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In order to optimize her patient care, Dr. Natasha began to take an active interest in communicating with patient families in unique ways. This dialog turned to real-time media venues to keep up with the pace of medical information online, and to add to the active online conversations that influence health care decisions.

This blog features adaptations and ideas that begin within the walls of her pediatric clinic. In addition, this is a place for personal refection on parenting, medicine, and advocacy.

Respectful, kind, and smart dialog is encouraged. Please see comments policy for details.

For child health relevant guest posting opportunities, contact kckidsdoc@gmail.com.

Dear Justin Timberlake: Revised Advice to the Prince of Pop

Posted by on Nov 19, 2015 in Child Health, Featured, In the News, Parenting, Vaccinations in Children | 0 comments

Dear Justin Timberlake: Revised Advice to the Prince of Pop

Dear Mr. Timberlake, 

I was not expecting to see you and I together. As a long-time fan, our names sharing space in the Celebrity Gossip column of In Touch Weekly was truly a surprise. 

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Now, JT. Can I call you, JT? I know that you remember me from a few months back. We shared some time in a darkened auditorium with a few thousand of my friends – I know you saw me. I was only a few feet away as you floated above my head. You looked directly into my eyes my soul while serenading a 20/20 Experience. I was the one wearing black. Remember? 

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This week, my 20/20 looks different. Apparently, In Touch Weekly connected with an anonymous source suggesting you and your wife have elected to not vaccinate your son. As much I understand Celebrity Gossip columns of entertainment rags do not have a strong history of accuracy nor general journalistic principles; this cuts me deep, JT. In fact, it cuts so deep that I’m not sure that I believe it.

My gut tells me that a Tennessee kid like yourself has better sense than to be swayed by the Hollywood anti-vax yimmer-yammer. 

Regardless, our newly established one-degree of separation implores me to respond. And now that I know that my words might directly influence the Timberlake lineage, I will speak directly from the heart of a fan. 

So, here goes. (Ahem.) 

JT- 
Let’s start talkin’ ’bout some issues. Talkin’ ’bout real important issues.

When it comes to scary diseases, we know What Goes Around…. Comes Around. It’s time to recognize that from the Blue Ocean Floor to a Spaceship Coupe in the sky, little roadies gots to be protected. And the very best way to protect our peeps is with vaccination, brah.

We can’t have Amnesia of diseases past. We need Tunnel Vision toward a healthy future. That means all of us have to do our part to protect our kids Until the End of Time. We know vaccines are Not a Bad Thing. They get your immune system defenses N*SYNC; ready to give the bacteria and viruses that are trying to Rock Your Body an early-round TKO. Amirite?

So, put on your Suit & Tie and bring the SexyBack to vaccines. When you’re ready to bring it on down to immunity-ville, I’ll be here. Meanwhile, if you are looking for a board-certified pediatrician to travel with you on your next world tour, you know where to find me. 

Your biggest vaccinated fan,

Dr. Natasha

PS: #HASHTAG! vaccineswork #HASHTAG! becausescience #HASHTAG! ididitallforthecookie #HASHTAG! dropsmic

 

 

Royals + Chickenpox = Bad News

Posted by on Sep 1, 2015 in Child Health, Featured, In the News, Parenting | 0 comments

Royals + Chickenpox = Bad News

Two of our beloved Royals are off the field after contracting chickenpox.

As the team (and the city) is in active preparation for a successful post-season, the news that 2 players are out due to a childhood disease is, well, a curveball.

Chickenpox is a vaccine-preventable disease that most children and adults no longer need to endure. The news of the virus infecting well-known members of the community should heighten our awareness that these serious diseases are still lurking. Keeping our families protected from an unexpected encounter with a person harboring a vaccine-preventable illness, is one of the reasons we want to be sure we are all up-to-date on vaccinations. 

This includes Moms and Dads, too. 

Adults who have had the chickenpox as a child have life-long protection from the classic infection. Not sure if you’ve had the pox? Call your mother. She’d like to hear from you. Those of us who had the itching bumps as a kid still harbor the virus in our nervous system, keeping the possibility of shingles in our future.

