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The ABC's of Common Vaccinations

Vaccination is one of the best ways parents can protect their children from diseases that could harm them and the community at large. Dr. Katherine Gergen-Barnett discusses common myths associated with vaccines and the importance of sticking to the recommended vaccine schedule for both children and adults.

Featured Speaker:

Katherine Gergen-Barnett, MD

Dr. Katherine Gergen Barnett is the Vice Chair for Primary Care Innovation and Transformation in the Department of Family Medicine at Boston Medical Center. She also serves as the Medical Director of the Yawkey Ambulatory Care Center within Boston Medical Center where she works as a primary care physician. Katherine joined the Family Medicine Practice team in 2009 after completing her Family Medicine Residency Program and her chief residency at Boston University. Originally from Washington, D.C. Katherine attended Yale University School of Medicine. Dr. Gergen Barnett also served as the Director of the Integrative Medicine Clinical Services at Boston Medical Center for 7 years. Her primary interests are behavioral health integration, preventive medicine, nutrition, mindfulness-based stress reduction, women’s health, and group care. Learn more about Katherine Gergen-Barnett, MD 

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Transcription:

Melanie Cole, MS (Host): Vaccine preventable diseases can be very serious or even deadly. Vaccination is one of the best ways parents can protect infants and small children. My guest today is Dr. Katherine Gergen-Barnett. She is the vice chair for primary care innovation and transformation in the department of family medicine at Boston Medical Center. Dr. Gergen-Barnett, what are some vaccine preventable diseases? Tell us a little bit about the state of vaccines today. 

Katherine Gergen-Barnett, MD (Guest): Hi, good afternoon. Thank you so much for having me. There are so many vaccines that we could talk about in our time together. I think some of the ones that I would most want to speak about today are the common vaccines that people hear about, such as flu. Which we certainly are hearing a lot about right now given the fact that it’s flu season. I’ll speak more to that. A lot of the childhood vaccines that I think that people have heard about but that now we’re talking about more, such as measles, mumps, rubella, polio. There’s a whole series now for something called HPV that’s really important for adolescents. As you get older, there’s also vaccines for things such as pneumonia and shingles. All of those are really important and there’s even more we could talk about. 

Host: Then let’s go ahead and start with flu. People wonder if they should get their flu shot, and, as you said, we’re in the middle of the season. How are the flu vaccines made? Because everybody wonders every year to year whether they're going to cover whatever strains of flu happen to be present at that time. 

Dr. Gergen-Barnett: That’s a great question. So first of all, just to kind of go into the flu a little bit so people understand it a bit better. The flu, or influenza as some people may have heard, is a virus. There’re many different strains of the virus. When you get the flu, it can be very dangerous. Now every year there are different strains of the virus that we think are going to be more prevalent or more likely to exist in communities. So as a result, before the fall hits and before influenza season hits, we have manufacturers of vaccines that are having to predict which kind of strains are going to be more likely. 

They actually take those strains as well as the more common strains and they package them. Then they make them very inert or dead kind of strains of the virus. Then they put them in a very safe way of delivering it so that when you get the flu shot you are not getting the live virus. You are getting something that imitates the strands of live virus so that your body then develops what we call an immunity to those strains of the virus. When you get exposed to the virus, in this case the flu, then you actually have the immunity to fight that virus. So, it’s a perfect way to prevent what can be very, very deadly in some communities. Especially for those who are very vulnerable, such as the very young and the very old, and can also make even those people who are very healthy generally very sick. 

Host: Flu is so important to know about, and awareness of the vaccine. We want to get through as many as we can today doctor. So, tell us a little bit, because there is a lot of myths about vaccines and parents have concerns, especially with young babies, about multiple vaccines like DTaP and the vaccine schedule. How is that figured out and why should parents adhere to that schedule. 

Dr. Gergen-Barnett: Such a great question Melanie. So, there’s actually a lot of different thinkers that go into this. So, it’s not just one group of doctors or researchers who come up with a vaccine schedule. It’s an internationally acclaimed or supported schedule that has pediatricians in, family medicine doctors such as myself, and doctors who just take care of adults all have looked at this. What we are seeing is first of all the United States has the safest vaccine distributor that we see anywhere in the world. We see all of our vaccines go through a very, very careful testing before anything is distributed. 

Then one of the things that I think parents really need to know—and, in fact, I’m a parent of three children as well as a physician. So really thinking on both sides of this. Children when they're first born, when we have our infants and they first come out, they have certain immunity built it, but it goes down very quickly. So, within the first couple of weeks of life even they no longer have immunity to [curia ph?]. So, the idea that we have to vaccinate these infants before they get exposed to things that could kill them is really, really important. And, again, the way that these vaccines are made and distributed, they're put in very, very small amounts that are incredibly safe and testing for children of all ages.

Now, I think that one of the concerns that I see in my office and I know people have is well is it safe to give all those vaccines at once? I will tell you that while I support every parent on their journey and what they need to do, we know without any hesitation that it is absolutely safe to give the vaccines on the schedule. In fact, what we do is we really support that because when you miss a vaccine or when you decide to delay a vaccine, you actually create an opportunity for your child to get quite sick. You also really need to be thinking about who is living in your community. So not only are you protecting your child, but you may be protecting the person who lives next door who has cancer and is more vulnerable. Or the older person who is more vulnerable. We call this something called herd-immunity. So not only are you doing it for your child, but you're doing it for the community.

