The Immunization Partnership asked some of the leading voices championing immunizations — the heroes in the fight against vaccine-preventable disease – what set you down the path of immunization advocacy? What made you passionate? In short, what is your origin story? Throughout the next few months, we hope to showcase the responses.
by Carol Baker, MD
When did you become passionate about vaccines?
It’s impossible to recall the day, month or even year. The arduous but exciting years of medical training, spurred by the dream of curing, evolved into the realization that my efforts often failed to dispatch death and disability resulting from infections such as meningitis, measles, polio, pertussis, hepatitis B, and even diphtheria. Maybe the first flicker of desire to undo nature’s seemingly random infectious disease afflictions was during the summer after my first year in medical school. I was assigned the task of collecting blood samples from newborn infants with congenital rubella syndrome. Once equipped with this routine skill, I would ponder the rooms filled with purple spotted babies staring blindly through cataracts, sensing the pain in their parents seeing eyes. Or perhaps it was the healthy 14-year-old girl at Los Angeles County Hospital, shopping with friends a few hours before my futile attempts to restore the damage already done by meningococcal meningitis. Possibly even the rotation in a rehabilitation hospital filled with iron lungs as nurses laughed at my poor first attempts to place patients into the coffin-like but life-saving machines for children and adults with polio. In reality, it was probably the accumulation of medicine’s limitations that catapulted me into realizing that prevention trumped treatment.
As a newly minted physician, I loved babies with their clean slate, their joy at fixing and following on their mothers’ faces and promise of that first word, first step, first day of school and all the firsts of growing up. During my pediatric residency in Houston, ecstasy in the nursery was replaced by a new infectious disease, a sudden surge of meningitis cases in infants less than 3 months of age. And these babies had a new kind of meningitis later proven to be caused by group B Streptococcus (GBS), a previously unknown human pathogen, and still the most frequent cause of young infant meningitis. My grief over the death of 25% of these patients and agony in seeing the disabilities that lingered in up to half of the survivors led me to “enlighten” and launch a war. I did so by puzzle solving: publishing a case series describing the mode of infections and clues to early diagnosis. Then I flew to the “home” of streptococcal research, the Rockefeller Institute in New York, to learn more about GBS from the brilliant and generous Rebecca Lancefield (the “mother” of streptococci). What I really wanted though was to stop infection before it happened (prevention). This resulted in more training — this time at Harvard Medical School where I completed the first step in developing a GBS vaccine, defining the pieces of the bacteria that allowed disease in otherwise perfectly healthy babies. While scientifically successful, I was beyond naïve with my plan to prevent GBS infant disease by vaccinating pregnant women. Like Sisyphus each rock of achievement in this pursuit was pushed down by the scientifically senseless, theoretical concern for safety. The end of this 4-decade pursuit has finally come as my vaccine is finally in commercial development.
With the delay in my ambition for a GBS vaccine, I turned my efforts at doing everything in my power to help other newly developed and licensed vaccines be administered to future children, so that they would not be afflicted by vaccine-preventable diseases. I did so through my policy and advocacy work with the American Academy of Pediatrics Committee on Infectious Diseases, the National Foundation for Infectious Diseases, becoming its President in 2009, and most recently as Chairman of the Advisory Committee for Immunization Practices to the Centers for Disease Control and Prevention. My work will never be done, but I continue the fight to keep my old enemies (e.g., measles), something which could be defeated if recommended vaccines for children were not missed or avoided.
Dr. Carol Baker is a Professor, Molecular Virology & Microbiology at Baylor College of Medicine, where her research is focused on neonatal infections and vaccine-preventable diseases.