(COUGHS, CRIES) (GASPS, CRIES) (CRIES) People are just not that used to seeing vaccine-preventable illnesses in our community, so it can be quite hard to actually imagine what that looks like. When you see your... incredibly healthy young man lying there,... not knowing whether he was gonna live or not was just awful. And I started begging. I started saying ridiculous things, like, 'Can't you just do a heart transplant? 'Can't you just do a lung transplant?' I was trying to think of ideas, cos I just didn't wanna think that this was it, that this was over. (GENTLE MUSIC) A mumps outbreak in Auckland. Over 100,000 baby deaths worldwide. (COUGHING) There have been 300 cases of mumps. (COUGHING) Copyright Able 2018. 90% of Kiwi kids like Oscar will be vaccinated, protecting them against diseases that once spread like wildfire. Oscar's vaccinations will help protect him against a range of diseases ` measles, meningitis, whooping cough and chickenpox. Some parents worry about the side effects of vaccines, but others are concerned not enough kids are being vaccinated to prevent outbreak of diseases. We're gonna give three vaccinations. One is an oral, which is a rotavirus. And we're gonna give on the left leg diphtheria, tetanus, whooping cough and the polio vaccine. And on the other leg, it's gonna be the pneumococcal. I don't wanna worry in the future have I done the right thing or not ` I want to know that he's covered. And I've had friends who've chosen not to vaccinate, and they question themselves, 'Is my baby gonna be OK? 'Did I make the right decision?' And I don't need that. Oscar. (CRIES) Oscar. Almost done. (CRIES) Oops. I think people are afraid of harming their children. At the basis of this is this, you know, protective love that we all feel for our children. And people are concerned. And they've heard something that maybe, you know, vaccines aren't as good as other people have said or maybe there's something associated with it that they should worry about. There is an issue, really, around the fact that lots of people have access to lots of information. And how can you tell which is good information and which is bad information? In the age of social media, opponents of vaccines are influencing opinion with anecdotes shared online. The science confuses many parents. So, now I think we are seeing communities of vaccine hesitancy, where they sort of talk internally, and they don't have the confidence and the trust to go outside their own internal conversation. As a young doctor, I worked in Africa, I worked in many countries, and so I've had a lot of personal experience of pretty well all these diseases. I can talk numbers, I can talk hundreds of thousands, and it doesn't mean anything like holding a dying child in your arms that's dying of measles. We don't wanna sell our science on fear, but then how do you get people to visually understand what these diseases are really like? (TYPING CLICKS) (DING!) Hey. How are you? Good. Good. Nice to see you. 'I'd never seen the measles before. 'Of course it wouldn't be something that I would even consider to be an infectious disease that's...' that's highly risky. But having been on the receiving end of a high-end reaction to it, it was, yeah, really scary. When I look back on it, it's, kind of, like I'm just lucky, cos I actually survived it, and some people aren't so lucky. When was 2, I made the decision not to vaccination Cameron for measles, mumps or rubella, and that was based on research around at the time about it causing autism, and I wasn't prepared to take that risk. I thought, 'Actually, no, that's not something I want to expose my children to.' He was 13, and he was in his first year at high school, which is a really impressionable year. I came back from school one day, and I felt pretty bad and pretty much curled up on the couch in a ball for a few days, and we thought it was just the flu going round. And then he was deteriorating further, and I took him in, and they put him on the table, and the doctor began checking him. And I was really worried at that point. And I was extremely alarmed when she said, 'We need to get him to hospital, and you can get him there faster than I can get an ambulance.' (TENSE MUSIC) And they were there waiting for us when we arrived. The next minute, we were in isolation. And a doctor came in that was well experienced and mature,... and he identified and diagnosed Cam with the measles. (MUSIC CONTINUES) The vaccination for measles is combined with mumps and rubella and is known as MMR. Doctor Andrew Wakefield made headlines 20 years ago, when his research highlighted a link between the MMR vaccine and autism. Vaccination rates dropped. The science took probably six or nine months to start coming through, by which time the damage was done. We now have excellent science. We've got more than 20 very large studies to show that there is no association with MMR and autism, but the myth has got stuck. (CONTEMPLATIVE PIANO MUSIC) (MONITOR BEEPS) I didn't realise how serious it was until, like, more and more doctors started coming in. And then they were all masked up and suited up coming in and taking heaps of tests. It was terrifying. It was, like, 'My God. You mean you can't fix it? 