Adults who contract chickenpox for the first time do have more complications from the virus, including lung and brain infections. So, if you are not sure that you had chickenpox as a kid, it’s not too late to get the varicella (chickenpox) vaccine. Adults need 2 doses of the vaccine for full protection, separated by 28 days. This vaccine is readily available at health clinics and doctors offices. 

All children should receive 2 doses of the chickenpox vaccine before Kindergarten. The first dose is given after the age of 1 year.

It is reassuring to know the Royals franchise took appropriate precautions to protect the rest of the team and community-at-large. Although it is unknown how long the players will be off the field, reports suggest it could be as long as 2 weeks before they don the Blue. 

We wish a safe recovery to our Boys in Blue. 

Grandma’s Chair

Posted by on Aug 31, 2015 in #hcsm, Child Health, Children's Health, Featured, Parenting, Vaccinations in Children | 0 comments

Grandma’s Chair

This post was originally published on the MHA@GW blog. It was part of a series celebrating National Immunization Awareness Month, featuring many writers supporting and advocating vaccines for all children. To read the other engaging submissions, visit the MHA@GW blog. 

I remember the chair covered in a pale mustard yellow. The fabric was worn so badly that the raised paisley pattern was nearly vanished from the edges of the arm cushions. Where my grandmother sat endured a permanent concave mark.

In that big, old chair I would sit on my her lap. Together, we would read all sorts of stories and tall tales, but what she liked to read most was the local paper. She would carefully read aloud each report, from front page to want ads. Between each article, she would add her two-cent editorial of the news.

“That just can’t be,” she would say of the day’s legislation. “Truman would never have let that pass.”

“Can you believe what they get away with these days?” sneering at a woman in a one-piece swimsuit from Sears.

Over time, her reading lessons were less about the news and more about grandma. Her comments revealed her own values and share bits of our family history. She shared traditions and common sense that only increased in value as I aged. Her words perpetually gained new meaning as I could apply them as a child, and in new ways as a young adult.

As I imagine sitting with her today, in that mustard paisley chair, I wonder what she would think of today’s headlines. Specifically, what would she think of Americans becoming ill with vaccine-preventable diseases?

I think my grandma might say, “My neighbor died of measles. We were so scared when your mother got the rash. I thought they were going to die, too. I thought everyone got a shot to protect themselves these days.”

She might get tears in her eyes, saying, “My brother still limps after being attacked by polio. When we could get that vaccine, I remember dragging your mother to the school, waiting in the line with our neighbors, and thanking the heavens that our kids have been saved. Why would people not want to protect their babies from that horrible disease?”

Unfortunately, I can only fabricate what she might have offered based on what I know of the history of her life. I no longer have the privilege of hearing these experiences first hand; to learn her fears, and the choices she made. And I’m not the only one.

Everyone in our generation, now raising children of our own, is losing access to these historically important stories of death and suffering from disease. The stories of lives that were taken away too early by now-preventable illnesses are hidden away in our own family trees. The re-telling of the desperate pleas for a miracle are becoming silent. 

We are now witnessing the consequences of this fading oral history.

Today’s news does not hold stories about the miracle of vaccines. The narrative has changed from stories of vaccine success into waves of warning. The opportunity to protect our children from disease is being incorrectly framed as oppressive and dangerous. What’s worse is that our moral duty to protect the children of our community is being deflected by our existence in suburbs of high fences and name-less neighbors.

Meanwhile, the success of public health initiatives is being compromised. Outbreaks of vaccine-preventable disease are increasing. More kids are getting sick.

Today we each have an opportunity to change this trend. We live in a time our grandparents could only imagine – that with one click we can touch our families, friends, and entire community. We can let others know a way to stay protected and safe from tragedy.

We can share our stories of healthy and thriving children protected by vaccinations.

We can work together to continue a swell of pro-vaccine dialog on the communication channels we use everyday. Facebook, Twitter, Instagram – these communication channels matter, just like the local newspaper that my grandma read to me. These channels carry influence and trust based on the connections we each have created. Our words carry weight in these social places we live. 

There can be immense power in a simple post, image, tweet, or snap that may land in the hands of a person making the choice to vaccinate. Your effort could be the very thing that helps another child get the protection they deserve.

Working together, our efforts and our voices will not be lost. They will be amplified as they are carried forward into the future, in a place where our grandchildren will be able to learn from us. 

