 So we're coming to you today from Nowcast Essay Studios on the sixth floor of Central Library with Dr. Dennis Conrad, and you are a pediatric infectious disease specialist. Tell me what that means. I am, beyond being trained as a pediatrician, I've taken extra training to specialize in the diagnosis and treatment of infections that occur in children. As well, and especially pertinent to today, it also, I've been trained in the prevention of infections. And as we talk about vaccines, I'm going to hopefully provide information to show why vaccines are so important for children to receive. And I should say you're with the School of Medicine at the UT Health Science Center in San Antonio. Right. I'm in the University of Texas Health Science Center at San Antonio in the Department of Pediatrics in the Division of Immunology and Infectious Disease. Okay. All right. Well, part of the reason we're having this conversation is it's back to school time. And back to school comes with it some requirements for parents of little kiddos, right? It does. And among those is there is a minimum number of vaccinations that children need to have received for entry into school. Why these vaccines are important is not only does it prevent potentially serious disease occurring in the children, but it also helps prevent those children from potentially spreading infection to their classmates. Okay. Okay. So, there are some requirements, and those requirements basically are set by the state, right? Yes. The requirements, in fact, that's why they're called the minimum immunizations required for school entry. They're actually set by legislative actions, so there are law that is required for entry. They include protection against diphtheria, tetanus, and pertussis. It includes protection against polio. It includes protection against measles, mumps, rubella, and varicella, which is also known as chickenpox. It prevents disease due to hepatitis A and hepatitis B, and for children entering the seventh grade, they also need to receive a vaccine to prevent against meningococcal disease, which parents may know as the meningitis vaccine. Right. Right, okay. However, that is not the total number of vaccines children should receive. There's more that they really should get. Other important vaccines that they should have received in childhood to protect them from potentially serious infections, these that I've mentioned are just those that are required for school entry. Okay, so there are others they should get and beyond the absolute state requirements? Correct. Right. I'm an advocate for immunizations because it can actually prevent disease. It is far better to prevent a disease than treating it after it occurred, and unfortunately and sadly in my career, I have actually seen children who have died of illness that could have been potentially prevented by immunization. And that's why I embrace the fact that all children should receive these vaccines for school entry, but beyond that they should receive all recommended childhood immunizations to protect them against serious diseases, as well as to protect society as a whole against serious diseases. That's a big question too. I mean, it's not just about the individual kid. It's about the community. I agree. I have read and in fact have heard recently that there is an increasing number of parents who hopped out of immunization, having a philosophical exemption request to for their child not to be immunized. What bothers me is those parents believe they're acting on their child's best interests by not immunizing them because they fear that the vaccines may cause side effects. However, what they do not recognize is that the diseases that the vaccines prevent are far more likely to cause serious illness in the child than any perceived side effect of the vaccine. And more importantly, if these children become infected, they could potentially spread infection to others. Children's have been concerned about measles immunization because of the concerns for autism, even though a number of studies have shown that there really is no linkage between that. If a mother decides, however, that she is not going to have her child immunized against measles, that child in turn develops disease and spreads the infection to their neighbor who happens to have leukemia, that child could actually die from the measles. So we have a responsibility not only to protect our children, but to protect our community. And that's why immunizations are so important. In the school classroom, because of the number of children together in a very closed area is one of the most effective ways to spread infectious disease. So those immunizations are really important, critically important. They wouldn't stress their requirements. In fact, mandate their requirements by law. If we didn't feel they served the best interests of our citizens of Texas and the United States. Okay. Well, and it's not just for the little kiddos, right? Kids going to college do face, and then this isn't necessarily a state mandate. It's a school-by-school mandate, but certainly they need meningitis vaccinations. Correct. In fact, there are some vaccines that are required for entry in the kindergarten through seventh grade. There is a vaccine that's specifically indicated for seventh grade, which is the menengal cockle vaccine, the meningitis vaccine. And if it's been five years since they received their last dose of pertussis vaccine, which is also known as whooping cough, they should be immunized as well. But that goes beyond. Many colleges require immunizations as well. Protection against the Nigeria meningitis, the meningitis vaccine. Many colleges are requiring that for entry. And some colleges even require them to be fully immunized for the other vaccines. I have heard stories of parents who have chosen not to have their child immunized through school, but once they enter college. They just said, you require these immunizations. And many entering freshmen have written their parents and said, thank you for not immunizing me, because today I have to get five shots. Oh my. So