Asking Before They Play: How to Handle the Response

July 23, 2014 17 comments
In the first part of this series, Ask Before They Play to Keep Chickenpox, Pertussis and Measles Away, Dr. Zibners explores why a parent might be concerned if their vaccinated child has unvaccinated playmates.  In the second part, Are Your Child’s Friends Vaccinated, she provides tips on how to pose the question to others.  In this final post she offers suggestions on how to respond when the answer isn’t exactly what you were hoping for.

 

DrZibnersPart Three: Handling the Response

By Dr. Lara Zibners

In parts one and two of this series, I’ve been equating a conversation about firearms in the home to one about immunization. Both can be awkward but both are very, very necessary. But suppose the answer isn’t the one you were hoping for.

You take a deep breath and spit it out: “Do you keep a loaded gun in the house?” If the answer is yes, there’s another conversation to be had: “Where are they kept? Are they secure? Where is the ammunition? I meant a revolver, not your staple gun!”

In the same way, you may want to open the conversational door about vaccines. What if the answer is

“Oh, no, we don’t vaccinate”

Do you panic? Jump to conclusions? Grab your child and run screaming?

No. Obviously not. My kids are numerous (3) and heavy (nearly 90 pounds combined). I can’t run anywhere. But besides that, it’s best not to start the conversation by assuming that every unvaccinated child has parents who are unwilling to vaccinate. If you find out that your child’s best friend hasn’t had his MMR vaccine, don’t turn away just yet. Take a deep breath and ask one simple question: Read more…

Asking Before They Play: Are Your Child’s Friends Vaccinated?

In the first part of this series, Ask Before They Play to Keep Chickenpox, Pertussis and Measles Away, Dr. Zibners explores why a parent might be concerned if their vaccinated child has unvaccinated playmates.  Today, she offers suggestions on how to pose the question to other parents. DrZibners

Part Two: Posing the Question

By Dr. Lara Zibners

As kids get older, they naturally start wanting to go play at other people’s homes. As parents, we should encourage this developing independence, shouldn’t we? Not to mention the few hours of freedom we can selfishly steal from the arrangement. Yet it’s a little scary, watching them walk into another house. Another environment. Another set of rules. How do you know it’s as safe as the one you’ve created in your own home?

The answer is that you can’t always be certain. The other parents might be more relaxed about some things, more uptight about others. I, for one, am fully aware that my “two ice cream bars each and that’s it, people!” is a bit liberal for many of our friends. Then again, the way I freak out, hysterically screeching when I see a latex balloons being brought into our home…perhaps others view that reaction as inappropriate. But from my standpoint, I’ve never cared for– let alone heard of– a child who was killed by an ice cream sandwich. The latex balloon? Right. Number one non-food related fatal choking hazard. The point is we all have our priorities when it comes to the safety of our kids.

Photo credit: M. Danys

Photo credit: M. Danys

As a parent, when you decide that it is a priority to limit your child’s contact with unvaccinated children, that’s absolutely within your right. Please know that you aren’t alone if you are nervous or worried about upsetting or offending another family by asking about vaccine status. But it’s important and simply has to be done.

But what do you actually do? How do you ask? Blurt it out? Casually drop a line into the conversation? Tell a hilarious story about the last time little Bobby went for his routine immunizations and watch the reaction? It can be awkward. Especially if you haven’t given it some thought.

But it’s something you really need to think about. It’s fine to decide in your mind that you don’t want unvaccinated children putting your own at risk. However, it’s another thing to put those feelings into words. As an example, the Ask campaign has done a great job of raising awareness about the dangers of unsecured guns in homes with children and encourages parents to inquire about the presence of firearms in the homes where their children play.  Why can’t vaccine status be a similar conversation we have with other parents? Read more…

Ask Before They Play To Keep Chickenpox, Pertussis and Measles Away

July 15, 2014 15 comments

Part One: Why Ask at All?

DrZibners

By Dr. Lara Zibners

 “Oh, you know, we never had baby gates, because, you know, of the controversy.”

This was the response I got from a mom at a playgroup after some random conversation about safety. Our house had a flight of stairs just off the living room that was 16 wooden steps ending directly onto a slab of stone. So we had baby gates at either end. The story was likely the one about me installing these gates and then calling the company to find out how to open them. They were that good. Anyway, it made perfect sense to me that small children + long staircase + stone floor = potential significant injury. Until that exact moment, I was unaware there was a “controversy.”

Yet, apparently this other mother had read something about boundaries and teaching children to respect the staircase from behind imaginary walls. Which would then in turn help them develop self-control. Whatever. To my mind, having your frontal lobe all bruised up after a flight down a staircase would also create long-lasting issues, so I went for the option with an immediate safety return.

If you look between the lines of this exchange, you can see that it’s not so different from finding out that this mother was a vaccine-refusing parent. Her philosophy about parenting was so incredibly different that mine, and her ideas seemed so far out there, that I had no answer for her. Just a smile and a nod. (And a snarky comment about traumatic brain injury—I couldn’t help myself.)