'This isn't antibiotics that'll make it go away?' They talked about brain damage from the severe state of measles and possibly even death, which was really scary. And when they put him on oxygen, they said that they had serious concerns for him. (CONTEMPLATIVE MUSIC) When you see your... incredibly healthy young man lying there,... not knowing whether he was gonna live or not was just awful. It was absolutely awful. And you've got no control ` you're completely in the hands of the doctors. And everything that they do, your complete trust in them. So, yeah, it was devastating. (SNIFFLES) And to think that I was potentially responsible for that too, there was a lot of guilt around that, because I hadn't revisited that information. Yeah. (SOMBRE PIANO MUSIC) New Zealand starting immunising for measles in 1969, drastically reducing deaths. Prior to a vaccination programme, pretty well every child in the country catches measles. Now, people go, 'So what? That's not a big deal. They'll then get immune.' But for every child that gets measles, around about one in a thousand, one in 2000 will die. What we do know historically is we have adults in the New Zealand community with brain damage, with sight problems, with hearing damage from measles, from mumps, from rubella. They tend to be invisible ` they live in small communities, they're now in adulthood. They were in the times before we had vaccination programme. We don't see them wandering around community regularly any more. The first vaccine developed and the only one to successfully eradicate a disease was for smallpox. It took hundreds of years to wipe it out. And in the 1940s and '50s, a polio outbreak in New Zealand paralysed and killed thousands of children. ARCHIVE: In the all-out fight against polio, there were many years of struggle and heartbreak. Parents lived in fear of polio's sudden attack and the tragic aftermath. Desperate to contain the virus, authorities closed schools for four months. When the polio vaccine became available in 1955, one of New Zealand's greatest health risks disappeared. Vaccines introduce the disease to the body's immune system so the body learns to recognise and protect against any future attacks. Vaccines are made from a killed, weakened or partial version of the virus or bacteria. To stop outbreaks of disease, health officials rely on herd immunity. So, this is about stopping the organism's spread in the community. Our strategy is if enough people are vaccinated, measles does not spread in the community and we'll eradicate it. Now, that requires healthy people to be vaccinated to protect those who are unable to be vaccinated. Children with poor immune systems can't have the vaccine. So if a child's had cancer and they're on cancer drugs and they're getting better, but they're at preschool, they're at very, very high risk of measles. And they are relying on stopping the disease spread through the whole community. So it's not an individual argument; it's a community collective argument. While medical officers can predict some outbreaks, others arise without warning. In the past year, Auckland's experienced one of the worst outbreaks of mumps in 30 years. Dr Julia Peters and her team at the Auckland Regional Public Health Service are trying to contain the spread. She meets with a team of 30 doctors once a week to review developments. Three-quarters of our cases are either unimmunised or partially immunised. So I think we are up to... is it... 872 cases for this calendar year? We're dealing with a large number of notifiable diseases ` pertussis, meningococcal disease, TB, so we've got those coming in every day. We would be getting probably about 60 cases of mumps notified to us a week. We've had to employ extra staff to help us because for every case, there's a whole raft of people around them who could be potentially vulnerable and impacted. At the moment we're dealing with three geographic clusters of pertussis cases ` a real hot spot in Waiheke, another few up in Laingholm and a newer one in Murrays Bay. (CONTEMPLATIVE MUSIC) (TYPING CLICKS) (DING!) (COUGHS) (GASPS, COUGHS) (CHOKES) When they told me that Boston had pertussis, I thought it was just gonna be the cough, but it's not just the cough with a baby ` it's extreme. He wakes in the morning and usually has a large coughing fit when he wakes. Because he's been asleep most of the night, there is a massive buildup of mucous. Sometimes the coughing fits can be up to 90 seconds where he is choking and coughing. Pregnant women should be given a booster vaccine which will protect their unborn baby until 3 months, but Deanna wasn't informed. He was 12.5 weeks old. We hadn't had a chance to have his three-month immunisation yet, cos he wasn't quite three months, and we noticed he was just coughing a lot and vomiting, and it seemed to be a lot more mucous that was building up. He appeared to have stopped... like, holding his breath and really struggling to get his breath back. (COUGHS, CRIES) (CHOKES) (COUGHS, CRIES) (GASPS, CRIES) My husband said to me, 'This is not right. He's got to go to A & E.' (COUGHS) (CRIES) It's OK. That night, he just got so bad. It was so scary. (CRIES) He had so much thick mucous that he couldn't expel it himself, so they were using a suction machine to take that out, and then the bits became longer and started to get this whoop. (CRIES) Then they started using oxygen, because he was struggling to breathe. Shh, shh, shh. The only comfort we really had at the time was them saying to us, 'Oh, we have seen babies worse than him.' They said to us that we would just have to wait until he doesn't need any help from the doctors or nurses. So that took 10 days of not having oxygen or the suction machine ` it did get worse before it got better. Luckily for us, it didn't get to where he lost