By: Harvey S. Kaplan, MD, FAAP
I graduated from New York Medical College in 1963 and completed a pediatric residency at Stanford in 1968. My entire career in pediatrics was at San Mateo County Hospital. During that time, I saw many diseases disappear from pediatric practice due to vaccines.
I remember a morning, many years ago, when the front doors of the Pediatric Clinic clanked open and a young Hispanic mother, having traveled alone on a bus and walking four blocks to the hospital, approached the reception desk carrying her quiet infant wrapped in a blanket. It didn't take much more than a quick look to confirm he was very sick.
The baby was 6 months old and while he survived following treatment for bacterial
meningitis, he was unfortunately left with severe
hearing loss and a
developmental disability. He was born in the early '70's before the introduction of the
Hib vaccine a decade later.
Haemophilus influenza type B (Hib) was a common cause of invasive bacterial disease.
Another complication of Hib infections in addition to meningitis was
epiglottitis, a frightening obstruction of the airway. Children appeared extremely anxious, leaning forward, shoulders hunched, and literally gasping for air. It was one of those feared, life-threatening emergencies that pediatricians and parents faced before the Hib vaccine was introduced.
Complications related to
varicella sometimes resulted in hospitalization in the days prior to the introduction of the
chickenpox vaccine in 1995. One day, the ER called me and said they had a 10 year old with extensive chickenpox lesions, fever, and that the lesions were "black." These "black pox" were due to hemorrhagic complications causing skin bleeding.
I remember a child hospitalized with severe chickenpox with so many skin lesions that it was almost impossible to find a clear space to start an IV for fluids and antibiotics. The child had a secondary bacterial infection.
Pediatricians still need to think about these things, but they aren't everyday events like they were when I started my career. Now, doctors have to counsel parents who are dubious about vaccinations; I don't remember that before. The fear of immunizations is new to me. I retired five years ago, but
when I was in practice, parents did not question the fact that immunization would protect their children from potentially deadly diseases. They were correct, because vaccines are good for children.
About Dr. Kaplan:
Harvey S. Kaplan, MD, FAAP graduated New York Medical College in 1963, interned at Kaiser Hospital San Francisco in 1963-64 and then served in USAF Medical Corps rank of Captain from 1964-1966. In 1969, Dr. Kaplan began employment as a staff physician at San Mateo Medical Center, serving as Chief of Pediatrics for 35 years. After retirement, Dr. Kaplan served for 11 years as a commissioner on the San Mateo First Five Commission and currently serves on the Board of Directors of San Mateo CASA, providing volunteers to aid children in foster care. He and his wife, Gay, have a son and daughter, and five grandchildren.
Medicine Before Vaccines
This article is part of a series of first-person accounts from senior pediatricians about what it was like to practice pediatric medicine before vaccines for diseases like meningitis, measles, and the flu were available. These articles are being published in recognition of National Immunization Awareness Month, which is held in August every year.