#vaccineswork

Introducing #31DaysVaxFax

Posted by on Aug 1, 2015 in Child Health, Featured, Parenting | 0 comments

Introducing #31DaysVaxFax

Everyone loves “fun facts.” These shareable bits of trivia are quick nuggets that are meant to pique interest in an interesting topic, but ultimately add to our mental Rolodex of understanding.

Like this:

Humans are born with 270 bones, but die with 206 bones. Certain bones fuse during the course of our growth to account for this change. 

Fun fact, right? But, wait – There’s more!

Each day of August, I’m going to be recognizing National Immunization Awareness Month by sharing bite-size bits of vaccine knowledge. These tweets, grams, and posts are meant to be easily liked and shared throughout our favorite social networks.

My goal in creating these facts is simple: To offer an opportunity for the vast majority of us who have chosen to vaccinate our children, a super-easy way to share what we know. These facts are meant to help us work together to share what we believe to be one of the best technologies for keeping our kids safe from illness. Plus, they are meant to encourage interest and understanding in something so important for the health of all kids. 

And, I promise we will have some fun along the way. 

Join me all this month on the KCKidsDoc channels – Twitter, Facebook, and Instagram – and follow #31DaysVaxFax and #vaccinesworkkc .

Pick your favorite fact, on your favorite channel, and share it. Here we go!

Big thanks to Dr. Autumn Han, a 3rd year resident at Children’s Mercy Hospital, for helping this project become a reality. Your hard work in vaccine-fact-hunting was impressive and appreciated. Cheers!

50 Phone Calls: Our Kids Deserve To #BVaccinated

Posted by on Jun 23, 2015 in Child Health, Featured, Parenting | 0 comments

50 Phone Calls: Our Kids Deserve To #BVaccinated

Imagine receiving a phone call. Your child is in the hospital with a serious infection. In the few short hours it takes you to arrive at her bedside, she is now so sick that she cannot speak. She needs machines to help her breathe, blood transfusions, and aggressive antibiotics. Tubing, pumps, and monitors surround her. She is fighting for her life.

But you just talked to her yesterday. She said she was just coming down with a cold….

Parents of young adults infected with serogroup B bacterial meningitis often share this same haunting story. Sadly, fifty* more parents in the US will get this phone call in the upcoming year.

Fifty.

We commonly hear about meningitis striking college campuses, having devastating effects on American youth who have been infected. In the last few years, the KC area has not been spared. We experienced a fatal case of meningitis in Madison County, and other cases at University of Missouri and the University of Kansas where the students thankfully survived.

Although most of my families know meningitis is a vaccine-preventable disease, many parents do not know the meningitis vaccine commonly given to our middle and high school students protects against only 4 members of the bacterial meningitis “family.” A fifth member of the “family” remains responsible for 1/3 of meningitis cases in young adults – and is not part of the commonly administered vaccine.

Today’s great news is that we now have FDA-approved vaccines with the ability to protect against a fifth “family” member, serogroup B (MenB).

The MenB vaccines work. They are safe. And they can prevent those 50 phone calls.

Our challenge today, however, is that these new vaccines are only available to very specific individuals, leaving the vast majority of young adults unprotected. The next step is for the CDC to fulfill their role in the regulatory process so these vaccines can be made available to the public to prevent outbreaks.

I strongly encourage the ACIP and CDC to allow these vaccines to be made available to the broadest possible population. Increased vaccination rates will proactively reduce the chance for outbreaks here in Kansas City, statewide, and nationwide. As a parent and pediatrician, this approval is of upmost importance in combating the threat of meningitis in our communities.

And fifty families are counting on it.

*Projected number based on historical incidence as published by the CDC and FDA.

7 Things About Tampons: A Post for Moms and Dads.

Posted by on Jun 10, 2015 in Child Health, Featured, Parenting | 0 comments

7 Things About Tampons: A Post for Moms and Dads.

Swim season, sleepovers, and summer sports camps – many tweens and teens are asking about tampons. It’s time for a refresher. 

1. It’s OK for her to use a tampon. 
Using tampons is normal and safe, even from the very first period. In other words, there is no medical reason that a young girl cannot wear a tampon. Using tampons do not imply “sexual maturity” or advanced sexual interest. Tampons are just another form of hygiene product – simple as that. With some technical instruction, her experience should be straightforward and positive. Your support in the process will only make it easier. 

