If Only

Ada turned a year old last Thursday (soon I will hopefully find the words I want to say to her in her birthday letter—it is one of the hardest yet). I took her to the pediatrician today for her one-year well visit. I knew some shots would be involved.

I was prepared for the shots.

I was prepared for Ada’s reaction to the shots.

I wasn’t prepared for my reaction to the shots.

The nurse gave me the information sheets about each vaccine—Ada got the hep A, chickenpox, and pneumococcal vaccines today. Surely I’ve seen these information sheets before, but somehow I’d never really seen them.

The pneumococcal conjugate vaccine (PCV13) is the vaccine that prevents invasive pneumococcal disease. That is, it prevents what killed Hudson—a bacterial meningitis caused by Streptococcus pneumoniae bacteria. Strep pnuemo is one of the most common bacteria in the world—it colonizes in the noses and throats of most people all the time, and it usually causes no worse than a cold or a sinus infection.

Some of the information on the sheet I already knew. I already knew that strep pneumo meningitis is fatal in only about 10% of cases. I already knew that there are 93 strains of strep pneumo. I already knew that the prior vaccine, Prevnar (the vaccine that Hudson received) covered only 7 of these strains, whereas the new one, released just after Hudson got her last Prevnar vaccine, covered 13. In both cases, the vaccine covers the strains that cause the most severe infections.

But I learned some new things about strep pneumo today.

Pneumococcal meningitis affects fewer than 1 person in 100,000 each year. I knew it was rare, but I didn’t know it was that rare.

Before the pneumococcal vaccine was available, pneumococcal meningitis caused about 200 deaths per year in children under 5. I knew that death from pneumococcal meningitis is rare, but I didn’t know it is that rare. If it was that rare before vaccines were available, imagine how rare it is now.

Some strains of strep pneumo are resistant to antibiotics. I didn’t know that. That’s why vaccination is so important, apparently. But the vaccine only covers 13 strains.

It has been four years, three months, and eight days since pneumococcal meningitis took Hudson from me. Although I have accepted that she is dead, that she is gone, that she is not coming back, that there will be no “First Day of Kindergarten” photo to share on Monday, I cannot help, yet again, but wonder if only.

If only the strep pneumo bacteria had stopped at giving Hudson a sinus infection.

If only the pneumococcal vaccine Hudson received could have prevented that terrible bacteria from invading her bloodstream, and later, her cerebrospinal fluid.

If only the antibiotics that were flowing into her bloodstream a mere 40 hours after she first woke up with a mild fever could have beaten that terrible bacteria back.

If only Hudson could have been in the 99,999 instead of being the one.

If only Hudson could have been in the 90% who lived instead of the 10% who died.

If only Hudson had lived.

If only Hudson were here.

If only.

If only.