it comes around to haunt them. It does. And more importantly, the colleges recognize it's significant. There have been outbreaks of disease, including fatal cases, on college campuses in the last several years of infection due to Nigeria meningitis. And that's why colleges are stressing the fact that we need to protect our student population by making sure that they're protected by immunization. So what parents need to understand is immunizations are life long. Right. And that's why the flu vaccine every year is so important. And when we were talking earlier, you said also that vaccinations are important for grandparents too, the flu vaccination, but also more. Exactly. Flu is very important, but whooping cough, pertussis is a serious disease. We are still seeing cases here in Texas, including fatal cases that occur in infants, because an infant really shouldn't receive their first dose of whooping cough vaccine until the age of two months. We are recommending that all pregnant women receive a pertussis booster at the beginning of their third trimester of pregnancy. And this is a recommendation, and it's for every pregnancy that they receive it. Beyond that, anybody who will have contact with that infant, older brothers and sisters, grandparents, daycare workers, anybody with contact with young children should make sure that they've received a whooping cough pertussis booster and that they're actually are current. That's called cocooning. We actually protect the infant by making sure everyone else around them is vaccinated and prevent disease. Now the flu vaccine is interesting. In the 1960s, Japan required that all grade school children receive influenza vaccine. What they noted and in fact hadn't recognized it until they had made the recommendations and it was done, the number of serious diseases including hospitalization and deaths occurring in the elderly was appreciably reduced during that 10-year period where influenza was mandated as an immunization for children. So it was protecting the children or giving them the immunizations protected adults around them. Exactly. The highest attack rate, which is how we describe those who will become infected following exposure for flu is actually the grade school children where 40 to 50 percent of a classroom may become infected. They bring it home from school and infect others. That's why making sure that everybody in the household receives their influenza vaccine every year is important. And in this case, it is the children who protect their parents and grandparents by making sure that they're immunized as well. We don't require flu vaccination for school entry, but if I could enact it, that would be something I would do. On behalf of the whole community. On behalf of the whole community. I think that looking at it from that big picture is really important. I agree. We are part of a community and we have responsibility for our own health, but we have a responsibility for the health of our neighbors. One of the easiest ways we can fulfill that responsibility is making sure that we are fully immunized to protect us from possibly spreading disease to others, especially those whose health prevents them from receiving the immunizations themselves. Exactly. As you were talking about someone with leukemia. The child with leukemia or somebody with abnormal immunodeficiency or the adult being treated for cancer. Those persons cannot receive certain vaccines because of the risk. We have a responsibility to protect them by our actions. From receiving the infectious disease. Well we were talking about a little bit about what's new out there. I mean some new vaccines that people are working on. Vaccines for other diseases like Ebola, West Nile. Ebola was certainly two years ago when Ebola was a significant disease. There was a big rush for the development of an Ebola vaccine. The current vaccine that I really think has entered the news is protection against Zika. I have seen in some brief news reports that the vaccine candidate that they are developing as a Zika vaccine appears to be highly effective. We are also attempting to develop vaccines to protect against West Nile. One of the larger studies that have been done for the last decade has been to developing an effective vaccine to protect against malaria. Now to me that's fascinating because obviously Bill Gates and his wife have put their fortune behind developing the malaria vaccine and there's a reason that they're aiming squarely at malaria. There is. When people do research for vaccines many of the considerations they make is not how much money can we make from the product but how many lives can we protect. And when they looked at potentially vaccine preventable disease an effective vaccine against malaria will prevent the greatest number of childhood deaths worldwide compared to any other infectious disease that is potentially vaccine preventable. So many of the vaccines that are developed are truly developed to improve the health and welfare of children of this world and malaria if we have an effective vaccine will substantially improve the quality of life for those countries where there are too many children die each year as a complication of infection. Well that's a noble goal and in fact the one who gets it will probably get the noble prize. Okay for that reason for sure. Wow. Well thank you very very much Dr. Conrad for taking the time and I promise you I'm going to go get my pertussis booster which I haven't had in a while I learned something here. And remember to get your flu shot and my flu shot in about a month and thank you for inviting me. I always enjoy the opportunity to tell people about the importance of vaccines. They're the most cost-effective thing we do in medicine and the old adage of pounder for an ounce of prevention is worth a pound of cure can be easily met by immunization. So after hearing this not only should you go out and be immunized but you should advocate to your neighbors to make sure that they're fully immunized as well. I'll do it. Thank you. You're welcome. Thank you so much. You're welcome.