It was the best of times: Present day - Cora was excited and nervous. She was 4 years old and about to have her annual physical. She loved going to her pediatrician, but knew she would be getting shots this visit. Her mom had told her that even though the shots might hurt a little, they would keep her from getting really bad diseases. And she REALLY didn't want a disease! She hugged her bear Rosebud tighter and walked into the office ...

It was the worst of times: 1915 - Henry's mom was getting concerned because over the last few hours he started to look and feel sicker. His fever was high, his neck looked swollen and he had developed a nasty cough. When her husband arrived home from work, they quickly bundled him and took him to the hospital …

Cora: The physical exam went well. Dr. Tony then started to explain to Cora that the next step was for her to receive her vaccines. She gave him a panicked look. Dr. Tony quickly sat down next to her and told her that the shots might hurt a little, but they would teach her body how to fight bad infections. "You mean diseases?" she chimed in. "Yes, diseases," Dr. Tony replied. "The vaccines protect you from getting really sick and going to the hospital." Next, the nurse entered the room, gave the shots and finally gave Cora a My Little Pony sticker. As she proudly showed off her new sticker, Cora suddenly realized that the shots really hadn't hurt all that much after all.

Henry: The doctor confirmed their greatest fear: Henry had diphtheria. They would immediately administer the diphtheria antitoxin and hope that it would help. Weeks later, Henry finally left the hospital, lucky to have survived his ordeal.

Although the above story line is pretty ominous, very few people nowadays remember what it was like before vaccinations became commonplace. This is a controversial subject to some people, but there is no refuting the fact that immunizations have saved the lives of countless children and adults.

It was the age of wisdom: The practice of immunization has been documented as far back as a thousand years ago in China. The idea is to "fake out" the body's immune system by giving it a safe version of a serious disease so it will develop immunity without experiencing the bad effects of the actual disease. In 1796, Dr. Edward Jenner successfully used cowpox to immunize people against smallpox. Over time, more and more vaccines have been developed, culminating in our current list of vaccines in use today. Now, in the 21st century, it is very rare for children and adults to get these deadly diseases. We have gotten better in developing vaccines that will give effective protection, while minimizing adverse effects. We have eliminated smallpox and virtually eliminated polio. Other "childhood" diseases have been corralled into fewer outbreaks and rare occurrences. The schedule of vaccines used today prevents measles, rubella, mumps, diphtheria, pertussis, tetanus, chicken pox, infantile diarrhea, Hepatitis A and B, several forms of meningitis and even cervical cancer.

It was the age of confusion: As with everything in the world, success brings other issues. Although vaccines have been used to eradicate or control many deadly diseases, some parents have become hesitant to have their children receive them. With the Internet readily available, it is very difficult to know what information you read is real, and with the sheer amount of websites touting themselves as vaccine experts, it is hard for parents to make informed decisions. Vaccines or their components have been accused of causing autism and other neurologic disorders; however, no reputable study has shown this to be true.

But it is true that in some instances, vaccines have caused more harm than they were intended to prevent. These vaccines were quickly pulled out of use and replaced with safer ones. Sometimes an individual child experiences a rare, but serious, reaction to the vaccine. But the vast majority of vaccinations are given without complications.

It was the season of light: Thanks to an active vaccination schedule, childhood mortality has drastically dropped. Vaccines are continually monitored for safety and modified to ensure safety. ALL vaccines for children under 3 years of age are Thimerisol (mercury)-free.

Common side effects of vaccines are fever, muscle aches and irritability. More serious side effects include allergic reaction, seizures or coma. These serious side effects are very rare. The Centers for Disease Control and Prevention (CDC) have extensive lists of the side effects associated with each vaccine on their website, cdc.gov.

It's important to remember that, like any other medication, vaccines are continually monitored for safety.

In Virginia, all entering kindergartners are required to have their entire Diphtheria/Tetanus/Pertussis, Polio, Measles/Mumps/Rubella, Chicken Pox and Hepatitis B series and boosters completed before school entry.

Sixth graders need to receive the Tdap (Tetanus/Diphtheria/Pertussis booster) for school entry.

Most universities require new students to receive the meningococcal meningitis vaccine.

Other recommended vaccines include Hepatitis A and Human Papilloma Virus (HPV).

It was the season of darkness:

I think readers might be interested in these statistics:

  • Before a vaccine was available, pertussis killed about 9,000 people in the United States each year. Now, the pertussis vaccine has reduced the annual number of deaths to less than 30 (KidsHealth.org).

  • Diphtheria once was a major cause of illness and death among children. The U.S. recorded 206,000 cases of diphtheria in 1921, resulting in 15,520 deaths. Before there was treatment for diphtheria, up to half of the people who got the disease died from it.

  • Starting in the 1920s, diphtheria rates dropped quickly in the U.S. and other countries that began widely vaccinating. In the past decade, there were less than five cases of diphtheria in the U.S. reported to CDC (Centers for Disease Control and Prevention).

"It is a far, far better thing that I do … "

In our practice, Capital Area Pediatrics in Sterling, VA, at every check-up, we routinely discuss the benefits and side effects associated with vaccines scheduled for that visit. Occasionally, parents will ask for a modified schedule, or decline them outright. We generally honor those requests, but point out that the decision to not vaccinate not only puts their child at risk of getting these preventable infections, but potentially exposes other children to them as well. All students in public schools are required to have their vaccinations unless certain waivers are granted.

As pediatricians, our primary goal is the well-being of our patients. The use of vaccines is the best tool we have to help protect children from deadly diseases. I strongly recommend that if you have questions or concerns about the vaccines your child is going to receive, speak with your pediatrician. In my 20+ years of practice, I have seen only a handful of cases where children contracted some of these serious infections. I attribute this to the widespread use of vaccines. All we have to do is "Google" smallpox, polio or diphtheria to see what benefits vaccines have given us.

Go to: www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html to see the current vaccine administration schedule.


William "Dr. Bill" Incatasciato is a pediatrician at Capital Area Pediatrics in the Countryside Shopping Center in Sterling. For more information about Dr. Bill and his practice, visit capitalareapediatrics.com.