Host: Let’s bust up a myth right now. People worry about the autism link and vaccines. I'm glad that you mentioned herd-immunity doctor because people think, “Well I don’t have to get vaccinated because everybody else will.” So, they have concerns. Just speak about the autism myth and clear it up once and for all.

Dr. Gergen-Barnett: I wish I could clear it up once and for all, and I cannot say this strongly enough. There is no data to support that any of the vaccines are linked to autism. There is absolutely no data. There was one paper that came out that was published a number of years ago that has since, actually every single part of that paper has been looked at and actually shown to be false and it was bad data. There has been absolutely no ability to then show, again which is really important in science. Because if you have one piece of data that comes out, in order for it to be proven, you need to have other people to replicate it. In other words, get the same results. There has been no researcher internationally who has ever been able to get the same results.

So, I want to say, again, that I think it’s absolutely… I want to say immoral. I think it’s unprofessional to say the least to say that there is a link. Because what we’re doing is we’re putting hundreds and millions of people in harms way by continuing to bring this myth into the light. In fact, one of the things that I would like to point out is  there has been declared a national emergency of a measles outbreak in Washington state, right over the border from Portland, Oregon in a community that specifically has decided to not immunize. In part because of some of the myths or concerns that have come out. It has, again, left children and older people in harms way as a result of this.

The WHO in their 2019 strategy for health for the world, one of the things they specifically talked about is vaccines and working on communities where there is a reluctance to bring in vaccines, even with the accessed vaccines. 

Host: Absolutely. I am with you 100% on that. The measles outbreak is terrifying and also very sad. When you mentioned older adults, Dr. Gergen-Barnett, there are some vaccines for adults, and adults don’t even think about this. But shingles and pneumonia. Even as our teens get older before college there’s meningitis. Speak about how we know what vaccines we should be getting as we get older because there’s so many and we could talk for a very long time about these. I’d like you to just talk about the older individuals and adults, and why it’s important that we discuss with our providers the vaccines we should be getting and when.

Dr. Gergen-Barnett: So, thank you Melanie for asking that question. So as a family medicine doctor I take care of people from birth until very, very old age. So, I have these questions a lot in my office. One of the things that we all need to understand is that even if you get immunized when you're a child, a lot of the immunizations wear off. So, there are certain ones that you need to get something called a booster so that you're protected. Others that you need to get a new set of shots as you get older.

So, the boosters that we don’t often think about or hear about are particularly for tetanus that’s mixed with something called pertussis. So, you may have heard of it. It’s called TDaP. Pertussis can be actually deadly. We now are recommending, in fact, that women who are pregnant and around 27 or 28 weeks get reimmunized for pertussis to protect their newborn. Additionally, I recommend a partner and family members of pregnant people to make sure they’re immunized again against pertussis.

Now to move on to the other vaccines that you were talking about. So, shingles is something that maybe somebody you know has gotten. It’s incredibly painful. People can get hospitalized for it. It comes when you're older. It comes from having the virus in your body, often times from a long time ago. Many of us growing up who are at an older age now didn’t get the chicken pox vaccination. So, you have the virus still living in your body. When you get older and your immune system comes down, you can get an outbreak again of the chicken pox. It comes out in a kind of way of being very, very painful rash that’s called shingles. So that is absolutely available and we’re really recommending that now over the age of 50.

Then the pneumonia shot, which you mentioned. So, we actually look at people who have a lower immune system, such as people who have diabetes or asthma or COPD, and we recommend that they get one pneumonia shot earlier. Then everybody over the age of 65 get a pneumonia shot. Again, that is something that can prevent hospitalizations and serious illness and even death in some cases.

Then the last one that I wanted to touch base on, and I think like you said we can speak all day about vaccines. But really thinking about a shot called HPV. You may have heard about this, but we’re now recommending this shot and series of shots for boys and girls at the age of 11 and up. It really protects kids now, or as they get older, from a virus that can cause cancer. It’s kind of an amazing thing as somebody who does a lot of women’s health and takes care of adolescents that we now have this available. And it protects our young men and women from developing things such as cervical cancer and even penile cancer for men and boys. We really now start to talk to young adults, 11 and 12, recognizing that this is not something that’s going to affect them for a long time. But if we immunize them again at around age 11, it means that we’re protecting them for many many years.

Host: Such important information. Dr. Gergen-Barnett wrap it up for us. What advice do you give parents and families every single day that you want the listeners to take away from this segment about vaccines. The importance of discussing your concerns with your provider and sticking to that schedule and getting the appropriate vaccines so that we’re safer as a community.

Dr. Gergen-Barnett: I really want people to be able to have discussions with providers. I want them to be able to go in with their questions. I want people to go in with the ability to have an open heart and understand that all of this is going towards wanting to take care of and protect the individual and family members. Also, really understanding that all of these vaccines are out there to protect us, and they are all safe. Having these conversations and asking these questions is 100% the right thing to do. If you have questions before you go see your provider, there’s also some very reliable information out there. I would actually ask you to look at the Department of Public Health wherever you live. They have great information on vaccines. You can get very good information from vaccines, even at a local pharmacy. The CDC has some excellent information about vaccines as well.

Host: Thank you so much Dr. Gergen-Barnett for coming on and for sharing your expertise. Explaining to the listeners why vaccines are so important and even how they're made. Thank you again for joining us. This is Boston Medtalks with Boston Medical Center. For more information, you can go to bmc.org. That’s bmc.org. This is Melanie Cole. Thanks so much for tuning in today.

Learn more about Family Medicine at BMC