The rch paediatrician

Interview with Dr Margie Danchin

“I work in a hospital where I see families every day who juggle tremendous hardship and adversity and that’s a reminder to me that my concerns are often trivial in comparison.” Margie Danchin.

Dr Margie Danchin is a paediatrician at Melbourne’s Royal Children’s Hospital who respects our desire to question the system.

This mum-of-four understands the doctor/patient relationship can be intimidating for some, particularly when it comes to immunising our children.

So thought you guys would like some advice from a trusted expert, but before we get on to that let’s find out how this lovely mum of four beautiful kids navigates family life.


Martine Harte: Margie you and husband have four children, how do you go managing kids and busy careers?


Dr Margie Danchin: I think balance is really tricky and I think it can exist for people but what it means to people is different.

I believe the most important thing is to understand what your priorities are, what works for you, because some people perceive balance as being at home full-time or as having a full-time job and having full-time care for their kids but having great quality time on the weekends (balancing it that way) but for me spending roughly half the amount of time with my kids each week is important to me, so that has caused stress and chaos for me because it’s really hard to do.

For me it’s really important to prioritise time with the kids so the only way I can do it is with help. I rely on a nanny part-time– somebody else at home to keep things ticking over. I have a really fantastic working relationship with our nanny who has been with us for eight years but there is no magic potion.

It’s really hard.


 “No magic potion” – very true. Do you have anything you tell yourself when it gets hard?


Dr Margie Danchin: I have an incredibly supportive husband and a very wise mother who is an amazing influence in my life. Mum always says to me, just be kind to yourself, you can’t do it all.

When I’m in tears and running late for a meeting because I left home late because I had the toddler clinging to my leg as I was trying to leave; I know it doesn’t look professional, I just say, “Look Margie be kind to yourself, you are here.”

You potentially can have it all but not all at once, so if everyone is happy at home and maybe you’re managing some personal time and fitness, work is often not going so well. If work is going well then maybe meeting the kids or family’s needs or working on your fitness isn’t going so well. So I think the way I’ve dealt with it in the last few years is to say, “Balance across all these domains is hard and not really possible and that’s ok”.

I work in a hospital where I see families every day who juggle tremendous hardship and adversity and that’s a reminder to me that my concerns are often trivial in comparison. I may see a family juggling three children with autism or a parent managing a child who needs overnight feeding and has multiple seizures every day and I am constantly reminded to be so grateful for what I have.

Yes you work at the magnificent Royal Children’s, specialising in immunisation (an emotional subject) are the medical profession concerned about immunisation rates?


Dr Margie Danchin: In the media immunisation coverage rates are quite regularly portrayed to be falling but in fact the data obtained from the Australian Childhood Immunisation Register tells us that rates are quite stable, with national rates holding steady at around 91- 92%.

The rates for the 12-month old age group have dipped slightly in recent times but overall immunisation rates across Australia are quite high.

What appears to be growing are the groups of people expressing concern about vaccines.

They may cluster in certain communities across Australia, such as the Byron bay area, but pockets of low coverage are now seen in some of the wealthier, inner city suburbs in both Melbourne and Sydney as well. Parents from these areas are often very well-educated and are in higher income brackets.

Parents seem to fall in to two main groups – those that refuse all vaccines and those that question vaccines with varying degrees of concern or hesitancy. Some of these parents may choose to delay vaccines until their child is older or only choose some vaccines. A lot of these people actually still go on to vaccinate but they have serious concerns.


But it’s about social responsibility isn’t it?


Dr Margie Danchin: There is a strong element of social responsibility, which enters on the idea of herd immunity. By immunising our children we are not only protecting our child but we’re protecting other children in the community.

For example, a child under six months of age who has not had three doses of whooping cough vaccine is not yet protected and is very vulnerable, but if toddlers, school age children and parents are protected and whooping cough isn’t circulating in the community, your children under six months, especially those under four months, are at less risk.

But when I talk about the concept of herd immunity a lot of parents say, “I respect that but I’m just more concerned about protecting my child.” Its a really fascinating thing to discuss, because their social responsibility is not as great as their responsibility to their child.

Why do you think people are so concerned? What’s missing in the conversation?


Dr Margie Danchin: I think some health care professionals have traditionally approached this issue in a paternalistic, dogmatic way with people who have expressed concerns, either dismissing their concerns as trivial or bombarding them with huge amounts of information in a way to convince them and to push the pro-vaccination view. We now have evidence to suggest that these approaches don’t work.

People expressing concerns are often well-read, highly educated people, they’ve done their homework – admittedly not always from reputable sources – but they’ve gone out there and sourced information and I don’t think that they respond favourably to being paternalised, spoken down to.

I try to focus very strongly on communication with families, in my specialist immunisation clinic, which I work in every Tuesday morning at the Royal Children’s. I see these families coming in and I try very hard to put them at ease and encourage them to express their concerns. Probably the most common question I get asked is, “Are there too many vaccines given at one time on the current immunisation schedule and do the number of vaccine antigens overwhelm the baby’s immune system?”

A lot of people believe the vaccines are given straight into the bloodstream, they don’t understand they’re given into muscle, so there’s this perception that these horrible nasty vaccine antigens are given to children straight into their bloodstream and can cause harm.

When we ask them, “what harm, what are you afraid will happen to your baby?”  They very often say, “look I don’t actually know but I’m just worried.” And I can understand that. Sometimes acknowledgement is enough to get them started.


Dr Margie is now a resident blogger at the outstanding Royal Children’s Hospital in Melbourne.

Keep up with their awesome work and Margie’s informative posts by popping over here

More info? Zip over to the Australian Childhood Immunisation Register here