2. Buy the right stuff.  
Tampons come in lots of shapes and sizes. Girls are more successful with a slim, “slender,” or “junior sized” tampon. Choose a tampon for light flow. Finally, a tampon with a plastic applicator will allow increased comfort and easier insertion. With all the different options, you may want to grab a couple of different brands or styles for her to try out. 

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3. I Googled “female anatomy,” so you don’t have to. You’re welcome.
You can’t be successful at putting in a tampon, until you know where it goes. Most girls have not thought about their female anatomy since watching “the video” in 5th grade, but understanding anatomy is clearly crucial to tampon success. All tampon brands include an instruction sheet in the box with the basics, but here is an additional anatomy diagram of the vulva to help explain where a tampon should go. Feel free to pass it along, and then…. 

4. Offer other helpful tools. 
The only way to learn anatomy is to look at it. I recommend offering a small hand mirror. Using a diagram as a guide, she can visualize her own body in private. For additional help, there are also some videos she may want to use to learn about the tampon, and demonstrations on how to insert it. Here is a nice video for the basics. Alternatively, here is a more comprehensive video from Boston Children’s Hospital using a realistic model (NSFW). 

5. A few practical tips to pass along. 
Wash your hands. This is not a race, take your time. Practice when your flow is medium to light, not in between periods – when more natural lubrication is present. When inserting, aim towards your low back, not towards your head. If the tampon is correctly in place, it should not hurt. Finally, some water-based lubrication applied to the applicator may make the first few tries a bit easier. 

6. Using tampons is just part of the story. 
Just because a woman uses tampons, does not mean she has to (or should) use them all the time. Tampons can be used for day or night wear (8 hours max.) Some women prefer to also have a pantyliner in place when wearing tampons in case of leaks, offering extra security for the first few experiences. Most girls continue to use pads when outfits better allow, and when sleeping at night. Alternating tampons with pads is the best way to prevent a rare complication of tampon use, toxic shock syndrome. More information about TSS is available from KidsHealth. 

7. Dads – you need to know about tampons, too. 
What if mom is out of town, or you have the girls for the weekend? Generally, most girls seek help from another woman on this one, however, a quick review of the basics will serve you well. Be sure that you know where the supplies are located to avoid urgently awkward trips to the pharmacy. Be respectful and available, but don’t demand a lot of dialog – many girls are thankful for calm support and some privacy. 

Good Luck! 

Will Craniosacral Therapy (CST) Help My Baby Nurse?

Posted by on May 20, 2015 in Child Health, Featured | 0 comments

Will Craniosacral Therapy (CST) Help My Baby Nurse?

This post is written by pediatrician, Dr. Julie Ehly. Dr. Ehly is my “next door neighbor” at Pediatric Associates, where she has a thriving general practice. I value Dr. Ehly’s experience and guidance inside the clinic where she has a passion for all things pediatric, including early infant development and family education. Her mentorship extends outside the clinic, as I am privileged to know her as a friend and role-model. I’m excited to share Dr. Ehly’s first guest post on KCKidsDoc. Enjoy! 

 

Everyday in clinic, parents ask about ways to optimize their breastfeeding experience. These families want their babies to gain all the breastfeeding benefits that we know breastfeeding holds. When breastfeeding is a struggle, however, parents look for every possible solution to improve their baby’s ability to nurse. 

Recently, we have been hearing more parents ask if craniosacral therapy (CST) will improve breastfeeding. 

What is CST?

The premise of CST for breastfeeding difficulty is to use physical touch to optimize the alignment of baby’s palate and skull bones that have slid out of place during the birth process. The technique centers on the belief that this birth “trauma” contributes to latch or suck difficulty. By massaging the bones of the skull and spine into neutral position, CST claims to enhance tongue thrusting, sucking reflex, and latch.

Does CST help nursing?

Simply, we don’t know. 

While use of CST may be increasingly commonplace, there is limited scientific evidence supporting its use. The vast majority of the research surrounding CST for breastfeeding is published solely by the developer of the technique, clearly leading to biased reporting of outcome. To date, there have been no independent studies holding CST to the scientific rigor of which other breastfeeding recommendations are held; and it is challenging to find supporting research that these techniques are reproducibly helpful. In addition, there is a limited understanding risk of CST , especially in children and newborns. 