his life. Baby Boston contacted the hundred-day cough or pertussis just before he turned 3 months. I guess the issue with pertussis is that it is particularly serious in children under 1, and so children can lose weight with it, cos they start coughing or they vomit up their food, they can stop breathing, they get pneumonia or they often end up in hospital. Whooping cough, you can get the disease repeatedly throughout your life, so you need boosters. So the New Zealand strategy, the world strategy, is to protect young infants against whooping cough and making sure the infants start their own immunisation programme on time. The last epidemic, we had about four young infants die. They were too young to have started their vaccination programme. Mothers vaccinated during pregnancy help protect their baby in the first three months. You know you get those little baby's first year books, and you fill out, you know, their height and weight and all that. But this book is mostly unfinished. (TUTS) Riley would have been 3 now... and running around and... probably enjoying our new backyard and playing with his... his sisters. It's weird seeing photos of me with him, just on a completely different path in my life and, you know, never experienced tragedy, and... I just wish I could go back to that. Riley was really the perfect newborn baby ` he just fed a lot and slept a lot, and he didn't really cry. He was very settled and happy,... and he was just perfect. Well, Riley first started getting sick when he was about 3 weeks old. He had what I thought was a cold, um, a bit of a runny nose and sneezing a little bit. And then when he was 4 weeks old, he started coughing. (COUGHS) (GASPS, COUGHS) Then that night, Riley didn't really wanna breastfeed. He slept through the night, which was really weird for a newborn baby who, you know, I was so used to him waking up every couple of hours. So we made the decision the next morning to take him to the hospital, and they swab tested him, and it turned out to be whooping cough. Catherine wasn't aware she needed another booster vaccine for her third pregnancy. (HICCUPS) We were admitted that night, and I kept trying to breastfeed, but he just wouldn't latch on. It was getting hard for him to breathe, I think. So they put him on oxygen, and I expressed milk, and they fed him with a nasal gastric tube. I was very confident ` you know, I thought we'd be out of there in no time. But he progressively just seemed to get worse and worse. So you think the cough being the main issue, but it's the toxins from the Bordetella pertussis bacteria that does all this damage with whooping cough. When we were told that he needed to be moved into the Intensive Care Unit, I remember seeing a drawer that said 'Baptism gowns,' and I saw brochures ` you know, 'How to plan your child's funeral' and things like that. That's when I started to feel really, really worried. So, the decision was made for him to be placed in an induced coma, and they put him on a ventilator. They told us that they needed to... take out his blood and spin it, and then put his blood back in to help with his white blood cell count. But that didn't work. So that about day three or four of him being in hospital. So I was sent home, told to get a few hours' sleep and rest and come back, because, you know, tomorrow would be the day that Riley fights for his life, basically. But it was only a couple of hours later that Greg called me and called me back into the hospital and said, 'You've gotta come back.' You know, my heart just sunk. I just knew that things were looking really, really bad. (TINKLY PIANO MUSIC) So, we had him baptised by the hospital priest. And I remember standing next to him, and he held my finger. And I just thought, 'Maybe there is some hope. Maybe there's still, you know, life in there, 'and maybe things would be OK. Maybe the doctors are wrong.' And then we're called into the family room not long after that and were given a pretty frank,... um, discussion with his doctor, who was pretty honest with us and told us that he didn't think Riley was gonna make it. And... (SIGHS) I don't know. I just remember shaking and feeling sick. And I started begging. I started saying ridiculous things, like, 'Can't you just do a heart transplant? 'Can't you just do a lung transplant?' I was trying to think of ideas, cos I just didn't wanna think that this was it, that this was over. We decided to... have him taken off the machines and placed in our arms. And we held him and... and sung lullabies to him. And I just remember looking at the heart monitor, and you'd watch for, like, the beeps, and they were getting slower and slower. And then he was gone. And we just left with this little tiny body in our arms. (INTENSE MUSIC) READS: I'll never forgot your sweet baby scent. I will never forget gazing into your luminous eyes when feeding you. I will never forget our time spent together at the beach, in the park or at the river. I'll never forget the little rolls at the back of your neck or the soft downy hair on your head that I loved to nuzzle in to. I never expected to arrive at that hospital with you in my arms and leave empty-handed. I never expected to watch your tiny body fail or to hold you in my arms as you passed away. My body still aches to hold you close, and while I know that will never happen again, you will always be with me in my heart, in all of our hearts. 