Is that really so different from mentioning your child’s flu shot appointment and being met with a response that implies (or flat out says) that the flu is not dangerous and actually good for building their natural immunity? Those of you who are convinced that immunization is the most effective way of protecting your children from a variety of preventable and life-threatening illnesses have already made peace with this decision. If, on the other hand, you’ve chosen to vaccinate but still have questions than I suggest you continue to hang around sites like this. The more you learn about the scientific evidence that supports immunizations, the more certain you will be in your decision.

FosterKidImageBut what do you do when you find out about parents who have made other decisions?  What do you do when you discover your child’s best friend is unvaccinated? Should you care? After all, is it any of your business?

Read more…

ACIP: Fifty Years of Vaccine Recommendations Continue with an Eye Towards Safety and Efficacy

July 11, 2014 2 comments

This year marks the 50th anniversary of the Advisory Committee on Immunization Practices (ACIP).

Use of a jet injector during the 1976 New Jersey Influenza A immunization project in which 45 million adults in the United States received a vaccine containing the A/New Jersey/76 influenzavirus ("swine flu" virus).

Use of a jet injector during the 1976 New Jersey Influenza A immunization project in which 45 million adults in the United States received a vaccine containing the A/New Jersey/76 influenzavirus (“swine flu” virus).

The Committee, founded by the Surgeon General in 1964, originally consisted of 10 members and included influenza vaccine as one of its first agenda items.  When the committee convened last week to continue their ongoing efforts to develop safe and effective vaccine recommendations, there were over 50 members present and influenza was once again on the agenda.

The changes in immunization recommendations in the past fifty years have been nothing short of astounding.  Not only do we continue to see new vaccines, but we have exceptional standards in place to evaluate the increased safety and efficacy of these new recommendations.  The Committee’s commitment to the public is exemplified by the great lengths they take to examine all the evidence prior to making their recommendations.

After an extensive review of the data compiled by a special Influenza Working Group, a unanimous decision was made by the ACIP to recommend the Live Attenuated Influenza Vaccine (LAIV), commonly referred to as the nasal mist vaccine, as the preferred influenza vaccine to be administered to healthy 2-8 year olds when available.   Through their further review of the scientific research presented at the February meeting, the Committee found that LAIV was a more effective vaccine for this age group.  The studies also confirmed that there were no identifiable safety concerns that would prevent the Committee from recommending LAIV over the Inactivated Influenza Vaccine (IIV), commonly referred to as the flu shot.

While the recommendation can be applauded for providing better flu protection among a vulnerable age group, there were some concerns that the recommendation comes too late in the year.  Most pediatric providers have already submitted their vaccine supply orders for the upcoming flu season and without anticipating this new recommendation they may not have ordered enough LAIV to accommodate their patients. It is also unknown whether the vaccine manufacturer has planned to produce enough vaccine to meet the public’s demand.   To help address these concerns, the Committee emphasized that while LAIV is preferred, if it is not immediately available, the injectable vaccine should be used and vaccination should not be delayed.

It should be noted that some people should not receive the live attenuated influenza vaccine.  (For details of the ACIP’s specific recommendations and a list of those with LAIV contraindications, click here.)   Also, regardless of whether children receive the LAIV or IIV, the recommendation remains that children, age 6 months through 8 years of age, should receive 2 doses of flu vaccine in the first year that they are vaccinated for influenza.

In addition to voting on influenza vaccine recommendations, the Committee also heard various presentations related to influenza vaccine safety.  Read more…

Celebrating Our Nation’s Investment in Public Health and Vaccines

July 4, 2014 1 comment

Independence-DayHansPetersenAs people across the nation are getting ready to celebrate Independence Day, I’m reminded of how grateful I am to live in a country that values freedom.  As a citizen of the United States, I’m encouraged to participate in our democracy, I’m granted various protections, and I benefit from our nation’s investment in public health.  While our democracy is far from perfect, I do believe that great efforts are made to keep Americans safe and healthy – despite the fact that some people would rather live recklessly and dangerously.

When looking back upon the history of our nation’s immunization policies, we get a glimpse of both the good and the bad.  In a recent op-ed in Politico entitled “How Congress Brought the Measles Back“, Sarah Despres explains how Congressional actions have negatively influenced public opinion regarding immunizations in a way that has continued to interfere with good public health practices.   On the flip side we also hear stories about people like Andy Marso, a passionate meningitis survivor who has been instrumental in advocating for state legislation that will help protect college students from a devastating disease that almost cost him his life.  The point is that while our democracy and our public health programs are far from perfect, we have the ability to exercise our voice in the legislation that governs our nation’s policies.

We won’t always agree on what’s best, but when the discussion turns to vaccine choice some people feel strongly that they should not be “forced” to vaccinate either themselves or their children.  They argue that such government requirements interfere with their individual freedoms. Admittedly, I get a bit upset when I read such statements.

