1
00:00:00,631 --> 00:00:05,059
One of the first patients
I had to see as a pediatrician was Sol,

2
00:00:05,368 --> 00:00:08,154
a beautiful month-old baby

3
00:00:08,154 --> 00:00:11,828
who was admitted with signs
of a severe respiratory infection.

4
00:00:11,828 --> 00:00:16,111
So far, I had never seen
a patient worsen so fast.

5
00:00:16,808 --> 00:00:19,805
In just two days
she was connected to a respirator

6
00:00:19,805 --> 00:00:22,551
and on the third day she died.

7
00:00:22,551 --> 00:00:25,301
Sol had whooping cough.

8
00:00:25,301 --> 00:00:30,008
After discussing the case in the room
and after a quite distressing catharsis,

9
00:00:30,458 --> 00:00:32,509
I remember my chief resident said to me,

10
00:00:32,509 --> 00:00:35,849
"OK, take a deep breath, wash your face,

11
00:00:36,429 --> 00:00:39,050
and now comes the hardest part,

12
00:00:39,050 --> 00:00:41,460
we have to go talk to her parents."

13
00:00:42,146 --> 00:00:46,118
At that time, 
a thousand questions came to mind.

14
00:00:46,118 --> 00:00:50,452
From: "How a month-old baby
could be so unfortunate?

15
00:00:51,198 --> 00:00:54,070
To: "Could we have done
something about it?"

16
00:00:55,396 --> 00:00:57,681
Before vaccines existed,

17
00:00:57,681 --> 00:01:02,546
many infectious diseases
killed millions of people per year.

18
00:01:03,100 --> 00:01:06,631
During the 1918 flu pandemic

19
00:01:06,631 --> 00:01:09,781
50 million people died.

20
00:01:09,781 --> 00:01:13,059
That's greater
than Argentina's current population.

21
00:01:13,059 --> 00:01:17,105
Perhaps, the older ones among you
remember the polio epidemic

22
00:01:17,111 --> 00:01:20,034
that occurred in Argentina in 1956.

23
00:01:20,243 --> 00:01:23,560
At that time, there was no vaccine
available against polio.

24
00:01:23,560 --> 00:01:26,233
People didn't know what to do.
They were going crazy.

25
00:01:26,240 --> 00:01:28,371
They would go painting trees with lime.

26
00:01:28,371 --> 00:01:31,431
They would put camphor bags
inside their children's clothes

27
00:01:31,431 --> 00:01:33,633
as if that could do something.

28
00:01:34,286 --> 00:01:38,596
During the polio epidemic
thousands of people died.

29
00:01:38,596 --> 00:01:42,773
And thousands of people were left with
very important neurological damages.

30
00:01:44,646 --> 00:01:47,291
I know this because I read about it,

31
00:01:47,291 --> 00:01:51,075
because thanks to vaccines
my generation was lucky

32
00:01:51,075 --> 00:01:53,887
to not live through an epidemic
as terrible as this.

33
00:01:53,887 --> 00:01:58,683
Vaccines are one of the great successes
of the twentieth century's public health.

34
00:01:59,214 --> 00:02:01,228
After drinking water,

35
00:02:01,228 --> 00:02:04,843
they are the interventions
that have most reduced mortality,

36
00:02:04,843 --> 00:02:06,974
even more than antibiotics.

37
00:02:07,569 --> 00:02:12,557
Vaccines eradicated from the planet
terrible diseases such as smallpox

38
00:02:12,587 --> 00:02:16,204
and succeeded
in reducing mortality significantaly

39
00:02:16,204 --> 00:02:18,446
due to other diseases such as measles,

40
00:02:18,446 --> 00:02:21,784
whooping cough, polio and many more.

41
00:02:22,684 --> 00:02:25,860
All these diseases are considered

42
00:02:26,270 --> 00:02:29,913
Vaccine-preventable diseases.

43
00:02:29,913 --> 00:02:31,673
What does this mean?

44
00:02:31,673 --> 00:02:34,692
That they are potentially preventable,

45
00:02:34,692 --> 00:02:37,661
but in order to be so, 
something must be done.

46
00:02:37,661 --> 00:02:39,757
You need to get vaccinated.

47
00:02:40,267 --> 00:02:43,966
I imagine that most,
if not all of us here today,

48
00:02:43,966 --> 00:02:47,210
received a vaccine
at some point in our life.

