pediatric vaccination

Diphtheric Conjunctivitis

While many people who know of the infectious disease diphtheria - which we’re protected against by the TDaP vaccine, and which was the impetus for the “Great Race of Mercy”, which is commemorated by the Iditarod - know that it can cause systemic infections and death by suffocation, one of the most common complications is often confused for other conditions.

Diphtheria can cause an acute conjunctivitis if the bacteria infect the conjunctiva of the eye. If it is not brought under control promptly, the toxins exuded by the bacteria can cause necrosis in both the eyelid and the cornea, which can lead to serious vision problems or blindness in patients.

Historically, blindness was a major problem for survivors of diphtheria, scarlet fever, ocular gonorrhea, and smallpox.

Atlas of the External Diseases of the Eye. Dr. O. Haab, 1899.

Photo by Armelle Vanderhaghen/MSF

 In this picture MSF staff are removing medical supplies from a recently arrived cargo plane in Paoua. These supplies and the work performed by Médecins Sans Frontières are essential for a country that has been racked by violence since 2012.

   MSF has been performing medical treatment at a hospital in Paoua, Central African Republic since 2006.  Our activities include emergency care, routine vaccination, surgeries, pediatrics, obstetrics/maternity, and HIV-AIDS tuberculosis treatment.

luckystarsmd  asked:

Hi Wayfaring! Obviously, you are pro-vaccines, and I am too. It drives me crazy when I hear about parents refusing vaccination on faulty premises. There is a post going around tumblr about a pediatrician refusing to treat unvaccinated patients. I understand the risks these unvaccinated patients pose to other patients, but do you think doctors have an ethical obligation to these kids (who didn't choose to not vaccinate themselves)? Would you ban unvaccinated kids from your future practice?

I have a hard time with this concept, and my opinion goes back and forth. 

My office has taken the stance that we will accept children of anti-vax parents because they do need healthcare (and several other pediatricians in the area won’t take them), but we will discuss vaccination with them at every well child visit and make them sign refusals of vaccinations each time they turn them down. 

I have 2 patients who are unvaccinated or under-vaccinated because their parents don’t want to expose them to “chemicals”. One agreed to take some vaccinations once I showed her the labels on the bottles and proved that they did not contain mercury or thimerosol. There are few things that patients do that make me truly angry, but not vaccinating is one of them. It is very close to child abuse in my book.

Ultimately my goal is to take care of patients. If I refuse to see a patient because their family members are unreasonable, I’m not helping the patient. It think that’s what my office is getting at with their policy. However, I still wonder if there should be a “non-vaccinated” waiting area for those patients who come in for sick visits so that they do not infect other people in the waiting room.  

This is a discussion that I’m going to have to have with my future partners in a few months when I start my new job.