Frequently, when discussing the impact of vaccination programs with parents, I will mention that vaccines are a victim of their own success. This phrase, used frequently by pediatricians, is meant to explain that modern parents do not know what it was like when vaccine-preventable illnesses were just part of life. Many people are unable to imagine the horrors of these illnesses because we have never seen them. Discussed less frequently, there are quite a few other significant pediatric achievements that have changed our way of life.
A few weeks ago, the Pediatric Academic Societies held their annual meeting in San Diego. During the meeting, the researchers took time to look back on the seven greatest pediatric research achievements from the last 40 years. Collectively, these achievements have saved millions of lives and improved the quality of life for many others.
Recognized advancements include:
1. Immunizations to prevent rotavirus and haemophilus influenzae type b (Hib) infection.
Rotavirus is the most common cause of severe diarrhea in children. Prior to the introduction of the vaccine in 2006, rotavirus was responsible for 400,000 doctor visits and 60 deaths annually in the US. Globally, the numbers are much higher with as many as 450,000 deaths in developing countries. Since the introduction of the vaccine, these numbers have been drastically reduced.
Hib bacteria causes invasive infections, such as meningitis, pneumonia, cellulitis, infectious arthritis and epiglottitis. Children under 5 are most susceptible to infection. Hib vaccine became available in 1985. Prior to the vaccination era, 20,000 American children would develop severe disease and 1,000 would die each year from Hib infection. In 2006, only 29 cases of Hib infection were reported.
2. Saving premature babies by helping them breathe.
In 1959, two scientists reported on the importance of a molecule called surfactant. Without the chemical, found naturally in the lungs, babies born prematurely were not able to breathe. During the 1970s and 1980s, many trials were performed with both natural and synthetic surfactants. Currently, surfactant is administered to every infant born prior to 29 weeks gestation and certain older infants. Rapid surfactant administration is responsible for the survival of many babies born prematurely.
3. Reducing sudden infant death syndrome (SIDS) with the Back to Sleep campaign.
SIDS is the leading cause of death in infants under a month old. The Back to Sleep campaign, initiated in 1994, outlined several safe sleep guidelines. These included always laying a child to sleep on his or her back, in his own space. The child should be on a firm mattress and there should be no blankets, pillows, or other bedding in the space. Installation of these guidelines resulted in a 50 percent decrease in SIDS deaths.
4. Curing acute lymphocytic leukemia, a common childhood cancer.
Acute lymphocytic leukemia (ALL), is the most common childhood cancer accounting for 25 percent of cancer diagnoses for those under 15. Between 1975 and 2010, the five-year survival rate for ALL increased from 60 percent to 90 percent. Now, nearly 80 percent of patients under 18 with newly diagnosed ALL will survive long term with no complications.
5. Preventing HIV transmission from mother to baby.
More than 90 percent of pediatric HIV cases result from mother-baby transmission. In 2012, the CDC presented guidelines aimed at eliminating mother-child HIV transmission. The recommendations include, early HIV identification in women of child bearing age, provision of appropriate prenatal care, C-sections when appropriate, prevention of breastfeeding when indicated, and early initiation of anti-retroviral therapy. When all the interventions are applied, the transmission rate is reduced to less than 1 percent.
6. Increasing life expectancy for children with chronic diseases such as sickle cell disease and cystic fibrosis.
As recently as 1980, children with cystic fibrosis had a life expectancy of 20 years, that has now increased to 37.5 years. Similarly, children with sickle cell disease can expect to live to a median age of 40.
7. Saving lives with car seats and seat belts.
The first car seat came on the market in 1968, and the first federal car seat standards were created in 1971. In 1981, the American Academy of Pediatrics started its A First Ride…A Safe Ride program as a way of educating parents and legislators about the importance of car seat safety. Currently, all 50 states have laws requiring the use of car seats for infants and young children. Now, 48 states require booster seats for older children. Proper car seat use saves the lives of hundreds of children each year.
Thanks to these advancements, more of today’s children will grow into healthier adults. It is exciting to think what may be in store over the next 40 years.
Lisa Ryan, MD, is a pediatrician at Way to Grow Pediatrics. She can be reached at 636.344.2213.