Thursday, 4 February 2010

To jab or not to jab?

A patient came to see me the other week and asked me about the swine flu jab for her children. Should she get her children vaccinated?

She had two healthy children under five with no pre-existing illnesses. The media had helpfully pointed out that the children who had died from swine flu had pre-existing illnesses, although rather more unhelpfully no one was saying what these illnesses were.

Being a locum, I thought I had missed the official information to give to parents about the jab. I checked in with Dr Google but couldn’t find a thing. A few papers here and there, but nothing that had meaningful numbers in it. I was surprised as there is a wealth of very good information for parents about other vaccines but nothing that I could find for swine flu.

Eventually she decided that she wasn’t going to bother as she thought it was all rubbish. Not exactly the informed choice I was hoping for, but it’s her choice nonetheless.

Then the invite came through for our children, I was faced with the same choice: to jab or not to jab? I won’t bore you with medical papers that I read to see if was really necessary to vaccinate an otherwise healthy child for a mild illness (in most) that she may have already had or may not even catch.
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But what I wasn’t prepared for was the amount of hand wringing and floor pacing about the decision to potentially stick a needle in my child’s arm. Previously the wife had taken the children to their jabs so she had to endure the sight of a needle piercing their flesh, the looks of betrayal on their cherub-like faces and the inevitable ear piercing shriek that followed.

The daughter was sick the other day, and three weeks later she is still harping on about how she puked – God knows who taught her that word. Would I be prepared for her constant whining about how Daddy let the nurse hurt her and the years of counselling she would no doubt need afterwards? Not to mention the fact that it’s not nice to see your child in pain. Would I get emotional? I couldn’t blame it on the hayfever as it was winter. Perhaps blaming the dusty environment might help.

It made me realise that what we might regard as trivial – a quick jab, or a blood test - can be very upsetting for the child and parent and that might discourage them from attending or going along with the management plan. How do you explain to a 3-year-old what is about to happen? It's no wonder children bawl their eyes out when they attend the doctors.

I’ve asked colleagues and friends about the swine flu jab and it's been more or less a 50:50 split over whether their children have had it or not. The uptake is poor in the otherwise healthy, which has got me wondering whether it was worth offering in the first place?

The government wasted million on Tamiflu, which was largely useless. Have they done the same for the swine flu vaccine?

4 comments:

  1. Nice, honest account. We haven't started calling children yet, as far as I am aware. I'm not sure how to advise either. Let's see what others think.

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  2. Interesting to read this from the point of view of a doctor.

    I don't have children, but I remember thinking over MMR (where intellectually I known that the autism link is utterly unfounded) That when it came to getting my own hypothetical children vaccinated I would have paused for substantial thought. (I did feel guilty for thinking this).

    It seems like a universal bedside manner problem, since as you point out - sticking needles into children is bad, even if ultimately it is for the greater good. And maybe we've not really thought much about that in the past.

    I'm assuming that vaccinations are something where needles are pretty much essential. What is it about polio that means it can be delivered on a sugar cube?

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  3. What about naturally acquired immunity taking place through being unwittingly exposed to the virus in others?

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  4. interesting thoughts about the child's perspective, I think every parent feels guilty when they take their precious little one for those nasty jabs.

    When my elder son was a baby, in 1973, we opted not to let him have the whooping cough vaccine ~ the arguments were positive as whooping cough was not seen much in those days. However in the 1980s when I had two further children, whooping cough had returned and we decided to give them the vaccine.

    Regarding Swine Flu, from the research I saw, mainly from the US, it was only regarded as a danger if a child experienced respiratory problems and the US Govt appeared to recommend parents to seek medical advice immediately if the child was having difficulty breathing.

    Having nursed Guillan Barre syndrome patients I was aware of the mysteries of this illness. There appeared to be some incidence of GBS following vaccination against Swine Flu and although invited, here in France, to have the vaccine, we declined their kind offer.

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