Doctor’s experience overseas confirms value of vaccinations
INFECTIOUS DISEASES Tragic to see children with preventable illnesses, SickKids MD says
Dr. Shaun Morris spends much of his time thinking about infections that make kids sick.
As a pediatric infectious diseases physician at the Hospital for Sick Children, he looks after kids with serious infections, from meningitis to complicated pneumonias to infections that settle in the bones and heart. As a clinician-scientist, he studies vaccine safety and tracks vaccine-preventable diseases in children, including COVID-19, influenza and RSV.
Morris, who is co-director for SickKids’ Centre for Global Child Health, also leads research in other countries to help improve the health of women and children. He’s seen first hand the devastating spread of infections in regions that don’t have the resources for a strong health-care system, let alone robust immunization programs.
In January, Morris helped launch SickKids’ Vaccine Consult Service (VCS), which connects families with a registered nurse to get information and have open discussions about childhood vaccines. Initially a pilot project, the VCS was put on pause in March but is expected to resume later this year after securing additional funding.
With an overwhelming amount of information to sift through, Morris said an easy-to-book phone line from a trusted source helps families navigate their questions on immunizations. A recent report from Public Health Ontario highlighted that measles vaccination rates remain low among school-aged children.
Because immunization programs have been so good at preventing diseases in Canada, Morris said he understands why it can be difficult to fully understand the benefits of vaccines.
“It becomes very hard for people to make decisions when the risk of a disease is very abstract — often no more than a word or a Google image,” said Morris, a member of the Centre for Vaccine Preventable Diseases at the University of Toronto’s Dalla Lana School of Public Health.
“They can’t draw on personal experience or think of a family member or a community member who has had the infection because vaccines are so successful.”
With measles cases climbing in Canada, and public health leaders calling on people to ensure they are up to date on immunizations, the Star spoke to Morris about his work at home and abroad, including how he talks to families about the importance of vaccines.
What are some examples of vaccine-preventable diseases that you have seen in other countries? Fortunately, polio is almost eliminated from the world. But there are a few countries where that’s not the case. In some South Asian countries, for example, you see many, many people who in the past had paralytic polio and they’re profoundly affected.
Another example is HPV or human papilloma virus. That infection can be prevented by a newer vaccine that’s offered here (in routine school-based immunization programs). We prevent HPV infection because it can cause cervical cancer and other types of cancer.
I’ve spent time in cancer hospitals in other countries, where the HPV vaccine wasn’t available and they didn’t have good screening programs, and there were very large numbers of young women who had very advanced cervical cancer. It was very tragic and had an influence on me to do this kind of work.
What is it like to see a sick child with an infectious disease that could have been prevented with a vaccine?
It’s extraordinarily frustrating and sad when (an infection) happens that could have been prevented but wasn’t because of where a child happens to live. That’s not easy.
In some places, you don’t have the tools or resources to properly diagnose or treat a disease in the way that you have (in Canada). That’s difficult when there is a very sick kid in front of you.
When it comes to measles, why are vaccines so important? What is it like to treat a child with this disease?
There are two ways to think about measles.
One is that sometimes measles itself can cause serious infection in other parts of the body. So encephalitis, or an infection of the brain, or sometimes it can go down into the lungs to cause pneumonia.
The other thing measles can do is modulate your immune system … and that makes you more susceptible to other infections. Sometimes a child will get a bad bacterial pneumonia or bad diarrheal disease after an infection. And that happens a lot internationally.
For measles, there isn’t a good treatment once somebody has it.
What do you say to people who are not sure immunizations are crucial to their family’s well-being?
I start each vaccine discussion with the understanding that families want their child to be healthy. My job is to help people to navigate information. I want to ask questions, understand what people’s concerns are, and provide them with the information they need.
What are the challenges in navigating information on vaccines? There’s a huge amount of information that’s available. Everything from anecdotal stories to scientific randomized trials. But they should be considered differently and weighted differently in decision making. My job is really to help people to navigate it all.
We’re very fortunate to live in a country that, for the most part, does provide us with the tools and choices we need to keep ourselves and our children healthy. Certainly, relative to other parts of the world.