Lost Immunity by Daniel Kalla (free reads TXT) 📕

Stevens-Johnson syndrome?” she asks, referring to the potentially life-threatening reaction that causes severe swelling and blistering, especially of the skin around the lips and inside the lining of the mouth.

“Yes. The dermatologist already saw her. He agrees. We started her on high-dose steroids, but it’s progressed so rapidly. Even he was shocked.”

“And has she been on any new medications lately? Antibiotics? Anticonvulsants? Or any other drug associated with Stevens-Johnson syndrome?” Lisa asks.

“No medications. Only the meningitis vaccine.”

Lisa’s heart sinks. “When did she get that?”

“Two days ago, apparently.”

“And she didn’t develop the reaction until this morning?”

Cortez makes a gesture toward the curtain in front of the door. “According to the parents.”

“Can I see her?”

“Sure.”

Lisa pushes the curtain aside and steps into the room. Despite the beeping equipment and hive of activity around the bed, her gaze is immediately drawn to the patient, who lies with the head of the bed elevated to almost the sitting position. Mia’s eyes are glassy but open, meaning that, while sedated, she’s still conscious. A ventilator tube passes into her mouth, but Lisa can’t identify her lips through all the blistering and swelling.

“Who are you?” demands the wide-eyed man at the foot of the bed, who looks as if he could be a biker with his cropped hair, bulging shoulders, and sleeves of tattoos.

“I’m Dr. Dyer. With Public Health.”

The woman standing closer to the head of the bed grimaces. “Public Health?”

The man’s eyes narrow. “Does this have something to do with that vaccine Mia got?”

“That’s what we are trying to figure out,” Lisa says. “You’re the father?”

“Yeah, Jim Meyer.” He nods toward the woman. “My ex-wife, Susan. The mom.”

Lisa offers them a sympathetic smile. “When did Mia first complain or show any signs of this reaction?”

“Mia seemed OK at bedtime,” Susan says. “She crawled into my bed early this morning complaining of a sore mouth.” She stares helplessly at Lisa. “She never comes into my room at night.”

Lisa views Mia, whose head is still, but her eyes appear to follow them as they discuss her. She can’t imagine how terrifying it must be for the girl or her parents. “I know Dr. Cortez already asked you, but has Mia taken any medication in the past few days? Even over-the-counter pills.”

“Nothing,” Jim answers for his ex-wife. “Just that vaccine.”

Lisa turns to the patient. “Hi, Mia.”

The girl stares back groggily.

“Is it true, Mia?” Lisa asks. “You’ve taken no other medications? Not even ibuprofen or acetaminophen?”

After a slight delay, Mia shakes her head.

“So it’s got to be that fucking vaccine, doesn’t it?” her father barks.

“Please, Jim,” Susan says, exasperated. “The doctor is here to help.”

“It could be,” Lisa admits. “But we’ve inoculated over two thousand people, and we haven’t seen anyone react this way so far.”

His lips curls into a sneer. “And now you have.”

“We’ll see,” Lisa says. “Meantime, Mia is in good hands. Now that her airway is protected and she’s on the steroids, her doctors expect her to improve.”

“She just about died!”

“Jim!” Susan snaps.

“I understand,” Lisa says.

Susan turns away from her daughter and runs a finger in a circular motion around her own lips. “Will it scar?” she whispers.

“I don’t think so,” Lisa says, realizing that she’s not entirely certain of what the long-term complications from Stevens-Johnson syndrome are.

Jim spins away with a disgusted snort, but Susan’s eyes remain fixed on hers. “That vaccine was supposed to protect her, wasn’t it, Dr. Dyer?”

Lisa doesn’t try to argue. Instead, she simply nods.

Even after Lisa says her good-byes and drives back to the office, she has trouble shaking the memory of the mother’s betrayed eyes. She’s still thinking about it as she steps into her office. She has barely sat down behind the desk when Tyra walks in.

“Well?” the program director asks as she drops into the chair across from her.

“It’s not good, Tyra.” Lisa summarizes Mia’s condition.

Tyra shakes her head. “But this Stevens-Johnson syndrome can happen spontaneously, right? You don’t need to have been exposed to any medications?”

“The timing seems just too coincidental for that. Even the dermatologist has never seen the syndrome progress this rapidly.”

“But it’s not an allergy, right?”

“No. Technically not. It’s classified as a type-four immune hypersensitivity, because it’s mediated by T-lymphocyte cells. It’s more of a severe idiosyncratic reaction than a true allergy.”

“Exactly.” Tyra holds up her palms. “It could have happened after almost any medication, not just the Neissovax immunization.”

“But it did happen after Neissovax.”

“OK, OK. Let’s say Mia had a bladder infection and was started on a sulfa drug for treatment? And then she broke out in the exact same severe rash.”

Lisa rubs her eyes. “What’s your point, Tyra?”

“My point is: you wouldn’t stop giving out sulfa drugs to everyone else with a bladder infection because one person reacted as badly as Mia did.”

“You’d make a good lawyer, Tyra.” Lisa chuckles. “This is different, though. The amount of scrutiny this vaccine faces. Once word of this gets out…”

Tyra’s face scrunches up. “We can’t let those damn anti-vaxxers and their hysteria dictate how we manage a public-health crisis. Not after a single adverse reaction.”

“Even if it’s a near-fatal drug rash?” a voice asks from her doorway.

Lisa looks over to see Alistair Moyes. “Bad news travels fast,” she says.

“It does.” He steps into the room. “How is the patient doing?”

“Stable. Now.”

Moyes raises an eyebrow. “Stable on a life-support system?”

“Only to protect her airway until the swelling settles down,” Lisa says. “Besides, isn’t it a bit early to say ‘I told you so’?”

“That’s not why I’m here.”

“Why then?”

“I came to discuss the lab results we just received at the CDC.”

“Which results?” Lisa asks warily.

“The post-exposure antibody titers.”

“And?”

“They’re through the roof. Even more impressive than Dr. Klausner suggested.”

“So Neissovax confers full immunity against the Icelandic meningococcus?”

He nods. “In a hundred percent of the samples we’ve tested so far.”

“And what about this girl with Stevens-Johnson syndrome?” Lisa asks, bracing for the worst. “Is that enough to derail our vaccination campaign?”

Moyes studies her for a long moment. “As nasty as it sounds, it’s still only one reaction among