An antivaccine nurse (or physician) should not take care of children, period

Remember how many times I’ve said that when the next big outbreaks in the US happen they’ll probably happen in Texas? The reason is, of course, that the antivaccine movement there, lead by groups like Texans for Vaccine Choice, has successfully weaponized conservative, anti-government, anti-regulation politics to block policies to increase vaccine uptake, such as making nonmedical “personal belief exemptions” harder to obtain.They did this by painting school vaccine mandates as unacceptable examples of the government telling people what to do. They’ve also run antivaccine candidates against pro-vaccine candidates for the state legislature. Along with all this, the rate of personal belief exemptions in Texas has skyrocketed over the last 15 years. If this keeps up, it’s only a matter of time before outbreaks begin. Certainly, the odds of this happening are not helped by an antivaccine nurse like the one I learned about in Houston yesterday.

Yesterday, I learned that a Houston toddler tested positive for measles:

A toddler has tested positive for measles, confirmed by Texas Children’s Hospital, where the boy is being treated.

In addition, a nurse at the hospital’s West Campus is being investigated for posting about the little boy’s condition on an anti-vaccine Facebook page.

The City of Houston’s Health Department maintains this is a suspected case of the illness, and further tests will be needed to confirm it. The last time the health department investigated a confirmed case of measles was in 2013.

According to the health department, the case involves a male child between the ages of 1 and 3 years old. The little boy recently traveled internationally, and officials say it is possible he contracted the disease overseas.

So, is this toddler with measles a harbinger of things to come in Texas? I hope not, but it wouldn’t surprise me if it is. As is typical in these cases, the child appears to have caught the measles overseas. We know that Europe is currently suffering massive measles outbreaks in several countries, such as Italy, Serbia, and others.The child is said to be between 1-3 years of age, which means he probably should probably have gotten his first dose of MMR, but at the time of initial reporting, we didn’t know one way or the other. (More on that later.) Yes, it’s only one case, but it could well be a harbinger of things to come.

I hate to see a story like this. Texas, given its high rate of personal belief exemptions, is an outbreak waiting to happen. However, I hate to see something like this, something that makes this story even worse, so much more:

Over the weekend, a nurse working at Texas Children’s Hospital West Campus posted about the child’s condition on a Facebook page titled “Proud Parents of Unvaccinated Children – Texas.” That page appears to have since been taken down.

In screen shots viewed by Eyewitness News, the nurse stated, “.. for the first time in my career I saw Measles this week. Actually most of mycoworkers and the ER docs saw measles for the first time as well. And honestly, it was rough. The kid was super sick. Sick enough to be admitted to the ICU and he looked miserable…By no means have I changed my vax stance, and I never will. But I just wanted to share my experience and how much worse it was than I expected.”

If you watch the video and pause it at the right spot (around the 1:30 mark), you can see the entire Facebook post:

I note that this antivaccine nurse also wrote:

Maybe this was an extreme case. Maybe most fare better, but this poor kid was bad off, and, as a parent, I could see vaccinating out of fear. Seeing it made me a little more humble and maybe a little more understanding. I’ll continue along my nonvax journey with no regrets but I’ll definitely have more compassion to those who vehemently vaccinate.

You can see for yourself with more clarity, however, if you wish. Here are posts by this antivaccine nurse to the “Proud Parents of Unvaccinated Children – Texas” Facebook page as they were reported by a concerned parent on the Texas Children’s Hospital Facebook page:

That’s nice. Where’s your concern for your own children who could suffer the same fate, thanks to your medical neglect in failing to get them vaccinated. (And, yes, I do consider failure to vaccinate medical neglect. That is my opinion.) It’s hard to believe that an actual antivaccine nurse works in a pediatric ICU (PICU). This brings us to something else horrifying that this antivaccine nurse wrote later, also reported in the news:

The postings included some comments by other group members, and at one point, the nurse commented, “I’m not kidding that I thought about swabbing his mouth and bringing it home to my 13 (year old).”

This tells me that this particular nurse believes in the trope that “natural immunity” obtained by getting the disease is somehow superior to immunity obtained from being immunized. It’s not. While it’s true that the immunity induced by some vaccines wanes with time, so, often, does immunity caused by the disease. Also, the price of “natural immunity” to diseases like measles is suffering and the risk of serious complications, such as pneumonia, encephalitis, and subacute sclerosing panencephalitis (SSPE), not to mention the continued spread of the disease to others.

