Background
In 1980, Dr. David Fredenburg encountered a devastating experience that has fueled his passion for immunizations for over 35 years. David recounts, “Those were the dark ages when pediatricians only vaccinated against seven diseases: measles, mumps, rubella, diphtheria, tetanus, pertussis, and polio.” At the time, the incidence of pertussis had increased in both Canada and New England - due in part to parental refusal of the diphtheria, pertussis, tetanus vaccine. A set of twins born prematurely, having been exposed to pertussis before they could be vaccinated, came to his practice. Unfortunately, once pertussis symptoms become diagnosable, its course cannot be changed. The fatal disease claimed the life of one of the twins within 24 hours, and the other barely survived. David never forgot that day. Since then, the number of diseases vaccinated against has more than doubled - resulting in a profound reduction in illness. David wonders – in eliminating the fear of previously serious and fatal diseases, have we inadvertently made the situation worse?

 

A blessing that could become a curse…
As a pediatrician and professor in New Hampshire and an advocate for global vaccines, David shares his conflicting points of view on the condition of immunizations in the United States. On the one hand, vaccines have completely altered diseases, which have changed disease frequency. However, he believes that people have taken this as a sign that they no longer need to worry about those diseases. He shares, “As soon as we stop worrying, we stop looking for and noticing diseases. Once we have this laid-back outlook, we will find ourselves in trouble.”

 

Staying on the topic of pertussis – David asserts, “Today’s conditions are horrendous.” Because of the existence of the pertussis vaccine, parents and healthcare providers have come to think of pertussis as a non-issue over the years, which leads to its misdiagnosis as bronchitis or pneumonia. He outlines the three simple questions for physicians to ask patients for considering pertussis as the diagnosis:

Along these lines, he relates pertussis to the Measles Outbreak of 2015. He observes, “For the first time in decades, the United States exported an infectious disease. Because there is a (measles) vaccine and because so many children do get this vaccine, people assume safety. With the recurrence of measles in 2014, measles was often initially misdiagnosed, because healthcare personnel were generally unfamiliar with the diagnostic criteria - allowing the disease to be spread even further.”

 

What can be done to change perception?
David offers an education-based solution to improving vaccination rates. Although he believes that accurate knowledge of a disease can save lives, he says, “we have a system that is not interested in educating.” He urges students, parents, providers, and others to increase knowledge of vaccine-preventable diseases and their signs, symptoms, diagnoses, treatments, and prognoses; alleviate the all-or-nothing perception to vaccines; and work against the state legislation that inhibits higher vaccination rates.

 

What’s next?
In a state with no immunization registry, David has taken his fight to the state government. He advocates for universal immunization funding in his state, and he has testified to limit philosophical exemptions. He believes that working from this angle helps him to affect change. He says it’s nice to know you can offer beneficial information, but it’s important how it is used. Information can be misunderstood or disregarded, which affects its value. He leaves us with this, “Understanding the whole picture of the effect of vaccinations is important. Due to initial experience with diseases, parents and providers saw the need for vaccination, and then vaccines impacted the incidence of the diseases. As the diseases were no longer commonplace, complacency followed, subsequently allowing a number of diseases to come back to bite our children once again.”