49
00:02:48,512 --> 00:02:52,963
Now, I'm not so sure that many of us know

50
00:02:52,963 --> 00:02:57,288
which vaccines or reinforcements
we should receive after adolescence.

51
00:02:58,710 --> 00:03:02,793
Have you ever wondered
who we are protecting

52
00:03:02,793 --> 00:03:04,643
when we vaccinate?

53
00:03:05,068 --> 00:03:06,697
What do I mean by that?

54
00:03:06,697 --> 00:03:11,671
Is there any other effect
beyond protecting ourselves?

55
00:03:13,045 --> 00:03:15,170
Let me show you something.

56
00:03:15,756 --> 00:03:18,222
Imagine for a moment

57
00:03:18,222 --> 00:03:20,234
we are in a city

58
00:03:20,234 --> 00:03:23,475
that has never had a case
of a particular disease,

59
00:03:23,475 --> 00:03:25,183
such as measles.

60
00:03:25,429 --> 00:03:30,292
This would mean that in this city no one 
has ever had contact with the disease.

61
00:03:30,292 --> 00:03:34,877
No one has either the natural defenses
nor been vaccinated against measles.

62
00:03:35,675 --> 00:03:40,419
If one day, a person ill with measles
appears in this city

63
00:03:41,003 --> 00:03:44,507
the disease won't find much resistance

64
00:03:44,507 --> 00:03:47,441
and will begin spreading
from person to person,

65
00:03:47,441 --> 00:03:51,495
and in no time it will disseminate
throughout the community.

66
00:03:51,806 --> 00:03:53,533
After a certain time

67
00:03:53,533 --> 00:03:56,904
a big part of the population will be ill.

68
00:03:57,753 --> 00:04:01,912
This happened when there were no vaccines.

69
00:04:02,631 --> 00:04:07,113
Now, imagine the complete opposite case.

70
00:04:07,421 --> 00:04:09,828
We are in a city

71
00:04:09,828 --> 00:04:12,920
where more than 90 percent
of the population

72
00:04:12,920 --> 00:04:15,103
has defenses against measles.

73
00:04:15,103 --> 00:04:18,579
It means that they've had the disease,
and generated natural defenses.

74
00:04:18,579 --> 00:04:22,543
They either survived, 
or were immunized against measles.

75
00:04:23,201 --> 00:04:24,812
And one day,

76
00:04:24,812 --> 00:04:28,743
a person sick with measles
appears in this city.

77
00:04:29,231 --> 00:04:32,605
The disease will find much more resistance

78
00:04:32,605 --> 00:04:36,095
and won't be transmitted
that much from person to person.

79
00:04:36,784 --> 00:04:40,334
The spread will probably remain contained

80
00:04:40,754 --> 00:04:43,679
and a measles outbreak won't happen.

81
00:04:45,057 --> 00:04:47,756
I would like you
to pay attention to something.

82
00:04:48,809 --> 00:04:51,487
People who are vaccinated

83
00:04:51,487 --> 00:04:54,286
not only are protecting themselves,

84
00:04:54,286 --> 00:04:57,904
but by blocking the dissemination
of the disease

85
00:04:57,904 --> 00:04:59,537
within the community

86
00:04:59,537 --> 00:05:04,224
they are indirectly protecting
the people from this community

87
00:05:04,224 --> 00:05:06,386
who are not vaccinated.

88
00:05:06,688 --> 00:05:09,661
They create a kind of protective shield

89
00:05:09,661 --> 00:05:12,762
which prevents from getting in contact
with the disease,

90
00:05:12,762 --> 00:05:15,381
so that these people are protected.

91
00:05:16,670 --> 00:05:19,868
This indirect effect of protection

92
00:05:19,868 --> 00:05:23,374
which unvaccinated people have
within a community,

93
00:05:23,374 --> 00:05:27,379
simply by being surrounded
by vaccinated people,

94
00:05:27,949 --> 00:05:31,012
is called herd immunity.

95
00:05:33,132 --> 00:05:35,589
Many people in the community

96
00:05:35,589 --> 00:05:39,085
depend almost exclusively
on this herd immunity

97
00:05:39,085 --> 00:05:41,754
to be protected against disease.

98
00:05:42,756 --> 00:05:46,391
These people displayed in infographics
are not just hypothetical.

99
00:05:47,257 --> 00:05:50,595
These people are our nephews,
our children,

100
00:05:50,595 --> 00:05:53,972
who may be too young
to receive their first shots.

