I see this as a glass half-full, glass half-empty issue. Yesterday, a study was published in Pediatrics detailing research conducted in May of 2010 about parents’ preferences to use alternative vaccination schedules versus following the recommended CDC vaccination schedule. The majority of the media coverage focused on the finding that over 10% of parents followed a schedule other than the one recommended by the CDC. Not perfect and not ideal from a public health stand point. Yet, of course, the other way to see this is that nearly 90% of parents did follow the physician-recommended schedule. That’s a pretty good success rate for doctors.
As a pediatrician practicing in Washington State, I saw this study half-full. As I read through the methods, results, and discussion, I took notes on the cover page. I actually made that little doodle. I couldn’t help but think about the nearly 90% of families (87%) who followed the recommended schedule to protect their children and their communities. Clearly 87% is not 100% (I get that) and it leaves our communities and our children at risk, but I believe we can continue to improve trust with ongoing education.
Focusing on the group that does vaccinate their children on the schedule may be a good strategy to understanding where we can improve our communication about the benefits of vaccination. We often focus on the group that doesn’t vaccinate but we miss insight from those of us who do immunize our children on the schedule.
Details: The study was conducted on over 2000 respondents, where 771 families qualified by reporting having a child between 6 months and 6 years of age. They were asked if they followed the CDC schedule and then if they didn’t, they were asked to answer a series of closed-ended questions regarding the nitty gritty of the schedule they used. Parents’ age, gender, race/ethnicity, and level of education and family insurance were collected.
Influenza causes more hospitalizations than any other vaccine-preventable illness. It’s not just kids at risk for complications (asthmatics, diabetics, children with complex heart disease or immune problems) that die from the flu. Nearly 1/2 the children who died in this last year in the US were well, healthy children. PREVENT influenza, get a flu shot for all the members of your family. Although the flu vaccine dose is the same as last year, it’s recommended we all get a dose this season. For children who didn’t have a dose last year under the age of 9: they need 2 doses this year, separated by 1 month.
ERRATA: I said that 46% of all children who died between Aug 2010 and Aug 2011 were healthy kids. The correct number is even higher: 49% of the 115 children who died in the US were healthy children without significant flu risks. My apologies.
Our kids teach us a lot about life. Doesn’t matter if they’re in-utero, a newborn, a toddler, or a teen. An obvious statement of course, but not only do our children teach us about their journey, they teach us about our own. Today it happened again, O taught me something. He reminded me about self. He reminded me about our need to be who we say we are and our need to perform at our best. When we don’t, it can unravel us.
It is our own disappointment in self that stings the most. I thought about this while reading Dr Atul Gawande’s recent New Yorker piece entitled Personal Best. To me, Dr Gawande’s courageous act of getting an expert coach exceeds his desire to better himself as a surgeon and beat the national averages on complications. He wants to stay true to himself; he wants ongoing improvement and escalating precision. He doesn’t want to let himself down. If we let others down, it feels absolutely terrible. When we let ourselves down by acting against our integrity or mission, it can feel far worse. Visceral. Two things converged on me today: Read full post »
Don’t have 100 or so seconds? Here’s the Cliff Notes on what I said:
Family meals matter. Not because of the fruits and veggies but because of the communication that occurs. Any meal can be a family meal (breakfast on Tuesday or supper on Sunday). Don’t think only about dinner. Aim for 100% of your family at these precious events, but I say anything over 50% will make a difference in not only your child’s, but also your life.
There are 5 things I took with me from my online sabbatical in August. Know, however, I didn’t do as stellar of a job staying offline as I’d hoped and the 5 things are harder to hold onto than those numbers you see me grasping right there. I’d envisioned an entire month like the family photos: unplugged, disconnected, liberated, and focused. It wasn’t entirely like that. Clinic got nuts a few times, there were minutes I was still staring at my phone and hours every day I’d sit at the computer responding to emails, there were upsetting mega-tantrums from the boys and there were a few phone calls I fielded with bad news from friends. There were moments I felt inexplicably tired despite the uptick in sleep. All was not peace on earth.
Yet, let me be very clear: the month away was worth it. I learned a bit more about my relationship with technology, who I am as a person amidst 2011 information flow, and how I want my life as a parent and person to change.
