A Healthy Body Politic? Vaccines in Mexico

“Un momento,” called A’s teacher Anita as we strollered away from his Montessori school one afternoon.

When she caught up, she handed my husband a small slip of white paper printed faintly on one side.

“Today they came to give vaccinations. A had one for polio. They said that he wouldn’t have any reaction to it.”

My husband and I looked at the slip of paper a little dumbly. We nodded.

“Una vacuna,” I echoed.

“Only drops,” Anita reassured me. Then, because she’s figured out by now that I only understand about half of what I’m told in Spanish, she repeated herself. “And they said he wouldn’t have any reaction.”

I had heard about a vaccination campaign underway, because when I had taken my newborn for his February 4th appointment (scheduled for the day, but at no particular time), the Secretaria de Salud was out of vaccines and told me to come back later. I had not imagined, however, that the campaign would go so far as to canvas places in the community where children would be, including a private preschool.

We did not ask who “they” were—I knew it was some arm of the public health system, probably the Secretaria de Salud, as Mexico’s health ministry is called. We did not ask why our son had been vaccinated for something his shot record clearly indicated he’d already had—this is Mexico and I am resigned to a wider margin of error. Nor did I ask why I hadn’t been informed or my permission sought ahead of time: in Mexico, public health is, well, public. And it isn’t up to me as a parent, an individual, when the health of the public is at stake.

Salud

Fortunately, I love vaccines. Last year, when H1N1 cases were being reported at the university daycare where my then eighteen-month-old was supposed to spend his days (though I kept him quarantined at home), I sent my husband out on his bike in the frigid pre-dawn hours to wait in line outside the first clinic in the city offering vaccines to children under two. Of the first 80 doses available to the public, my son received number eight.

But this is me. And I know that far from everyone shares my zeal for needles.

At least in the U.S.

In Mexico, however, where the effects of preventable diseases are not so removed from collective memory, vaccines are a responsibility, a civic duty, and while the enforcement of regulations can be lax in Mexico (see my earlier work on seatbelts and lead-glazed dishes intended for food), vaccine requirements are upheld with a vigilance I haven’t seen applied to any other area.

At my son’s first visit to the pediatrician, we got the lowdown on how vaccines work in Mexico.

“They are required here, without exception,” the doctor explained. “Without them, children cannot get papers or enroll in school or anything else.”

We would have to get a vaccination book and have it certified by the civil registry, he explained. The schedule was different from that in the U.S., and some vaccines, such as tuberculosis, were not the same. Vaccines are given at public clinics, without cost.

“But it’s a good thing,” the doctor added. “I used to see babies with rotavirus all the time, and it was really awful. Then, about five years ago, they started vaccinating. I haven’t seen a case since.”

Yesterday, I returned to the Secretaria de Salud for the baby’s two-month shots. The inside of the building—green walls, some broken tiles, and rows of chairs that people seemed to have been sitting on a long time—looks like a cross between a public elementary school and a bus station. People go to the Secretaria for routine care: handwritten posters hang on the wall with information about prenatal classes and help for post-partum depression.

My sister, who is visiting, and I stood in line with other families to sign in at a desk, and we couldn’t help making a joke or two about how coming to the crowded Secretaria offered more opportunities for acquiring antibodies than by vaccine. We stood out, of course, not only because we were blathering in rapid-fire English or because my sister’s handbag so clearly cost a few months of a well-employed Mexican’s salary, but because I was carrying my baby wrapped to my chest instead of cradling him in my arms; worse yet, since it was sunny and in the 70s outside, I had not shrouded him in blankets. This is to say that judgment is a two-way street and we received as well as we gave.

The line moved slowly as the woman stamping vaccine booklets hand-entered everyone’s information on a large ledger sheet. Name of baby. Age. Address. District.

My son would get the DPaT series and his first Hep B. Neumocócica and rotavirus were not available; we’d have to take him to another center for those.

Stamp. Stamp.

Then we moved on to another line, this one much shorter, at the door marked “VACUNAS” with another handmade poster. Once we were inside, the baby got a needle deep in each leg while I looked out a high window at the sky.

Outside a moment later we bought churros from one of the clustered vendors selling sweets and balloons for teary children (or their teary mothers) and made a beeline for the pretty plaza across the street. I nursed the baby on a park bench while my sister snapped pictures with her iPod—a pigeon on the statue’s head, the clouds of balloons outside the Secretaria, me and my baby—and we talked.

We talked about vaccines, about islands vs. blanket coverage, about privacy and public good, about collective action problems, about rubella (my favorite example of why vaccines are not about the individuals who get them, since rubella itself is not much of a disease, but fetuses exposed during early pregnancy develop into blind children), and about tuberculosis, which is the first vaccine babies get in Mexico.

“I heard that people call the TB scar your ‘Made in Mexico’ mark,” I told my sister. “But W’s never swelled up.”

As I say this, I remember that I’d been warned that the blistering might occur weeks later. So I ran my finger over baby’s tiny arm. And, indeed, was that a bump? A bump that would become his first scar?

It was.

I shuddered.

But then I got control of myself. After all, my son was already part of Mexico’s collective self-improvement. He is, I realized, a Mexican citizen in more ways than merely the place of his birth.

More on Mexico’s Universal Health Care in NY Times: http://www.nytimes.com/2011/01/30/world/americas/30mexico.html

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This entry was posted in Living Abroad, Love in Mexico, Medicine, Mexico, Parenting and tagged , , , . Bookmark the permalink.

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