Three-year-old Emily Lastinger wasn't vaccinated for influenza because her parents forgot. Or because they were told to and thought it didn't matter. In 2004, it wasn't recommended for a healthy child her age.
Emily was a perfectly normal, bouncy little girl, said her father, Joe Lastinger. Five days after contracting influenza, she died. "We were shocked. It didn't really compute. People don't die from flu. We never thought her life was in danger. We're like a ton of other parents out there. It wasn't on our radar," said Lastinger, a healthcare executive who resides in Colleyville.
Less than two weeks later, the Lastinger's fourth child––a daughter––was born.
According to Texas Department of State Health Services, Texas is ranked ninth in the nation for the number of children appropriately immunized, compared to 49th in 1997. In the time since Emily's death, the CDC recommends mostly everyone older than 6 months be vaccinated against influenza.
State law requires students in Texas schools to be immunized against certain vaccine-preventable diseases. This includes all children attending or enrolling in childcare facilities or public or private primary or secondary schools or institutions of higher education.
"We're at a phase of vaccine history where effects of vaccine-hesitant parents are being felt," said Dr. Jason Terk, a Distinguished Consultant pediatrician at Cook Children's Physician Network and the Texas Medical Association Council on Science and Public Health Immediate Past Chair.
Texas began allowing exemptions from immunizations for reasons of conscience on Sept. 1, 2003, resulting from the passage of House Bill 2292, Texas Legislature 78 (R). It was passed at 11 p.m. on the last day of the Legislative Session. "It was sneakily done," Dr. Terk said.
In an increasingly libertarian political climate, Dr. Terk adamantly refuses to allow individual liberties to affect the safety of others in his practice.
"It's not the parent who is my patient; it's the child," he said. "I have to connect with parents in such a way to provide stewardship for making right choices for the child.
If a child suffers an adverse outcome without me providing this guidance, I haven't done my job."
Lastinger prompted, "How many parents yank their children out of swimming pools upon hearing a faint rumble of thunder? You're a parent, and you start to think about all these things you worry about," he listed. Electric shock and car seats to name two.
He couldn't identify why the flu wasn't higher up in his train of thought. "We should have known," he said. "There's a guilt that will stay with us forever and ever."
There have been nine fatalities resulting from lightning in the U.S. this year, according to the National Weather Service. In March, the CDC cited 105 influenza-associated pediatric deaths during the 2012-2013 season. Reports indicate that 90 percent of children who died were not vaccinated.
Jim Bob and Cynthia Haggerton, both chiropractors who specialize in pediatrics, see about 1,200 patients each month at Lifetime Family Wellness Center in Hurst and Argyle. "Do I want to be crunchy cool and not vaccinate?" asked Jim Bob Haggerton. That's not it at all. "It's not a lifestyle," he said.
He and his wife chose not to vaccinate their two children. He insists that vaccinations are "an every kid decision." It made the most sense for his family based on where they live and access to medical care and nutritious foods. The story might be completely different for anyone living outside of DFW or traveling abroad, he expressed.
His son was never sick until he began attending preschool last year. At the time, he was one of two children who weren't vaccinated at his school. He was sick repeatedly over and over for the first two to three months, said Haggerton.
"Birds of a feather flock together," said Dr. Terk, referring to vaccine-hesitant parents. Terk believes vaccination has become a victim of its own success. The general understanding of vaccine-preventable diseases is fading from immediate memory despite recent outbreaks in the U.S.
In May 2013, 34 cases of measles were reported in Brooklyn. Additional suspected cases are being investigated, according to the New York Department of Health and Mental Hygiene. All cases are part of the Orthodox Jewish community who were unvaccinated at the time of exposure. The index case was imported from London.
Measles is a leading cause of death in young children, according to the World Health Organization. In 2011, there were 158,000 measles deaths globally – about 430 deaths every day or 18 deaths every hour. The CDC declared measles eliminated from the U.S. in 2000, meaning the disease no longer spreads year round
To Lastinger, a vaccination is like "a little suit of armor." His daughter depends on it. She was diagnosed with leukemia when she was three. During treatment, she was more vulnerable than her classmates. With no immunity whatsoever to vaccine-preventable diseases like pertussis, commonly known as whooping cough, the Lastingers were scared.
"It hit home beyond flu vaccinations," said Lastinger, a Founding Board Member of the vaccine advocacy group Families Fighting Flu. "It drives home the importance of all vaccinations."
Dr. Terk earned his medical degree from the University of Texas Medical Branch at Galveston and completed his residency in pediatrics at Mayo Graduate School of Medicine (Mayo Clinic) in Rochester, Minn. He is the father of two boys.
Andrew Wakefield, a former British surgeon and medical researcher, published a fraudulent research paper in 1998 correlating the measles, mumps and rubella (MMR) vaccine with autism. His claims were discredited and officially retracted in Feb. 2010. His medical license was revoked. The legitimate fear he caused among parents cannot be erased as easily.
The foundation of vaccine safety is based on 13 large epidemiologic studies that were performed after the Wakefield study, explained Dr. Terk. "Physicians who choose to monetarily leverage peoples fears of vaccines by validating them and creating practices that cater to those fears are behaving unethically in my opinion," said Dr. Terk. He cautioned that vaccination is not a choice that is as simple as putting out a pro versus con list.
Some people are data-driven. Others trust their gut. "We had to shift how we tell the story of vaccines from talking about studies to talking about people," he said. "Stories have more currency."
Bottom line. "Find a physician whose values in providing medical care to your child are consistent with your own," said Dr. Terk. "You have to trust your provider; otherwise, it doesn't serve anyone's needs at all."