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One of the first patients
I had to see as a pediatrician was Sol,

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a beautiful month-old baby

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who was admitted with signs
of a severe respiratory infection.

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Until then, I had never seen
a patient worsen so fast.

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00:00:16,810 --> 00:00:19,810
In just two days
she was connected to a respirator

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00:00:19,810 --> 00:00:22,550
and on the third day she died.

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Sol had whooping cough.

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After discussing the case in the room
and after a quite distressing catharsis,

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I remember my chief resident said to me,

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"Okay, take a deep breath. Wash your face.

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And now comes the hardest part:

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We have to go talk to her parents."

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At that time, a thousand questions
came to mind,

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from, "How could a one-month-old
baby be so unfortunate?"

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to, "Could we have done
something about it?"

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Before vaccines existed,

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many infectious diseases
killed millions of people per year.

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During the 1918 flu pandemic

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50 million people died.

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That's greater than Argentina's
current population.

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Perhaps, the older ones among you
remember the polio epidemic

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that occurred in Argentina in 1956.

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At that time, there was no vaccine
available against polio.

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People didn't know what to do.
They were going crazy.

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They would go painting trees
with caustic lime.

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They'd put little bags of camphor

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in their children's underwear,
as if that could do something.

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During the polio epidemic,
thousands of people died.

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And thousands of people were left
with very significant neurological damage.

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I know this because I read about it,

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because thanks to vaccines,
my generation was lucky

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to not live through an epidemic
as terrible as this.

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Vaccines are one of the great successes
of the 20th century's public health.

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After potable water,

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00:02:01,230 --> 00:02:04,840
they are the interventions
that have most reduced mortality,

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00:02:04,840 --> 00:02:06,970
even more than antibiotics.

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00:02:07,570 --> 00:02:12,560
Vaccines eradicated terrible diseases
such as smallpox from the planet

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and succeeded in significantly
reducing mortality

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due to other diseases such as measles,

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whooping cough, polio and many more.

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All these diseases are considered
vaccine-preventable diseases.

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What does this mean?

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That they are potentially preventable,

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but in order to be so,
something must be done.

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You need to get vaccinated.

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00:02:40,270 --> 00:02:43,970
I imagine that most,
if not all of us here today,

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received a vaccine
at some point in our life.

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Now, I'm not so sure that many of us know

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which vaccines or boosters
we should receive after adolescence.

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00:02:58,710 --> 00:03:02,790
Have you ever wondered
who we are protecting

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00:03:02,790 --> 00:03:04,640
when we vaccinate?

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00:03:05,070 --> 00:03:06,700
What do I mean by that?

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Is there any other effect
beyond protecting ourselves?

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Let me show you something.

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Imagine for a moment

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that we are in a city

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that has never had a case
of a particular disease,

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such as the measles.

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This would mean that no one in the city
has ever had contact with the disease.

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No one has natural defenses against,
nor been vaccinated against measles.

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If one day, a person sick with the measles
appears in this city

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the disease won't find much resistance

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and will begin spreading
from person to person,

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and in no time it will disseminate
throughout the community.

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After a certain time

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a big part of the population will be ill.

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This happened when there were no vaccines.

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Now, imagine the complete opposite case.

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We are in a city

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00:04:09,830 --> 00:04:12,650
where more than 90 percent
of the population

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00:04:12,650 --> 00:04:15,100
has defenses against
the measles, which means

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that they either had the disease,
survived, and developed natural defenses;

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00:04:18,839 --> 00:04:22,540
or that they had been
immunized against measles.

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00:04:23,200 --> 00:04:24,810
If one day,

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00:04:24,810 --> 00:04:28,740
a person sick with the measles
appears in this city,

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the disease will find much more resistance

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00:04:32,610 --> 00:04:36,100
and won't be transmitted
that much from person to person.

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The spread will probably remain contained

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and a measles outbreak won't happen.

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I would like you
to pay attention to something.

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People who are vaccinated

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are not only protecting themselves,

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but by blocking the dissemination
of the disease

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00:04:57,900 --> 00:04:59,540
within the community,

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00:04:59,540 --> 00:05:04,220
they are indirectly protecting
the people in this community

86
00:05:04,220 --> 00:05:06,390
who are not vaccinated.

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00:05:06,690 --> 00:05:09,660
They create a kind of protective shield

88
00:05:09,660 --> 00:05:12,760
which prevents them from
coming in contact with the disease,

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so that these people are protected.

90
00:05:16,670 --> 00:05:19,870
This indirect protection

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that the unvaccinated people
within a community receive

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simply by being surrounded
by vaccinated people,

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is called herd immunity.

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00:05:33,130 --> 00:05:35,590
Many people in the community

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depend almost exclusively
on this herd immunity

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to be protected against disease.