So, should I try CST with my baby?

Without evidence supporting improved breastfeeding outcomes or data supporting safe use in infants, we cannot recommend CST to our patients. 

As partners in your newborn’s care, we want mothers to succeed at breastfeeding. 

One of our many practice goals is to help patients make health decisions supported by well designed scientific research, or evidence-based medicine. We can lean into evidence to help us make a care plan that will have a greater chance of success for all our patients. Supporting therapies and procedures that have not passed scientific rigor are challenging for many of us to fully support or promote. Simply, alternative therapies such as CST are inherently unable to be studied in the scientific placebo controlled manner we value as physicians. 

CST may be practiced by a variety of providers from massage therapists to chiropractors. It is not a regulated practice in the US, and training and implementation is variable. If you choose to pursue CST for your infant, ensure that the practitioner is accredited in pediatric care. Be sure to ask questions of the provider about the techniques used, understand the goal of treatment, and observe the bodywork that is being performed. 

Early breastfeeding problems in infants can be attributed to multiple causes, many that can be supported by lactation specialists and a baby’s pediatric doctor. If you are experiencing breastfeeding problems, please talk to your baby’s doctor early to be connected to a trusted support team. We meet breastfeeding difficulties with compassion. We want success, with safety.

Until you connect with someone to help, there is a ton of breastfeeding advice available at healthychildren.org.

Listeria in Kansas: What you need to know

Posted by on Apr 22, 2015 in Child Health, Featured, Parenting | 0 comments

Listeria in Kansas: What you need to know

In the last month, certain varieties of Sabra hummus and all Blue Bell Creamery products have been recalled due to concerns of Listeria contamination. These products have been pulled from KC-area shelves, and should be removed from your fridge at home.
 
Here’s what you need to know.
 
Why is this important?
 
Listeria is a bacterium responsible for a severe form of food poisoning called listeriosis. To be clear, listeriosis is NOT a common illness. In addition, there have been reports of otherwise healthy individuals eating Listeria-contaminated products with minimal to no symptoms. However, when certain susceptible individuals (infants, elderly, and immunocompromised) become infected, listeriosis can be life-threatening. Pregnant women are also more likely to develop listeriosis after exposure, which can cause harm to the fetus or newborn.
 
Listeria is tricky bacterium. It is very “sticky” on the outside, so it can live on surfaces for a very long time. In addition, it can grow in conditions where other bacteria are unable to thrive. Due to the severity of the infection that Listeria may cause, food products and food production lines are commonly monitored by health authorities for its presence. 
 
So, what’s the deal with the food recalls?
 
In Kansas, health authorities recognized a pattern of unfortunate deaths caused by listeriosis at a local hospital. These deaths were over a period of years, not a sudden cluster of infection, and determined to be caused by Blue Bell products. The recall is necessary as the company begins to identify the source of contamination in one of its many production plants. Listeria in Sabra was found during routine food product inspection. No illness or death has been directly reported by hummus-eaters.

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I’m pregnant and I eat ice cream. 

Telling a pregnant woman that she should stop eating ice cream makes about as much sense as telling a toddler that she doesn’t need to bathe. So, eat up. Outside of the Blue Bell Creamery products, there have been no other concerns about dangers of eating ice cream; within moderation, of course. :-)

If you are pregnant in KC and you have eaten Blue Bell ice cream, don’t panic. Call your OB for next steps, which may likely be to do nothing. Unless you are showing signs of illness, it is unlikely you need to be medically tested or treated.  

What should I do now?

  • Check the fridge and dump recalled food items in the trash.
  • If your family has had a known exposure to the recalled food items, a healthy level of observation needs to be maintained. However, there is no need for intervention or evaluation on people who are not sick. Listeriosis kind of looks like meningitis – fever, body aches, headaches, neck pain, plus some gastrointestinal symptoms. Pregnant women often describe a flu-like illness with fever and diarrhea. Call your doc if you are worried.
  • Routine food-borne illness precautions are always in play –> Cook food well. Wash raw veggies. Avoid unpasteurized dairy products. Wash hands and cooking prep surfaces if exposed to uncooked foods.

Where can I go for more information?
 