101
00:05:55,104 --> 00:05:57,414
They are our parents, our brothers,

102
00:05:57,414 --> 00:05:58,835
our acquaintances,

103
00:05:58,835 --> 00:06:00,707
who may have a disease,

104
00:06:00,707 --> 00:06:04,364
or receive medication
which lowers their defenses.

105
00:06:06,006 --> 00:06:10,084
There are also people
allergic to a particular vaccine.

106
00:06:11,349 --> 00:06:13,749
They could even be among us,

107
00:06:13,749 --> 00:06:15,613
any of us who got vaccinated,

108
00:06:15,613 --> 00:06:19,410
but the vaccine
didn't produce the expected effect.

109
00:06:19,410 --> 00:06:23,602
Because not all vaccines
are always 100 percent effective.

110
00:06:23,602 --> 00:06:27,580
All these people depend almost exclusively

111
00:06:27,879 --> 00:06:31,355
on herd immunity
to be protected against diseases.

112
00:06:32,393 --> 00:06:37,200
To achieve this effect of herd immunity,

113
00:06:37,200 --> 00:06:41,871
it is necessary that a large percentage
of the population is vaccinated.

114
00:06:42,495 --> 00:06:45,570
This percentage is called threshold.

115
00:06:45,570 --> 00:06:49,327
This threshold depends on many variables.

116
00:06:49,327 --> 00:06:51,735
It depends on the germ's characteristics,

117
00:06:51,735 --> 00:06:56,037
and those of the immune response
that the vaccine generates.

118
00:06:56,037 --> 00:06:58,434
But they all have something in common.

119
00:06:58,434 --> 00:07:03,635
If the percentage of the population
in a vaccinated community

120
00:07:03,976 --> 00:07:07,047
is below this threshold number,

121
00:07:07,047 --> 00:07:11,110
the disease will begin
to spread more freely

122
00:07:11,110 --> 00:07:13,956
and may generate an outbreak

123
00:07:13,956 --> 00:07:16,375
of this disease within the community.

124
00:07:16,375 --> 00:07:18,073
Even diseases

125
00:07:18,073 --> 00:07:22,861
which at some point were controlled
may reappear.

126
00:07:24,547 --> 00:07:26,735
This is not just a theory.

127
00:07:26,735 --> 00:07:29,100
This happened and is still happening.

128
00:07:31,047 --> 00:07:35,907
In 1998, a British researcher
published an article

129
00:07:35,907 --> 00:07:38,750
in one of the most important
medical journals,

130
00:07:38,750 --> 00:07:41,147
saying that the MMR vaccine,

131
00:07:41,147 --> 00:07:43,877
which is given for measles,
mumps and rubella,

132
00:07:43,877 --> 00:07:45,746
was associated with autism.

133
00:07:45,746 --> 00:07:48,450
This generated an immediate impact.

134
00:07:49,005 --> 00:07:53,663
People began to stop getting vaccinated,
and stop vaccinating their children.

135
00:07:53,679 --> 00:07:55,301
And what happened?

136
00:07:55,301 --> 00:07:57,980
The number of people vaccinated,

137
00:07:57,980 --> 00:08:01,964
in many communities around the world,
fell below this threshold.

138
00:08:01,964 --> 00:08:05,519
And there were outbreaks of measles
in many cities in the world.

139
00:08:05,519 --> 00:08:07,961
In the U.S., in Europe.

140
00:08:07,961 --> 00:08:10,123
Many people got sick.

141
00:08:10,123 --> 00:08:12,900
People died of measles.

142
00:08:13,867 --> 00:08:15,352
What happened?

143
00:08:15,352 --> 00:08:19,468
This article also generated a huge stir
within the medical community.

144
00:08:20,018 --> 00:08:23,691
Dozens of researchers began to assess
if this was actually true.

145
00:08:25,126 --> 00:08:28,422
Not only could no one find

146
00:08:28,422 --> 00:08:33,668
a causal association between MMR
and autism at the population level,

147
00:08:33,668 --> 00:08:38,571
but it was found that this article
had incorrect claims.

148
00:08:38,821 --> 00:08:41,365
Even more, it was fraudulent.

149
00:08:42,119 --> 00:08:44,509
It was fraudulent.

150
00:08:45,119 --> 00:08:49,246
In fact, the journal publicly retracted

151
00:08:49,246 --> 00:08:52,373
from this article in 2010.

