The editors of the March 7, 2019, MMWR, the Centers for Disease Control’s flagship weekly on disease outbreaks in the U.S. and around the world, did something unusual. The same MMWR that alerted the world to HIV/AIDS in the 1980s or the go-to report on the outbreaks of swine flu, bird flu and most recently the Zika and Ebola virus epidemics devoted some valuable MMWR real estate to reporting a case study: an act that underscores the importance of this case study.

I urge every parent to check out Judith A. Guzman-Cottrill et al’s article: cdc.gov/mmwr/volumes/68/wr/mm6809a3.htm?s_cid=mm6809a3_w. It is highly readable to the general public.

They reported the case of a six-year-old Oregonian boy who was never vaccinated by his parents. Six days after he fell and cut his forehead on his family’s farmstead he started crying and having spasms of his facial muscles. The spasms soon spread to his limbs and spine. When he developed breathing difficulties his parents alerted EMS, and he was soon airlifted to a children’s hospital, where a diagnosis of tetanus was made.

His care team thoroughly cleaned out his forehead wound and they administered anti-tetanus serum to target the tetanus toxins attached to nerve endings in his muscles and spinal cord. They sedated him and inserted a breathing tube through his mouth into his airway, but a few days later they had to insert a tracheostomy tube and place him on a mechanical ventilator because his severe spasms were affecting his muscles of respiration: his diaphragm, rib cage muscles and upper back muscles. He received antibiotics, sedatives, muscle relaxants and medications to maintain his blood pressure.

In all, he spent more than five weeks on a mechanical ventilator, out of his almost seven weeks in intensive care and a total of eight weeks in the hospital. But his ordeal was not over. He had to go into a rehabilitation center for 17 more days to relearn how to walk and balance. Three and a half months after the seemingly innocuous fall, he returned to baseline, to normal activity.

The bacterial spores that cause tetanus are ubiquitous in soil, which explains why the doctors first cleaned out the Oregon boy’s forehead wound of any residual soil. Farmers, mechanics, hikers, children are all frequently in contact with soil and therefore prone to exposure to Clostridium tetani, the microorganism that causes tetanus, but we all may fall in the park or hurt our hands in our backyards. We all therefore need to be vaccinated against tetanus.

Reading the case report took me back to 30 years ago when I was a pediatric house officer (the rookie of the medical team) in a poorly resourced hospital in Nigeria. On my 24-hour call, I had five newborns with tetanus under my care among the 30+ in-patients that night. We kept them in a dark side room, we sedated them and gave them anti-tetanus serum but we didn’t have a mechanical ventilator. When the spasms were too high we tried to increase their sedation but we could only go so far or they will die from sedation. That night I had the unenviable duty of certifying three of them dead. The experience is forever etched in my memory.

These children could have been saved from this ordeal if their mothers had been adequately vaccinated in the prenatal period. They would have received temporary immunization against tetanus across the placenta. Unfortunately, the parents of these children were rural dwellers who had limited access to prenatal care and immunization services. Thankfully, in 2019, access to vaccines in that part of Nigeria is much improved, albeit not perfect.

If the Oregonian boy had been taken to his doctor or the emergency room when he initially suffered the cut, the doctors would have asked about his immunization status and they would have given him the anti-tetanus serum and the vaccination that would have prevented the pain and suffering that he went through, but the more efficient approach is to get children immunized as recommended by the CDC schedule for immunizations. After all of his suffering and near-death experience, his parents still refused to have him fully immunized for tetanus and they refused all other vaccines as well. I am gobsmacked!

The direct cost to the hospital for his care was $811,929. Add to that air ambulance and rehab care, and then add the lost work days and income of his parents, and the unquantifiable pain and suffering of this young boy. All of these could have been averted by a five-dose DTaP vaccine given at 2, 4, and 6 months of age, and then a fourth dose at 15 to 18 months, and a fifth dose at age 4 to 6 years.

The World Health Organization (WHO) recognized vaccine hesitancy (failure vaccinate at all and delayed or inadequate vaccination) as one of the top 10 threats to global health. Unvaccinated children are at risk of vaccine-preventable illnesses and they put other children who cannot be vaccinated for health reasons at risk. Furthermore, they may put frail grandparents or relatives on cancer treatment or other forms of immune suppressive treatment at severe risk.

About a hundred million kids are vaccinated every year in this country. In my humble opinion, if vaccines are so bad, we wouldn’t need to depend on hearsay and gossip on social media platforms to know about people harmed by vaccines. They will be everywhere in our neighborhoods, playgrounds and church pews.

The import of this article is to reassure parents that childhood vaccines are safe and the benefits outweigh the risks. Through vaccinations we eradicated small pox in 1980. Thanks to efforts by WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, GAVI, Gates Foundation and various national governments, we are on the verge of eradicating polio. Only 33 cases of polio were reported worldwide in 2018 and they were all in conflict zones where the provision of routine vaccination services is challenging. We know vaccines work and every effort is made to make them safe.

If people walk miles in conflict zones to vaccinate their children, we ought to be able to do so in America, where the vaccines are readily available for all children, with or without health insurance.

For more on vaccines and immunizations, parents should talk to their pediatricians and family physicians or visit the CDC website at cdc.gov/vaccines/index/html, where our tax dollars have paid for public servants to provide us with objective, unprejudiced information about vaccines.

By the way, don’t forget to immunize your pets. Rabies is not a joking matter!

Oyerinde is a pediatrician at the CHI St Alexius Health Medical Plaza in Minot.