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The unvaccinated people you see
in infographics are not just hypothetical.

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Those people are our nieces
and nephews, our children,

99
00:05:50,600 --> 00:05:53,970
who may be too young
to receive their first shots.

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00:05:55,100 --> 00:05:57,410
They are our parents, our siblings,

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00:05:57,410 --> 00:05:58,840
our acquaintances,

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00:05:58,840 --> 00:06:00,710
who may have a disease,

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or take medication
that lowers their defenses.

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There are also people who are
allergic to a particular vaccine.

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They could even be among us,

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any of us who got vaccinated,

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but the vaccine didn't produce
the expected effect,

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because not all vaccines
are always 100 percent effective.

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All these people depend
almost exclusively on herd immunity

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to be protected against diseases.

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To achieve this effect of herd immunity,

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it is necessary that a large percentage
of the population be vaccinated.

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This percentage is called the threshold.

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The threshold depends on many variables:

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It depends on the germ's characteristics,

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and those of the immune response
that the vaccine generates.

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But they all have something in common.

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If the percentage of the population
in a vaccinated community

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is below this threshold number,

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the disease will begin
to spread more freely

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and may generate an outbreak
of this disease within the community.

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Even diseases which were 
at some point controlled may reappear.

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This is not just a theory.

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This has happened,
and is still happening.

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In 1998, a British researcher
published an article

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in one of the most important
medical journals,

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saying that the MMR vaccine,

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which is given for measles,
mumps and rubella,

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was associated with autism.

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This generated an immediate impact.

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People began to stop getting vaccinated,
and stopped vaccinating their children.

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And what happened?

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The number of people vaccinated,

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00:07:57,980 --> 00:08:01,960
in many communities around the world,
fell below this threshold.

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00:08:01,960 --> 00:08:05,520
And there were outbreaks of measles
in many cities in the world --

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00:08:05,520 --> 00:08:07,960
in the U.S., in Europe.

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Many people got sick.

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People died of measles.

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What happened?

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00:08:15,350 --> 00:08:19,470
This article also generated a huge stir
within the medical community.

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Dozens of researchers began to assess
if this was actually true.

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Not only could no one find

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00:08:28,420 --> 00:08:33,669
a causal association between MMR
and autism at the population level,

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00:08:33,669 --> 00:08:38,570
but it was also found that this article
had incorrect claims.

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Even more, it was fraudulent.

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00:08:42,120 --> 00:08:44,510
It was fraudulent.

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00:08:45,120 --> 00:08:51,550
In fact, the journal publicly retracted
the article in 2010.

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One of the main concerns and excuses
for not getting vaccinated

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00:08:56,780 --> 00:08:58,970
are the adverse effects.

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00:08:59,770 --> 00:09:05,410
Vaccines, like other drugs,
can have potential adverse effects.

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00:09:05,970 --> 00:09:08,480
Most are mild and temporary.

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00:09:08,480 --> 00:09:14,470
But the benefits are always greater
than possible complications.

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When we are ill,
we want to heal fast.

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00:09:20,300 --> 00:09:22,420
Many of us who are here

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00:09:22,420 --> 00:09:26,090
take antibiotics
when we have an infection,

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00:09:26,090 --> 00:09:29,270
we take anti-hypertensives
when we have high blood pressure,

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we take cardiac medications.

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00:09:31,450 --> 00:09:34,700
Why? Because we are sick
and we want to heal fast.

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And we don't question it much.

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Why is it so difficult
to think of preventing diseases,

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00:09:41,890 --> 00:09:45,100
by taking care of ourselves
when we are healthy?

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We take care of ourselves a lot
when affected by an illness,

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or in situations of imminent danger.

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I imagine most of us here,

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remember the influenza-A pandemic

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which broke out in 2009
in Argentina and worldwide.

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When the first cases
began to come to light,

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00:10:05,520 --> 00:10:09,360
we, here in Argentina,
were entering the winter season.

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We knew absolutely nothing.

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Everything was a mess.

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People wore masks on the street,
ran into pharmacies to buy alcohol gel.

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People would line up
in pharmacies to get a vaccine,

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without even knowing
if it was the right vaccine

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00:10:24,810 --> 00:10:27,350
that would protect them
against this new virus.

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00:10:27,350 --> 00:10:29,650
We knew absolutely nothing.

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00:10:29,650 --> 00:10:34,480
At that time, in addition to doing
my fellowship at the Infant Foundation,

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I worked as a home pediatrician
for a prepaid medicine company.

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00:10:39,670 --> 00:10:42,910
I remember that I started
my shift at 8 a.m.,

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and by 8, I already had a list
of 50 scheduled visits.

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It was chaos;
people didn't know what to do.

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00:10:50,860 --> 00:10:55,410
I remember the types of patients
that I was examining.

