Why did the vaccine fail?

In the novel Ten Days, when the doctor asked Anna if her terribly sick baby, Eddie, had received the “meningitis” vaccine, she couldn’t remember…too many vaccines, too much worry while he was in the intensive care unit.  But, that question terrified her.  What if she had forgotten the appointment to get the vaccine and he was sick because of her error?  That was more than she could bear—to be responsible for his horrible illness.

Jake, her husband, sifted through the vaccine records at home and finally—while Anna, barely breathing from anxiety, waited in the hospital phone closet—confirmed that Eddie had, indeed, had the right number of doses of the “meningitis” vaccine.  So, why did he get pneumococcal meningitis?  That was the infection the vaccine was designed to prevent.

Why didn’t it work?  Bad lot of the vaccine?  False claim of protection?  Wrong dose?  Something abnormal with Eddie so his body didn’t respond appropriately to the vaccine?

Eddie’s illness was a tragedy, one that rarely, but occasionally, happens.  The answers to the questions of why the vaccine didn’t work for him are “No,” “Absolutely no,” “No,” and “Unlikely.”

Bad lot?  Vaccines are—and, boy, are we grateful for it—carefully regulated by the FDA for optimal quality control. That’s the reason why vaccine shortages occur from time to time—when a drug company fails QC or other good manufacturing practices tests, lots aren’t allowed on the market until the production problems are fixed.  So, bad, or weak, lots of vaccine won’t be shipped to doctors’ offices or hospitals in the United States.

False claim of protection?  While promotion for almost everything on the market seems to fall into the snake-oil-salesman category (think energy drinks, bottled water, weight loss diets, and cellulite removers), advertising of vaccines and other medications is monitored by the FDA to prevent drug companies from scamming American citizens, and physicians, about the safety and efficacy of their products.  We have just witnessed what happens when the FDA is not granted oversight of an injectable drug—the fungal meningitis epidemic.  False promises aren’t tolerated by the FDA.

Wrong dose?  The dose of nearly every vaccine given as a shot to babies is the same…0.5 ml (a teaspoon).  Only a terribly inexperienced nurse would give too low a dose.

Something abnormal with Eddie?  Could his immune system somehow refuse to make antibodies (proteins in the blood that protect vaccinated babies against infection) to the vaccine?  It’s possible and very, very rare.  Because I wrote the book Ten Days and am, thus, the oracle on the characters, I know that wasn’t the problem for Eddie.

So, why did he get sick, even though he had the “meningitis” vaccine?  The answer lies in what scientists and physicians know about vaccines in general—none are 100% effective (kind of like everything else in life).  The newest “meningitis” vaccine has an Achilles’ heel.  It is designed to prevent infection with 13 of the most common kinds of the pneumococcus germ (which causes many cases of meningitis).  But, there are almost 100 kinds of the germ, so not all are covered by the vaccine.  Eddie was unlucky enough to have gotten sick with one of the kinds for which the vaccine doesn’t work.

In spite of all the terrible things that happened to Eddie, Anna was relieved she had had him vaccinated.  If she hadn’t and he became sick, she would never forgive herself.  Guilt is a heavy burden.  She felt the weight of guilt about many things, but not about failing to vaccinate him.  It was a small, but important, relief.