cannot afford a group plan.  She was miles ahead of many women in Chicago however, particularly those living on the South and West sides. 

Too many women in Chicago receive no pre-natal care and simply go to Cook County’s Stroger Hospital when labor begins.  We talk about food deserts in America, but how about healthcare deserts?  What happens to uninsured women unable to find an affordable health care provider to save their soul let alone an obstetrician, a doula, a midwife, a pediatrician - professional medical support of any kind.  I’m grateful Moe and Don had the resources to give June a healthy start.  Quality health care is a blessing families of privilege take for granted.

But back to June.  At her four-month checkup, she received the second of her DPT shots, another oral dose of the Rotavirus vaccine, and more.  June is on a schedule, recommended by the CDC, of being protected from 14 potentially serious diseases by age 24 months.  And so are most American babies.

I don’t know how many or what kind of vaccinations I received as a child.  I remember the sugar cube containing the polio vaccine melting on my tongue in the cafeteria of Danvers Grade School when I was 6 or 7.  I remember the smallpox vaccination, a group of needles that scratched the surface of my upper arm and was checked later by the school nurse.  My Mom is no longer here to ask, but I think I know how it worked.  She would have talked it over with Doc Boone, one of two General Practitioners in the town of Danvers in the ’50s and ’60s.  Two doctors and a pharmacy to boot in tiny Danvers, population 800.  Health care has changed greatly. 

Doc Boone was a quiet man who seemed shy and whistled softly while he examined me.  I could never recognize the tune.  He was a big white-haired man that we trusted implicitly.  He lived with his family in a brick ranch house that also served as his office.  I grew up with his kids.  He would never recommend anything that would harm our family, we were sure of that.  If he recommended childhood vaccinations, Mom and Dad would have taken his advice.

That’s what June’s parents are doing, as do most American parents still.   Vaccination rates for the kind of shots June is getting, the standard protocol for American kids ranges from 81% for DPT to 93% for Polio.  Although the number of parents seeking and getting exemptions from vaccines mandated prior to school admission has gone up recently, our confidence in those vaccines and our willingness to comply remains strong. 

So, we’ll vaccinate our babies, but we won’t take a vaccine for a virus that has disrupted our way of life and our economy, promises to shut down our schools again, and has killed 675,000 Americans?  Really?  We won’t get a shot that threatens our very lives, the lives of those we love, and our neighbors?  What happened?

I won’t pretend I know.  But somehow, we let politics come between us and our common sense.  We’ve allowed rumor to replace fact.  Too many have bought into a bogeyman characterization of the American healthcare system as Big Pharma in cahoots with profit-hungry healthcare organizations that care little about us as individuals.    

But what about the person you most trust for advice about your health?  The Doc Boones of today, the persons you go to when you are sick or in pain?  That face that sits across from you in the exam room, now next to a laptop, and listens to your worries about your health.  What do they say about vaccination?

I had an appointment with my trusted medical professional this week about an old person’s problem not related to COVID.  She’s not a doctor, but a Nurse Practitioner.  I like her better than my doctor.  In fact, I have lost track of who my doctor is these days.  My Nurse Practitioner answers my emails promptly and will do virtual appointments.  She’s accessible, smart, and practical.

“What do you tell your patients who won't take a COVID vaccine?”

She paused.

 “Well, what I say has changed as the pandemic has gone on because we learn more all the time.  There is so much research going on, so many studies out, and it all confirms the safety of these vaccines.  They may be the safest and most effective vaccines ever because of how they’re built.  And I tell them that.”

She sighed.

“And that’s usually not enough.  I ask them what, in particular, they are concerned about so I can tell them what I know specifically.  Myocarditis was a real concern for me and lots of us, but the numbers turned out to be so small that it really is not significant.  Then there was that fear of the vaccine affecting reproduction in women that was completely debunked.  I feel the vaccines are medically proven. There really is no scientific reason to fear any of these vaccines.”

She shook her head.

“It’s so frustrating.  Some people don’t have any specific fear but are just uneasy.  I see it in their faces.  I ask them how long it is going to take for them to be comfortable with it.  Some of my unvaccinated patients are in high-risk categories; obese, elderly, underlying conditions.  They’re taking a big chance by not being vaccinated.  Some of those people get flu shots every year, where the formula changes each time, and don’t think anything of it.  They just say they want to wait on this vaccine and I tell them ‘don’t wait till it’s too late.’”   

“Once, while talking to a patient I know very well, the last patient on Friday of a bad week kind of thing, I just sort of let him have it.  I told him I’ve had patients die from COVID.  I have long-haulers who may never get off oxygen or return to work.  I have wives who have lost husbands and kids who have lost parents.  Those families are never going to be the same again.  That’s what you risk when you refuse to be vaccinated.”

She was on a roll.

“Now I am saying something different.  Look at hospitalizations.  If there are 14 people in our hospital with COVID, 12 of them are unvaccinated.   And virtually all those dying of COVID now are unvaccinated.  It’s become very plain that vaccines prevent hospitalization and save lives.  Sure, there are break though cases where vaccinated people still contract the virus.  But their symptoms are usually mild, and they are rarely hospitalized.  And they certainly don’t experience the lingering effects that my poor long haulers do.  It’s a no-brainer.  And, I hate saying that because some of my patients who are unvaccinated are very smart people.  To them, I say if you don’t want to get vaccinated to protect yourself, do it for your family.  I don’t care why just do it.”

All I could do was nod and agree.

“You probably didn’t expect to hear such a long answer.”

“No.  But thanks.  More people need to hear what our local medical professionals think.  Not just talking heads on TV.”

“I wish they could.” 

“Me too.”

 

Vaccines are a vital part of modern healthcare.  Starting with the rabies vaccine in 1885, which thankfully isn’t needed universally but can wait till a real risk of rabies is encountered, we have found safe ways to prevent disease before it occurs.  Vaccines make us healthier and we live longer as a result.  What is the problem?

Whatever the concerns about the negative effects of COVID vaccines, they are far outweighed for me by the very real risks of getting COVID itself.  My next-door neighbor died of COVID.  I don’t need convincing.  Yet people in my extended family refuse to be vaccinated.  Of all the things that can and do divide Americans, we have let a simple and safe medical procedure further alienate us from one another, with deadly results.  It’s amazing to watch.  I wish I had an answer, a plan, to overcome this craziness, but I don’t.

I had two shots of Moderna vaccine in January and February and I feel fine.  I’m anxiously awaiting the opportunity to receive a booster once a plan is worked out.  I want to be as safe from COVID as I possibly can be, and more than that I want to make sure I am not a threat to people I love, like my granddaughter June.

June, at seven months old, is not eligible for a COVID vaccine but as you saw at the beginning of this piece, she has had whopping amounts of preventative medicines.  How does she feel?  You be the judge.  Here she is at her Uncle Dean’s condo a couple weeks after the latest round of shots playing peek-a-boo with her grandma.