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My son depends on herd immunity, so thanks for getting your flu shot

Jennifer Gunter, MD
Conditions
October 17, 2014
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This weekend the kids and I had our influenza immunizations.

There is always a difficult lead up as Oliver has severe anxiety around every medical procedure. An EKG (painless heart rhythm test) and a throat swab cause extreme fear and often tears and anything with a needle, well, let’s just say that’s on a whole different level of terror and emotional pain.

I remind myself that his anxiety is a normal response to an abnormal situation.

It is not a normal experience to be born at 26 weeks weighing 1 lb 11 ounces or to spend the first 9 1/2 weeks of your life in an intensive care unit and then to be on oxygen for your first year.

It is not a normal experience to need your first heart surgery a few weeks after birth, but to be too small for any of the equipment.

It is not a normal experience to have had two intensive care unit (ICU) admissions for viral pneumonia and to have lost count of the “regular” pneumonia hospital admissions.

It is not a normal experience to need a simple dental procedure in the operating room with two anesthesiologists because your risk of a dangerous, irregular heart rhythm with all anesthesia is so high.

This is not in the scope of anyone’s normal, never mind all by your eleventh birthday.

This one-two lung-heart insult (lungs exposed to air 14 weeks to soon and only a partially repaired heart defect despite two surgeries) leaves Oliver especially vulnerable to viral infections. Each subsequent pneumonia only scars his lungs further, increasing his vulnerability the next time a harmful virus navigates his respiratory passages.

Despite being vaccinated every year Oliver has had influenza A twice. Once going to the ICU for 7 days. His bouts with the flu despite annual vaccinations doesn’t tell me the vaccine doesn’t work, rather it just reaffirms for me that some people are just so high risk. Even with vaccination some people will still catch the flu, it’s just it for most (those with robust heart and lungs) it will be a milder illness. I don’t like to think what might have happened had Oliver never been vaccinated. And so Oliver is exactly the kind of child who should come to mind when one thinks of herd immunity, the idea that decreasing the amount of a contagious illness in a community helps the most vulnerable.

If Oliver could get the FluMist (the nasal spray) the annual flu shot wouldn’t be something to add to our Aegean Stables of medical care, but respiratory viruses are one of Oliver’s nemeses. Even a seriously weakened virus could raise havoc if placed directly into his respiratory tract. And so he is stuck with a fear that is so terrifying that it cannot be overcome by any amount of reasoning, promise of gifts, explanations, cuddling, and love.

The boys whined about the line at the clinic until I told them a line made me happy because that meant so many people were taking their vaccinations seriously. After my usual bag of tricks to try to quell Oliver’s rapidly escalating panic was quickly depleted I began to explain how vaccinations worked, the complexity of the science temporarily derailing his freight train of fear. When I stopped a mom thanked me. She’d been struggling how to explain it all to her daughter, and so they had just stopped and listened to us. And then I said, “No, thank you.”

By this point several more people in line were listening.

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Then I said, “Oliver, we need to thank everyone here in line because every single person who gets vaccinated against the flu is helping you.” And then I added, a little louder so everyone could hear, “My son is the kind of person who depends on herd immunity, so thank you.”

Everyone in that line lives or works or goes to school in our county and every single one is contributing to our herd immunity. The lives of people like my Oliver depend on that. Although it is important to remember that everyone is at risk for serious influenza-related illness (about half of the children who die from influenza are otherwise very healthy and have no risk factors). That is of course why we have a vaccine. Thousands of people die from influenza every year. If it were only a nuisance, like the common cold, we wouldn’t be so invested in preventing it.

So, thank you from the bottom of my heart for getting your flu shot. If you are vaccinated you are protecting yourself and are also less likely to start a potentially fatal chain of events for someone else.

How great is that?

Jennifer Gunter is an obstetrician-gynecologist and author of The Preemie Primer. She blogs at her self-titled site, Dr. Jen Gunter.

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My son depends on herd immunity, so thanks for getting your flu shot
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