My daughter, Rory, was fully vaccinated on time from birth to first grade. When she was a toddler, our insurance
didn't cover immunizations, so I took her to the local health
department for her shots, tightly hugging her wriggling body
as nurses zeroed in on her chubby thighs, the needle's quick pinch causing Rory to cry.
I would cry as the nurses applied cartoon character bandages to each of her legs; I hated seeing her in pain, even if only for a moment, but I never hesitated when it came time for her vaccines
. That changed when she was six years old.
Rory woke up one morning and said her new gym shoes, which she'd been wearing all week, felt "weird." We were already late for school, so I tried everything I could think of to get her into the shoes — cajoling, bribing, and finally using a stern voice and her full name — but nothing worked. I hauled a pair of shoes she'd outgrown from the back of her closet, and Rory crammed them on her feet.
Soon after, these sensory issues were accompanied by insomnia and a change in personality, and my sweet little girl became defiant and aggressive. Rory began having conversations with herself, or perhaps, because she was hallucinating, she was talking to someone she thought was there; her speech made little sense to those who were actually around her, and it eventually became like a tossed salad of words.
Rory walked like a swamped ship for a while, eventually moving
less and less until she sat mute and catatonic, her body writhing involuntarily, her dilated pupils, like dark puddles, obscured her lovely hazel eyes, and she stared vacantly into the distance as if she were trying to see something far away.
We were desperate for a diagnosis for three years, and she finally got one: autoimmune encephalitis (AE), a recently discovered disease in which the immune system mistakenly attacks healthy brain
cells, resulting in neurologic and psychiatric symptoms. If left untreated, AE can cause permanent disability
Over the next four years, a team of doctors at Duke Children
's Hospital in Durham, North Carolina
, essentially rebooted Rory's immune system, giving her steroids to reduce brain inflammation and an immune-suppressing medication, commonly used by transplant patients to prevent organ rejection, to prevent her immune system from producing auto antibodies.
She began to improve gradually.
I held my breath every time Rory got a cold, someone in her class got strep throat, or the child seated next to her was sent to school with a stomach bug; would this be the thing that sent her immune system spiraling out of control again? There was no way to know without knowing what had caused the autoimmune encephalitis in the first place.
As Rory's health improved, another worry began to take hold for me: vaccines. By design, they activate the immune system just enough to make antibodies. They had been contraindicated during Rory's treatment due to her suppressed immune system and immunoglobulin infusions, so she relied on herd immunity
to stay healthy.
Rory's pediatrician noticed she was missing two vaccines at her yearly checkup: a Tdap for tetanus, diphtheria, and pertussis and a meningococcal for meningitis. I admitted to being afraid to do anything that might activate Rory's immune system.
Instead, she told me she understood, claiming that the vaccine's immune system activation would be much smaller than the disease's uncontrollable cascade, and she suggested we start with Tdap, which Rory had tolerated as an infant and toddler.
My stomach churned as the needle sank into Rory's arm. Over the next 24 hours, my nervous attempts to casually assess her condition were met with teenage-appropriate eye rolls. As expected, she developed a sore arm, but otherwise she was fine.
According to a preprint by The COVID States Project, now that a COVID-19 vaccine
is available, a reported 25% of parents surveyed said their children will not receive it when eligible, and 36% said they would wait to vaccinate.
To achieve herd immunity, approximately 80% of the population must be vaccinated, and to minimize community spread, which will allow restrictions to be lifted indefinitely, that number must be closer to 70%; children are critical to meeting these targets.
While it is disheartening that so many parents say they will not vaccinate their children or will wait, I understand why. Fear is powerful. I hope these parents have a pediatrician like ours, who acknowledged my uncertainty, empathized with me, and guided me through my fear.
and Drug Administration approved Pfizer
's vaccine for 12- to 15-year-olds on Monday, with the Centers for Disease Control and Prevention
issuing guidance this week. When that happens, I'll sign Rory up right away. I'll do it because I want her to be healthy, because I want our lives to resume, and because it's our turn to protect others.
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