By Stuart H. Ditchek, MD
Board Certified PediatricianFaculty, NYU School of Medicine
The issue of childhood vaccinations is critical for parents to understand fully and not be influenced by parties that frankly will take no responsibility should a child be harmed by a serious and preventable infection. During my early career and training, I witnessed the horror parents faced in the pre-vaccine era. I trained in the 1980s at Kings County Hospital which was an epicenter of care for many poor families and many new immigrant families.
Many came from countries that had very poor conditions, poor nutrition, and limited vaccination availability. We treated many cases of bacterial meningitis (typically Haemophilus Influenza B or Hib), whooping cough (Pertussis) and Measles. Babies with whooping cough have sporadic but severe episodes of coughing spells to the point of turning blue (cyanosis).
Firsthand Experience in the Pre-Vaccine Era
The drooling and secretions would not allow the child to even take a complete breath. All we could do was provide oxygen by mask and hold the child until the coughing fit and choking resolved. Many suffered seizures as a result causing significant damage to their young brains.
In the case of bacterial meningitis which we saw frequently, there was not yet any vaccine (Hib vaccine). Babies were brought to the hospital with fever and often poorly responsive as these infections act quickly and invade the spinal fluid surrounding the brain.
Spinal taps were a daily event in order to determine the extent and specific type of the infection. Virtually none of these babies left the hospital intact. Many died over days. Those that survived were often left with deafness, blindness, or severely cognitively impaired. Since the vaccine introduction in the early 1990s, the number of cases of invasive Hib infection in the United States has gone from 20,000 cases a year to less than 50 currently. This accounts for more than 99 percent reduction. I have not seen a case of Hib meningitis or invasive disease since 1991.
Measles victims were often admitted with classical rashes followed by high fevers, coughs and in many cases invasion of the lungs and involvement of the developing brain(encephalitis). Many affected babies who were admitted died or were left with lifelong neurological impairment as Measles can destroy young brain tissue often liquefying the damaged brain cells.
Let’s take one more example that hit our community in the most catastrophic manner. The names have been changed for anonymity purposes. Years ago, Sara, a”h, was a young mother of a four-year-old child. Sarah was a patient in my practice in her later teen years. At the age of 26 years old, she developed rapid onset meningococcal disease (bacterial blood and brain infection). Despite dramatic efforts to save her, she succumbed to the infection within 36 hours. This was not uncommon in the pre-meningococcal vaccine era.
The meningococcal vaccine was approved several years later, too late to save Sara. Several years later when her mother Rebecca, a”h, was suffering from end stage cancer. I had the privilege of spending many hours with her. I asked if I could encourage apprehensive parents to vaccinate by using her name and discussing the tragedy. She looked at me and said, “Of course! Why should any parent ever suffer the loss of a beautiful child as we did when it is preventable? Please tell them what I said.” I have not seen a single meningococcal infection since the vaccine has been implemented in my practice.
Debunking Vaccine Myths and Ensuring Safety
The anti-vaccine movement has exploded in recent years for a variety of reasons, all false and misinformation. They would have you believe that doctors are being paid and influenced by “big pharma” or false claims that vaccines cause autism. This issue has been studied repetitively over the last forty years with absolutely no evidence of that claim. They will also tell you that vaccines are not monitored for safety, also false.
Vaccines go through well over ten years of study before approval. I have participated in both successful and unsuccessful FDA-monitored vaccine trials and I can attest that the oversight is absolutely intense and multi-layered.
Parents should not confuse theemergency implementation of the COVID vaccine with childhood vaccinations. That vaccine was critically needed during the peak of the pandemic when we were seeing many thousands of deaths a week during the Spring and Fall of 2020. At this time, the vaccine saved millions of lives worldwide. The mandates that followed were certainly politically influenced on both sides of the aisle. The mandates had nothing to do with childhood vaccinations for the diseases being discussed. At this point, there is very little need for COVID vaccination except in the highest risk groups.