Clearly, part of the experience of being a parent is housed in the soul.
You know this. Something happens the day you become a parent. Like a huge shift in your footing, that unexpected large wave washing out the sand where you stand, or how it feels in your toes when you try to gain traction running downhill. It happens without our control. The transition is very loud yet somehow its inaudible. It’s huge, unquestionably bigger than any anticipation and warning about having a child. Being a parent is greater than our own capacity to explain it thereafter. And it’s tactile, although you can’t really feel the transition to parenthood like you feel a touch on your skin on a warm day or the cold air when you walk out into a mid-January night. Rather, you feel it shift inside. Somewhere in an unidentified part of who we are that isn’t detailed in the anatomy textbooks. Becoming a parent is becoming more aware. My time away helped me see this. So, here are the lessons:
I found my sons’ first birthdays very emotional. Magical, even. Looking back provided great perspective on how much can happen in 1 year of time. What our children accomplish in the first 12 months is simply astonishing.
I wonder, can we prioritize sleep? I mean this sincerely. Can we really value it? Sleep is one of the essential parts of being human yet unlike some of the other essential things (think food, exercise, oxygen, or shelter) no one seems to give us credit when we sleep. Come about age 11, kids start to be praised for their achievements more than their skills in self-preservation.
Like most busy moms, I speak from an experienced place–I’m up early today after going to bed late last night. With the dog awakening us with vomiting at 2:30am, I clocked in under 6 hours of sleep when the alarm clock broke the silence this morning. Clearly it is our own responsibility to find ways to prioritize sleep. No one will do it for us. So, how we both model sleep and also advise our children as they grow matters. It is well understood that sleep deprivation isn’t good for us. It’s not good for our performance, our driving, our friendships, our mood, or even our waistlines.
In clinic, I ask teenagers what time they go to bed. I ask them if they sleep with their phones, if they wake up to an alarm, and how easy it is to fall asleep. I ask parents and I ask about the little ones, too. But it’s the teens (and parents) I worry about most. Those little 6-month-old-midnight-screamers, they’ll figure it out. The over-subscribed-stressed-out high-(or-low)-achieving teens? They need a little time on this…A study published this month only confirms my concern. Read full post »
I don’t diagnose Chickenpox often. I’ve seen patients with Chickenpox only a handful of times since I started medical school in 1998. Auspiciously, there simply haven’t been many children to serve as my teachers. Varicella virus causes Chickenpoxand there’s a vaccine for that. So, like Smallpox or Polio, I’ve been forced to learn a lot about Chickenpox in textbooks. My strongest professor in the Chickenpox department is my own memory; I had Varicella between the age of 5 and 6 years. It was the one week of my childhood where I remember being really babied– my mom gave me a small gift or craft every day while I was home from school. I got to watch TV on the couch. I must have looked pretty awful…But it wasn’t so bad and I was lucky. I was a healthy 5 year old girl who had a case of chicken pox that was “run of the mill”: lots of spots, lots of itching, a week of fever and feeling crummy. Then poof, I scabbed over and got better. The only remaining trace (besides the virus that may live in my nerves) is the scar on my L forehead. You seen it?
The big trouble with Chickenpox is you can’t predict which child will have a serious complication (a brain infection, an overgrowth of flesh eating bacteria in the sores, or a life-threatening pneumonia).
While I was finishing up college, the Varicella vaccination was introduced into the United States. At that time, over 150 people died every year from Chickenpox and over 11,000 people were hospitalized annually. This created a huge economic toll (from missed work to health care costs).
So my apparent lack of clinical opportunity with Chickenpox reflects reality. A study published this week found that over the last 12 years there has been a 97% reduction in deaths from Chickenpox in children and adolescents younger than 20 years of age. There’s been an 88% reduction of Chickenpox deaths over all (kids plus adults). These are staggering statistics. Read full post »
Seattle Children’s provides healthcare for the special needs of children regardless
of race, sex, creed, ethnicity or disability. Financial assistance for medically
necessary services is based on family income and hospital resources and is provided
to children under age 21 whose primary residence is in Washington, Alaska, Montana