Tag Archives: vaccine

From the desk of Doc Smo: Vaccine refusal growing? (Article)


Okay, it’s time for a little quiz about the practice of childhood vaccination in the United States.  You have probably heard about the resurgence of measles here. This resurgence is directly related to the failure to vaccinate children.   Last week, the Center for Disease Control (“CDC”)  published some data that attempts to explain the resurgence of measles in more detail.  Specifically, the CDC looked at the rate of measles vaccination at age five, the year of school entry for most children, across the United States.  Here are some of the questions that the CDC posed and answered:


What percentage of children have received two doses of MMR (Measles vaccine) by their fifth birthday?                                                                   (94.8%)


What percentage of families claim religious, medical, and/or philosophic reasons to exempt their children from getting MMR vaccine?        (0.1%-7%)


Which states do not allow religious exemption from vaccination?                                                                                                                                            (Mississippi and West Virginia)


Which state had the lowest rate of children having two doses of MMR  vaccine?                                                                                                                 (Colorado)


Which state has the highest vaccine rate for MMR vaccine?                                                                                                                                                       (Texas)


Which state had the highest rate of children not being vaccinated due to exemptions?                                                                                                      (Alaska)


Since parental refusal to vaccinate receives a lot of press, I was  surprised to see how few children are exempted from the requirement.  On average, only 1.5% of kindergartners have been exempted from the MMR vaccine.  Fortunately, this percentage represents only a 0.2% increase from the previous year. What I learned from this study is that even small increases in vaccine refusal can lead to quick and large increases disease frequency. Additionally, this is a reminder that the measles germs haven’t gone away and the only thing holding it back is getting all of our children vaccinated!  Parental resistance to vaccination does not seem to be increasing rapidly but even a little resistance can spell trouble for children. Get those kids of yours vaccinated!


Your comments are welcome. Please direct them to my blog at www.docsmo.com.   Until next time.


Vaccination Coverage Among Children in Kindergarten — United States, 2011–12 School Year


August 24, 2012 / 61(33);647-652




Avoiding a potential teenage tragedy (Pedcast)

Most cases of meningitis can be avoided with vaccines.  Listen and learn why Dr. Smolen thinks your child should get a vaccine that can protect children from a horrible infection from a germ called “meningococcus”.  Get ready for your free pediatric education to continue!


-Welcome to another edition of DocSmo.com., the blog designed to give parents information they can use as their children progress from diapers to the diploma.

-I am your host, Dr. Paul Smolen, founder of the DocSmo blog

-Thanks you for joining me today.

– Today, we are going to discuss a disease that is extremely frightening, both for families and doctors.

-Fortunately it is rare and usually preventable.

-I thought it would be good for my listeners to learn about a disease process called sepsis: specifically sepsis from a germ called meningococcus.

-So let’s talk kids with today’s discussion of how the germ meningococcus, also known as Neisseria Meningitis, can devastate a child in a matter of hours AND learn what we can do to prevent that from happening.

– We are going to start today’s discussion with a cruise down what I call science lane. … that place where we learn a little biology and pathophysiology.

– So what is meningococcus?  Well I’m glad you asked.  Meningococcus is one of a group of bacteria known as cocci-meaning round, which has a particular affinity to get into a child’s blood circulation and then ultimately into the coverings of a child’s brain called the meninges…hence the name meningo…coccus.

-In most children’s noses, “Meningo””coccus”  is just an ordinary germ among many, but under just the right conditions, it becomes a “pathogen” or a germ that can cause devastating disease.  If this germ is able to enter the blood, it can provoke a sudden drop in blood pressure.  If it reaches the brain, a horrible condition called meningitis.



-And here is the way it usually happens.  A perfectly normal child or teen touches this germ and unknowingly inoculates it into their nose by touch.  Within a short period of time, hours to days, the germ grows to sufficient numbers in the child’s nose, that some of the bacteria start to get into the child’s blood.

-Bacteria in the blood…. A condition called sepsis or septic shock.  Oh my gosh, this child now in serious trouble.  All their defenses are down, pathogenic bacteria have made it into their blood, and this child’s body is about to come unraveled.

-At this point, one of two things are likely to happen.  Either the meningococcal germ provokes a sudden drop in blood pressure by causing leaky circulation which doctors call “shock”or circulatory collapse, or the child evades the shock, and instead develops a brain infection called meningitis.

-Either of these things can and may cause death in a matter of hours.

-Remember, this was a perfectly healthy child just a few hours ago and is now they are clinging to life.


–Fortunately, these events are fairly rare but, as you can see, are devastating to those who experience it.

–By studying a large number of cases of disease caused by meningococcus, experts have determined that teens and young adults are particularly susceptible to an overwhelming infection with meningococcus. In particular, children who first start living in a close, secretion proximity to many other people such as in a dormitory or in a military barracks.

– As I said earlier, the chance of this happening to your child is very low, but when you consider all the children in the US, there are actually about 1000 children who experience this every year. 1 child is too many, much less a 1000.


– The good news is that we are not helpless in our defense against this nasty germ. A vaccine that is currently licensed by the FDA and recommended by the CDC can go a long way at protecting your child. The vaccine is usually given to children 11 years age with a booster just before college.  Soon you will hear about a vaccine that can protect children down to the age of 6 weeks from this form of meningitis.  Great news for little people. So here are things I want you to remember:


-I think it is important for you to follow the recommendations and get your child vaccinated against this terrible disease at the appropriate age. Remember that DocSmo pearl:  Prevention trumps treatment!  Vaccines prevent disease.