152
00:08:52,883 --> 00:08:56,784
One of the main concerns and excuses
for not getting vaccinated

153
00:08:56,784 --> 00:08:58,967
are the adverse effects.

154
00:08:59,767 --> 00:09:02,593
Vaccines, like other drugs,

155
00:09:03,263 --> 00:09:05,966
can have potential adverse effects.

156
00:09:05,966 --> 00:09:08,483
Most are mild and temporary.

157
00:09:08,483 --> 00:09:11,377
But the benefits are always greater

158
00:09:11,377 --> 00:09:13,992
than possible complications.

159
00:09:16,095 --> 00:09:17,996
When we are ill,

160
00:09:17,996 --> 00:09:20,293
we want to heal fast.

161
00:09:20,293 --> 00:09:22,424
Many of us who are here

162
00:09:22,424 --> 00:09:26,089
take antibiotics
when we have an infection,

163
00:09:26,089 --> 00:09:29,272
We take anti-hypertensives
when we have high blood pressure;

164
00:09:29,272 --> 00:09:31,454
we take cardiac medications.

165
00:09:31,454 --> 00:09:34,701
Why? Because we are sick
and we want to heal fast.

166
00:09:34,702 --> 00:09:36,722
And we don't question it much.

167
00:09:36,722 --> 00:09:41,147
Why is it so difficult
to think of preventing diseases,

168
00:09:41,885 --> 00:09:45,102
by taking care of ourselves
when we are healthy?

169
00:09:45,102 --> 00:09:48,290
We take care of ourselves a lot
when affected by an illness,

170
00:09:48,290 --> 00:09:51,249
or in situations of imminent danger.

171
00:09:52,142 --> 00:09:54,805
I imagine most of us here,

172
00:09:54,805 --> 00:09:58,541
remember the influenza A pandemic

173
00:09:58,541 --> 00:10:01,933
which broke out in 2009
in Argentina and worldwide.

174
00:10:02,490 --> 00:10:05,522
When the first cases
began to come to light,

175
00:10:05,522 --> 00:10:09,364
we, here in Argentina,
were entering the winter season.

176
00:10:09,914 --> 00:10:12,115
We knew absolutely nothing.

177
00:10:12,115 --> 00:10:13,534
Everything was a mess.

178
00:10:13,534 --> 00:10:18,898
People wore masks on the street,
ran into pharmacies to buy alcohol gel.

179
00:10:18,898 --> 00:10:22,245
People would queue in the pharmacies
to receive a vaccine,

180
00:10:22,245 --> 00:10:24,809
without even knowing
if it's the right vaccine

181
00:10:24,809 --> 00:10:27,347
that would protect them
against this new virus.

182
00:10:27,347 --> 00:10:29,648
We knew absolutely nothing.

183
00:10:29,648 --> 00:10:32,800
At that time, in addition to doing
my research scholarship

184
00:10:32,800 --> 00:10:34,739
at the Infant Foundation,

185
00:10:34,739 --> 00:10:38,652
I worked as a home pediatrician
for a prepaid medicine company.

186
00:10:39,671 --> 00:10:42,914
I remember that I started
my shift at 8 am

187
00:10:42,914 --> 00:10:47,063
and already I had a list
of 50 scheduled visits.

188
00:10:47,063 --> 00:10:49,944
It was chaos,
people didn't know what to do.

189
00:10:50,860 --> 00:10:55,413
I remember the types of patients
that I was examining.

190
00:10:55,690 --> 00:11:00,046
The patients were a little older
than what we were used to see in winter,

191
00:11:00,046 --> 00:11:02,389
with longer fevers.

192
00:11:02,389 --> 00:11:06,073
And I remember I told my mentor
at the research scholarship,

193
00:11:06,073 --> 00:11:09,588
and he, for his part, had heard
the same from a colleague,

194
00:11:09,588 --> 00:11:12,315
about the large number
of pregnant women

195
00:11:12,315 --> 00:11:14,014
and young adults

196
00:11:14,014 --> 00:11:16,251
being hospitalized
in intensive care,

197
00:11:16,251 --> 00:11:19,162
with clinical profiles
difficult to handle.

198
00:11:20,759 --> 00:11:24,414
At that time,
we set out to understand

199
00:11:24,414 --> 00:11:26,255
what was happening.