All you would ever want to know about Listeria can be found on the CDC website. For more info on how to avoid infections during pregnancy, here’s some insight from UpToDate.  And, of course, for advice specific to your family, give your doc a call.

Moving? 3 Tips to Help Find the Best School

Posted by on Mar 9, 2015 in Featured, Parenting | 0 comments

Moving? 3 Tips to Help Find the Best School

Springtime is a popular season for moving to a new home. Some families are relocating to new, unknown cities for a parent’s job. Others are considering a move across town to get more room for the kids, or prepare for school entry.

Regardless of the reason, parents often stress the educational options of a community when they consider the location of a new home. I am commonly asked about how to find out information about local schools before considering a move.

-How can we begin the search when we don’t know anyone in [enter new city name]? How can we learn more about the schools in the KC area? What are my child’s education options if we don’t move? What tools can we use?-

To answer these questions, I turned to my friend Nick Elam at Zillow. Nick has knowledge of the real estate market, in addition to an understanding of the type of information parents need when shopping for a new home and new school.

He offers some great resources to consider in this guest post.

How to Compare Kansas City Schools Before Moving

By Nick Elam

Source: Zillow.com

Source: Zillow.com

Moving is complex. Finances, jobs and daily routines are all simultaneously in flux. Moving with children only increases stress when parents are unsure about the schools their children might attend. One way to curb this moving stress for the whole family is using good resources to research quality schools. Being knowledgable about the best education options for your family will narrow down suitable locations for the move.

1. Determine the type of school to fit your child and family needs. Public, private and charter schools all provide different structures and approaches to education. Public schools are free, but often suffer budget cuts and high student-to-teacher ratios. Private schools or religious usually have higher test scores, yet require substantial tuition costs. Charter schools allow teachers more freedom to design curriculum, but smaller class sizes and less funding per pupil make enrollment competitive. Deciding on one type points parents in the right direction to suitable neighborhoods.

2. Once your list of possible school types has narrowed, compare the performance levels of individual schools to determine the quality of education offered. GreatSchools is an exhaustive resource for in-depth comparisons of schools’ test scores, subject proficiencies, parental reviews and college preparedness. Based on a 1-10 scale, GreatSchools applies a rating of 10-out-of-10 to schools measuring well-above their state averages. Simple demographic information can also be found at the National Center for Education Statistics which may add value to your research.

3. While school type and test scores point to a school’s performance, they don’t portray the entire student experience. Parents should actively seek parental feedback to fully evaluate whether schools fit their children’s needs. Casually contact parents and ask about their child’s experience. Keep in mind that every student is different, so seeking multiple opinions paints the most thorough picture. Visit school websites to identify PTA representatives and community blogs to connect with local parents to make more informed decisions. Then prepare for your visit to the school using all the great research and feedback you have obtained.

Comparing these metrics assists families in finding ideal areas with quality schools before relocating. Parents then need to consider neighborhoods, commute and cost of living before identifying the best location to purchase a home. Zillow is a great tool to combine much of this information in one place, plus can be searchable by assigned schools. Although it may be a bit overwhelming, I hope these resources make the search much easier.

Dear Doctor No Longer Seeing Vaccine-Hesitant Families

Posted by on Feb 26, 2015 in Child Health, Featured, Parenting | 7 comments

Dear Doctor No Longer Seeing Vaccine-Hesitant Families

Dear Doctor no longer seeing vaccine-hesitant families,

I know that creating your “no tolerance” office-wide vaccine policy was not easy, or came without soul-searching. I can only imagine the heated boardroom meetings and passionate arguments throughout the weeks the policy was being drafted. I trust it is because of your support and love for the families you currently care for that you felt the need to create the policy, and it is with a heavy heart you are watching some families now leave your care.

As a fellow pediatrician in your community, we share the same commitment for providing optimal care to the patients we serve. We both believe fully in the safety and efficacy of vaccines, including the vaccines that we have given on-schedule to our own children. We never promote or encourage a non-standard vaccine schedule to any of our families, as evidence suggests this creates an increased risk of illness and death to children. We publicly support vaccination in local and national media. We share the same desire of wanting our families to feel safe in our offices, when well or sick.

