Editor-in-Chief Stanford T. Shulman, MD, chats with leading pediatric experts about medicine and life beyond practice.
Larry K. Pickering, MD, FAAP, FIDSA, is senior adviser to the director of the National Center for Immunization and Respiratory Diseases of the CDC; editor of the Red Book; Executive Secretary of the ACIP; and Professor of Pediatrics at Emory University School of Medicine. He is the recipient of the 2007 PID’s Distinguished Physician Award and the AAP 2010 Award for Lifetime Contributions to Infectious Diseases Education; 21st Annual IDSA Edward H. Kass Lecture in Infectious Disease History.
Dr. Pickering has disclosed no relevant financial relationships.
“Larry is one of the very most distinguished pediatric infectious diseases experts in the world, but also one of the most approachable. He is also a great sports fan; we had the pleasure of sitting together at the United Center in Chicago to see one of the most exciting NBA playoff games ever — the Chicago Bulls vs. the Boston Celtics — in triple overtime, on April 30, 2009. The Bulls won 128–127! “
Dr. Shulman: What do you think have been the developments in your specialty that have had the most impact?
Dr. Pickering: Clearly, the one item that has had the most impact has been vaccines. They have prevented thousands of illnesses, they have saved thousands of lives, and they continue to do so.The problem is that we’ve been too successful. We don’t see the diseases anymore, so parents and young physicians don’t even realize how significant these diseases are.Secondly, there are people out there who put forth false claims about vaccines. But parents worry when they hear this stuff, and once the fear is out there, it’s hard to remove.The other thing about herd immunity that is absolutely critical is that there are people in our society who have various primary and secondary immune deficiencies; if they receive vaccines, their underlying disease does not allow them to produce the appropriate response to provide protection. If we as a society don’t ensure that we provide immunizations to people who can take them, then we are putting these other people at risk.
Dr. Shulman: How can a pediatrician convince hesitant parents to vaccinate their children?
Dr. Pickering: I think that most of the parents are good parents. They love their children and they want the best for them. Most of the parents we talk to about this will get their children immunized. There are some parents for whom it won’t matter. This is a minority of families, though. Studies show that it’s less than a half of a percent of the population.When I talk to parents, I try to find out why they are reluctant. Then I give them examples from my own experience. I have seen children become very sick and even die from these diseases. Measles. Hemophilus influenza meningitis. Chickenpox. A year or two ago, there were some well-publicized cases of kids with “flesh eating” bacteria — they had gotten that strep infection because they’d had chickenpox first.
Dr. Shulman: What advice would you give a practitioner who is just starting out?
Dr. Pickering: The major thing to remember is how fortunate we are in the medical field because every day we have the opportunity to help someone. Children are so innocent and they want help. They might not always be able to say it, but I think they are deeply appreciative for what we do for them.
Dr. Shulman: If you’d not chosen medicine, what else would have interested you?
Dr. Pickering: I would not change what I do. I like being an infectious disease pediatrician. But I expect I would have been a professional tennis player.
Dr. Shulman: Could you have fulfilled that expectation?
Dr. Pickering: Absolutely not (laughs).
Dr. Shulman: What do you like to do with your free time?
Dr. Pickering: Tennis and biking are the main things. My wife does genealogy, so we go visit graveyards where we grew up in Ohio and Pennsylvania. It brings us full circle to what we started this discussion with: When you see these itty bitty graves of kids — often several kids in the same family — who died from the diseases that we now can vaccinate against, it reminds you of how much we’ve achieved.