200
00:11:27,298 --> 00:11:30,417
Monday, early morning,
we took the car

201
00:11:30,417 --> 00:11:33,345
and we went to a hospital
in Buenos Aires province,

202
00:11:33,345 --> 00:11:35,928
that was supposed to be
a reference hospital

203
00:11:35,928 --> 00:11:39,005
for cases of the new influenza virus.

204
00:11:39,005 --> 00:11:41,554
We arrived at the hospital,
it was crowded.

205
00:11:41,554 --> 00:11:45,469
All health staff was dressed
in NASA-like bio-safety suits.

206
00:11:45,469 --> 00:11:47,667
We â with face masks in our pockets.

207
00:11:47,667 --> 00:11:50,402
Just like a hypochondriac,
I didn't breathe for two hours.

208
00:11:50,402 --> 00:11:53,515
But we could see what was happening.

209
00:11:53,515 --> 00:11:57,208
Immediately, we started reaching out
to pediatricians

210
00:11:57,208 --> 00:12:01,428
from six hospitals in the city
and the Buenos Aires province.

211
00:12:01,443 --> 00:12:04,766
Our main goal was to find out,

212
00:12:04,766 --> 00:12:08,662
how this new virus behaves
in contact with our children,

213
00:12:08,662 --> 00:12:11,238
in the shortest time possible.

214
00:12:11,238 --> 00:12:14,196
A marathon work.

215
00:12:14,196 --> 00:12:17,098
In less than three months

216
00:12:17,378 --> 00:12:23,160
we could see what effect
this new H1N1 virus had

217
00:12:23,160 --> 00:12:29,301
on the 251 children
hospitalized by this virus.

218
00:12:29,523 --> 00:12:33,501
We could see which children
got more seriously ill:

219
00:12:33,501 --> 00:12:37,119
children under four,
especially those less than one year old;

220
00:12:37,119 --> 00:12:39,922
patients with neurological diseases,

221
00:12:39,922 --> 00:12:43,214
And young children
with chronic pulmonary diseases.

222
00:12:43,214 --> 00:12:48,020
Identifying these risk groups
was important

223
00:12:48,020 --> 00:12:50,728
to include them as priority groups

224
00:12:50,728 --> 00:12:53,731
in the recommendations
for getting the influenza vaccine,

225
00:12:53,731 --> 00:12:55,589
not only here in Argentina,

226
00:12:55,589 --> 00:12:59,650
but also in other countries
which the pandemic not yet reached.

227
00:13:00,747 --> 00:13:02,942
A year later,

228
00:13:02,942 --> 00:13:07,516
when a vaccine was available
against the pandemic H1N1 virus,

229
00:13:07,516 --> 00:13:10,238
we wanted to see what had happened.

230
00:13:10,238 --> 00:13:13,414
After a huge vaccination campaign

231
00:13:13,414 --> 00:13:16,453
aimed at protecting risk groups,

232
00:13:18,233 --> 00:13:19,953
these hospitals,

233
00:13:19,953 --> 00:13:25,144
with 93 percent
of the risk groups vaccinated,

234
00:13:25,144 --> 00:13:28,772
had not a single patient

235
00:13:28,772 --> 00:13:31,446
with the pandemic H1N1 virus.

236
00:13:31,446 --> 00:13:34,502
(Applause)

237
00:13:36,602 --> 00:13:38,269
In 2009:

238
00:13:38,469 --> 00:13:40,056
251.

239
00:13:41,736 --> 00:13:43,449
In 2010:

240
00:13:43,689 --> 00:13:45,032
Zero.

241
00:13:45,042 --> 00:13:49,266
Vaccination is an act
of individual responsibility,

242
00:13:49,756 --> 00:13:53,245
but it has a huge collective impact.

243
00:13:54,788 --> 00:13:58,970
If I get vaccinated,
not only am I protecting myself,

244
00:13:59,740 --> 00:14:02,631
but I am also protecting others.

245
00:14:03,515 --> 00:14:05,887
Sol had whooping cough.

246
00:14:07,971 --> 00:14:09,703
Sol was very young,

247
00:14:09,703 --> 00:14:14,227
and she hadn't yet received 
her first vaccine against whooping cough.

248
00:14:15,164 --> 00:14:18,962
I still wonder
what would have happened

249
00:14:18,962 --> 00:14:22,935
if everyone around Sol

250
00:14:22,935 --> 00:14:25,484
had been vaccinated.

251
00:14:26,234 --> 00:14:29,271
(Applause)