-Be aware that the combination of fever, neck pain with stiffness, and a rash should be considered meningitis due to meningococcus until proven otherwise.  Get medical help immediately!  Minutes are important in this situation.


-In fact, fever along with any rash should always be evaluated by a medical professional, especially in children.


-The rate of illness due to Meningococcus is much higher in certain parts of the world than the US.  Get vaccinated before you travel to these places even if you are not a child.


-If your child has been exposed to bacterial meningitis, let your child’s doctor know immediately.  Treatment with antibiotics may be warranted to prevent your child from getting sick.


Thanks you for joining me today. Your tuition free pediatric education continues.

We recently topped the century mark with posts, so take the time to check out other episodes of DocSmo.

Let me remind my listeners that these pedcasts are for informational purposes only.  For specific medical advice for your child, talk to the wonderful person you call their doctor.

Please feel free to comment on my blog, subscribe on iTunes, like us on Facebook or Twitter.  That way you will automatically get all the new content posted like the Lunchroom lowdowns, the memos from the desk of Docsmo, along with all the new pedcasts.

We have made it easy to send episodes of DocSmo on our website so if you think a relative or friend, might enjoy this experience, you have my permission to send it on.


This is your host, Dr. Paul Smolen, recording in studio 1E from Charlotte, NC, hoping that your child’s next infection, goes in the right direction.


Until next time

Smo Notes:



HPV Vaccines: “Prevention Trumps Treatment” (Pedcast)


-Your host here, Dr Paul Smolen, here to continue your free pediatric education with information parents can use from gestation to graduation.
-What I like about pediatrics is that it is a preventative specialty.
-It is much easier to prevent an illness than treat one, especially cancer.
-You heard me right, cancer.
-I remember the microbiology lecture in med school where the Professor said emphatically, “No human cancers are caused by viruses”
-What a frightening thought… a virus that you could catch that might give you cancer, spread around like the common cold!
-Time has proven that this statement was wrong, wrong, wrong…there are actually many viruses that are known about that can cause cancer which is our topic of discussion today.
-So sit back and turn up the volume so you don’t miss any of today’s, DocSmo.com

Cancer seems to be a genetic disease. It is the genes in the cell that control all aspects of a cell’s function… including its rate of reproduction.
-Sometimes when things go bad, the genes that say to the cell, divide and grow, are stuck in the on position, leading to uncontrolled growth. These out of control dividing cells are called cancer cells.
-They just can’t stop dividing and multiplying. They begin to crowd out all of their neighbors and eventually spread beyond the tumor.
-So how do these bad genes get into cells? Good question.
-We know that carcinogens such as chemicals and radiation, can damage our genes but how about if the genes are inserted into our chromosomes when we get a viral infection?
-Interesting possibility

-The answer turns out to be a big yes.
-Here are the viral infections that we know of today that can directly or indirectly cause cancer:
Hepatitis B and C
Epstein Barr virus that causes mononucleosis
And finally, a group of viruses called HPV viruses
-If you have children who you have been dragging to the pediatrician, you will recognize a few of these infections as vaccines that are recommended at their visits… the Hepatitis B vaccine that is recommended to be given to newborns and the HPV vaccines recommended for preteens.
-These two vaccines are both safe and extremely effective. If every child were to be vaccinated at the appropriate time with these vaccines, it is thought by experts that essentially all liver cancer caused by Hep B would be eliminated and 70% of abnormal pap smears and cervical cancers caused by HPV wouldn’t happen.
-Remember this DocSmo pearl, “Prevention trumps treatment”.

-In my November 2011 Pediatrics journal, there is an article looking at the HPV vaccine rates for girls 13-17, during the 2008-9 in the US.… at that time, only about 20% of these girls had completed the HPV series of 3 shots. Hopefully we are doing better now.
-In Australia of all places, the government has made a big effort to vaccinate all of their teen girls.
-And it is working. Recent evidence, just a few years after they started making the HPV shots a priority, found that rates of very abnormal PAP smears ( early cervical cancers) have fallen dramatically, by 38% in just a few years.
-The Australians are going to reap tremendous benefits from their efforts to vaccinate because far fewer of their children are going to get cervical cancer. remember, “Prevention trumps treatment”.
-You may be aware that in October of 2011, the Center for Disease control is now recommending HPV vaccines for the boys… this is going to hopefully hasten the day when these cancer viruses disappear altogether. We’ve done it before… anyone seen a case of polio or smallpox recently?

-So the next time your pediatrician suggests one of those shots be given to your son or daughter, even if they squawk, even if frightens you or them, even if it is expensive, even if you would rather get home sooner and not wait for the nurse to get the shot….do it.
-You will be glad you did.
-The “experts” seem to almost always be right when it comes to infectious disease recommendations. They have a great track record so when they do something, I listen, and you should too.

-That wraps up our discussion today. I hope you found it informative and relevant.

-The pediatric blog known as DocSmo.com is beginning to catch on and you can help.
-If you like what you hear, go ahead and write a review on iTunes and subscribe to the fresh new content I put on weekly. Like us on Face book, or follow us on twitter.
-As always, your comments are welcome and I will try and respond personally
-This is Dr Paul Smolen, your pedcast host, broadcasting from Studio 1E, hoping you won’t hesitate to take your little tot for their next shot.

Until Next time

Smo Notes




The Success of Rotavirus Vaccine (Pedcast)

The stats are in and are amazing.  In today’s pedcast, Dr. Smolen brings the latest information about the incredible effectiveness of rotavirus vaccine.  This podcast if full of useful information that parents should consider when deciding whether or not to vaccinate their children against rotavirus diarrheal illness.

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