When flying, many people secure their luggage better than they secure their children. It seldom makes much difference. Unfortunately, many choose to do the same regarding immunization, where the risks are much greater and more widespread.
Before a plane takes off, the flight attendants make sure people have placed their bags properly in the overhead racks or under a seat. They also check each passenger to be sure their seatbelts are securely fastened–if they are over two years of age. Children under two years old aren’t required to wear restraints of any kind.
These same children face a similar situation when it comes to meningococcal meningitis. This is a dreaded disease that can be lethal within hours of the onset of symptoms. For those who survive, it can have very serious consequences such as blindness, deafness, and even amputation of arms and legs.
Fortunately, in April 2011 the Food and Drug Administration approved a vaccine for this disease for children aged 9 months through 23 months. A vaccine for use in older children was previously approved.
However, for the age group of 9 months to 23 months, the Centers for Disease Control’s Advisory Committee on Immunization Practices has recommended that only children with certain risk factors receive the vaccination. These include children with immune deficiencies, those traveling to countries in which the disease is epidemic, and those in a defined risk group during a community or institutional outbreak.
Although rare, the disease is endemic in the United Sates and springs up without warning. Those who are not vaccinated when it initially presents in a community will be the first to contract it. This is analogous to the situation with airplane passengers. Airline accidents or high-turbulence incidents are rare, but when they do occur, those passengers not properly restrained are at highest risk of injury or even death.
In such cases, it’s essential to measure any potential inconvenience against the likely risks. The side effect of taking this vaccine is some skin irritation, but vaccination is the only way to prevent this type of meningitis. In the past, when vaccines received approval from the FDA indicating they were safe and efficacious, the CDC would review them and ultimately add them to its recommended vaccine list. The CDC is moving much more slowly on this vaccine, and there is fear it will be recommended only for the high-risk children when indeed all unvaccinated children are at risk.
If the vaccination is not placed on the recommended list, pediatricians are unlikely to recommend it to parents, and many won’t even notify them of its existence. Thus parents won’t even have the option of choosing it for their child. At least in the case of the airliner the parent can choose. He knows that if he wishes to secure his child properly he can purchase a ticket for his baby so that he has his own seat. An FAA-approved child restraint can then be used to protect him.
The CDC should give parents the choice of whether to immunize their children aged 9 months through 23 months against meningococcal meningitis. Placing it on the recommended list is the only way to do that.
Dr. Richard Dolinar ([email protected]) is a practicing endocrinologist and a senior fellow for health care policy at The Heartland Institute.