While I believe vaccines are the best way to protect from dangerous and deadly diseases, I also believe that people should have a say about their medical choices.  However, to say that people are “forced” to vaccinate is grossly inaccurate.  By exaggerating this claim, vaccine refusers are simply trying to garner support from a larger audience who wish to oppose any government intervention in their lives, regardless of any benefit it may provide to the masses.  Unfortunately, they fail to realize how vital this protection has been and how much death and suffering has been avoided because of the policies they so vehemently oppose.

The truth is that we all have choices.  Read more…

How Meningitis Nearly Killed Me, Then Changed My Life for the Better

June 26, 2014 28 comments
Andy and his roommate visit Gooseberry Falls just days before he falls ill.

Andy and his roommate visit Gooseberry Falls during spring break of his senior year of college.  This is one of the last pictures he took prior to contracting meningitis.

By Andy Marso

I occasionally look at pictures of myself on a spring break trip in 2004, about a month before I almost died of a meningococcal infection.

I was a senior at the University of Kansas at the time and I brought my Brazilian roommate home to show him what spring break is like in Minnesota. There are pictures of him, with his shoulders hunched against the cold, and me and another friend in front of a frozen Gooseberry Falls, the ice and snow stubbornly refusing to cede the ground it had held for months just because the calendar had turned to March.

They are the last pictures I have been able to find in which I still have four normal limbs.  They are the last pictures of a different Andy Marso, one who was carefree and naïve and didn’t realize how quickly he could lose the life he loved.

Sometimes, when I look at those pictures, there are things I want to tell that Andy.

MarsoBurnUnitArmResizedI want to tell him to turn and run up that frozen waterfall, to leap nimbly from one rock to the next, because some day he won’t be able to.

I want to tell him to flex those fingers poking out the sleeves of his fleece hoodie and marvel at all of the tiny, delicate muscles, nerves and joints that can move in ways that no machine can fully duplicate.

I want to tell him about Neisseria meningitides, the tiny bacterium that will soon invade his bloodstream.

I want to tell him that within weeks he will go to bed thinking he has the flu and by the next night he will be in intensive care, in a medically-induced coma, with his organs failing and his parents praying he will live.

MarsoBurnUnitLegsI want to warn him that when he wakes up from that coma, he will face suffering worse than any he has ever imagined for himself. That for months, medical professionals searching for living, bleeding tissue will slice layer after layer of dead flesh from his arms and legs until his bones and tendons are exposed, but they will be unable to save his toes and most of his fingers.

I want to tell him that in losing that, he will gain new purpose. Read more…

Insider Explains Why Congress is Responsible For Return of Measles

June 23, 2014 10 comments

SarahDespresAs a long-time staffer for Rep. Henry Waxman (D-Calif.), Sarah Despres knows a bit about Congress.  As counsel working on public health issues for the Democratic staff of the House Government Reform Committee for over a decade, Despres also knows a lot about immunization policy.

So why does she believe that Congress is responsible for the return of measles?   

Despres’ recent op-ed published in POLITICO Magazine’s Public Arena section  is based upon her experiences as a Congressional insider and makes a bold declaration that is very convincing.

“Public health has taken a giant, 20-year step back, and we have Congress to thank”, she explains.

Her no-holds barred article connects the dots between a stunning Congressional declaration in 2000, in which measles was believed to have been eliminated in the United States, to our current day concerns over the highest resurgence of measles cases in the U.S. since 1994 (as of today there are 514 reported cases in 2014).  She describes how our nation’s immunization program, which was once considered the crown jewel of public health, has suffered from repeated attacks.  Congressional members have fallen prey to unscientific theories at high-profile congressional hearings and inflammatory rhetoric has skewed the public’s opinions of life-saving vaccines.  And she faults Congress for not taking appropriate action to fix the problems they have essentially created.

What is most admirable about Despres’ article is not just in the evidence she presents, but in the purpose behind it.  She is not concerned about being politically correct.  Rather, she is assertive about demanding public accountability for an issue that she finds personally and socially concerning – an issue we should all find personally and socially concerning.

Her article drives home the point that what Congress says and more importantly, doesn’t say – matters.  Hearings held 14 years ago have set the stage for a disease comeback of dangerous proportions, and Sarah Depres is one woman who is bold enough to declare that Congress take responsibility.

She states,

Congress has an opportunity now to remedy its previous mistakes. It should use the return of measles to demonstrate its commitment to protect the public from vaccine-preventable diseases and give the CDC adequate resources to fund immunization programs. But Congress also has the bully pulpit. Committees can hold hearings to correct the record. Members should record public-service announcements, reminding parents to get their children and other family members vaccinated. And members should participate in immunization clinics in their districts as a show of support for the local public-health departments who are on the front lines preventing outbreaks.

I suggest we should all make similar demands on Congress and request that they help rectify a dangerous situation.

If you agree, please share Sarah Depres’ Politico article and send a similar message to your own Members of Congress.  It’s time we speak up in order to put measles back on the eradication list.

Sarah Despres is an Every Child By Two Board Member.   She is also a Director of Government Relations for the Pew Charitable Trusts specializing in health related projects and a member of the National Vaccine Advisory Committee.  You can follow her on Twitter @sarahhdespres.

 

 


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