32 days was not enough time with you, but I feel so blessed to have loved you and been your mother. Love, Mum. Sorry. The sad thing is I have been forgetting some of those memories. (SNIFFLES) (TINKLY MUSIC) (MUSIC CONTINUES) We received an incredible amount of support post losing Riley ` we had some wonderful messages. But we probably also saw the dark side of it as well in that there are people that, for whatever reason, genuinely believe their message and felt the need to attack us, because they felt threatened that their movement potentially was, you know, in danger. So, I mean, we had people contacting us, saying, 'Oh,' you know, 'your baby died because you chose to vaccinate him' ` I mean, people that didn't know our circumstances. Riley wasn't even old enough to be vaccinated himself. You know, 'It's survival of the fittest, and your child just wasn't ready to live on this planet ` 'that's why,' you know, 'nature's taken its course.' And the thing that probably struck me was if your movement needs to go and attack a family that's just lost a child, well, it's not a very good movement to be a part of to begin with, if that's the only way you can get to keep your message going, I guess. We have seen a groundswell of people who are active decliners in vaccination, who are questioning now the science of vaccination and who, worryingly, are actively engaged in persuading other people about the science of vaccination. (TYPING CLICKS) I went on the internet,... and I found what was the exact constituents of the first vaccination that children get. What's really important to notice is that they don't put that live organism in there. This is actually chickenpox. (CHUCKLES) But they've taken the virus. And they said how you recognise this virus ` your immune system just needs this little bit, so they just want to take it away from the virus; there's no chance that you can cause disease. Sometimes it's difficult to grow up enough virus to pull out just this one little constituent. And so sometimes they will take another organism, like yeast, which may be able to produce that product better, such that you can produce a lot of it very cleanly and very efficiently. So one thing about the immune system itself ` to get that immune response, sometimes you have to make it a bit sexy. And for that, we use products which are called adjuvants. So they are absorbed to something called aluminium hydroxide. Some parents question the use of aluminium cells designed to boost the immune response to vaccines. Aluminium is in fact the third-most common element. We eat it, we drink it, so we take it up every day. An average adult will ingest... about 7mg of aluminium salt,... and this small amount here. It turns out that is what a breastfed baby would take over a six-month period. If you look at a baby that's formula-fed, it's slightly more, and that's about 38mg. Now, the vaccines contain about 2.55mg. We've looked at the minimum risk levels a baby could have ` about 810mg, which is a significant amount. Now, in comparison, your vaccine is only 2.55mg. All vaccines go through strict clinical trials before they're used. The clinical trials are usually done on tens of thousands, sometimes hundreds of thousands. Now, those early clinical trials need to be big enough to satisfy the country that this vaccine is safe enough for the population it's being used in. Once the vaccine is licenced, we also rely on post-licensure surveillance. And every now and then you will pick up a rare event. Every time we get the children vaccinated, yes, there's a small risk involved here, but this definitely is much less than the risk of if my child was to get a vaccine-preventable illness. And there's a small group of children who can't be vaccinated ` for example, children who have cancer and are undergoing chemotherapy ` I need to vaccinate my children so that the herd immunity protects those quite vulnerable children. (CONTEMPLATIVE PIANO MUSIC) It took two years for my immune system to come right, and it was just months and months of getting sick almost four, five times a month and barely being able to make it in, like, two days a week to school. And, yeah, it was quite hard to fit back into, you know, social life and everything. If you're anti vaccine or vaccination, do a bit more research, and you might actually find that it's a lot better to get vaccinated than to not and go down the trail I went, cos it's not a good time at all. We have an opportunity here to try and help other families to not go through what we're going through, so it's about getting that message from a trusted healthcare provider, Because they're the ones that are going to give you the correct message. You know, they're the ones that are dealing with science and fact. My relationships are built on one-on-one relationship. I meet you, you meet me, we start a conversation, we get to know each other, and we start to share our value systems and we develop trust. You can raise your questions, I can address them or I can go and find them out ` that's a trusting relationship, and that's the core of people believing preventative health services work. I'd also like to see people just be kinder to each other, actually, and acknowledge that a lot of this, for a lot of people, comes from a place of concern for their children. So we just need to talk through what does that mean and why vaccination is actually the most effective way for us to guarantee that all children can be free from childhood illnesses. (GENTLE MUSIC) Captions by Faith Hamblyn. www.able.co.nz Captions were made with the support of NZ On Air. Copyright Able 2018. (MUSIC FADES)