I also can’t help but point out that this antivaccine nurse clearly knew that what she was doing was wrong and against hospital policy and could potentially get her into hot water, saying:

Sorry guys, I worked way too hard (and owe too much in student loans to jeopardize my license) 😬 so I deleted a lot of my responses. I love my job, I love being in healthcare. I really want to kee info to a minimum and if’when this case makes news I’ll elaborate! Love you all! Keep strong in your beliefs! We are all on this journey for a reason! And we are not wrong in our convictions. I’ll share more as I feel comfortable.

Sorry, but sharing ANY potentially patient-identifiable information is against the law, breaches patient confidentiality, and would continue to be wrong even after the story about this toddler with measles hit the news. I’d hate to be parents of this poor toddler, with an antivaccine nurse caring for my chid, knowing that she’s sizing up my son’s story and deciding what she thinks she can and can’t share about it among her antivaccine buddies on an antivaccine Facebook page. At the time, I was quite clear: An antivaccine nurse like this to be fired ASAP.

Fortunately, the hospital agreed, as reported last night:

A Texas Children’s Hospital nurse was fired after posting about a toddler, who tested positive for measles, on an anti-vaccine Facebook page.

The hospital sent the following statement regarding the incident:

We were made aware that one of our nurses posted protected health information regarding a patient on social media. We take these matters very seriously as the privacy and well-being of our patients is always a top priority. After an internal investigation, this individual is no longer with the organization.

Not surprisingly, the Facebook page where the nurse had posted about the child, “Proud Parents of Unvaccinated Children – Texas,” appears to have since been taken down. I’m guessing that the group is still on Facebook but that its administrators changed its setting to a secret group, so that only its members can see it. It’s also not too far out to speculate that the members of the group are commiserating with this nurse, portraying her as a “martyr” to pharma-led pro-vaccine zealots. The only thing that surprises me is that I haven’t seen her portrayed on antivax websites as a martyr yet.

In the meantime, I’m with Rebecca Lunstroth:

UT McGovern Medical School’s Assistant Director of Humanities and Ethics says although moral objections exist, medical professionals opposed to vaccines probably shouldn’t treat children.

“The beauty of healthcare, there is so many different routes that professionals can take,” said professor Rebecca Lunstroth. “If you don’t believe in vaccines, you probably shouldn’t go into pediatrics and you would be warned of that, that this is the standard and if you don’t believe in the standard, you should probably go into another practice.”

Precisely. The same is true of the neonatal ICU nurse whom I encountered on a panel on “vaccine choice” where she spewed antivaccine misinformation. If you’re a nurse (or a doctor) who “doesn’t believe in vaccines” or thinks vaccines are dangerous and ineffective, you really, really shouldn’t be treating children. Go into another specialty. I consider it not unlike the case of the pharmacist who is antiabortion and therefore refuses to fill prescriptions for the “morning-after” pill. If your beliefs make it so that you can’t do your job to the standard of your profession, you should not be in that profession.

As for the child’s vaccination status, here’s what subsequent reporting revealed:

Dr. David Persse, the director of the City of Houston Health Department, says the baby boy diagnosed with measles remains in the hospital. Dr. Persse said the baby was too young to get the measles vaccine, but the rest of his family is immunized.

So I’m guessing that the original description of the boy as being “between 1-3 years old” really meant that he was around one year old, because according to the schedule recommended by the CDC the first dose of MMR is recommended between 12-15 months of age. However, there is a caveat. Infants traveling internationally are considered high risk and the recommendation is:

Infants 6–11 months: 1 dose before departure. Revaccinate with 2 doses at 12–15 months (12 months for children in high-risk areas) and 2nd dose as early as 4 weeks later.

I’m guessing that a lot of parents don’t think of that, and, if the child’s pediatrician doesn’t even know that the child will be traveling to international destinations, then there’s no way of knowing. The reason international travel is high risk is because of low vaccine uptake in various parts of the world, unfortunately including Europe. The reasons, of course, that high vaccine uptake is important are that it not only prevents illness in individuals but through community immunity (the now-preferred term over “herd immunity”), it prevents the rapid spreads of the disease, serving as barrier to outbreaks. Of course, children too young to be vaccinated are among those protected by community immunity, as well as children who are immunocompromised and thus can’t be vaccinated with an attenuated live virus vaccine like the MMR.

All of this is another reason why this nurse should not be anywhere near patients. I hope that she retrains and finds a job where vaccines are not part of the discussion, as, given her history, it’s unlikely any pediatric hospital will hire her. Even better would be for her to reconsider her antivaccine beliefs and get her children’s vaccines caught up. Unfortunately, what’s more likely is that she’ll be portrayed as a martyr to the cause by the antivaccine movement, which likely will reach out to her.