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One of the first patientsI 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 signsof a severe respiratory infection.
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Until then, I had never seena patient worsen so fast.
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In just two daysshe was connected to a respirator
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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 roomand after a quite distressing catharsis,
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I remember my chief resident said to me,
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"OK, 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 diseaseskilled 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 greaterthan Argentina's current population.
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Perhaps, the older ones among youremember the polio epidemic
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that occurred in Argentina in 1956.
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At that time, there was no vaccineavailable 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 would put little bags of camphor inside their children's clothes
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as if that could do something.
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During the polio epidemicthousands 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 vaccinesmy generation was lucky
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to not live through an epidemicas terrible as this.
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Vaccines are one of the great successesof the twentieth century's public health.
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After potable water,
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they are the interventionsthat have most reduced mortality,
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even more than antibiotics.
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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
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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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I imagine that most,if not all of us here today,
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received a vaccineat 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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Have you ever wonderedwho we are protecting
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when we vaccinate?
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What do I mean by that?
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Is there any other effectbeyond protecting ourselves?
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Let me show you something.
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Imagine for a moment
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we are in a city
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that has never had a caseof a particular disease,
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such as measles.
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This would mean that in this city no one has ever had contact with the disease.
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No one has either the natural defenses against, nor been vaccinated against measles.
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If one day, a person sick with the measlesappears in this city
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the disease won't find much resistance
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and will begin spreadingfrom person to person,
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and in no time it will disseminatethroughout 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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where more than 90 percentof the population
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has defenses against measles.
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It means that they've had the disease,and have developed natural defenses.
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They either survived, or were immunized against measles.
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And one day,
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a person sick with the measlesappears in this city.
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The disease will find much more resistance
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and won't be transmittedthat 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 youto 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 disseminationof the disease
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within the community,
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they are indirectly protectingthe people in this community
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who are not vaccinated.
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They create a kind of protective shield
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which prevents then from coming in contactwith the disease,
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so that these people are protected.
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This indirect effect of protection
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which unvaccinated people havewithin a community,
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simply by being surroundedby vaccinated people,
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is called herd immunity.
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Many people in the community
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depend almost exclusivelyon this herd immunity
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to be protected against disease.
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These people displayed in infographicsare not just hypothetical.
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These people are our nephews,our children,
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who may be too youngto receive their first shots.
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They are our parents, our brothers,
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our acquaintances,
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who may have a disease,
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or receive medicationwhich lowers their defenses.
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There are also peopleallergic 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 vaccinedidn't produce the expected effect,
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because not all vaccinesare always 100 percent effective.
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All these people depend almost exclusively
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on herd immunityto 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 percentageof 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 responsethat the vaccine generates.
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But they all have something in common.
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If the percentage of the populationin a vaccinated community
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is below this threshold number,
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the disease will beginto spread more freely
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and may generate an outbreak
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of this disease within the community.
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Even diseases
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which at some point were controlledmay reappear.
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This is not just a theory.
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This happened and is still happening.
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In 1998, a British researcherpublished an article
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in one of the most importantmedical 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 stop vaccinating their children.
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And what happened?
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The number of people vaccinated,
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in many communities around the world,fell below this threshold.
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And there were outbreaks of measlesin many cities in the world.
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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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This article also generated a huge stirwithin the medical community.
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Dozens of researchers began to assessif this was actually true.
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Not only could no one find
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a causal association between MMRand autism at the population level,
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but it was found that this articlehad incorrect claims.
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Even more, it was fraudulent.
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It was fraudulent.
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In fact, the journal publicly retracted
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the article in 2010.
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One of the main concerns and excusesfor not getting vaccinated
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are the adverse effects.
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Vaccines, like other drugs,
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can have potential adverse effects.
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Most are mild and temporary.
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But the benefits are always greater
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than possible complications.
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When we are ill,
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we want to heal fast.
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Many of us who are here
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take antibioticswhen we have an infection,
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We take anti-hypertensiveswhen we have high blood pressure;
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we take cardiac medications.
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Why? Because we are sickand we want to heal fast.
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And we don't question it much.
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Why is it so difficultto think of preventing diseases,
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by taking care of ourselveswhen we are healthy?
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We take care of ourselves a lotwhen 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 2009in Argentina and worldwide.
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When the first casesbegan to come to light,
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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 queue up in the pharmaciesto receive a vaccine,
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without even knowingif it was the right vaccine
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that would protect themagainst this new virus.
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We knew absolutely nothing.
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At that time, in addition to doingmy research scholarship
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at the Infant Foundation,
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I worked as a home pediatricianfor a prepaid medicine company.
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I remember that I startedmy shift at 8 am
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and already I had a listof 50 scheduled visits.
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It was chaos,people didn't know what to do.
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I remember the types of patientsthat I was examining.
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The patients were a little olderthan what we were used to see in winter,
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with longer fevers.
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And I remember I told my research scholarship mentor,
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and he, for his part, had heardthe same from a colleague,
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about the large numberof pregnant women
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and young adults
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being hospitalizedin intensive care,
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with difficult to manage clinical profiles.
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At that time,we set out to understand
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what was happening.
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First thing Monday morning, we took the car
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and went to a hospitalin Buenos Aires province,
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that was supposed to bea referral hospital
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for cases of the new influenza virus.
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We arrived at the hospital; it was crowded.
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All health staff were dressedin NASA-like bio-safety suits.
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We â with face masks in our pockets.
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Being a hypochondriac,I didn't breathe for two hours.
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But we could see what was happening.
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Immediately, we started reaching outto pediatricians
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from six hospitals in the cityand the Buenos Aires province.
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Our main goal was to find out
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how this new virus behaved in contact with our children,
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in the shortest time possible.
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A marathon work.
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In less than three months
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we could see what effectthis new H1N1 virus had
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on the 251 childrenhospitalized by this virus.
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We could see which childrengot more seriously ill:
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children under four,especially those less than one year old;
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patients with neurological diseases,
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and young childrenwith chronic pulmonary diseases.
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Identifying these at-risk groupswas important
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to include them as priority groups
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in the recommendationsfor getting the influenza vaccine,
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not only here in Argentina,
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but also in other countrieswhich the pandemic not yet reached.
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A year later,
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when a vaccine against the pandemic H1N1 virus became available,
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we wanted to see what had happened.
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After a huge vaccination campaign
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aimed at protecting at-risk groups,
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these hospitals,
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with 93 percentof the at-risk groups vaccinated,
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had not a single patient
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with the pandemic H1N1 virus.
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(Applause)
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In 2009:
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251.
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In 2010:
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Zero.
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Vaccination is an actof individual responsibility,
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but it has a huge collective impact.
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If I get vaccinated,not only am I protecting myself,
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but I am also protecting others.
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Sol had whooping cough.
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Sol was very young,
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and she hadn't yet received her first vaccine against whooping cough.
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I still wonderwhat would have happened
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if everyone around Sol
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had been vaccinated.
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(Applause)