A tricky time as vaccine noise sows confusion
State Health Commissioner James McDonald. Credit: NYSDOH
As state Health Department commissioner, Dr. James McDonald leads on science and healthcare.
As a pediatrician, McDonald has administered tens of thousands of vaccines.
And as a dad, McDonald cares for two adult sons, who have autism spectrum disorder, and a daughter, who does not.
McDonald, 63, of Latham, New York, wears all three hats as he navigates the misinformation and uncertainty dotting an increasingly complex public health landscape.
But it's the pediatrician who often emerges first, the voice needed most now.
McDonald recalls treating an Amish infant with bacterial meningitis about 20 years ago, a child who survived thanks to a spinal tap and a quick hospital transfer. He remembers routinely sending children to the hospital with rotavirus and treating severe cases of respiratory syncytial virus, or RSV.
Such diseases, he noted this week, should now be on the verge of elimination, thanks to vaccination.
But nowadays, it's not that easy.
"One of the things you worry about is when you see more and more vaccine-preventable diseases becoming more common ..." McDonald said. "As a pediatrician, I've seen plenty of children who've been very ill, who are dying ... It's tragic when a child suffers. It's more tragic when a child suffers from a preventable disease."
It is a tricky time for pediatricians. Some parents and children come into the office ready for every shot, confident in a vaccine's efficacy and safety. Others come armed with doubt or distrust.
Such concerns exploded this week, after President Donald Trump's attempt to slash the number of recommended vaccines, split up the long-trusted measles, mumps and rubella shot, and encourage federal law enforcement to target states like New York that limit vaccine exemptions.
McDonald says the state's recommendations and requirements remain unchanged.
But the federal efforts may make parents question even trusted vaccines and again consider the long-debunked link between vaccination and autism, which Trump raised this week. (Says McDonald, with both physician and parent hats on: "There simply isn't one.")
That rhetoric, he says, "is sowing a ton of confusion."
"For the pediatrician in the exam room, this makes the job harder," he said.
Inside that exam room, the conversation between pediatrician and parent is the best chance to combat vaccine hesitancy. It must be "honest and open," McDonald said. Clear, fact-based messaging is key, with talk of both benefits and risks and a willingness to ask, answer and respect any question. But parents must do their part.
"When I'm talking to my patients, I have perhaps a 20-minute encounter every two months," McDonald said. "The rest of that time, families have access to all kinds of voices, and all of those voices get very confusing when you're talking about the matter of your health and well-being — it's critical to listen to an expert."
That shouldn't mean relying on social media or federal officials who've added to the chaos.
Instead, it comes back to your pediatrician, someone with years of training, who embraces proven science. Also helpful: Health Department experts who are coming to our communities, meeting families where they are, providing one-on-one and small group sessions.
On Long Island, those who oppose vaccines and vaccine mandates have raised their voices. As they mobilize, scientists and physicians will have to meet the moment.
In the quiet of a physician's office, or the privacy of a personal, direct conversation, there's an opportunity to remove the noise, the groupthink and the rhetoric, putting the health of parent and child first.
"What concerns me deeply is people getting confused when there's really well-established science that explains things, but people are trusting strangers on the internet who don't have the expertise, [and] they're making vital health decisions based on them ..." McDonald said. "People with popular opinions on the internet are not sitting at the bedside with you when your child is sick. Your doctor is."
Columnist Randi F. Marshall's opinions are her own.
Randi Marshall is a member of the Newsday editorial board.