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The patients were a little older than
what we were used to seeing in winter,

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00:11:00,050 --> 00:11:02,390
with longer fevers.

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00:11:02,390 --> 00:11:06,070
And I mentioned that
to my fellowship mentor,

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00:11:06,070 --> 00:11:09,590
and he, for his part, had heard
the same from a colleague,

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about the large number
of pregnant women

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00:11:12,320 --> 00:11:14,010
and young adults

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being hospitalized in intensive care,

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00:11:16,250 --> 00:11:19,160
with hard-to-manage clinical profiles.

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00:11:20,760 --> 00:11:26,600
At that time, we set out to understand
what was happening.

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00:11:27,300 --> 00:11:30,420
First thing Monday morning,
we took the car

192
00:11:30,420 --> 00:11:33,350
and went to a hospital
in Buenos Aires Province,

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00:11:33,350 --> 00:11:39,020
that served as a referral hospital
for cases of the new influenza virus.

194
00:11:39,020 --> 00:11:41,550
We arrived at the hospital;
it was crowded.

195
00:11:41,550 --> 00:11:45,470
All health staff were dressed
in NASA-like bio-safety suits.

196
00:11:45,470 --> 00:11:47,670
We all had face masks in our pockets.

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00:11:47,670 --> 00:11:50,400
I, being a hypochondriac,
didn't breathe for two hours.

198
00:11:50,400 --> 00:11:53,520
But we could see what was happening.

199
00:11:53,520 --> 00:11:57,210
Immediately, we started
reaching out to pediatricians

200
00:11:57,210 --> 00:12:01,430
from six hospitals in the city
and in Buenos Aires Province.

201
00:12:01,440 --> 00:12:04,770
Our main goal was to find out

202
00:12:04,770 --> 00:12:08,660
how this new virus behaved
in contact with our children,

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00:12:08,660 --> 00:12:11,240
in the shortest time possible.

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00:12:11,240 --> 00:12:14,200
A marathon work.

205
00:12:14,200 --> 00:12:17,070
In less than three months,

206
00:12:17,070 --> 00:12:23,160
we could see what effect
this new H1N1 virus had

207
00:12:23,160 --> 00:12:29,300
on the 251 children
hospitalized by this virus.

208
00:12:29,520 --> 00:12:33,500
We could see which children
got more seriously ill:

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00:12:33,500 --> 00:12:37,120
children under four, especially those
less than one year old;

210
00:12:37,120 --> 00:12:39,920
patients with neurological diseases;

211
00:12:39,920 --> 00:12:43,210
and young children
with chronic pulmonary diseases.

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00:12:43,210 --> 00:12:48,020
Identifying these at-risk groups
was important

213
00:12:48,020 --> 00:12:50,730
to include them as priority groups

214
00:12:50,730 --> 00:12:53,730
in the recommendations
for getting the influenza vaccine,

215
00:12:53,730 --> 00:12:55,590
not only here in Argentina,

216
00:12:55,590 --> 00:12:59,650
but also in other countries
which the pandemic not yet reached.

217
00:13:00,750 --> 00:13:02,430
A year later,

218
00:13:02,430 --> 00:13:07,520
when a vaccine against the pandemic
H1N1 virus became available,

219
00:13:07,520 --> 00:13:10,240
we wanted to see what happened.

220
00:13:10,240 --> 00:13:13,410
After a huge vaccination campaign

221
00:13:13,410 --> 00:13:18,180
aimed at protecting at-risk groups,

222
00:13:18,180 --> 00:13:25,140
these hospitals, with 93 percent
of the at-risk groups vaccinated,

223
00:13:25,140 --> 00:13:28,770
had not hospitalized a single patient

224
00:13:28,770 --> 00:13:31,450
for the pandemic H1N1 virus.

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00:13:31,450 --> 00:13:34,500
(Applause)

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In 2009: 251.

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00:13:41,490 --> 00:13:44,440
In 2010: zero.

228
00:13:44,440 --> 00:13:49,220
Vaccination is an act
of individual responsibility,

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00:13:49,220 --> 00:13:53,250
but it has a huge collective impact.

230
00:13:54,790 --> 00:13:59,410
If I get vaccinated,
not only am I protecting myself,

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00:13:59,420 --> 00:14:02,630
but I am also protecting others.

232
00:14:03,520 --> 00:14:05,890
Sol had whooping cough.

233
00:14:07,500 --> 00:14:09,700
Sol was very young,

234
00:14:09,700 --> 00:14:14,230
and she hadn't yet received
her first vaccine against whooping cough.

235
00:14:15,160 --> 00:14:18,960
I still wonder what would have happened

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00:14:18,960 --> 00:14:24,870
if everyone around Sol
had been vaccinated.

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00:14:25,740 --> 00:14:27,800
(Applause)