It is my opinion, however, that your new policy to exclude the vaccine-hesitant from your office is failing in both evidence and ethical ground. The policy falsely promotes safety to your current patients, it threatens to weaken the health of the Kansas City community we share, and it cripples the impact of our future pediatricians.

The claim that your vaccine policy increases safety for your families is not founded in evidence, and falsely promotes security.

You may feel that your policy is helping your patients. Anecdotally, you may even experience more families vaccinating under your guidance. The challenge, however, is that we share the need for scientific evidence to make medical decisions; not feelings or anecdote. To date, there is no evidence that an individual medical practice vaccine policy increases patient safety within a medical office. Claiming otherwise misrepresents true infectious risk to your patients, while falsely promoting increased security.

Multiple analyses have been performed surrounding vaccine-preventable disease outbreaks in the past. The results suggest illnesses such as measles and pertussis are spread primarily in public areas and in local ERs, not in physician offices. The few instances in which infections did originate in offices were in areas with sub-optimal vaccination rates or endemic disease.

Our daily reality, even under the most stringent restrictions, is that we all have under-vaccinated children in our offices everyday; notably all children under the age of 1. In addition, few vaccinated children have an imperfect response to the vaccine and leave themselves at risk. When these kids arrive ill at our door, there is no guarantee they don’t harbor a significant illness. More practically, ill parents bring children into our clinics everyday without us demanding their adult vaccine records. As you know, in recent outbreaks, adults are often the primary vector spreading illness to children, not the other way around.

These real-life dynamics exist in both our waiting rooms, regardless of policy; leaving your claim of protection emotional and short-sighted at best, opportunistic and promotional at worst.

This is not just about your waiting room. It’s about our Kansas City.

But even if this were true – that you were creating your office to be a more protective space – no studies have shown such a policy to increase community vaccination rates. It is community vaccination rates that are most protective for our families, not individual office waiting room rates.

By shutting your doors to the vaccine-questioning, and if more practices follow your lead, our community could develop a greater risk of disease. The under-immunized will be driven to our local ERs, urgent care centers, and sub-optimal providers; often sending these children and all future siblings to care providers with little to no training in immunology or vaccinology.

At extreme, the under-immunized will increase in number within the few health spaces that still allow them to pass the threshold, potentially forcing a geographic pocket with dangerously low herd immunity. You now have the making of an epidemic as the under-vaccinated cluster together, waiting for care; then return to work, school, churches, day cares, and play spaces all over our community.

Mathematical models suggests equal distribution of the under-immunized throughout a community is safer for the children of the community as a whole.  The small number of under-immunized are best served in equal distribution among all of us who provide passionate care for the welfare of all children. They are best served by those of us who have sacrificed life-years for exceptional education in child health, and by a group of leaders that share equally in the responsibilty for our city.

In turn, our city deserves our greatest collective effort to provide a chance for every child in our community to be vaccinated. We may be their only hope.

We cannot create a weakness in the next generation of pediatricians.

Vaccine hesitancy is as old as the small pox vaccine and will continue well after we have passed the care of our patients to the next generation of pediatricians. We have an obligation today to empower, train, and educate the next generation of doctors in effective science communication and unparalleled vaccine knowledge. This education cannot happen without allowing medical residents to sit across from families who love their kids, and set the record straight about vaccines.

I believe our obligation to promote science continues past our few years of service. We can facilitate a legacy of passionate vaccine educators by having pediatricians-in-training watch what we do, practice what we teach, and then carry that skill forward to a new generation of children. If an increasing number of attending physicians limit the opportunities for vaccine dialog in their offices, how can we ensure this training will be adequate?

Doctor, I have felt the sting of rejection when my efforts to get a child vaccinated have fallen short. It hurts and oozes. And especially in times of disease outbreak, it haunts. But meeting that rejection with an ultimatum of our own does not help the child coming to us for care. It does not help our community where we work and play together. It does not serve the mission in which we are called to serve as pediatricians. It benefits no one.

Consider expanding your policy restrictions to include the allowance of agreed conditions, so more children have the chance to be fully vaccinated by the age of 2 under your care. Allow more time for discussion and dialog throughout formative years to build trust and reliance in those of us most educated in child health.

Sincerely,

Dr. Natasha

*As always, the words and thoughts on this blog are my own. They may or may not represent my business partners.