Just to give one final example of how serious an issue vaccine safety is to physicians. In 1998, the initial Rotavirus vaccine was being implemented nationally. Many agencies and organizations were responsible to monitor for variations in safety signals. In 1999, monitoring agencies noticed a possible safety signal raising the question of whether a very small number of babies who received the vaccine had developed a complication of the intestine called intussusception.
The CDC, FDA, and American Academy of Pediatrics acted very quickly. Within 24 hours, ALL pediatricians in the United States received a series of faxes instructing doctors to immediately cease vaccination with Rotavirus vaccine and to return all existing doses to the manufacturer. The vaccine was put on hold, reformulated, tested, studied, and reintroduced in 2006 with none of the complications seen initially. That is how vaccine surveillance worked in the 1990s and it has improved dramatically since then with even better computer modeling. Pediatricians take vaccine safety very seriously as we should do with all therapies and interventions.
Currently, parents are being inundated with false information from anti-vaccine activists on social media. These are individuals who frankly feel that if they can create fear in young parents who will then refuse or delay vaccination, it will somehow validate their own dangerous actions.
The Measles crisis in Texas(January 2025) was very serious with three deaths and many hospitalizations including ICU admissions. Almost all cases were proven to be unimmunized.
Israel is currently experiencing a serious outbreak with over 500 cases in the past three months reported and growing. There have been many hospitalizations and currently several toddlers on ECMO(extracorporeal membrane oxygenation) who are critically ill, both with lung involvement. Unfortunately, a two-year-old passed away in Jerusalem in mid-August.
ECMO is used when the heart or lungs are no longer capable of providing oxygen when severely damaged. The child is sedated and invasive access lines are placed in the child as a life saving last effort. The ECMO machine then functions essentially as an artificial heart and lung by removing blood from the body and oxygenating the blood externally. The blood is then returned the bodyThis is a very high risk situation which can result in strokes, blood clots, bleeding, and infection complications, all avoidable if the children would have been immunized. These are preventable tragedies.
If the crisis hits our community, it could lead to many cases of Measles in children and pregnant women who have impaired immunity during pregnancy. Unfortunately, there are now many in the community who are avoiding vaccination, some by very nefarious means.
For those who have falsified vaccination records, they will be at very high risk when we are faced with new infections as the unimmunized account for more than 98 percent of new infections. What is especially dangerous to the public is that many with falsified records who come down with Measles will claim that they became infected despite immunization. This false claim will further erode trust in vaccinations which serves the anti-vaccine movement well.
Proper vaccination at 12 months and four years of age provides 98 percent immunity to children. Measles is a highly contagious infection which can remain in air particles in closed spaces such as rooms or elevators for several hours. The 2019 outbreak in the New York area had several terrible outcomes including children with encephalitis.
Why Vaccine Timing Matters for Babies
I am often asked why babies need to be immunized under a year of age. Some parents are attempting to tailor their own vaccine schedule starting late. This is a dangerous approach for a variety of reasons, most importantly the susceptibility of the young brain to infection.
Babies need to be protected from very young ages because they have limited ability to fight infections naturally. In addition, their immature blood brain barrier allows infection to invade from the blood to the young brain and damage the developing neurological system. Delaying vaccination until children are older makes absolutely no sense as it leaves the most susceptible, babies under a year of age, open to terrible outcomes should they get infected with one of these vaccine preventable infections.
In my practice, I have never, and will never allow modifications in the recommended vaccine schedules. The timing of vaccination was not created in a vacuum. It required many years of testing and research to know which vaccines need to be given and at what timing. Vaccines in 2025 are the safest vaccines and continue to be monitored as always. Seeing reemergence of these vaccine preventable diseases is devastating knowing historically how life was before many vaccines were available My prayer is that our communities will take these warnings seriously. Having a child is a gift and a privilege. It is not an experiment when being educated by those who quite frankly will take no responsibility when a child is stricken.