Consultant for Pediatricians Vol 7 No 9

A 17-month-old girl awoke with drooling, cough, respiratory distress, and a muffled cry and was brought to the emergency department. She had no nausea, vomiting, or diarrhea and no history of choking, aspiration, or airway problems.

Vaccines are perhaps the single most important contribution the 20th century made to civilization. They have been responsible for saving untold numbers of lives and for vastly improving the quality of many more. Although vaccines have had some bad press of late, they are still strongly recommended by the medical community. However, financial issues, difficulties with managed care organizations (MCOs) and other parts of our health care system, and problems with the manufacture and delivery of vaccines prevent optimal use of this crucial preventive service. Here I discuss the problems associated with vaccine delivery and administration and suggest several practical solutions.

Vaccines may represent the greatest advance in children’s health of the past 50 years, but they also, sadly, can frequently be a source of stress for today’s pediatricians. There is the issue of potential difficulty in recouping the cost of the vaccines from managed care organizations.

According to one Web site, pediatric health care providers should be arrested and prosecuted because of their involvement in the “chemical holocaust” of children.1 This chemical holocaust refers to vaccination- one of the greatest public health successes in the history of modern medicine.

Parents are understandably concerned about vaccines and autism, a relationship publicized by lawsuits, alternative therapies, and claims of government cover-up.

The approval of Gardasil (Merck)-a recombinant vaccine providing protection against human papillomavirus (HPV)-in 2006 sparked instant controversy.1,2 Because HPV infection is a sexually transmitted disease, the use of a vaccine for such a disease brought the following political, medical, and moral questions to the forefront:

A discussion of two types of Genital Lesions: Smegma and Torsion of the Testis.