Shot of Prevention

By Christine Vara

Thank you, thank you to the authors of the recent Parenting article, Your Most Common Vaccine Questions, Answered.  I would like to encourage every parent to read this, share this and comment below on it.  The purpose of my writing this blog is for this exact reason; to help parents navigate all the conflicting information out there.  Here Parenting has addressed the common questions asked by parents and provided straight forward answers.  It is my hope that when parents get answers to their questions, they will feel confident in choosing vaccinations to protect their children from preventable diseases. Let me know if there are other questions you have and we will work to get you the answers from reputable sources.

By Christine Vara

Yesterday morning on the Today Show, Matt Lauer interviewed Dr. Wakefield whose study, published in 1998, sparked a catastrophic collision of the scientific world of vaccines and autism.   To briefly summarize, Dr. Wakefield’s research suggested that the MMR vaccine could cause autism.   Not surprisingly, the publication of Dr. Wakefield’s study resulted in a chain reaction, which sparked controversy and concern amongst parents, scientists, doctors, lawyers and journalists.  Over the years, as detailed by the Associated Press yesterday, numerous studies have been conducted in an effort to verify his findings and yet none has found a connection between autism and any vaccine.  Along the road, a journalist revealed that Wakefield had conducted his research unethically, ten of the study’s authors renounced its conclusions and in February, the study was subsequently retracted by the medical journal who originally published it.  In his interview with Matt Lauer, what Wakefield described as a “bump in the road” was an announcement from Britain’s General Medical Council.  After nearly three years of formal investigation, the council found Wakefield guilty of serious professional misconduct and stripped him of his right to practice medicine in the U.K. 

What I find disturbing is not simply the fact that this man has been found to be unethical in his practice of medicine.   That certainly may be a bump in the road for Wakefield.  While that is concerning, it’s not nearly as disheartening as the far reaching effects that his now discredited study has had on the public at large – which I consider to be a major detour. 

First off, there are the alarming statistics that indicate that vaccine hesitancy has severely compromised public health efforts in our country as well as others around the world, especially in regards to measles.  Immunization rates have fallen, both as a direct and indirect result of Wakefield’s study, leading to a resurgence of diseases in recent years. I have to hand it to Wakefield though.  His one discredited study, with only a handful of patients, has rallied massive support, while follow on studies with thousands of patients disproving his theories remain practically obscure to the general public.  Ask the average parent on the street about vaccines and they will probably be able to tell you that they’ve heard of some link to autism.  What a challenge this presents to our public health advocates who must try to educate people regarding the overwhelming scientific evidence.  Have people come to disregard science so much that they will rally behind one study from a man with such questionable credentials?  Or are people more influenced by coffee-house conversation than by their own chosen medical professionals?

Then there is the careless, yet calculated misstatements that attempt to play on people’s fear of government conspiracy.  Now, I watch my share of movies, but I try to live my life in reality.  So when Wakefield claimed in yesterday’s interview that the U.S. government has been settling cases of vaccine-induced autism since 1991, I had to pinch myself.  While there is a National Vaccine Injury Compensation Program that exists, no one has ever been compensated for a vaccine injury that resulted in autism.   The statistics from the National Vaccine Injury Compensation fund are publicly available and are there to comply with full disclosure.  He certainly must know this, so why even suggest otherwise?

Surprisingly, these detours have also hurt the autism community.  Let me make it clear, as a fellow blogger at Squidilicious.com confirms in a recent post, not all parents with autistic children are convinced by Wakefield or his supporters.  They have probably suffered the most.  So much effort has been put into Wakefield’s claims that the suggested autism/vaccine link often overshadows other autism discussion.  When there is so much to learn in regards to autism, it seems a shame that anti-vaccine sentiment has become one of the main rallying cries for certain autism groups.  Why not concentrate our efforts on other autism awareness, resources and research that can truly change the lives of those who live with autism? 

So at the end of the Today Show interview, I was still left wondering whether Matt Lauer and other mainstream media will help to  address the risk of vaccine refusal and help to get the word out regarding the effectiveness of vaccines?  Will anyone respond to Wakefield’s accusations of the government paying out on injury claims linked to autism?  Probably not.  Which is why independent organizations like Every Child By Two are trying to look for a way back to the road of reason.  The road that leads to better health.  The road that should be paved by good science.  Of course, there are bound to be bumps along the way, but we must try to steer clear of any major detours.  As for Wakefield, we can only hope that this scientist, turned advocate, will finally pull off at a rest stop.

By Christine Vara

Mother’s Day may have come and gone, but a mother’s work is never done.  In today’s society, it’s no secret that mothers bear the majority of the responsibility in caring for the children.  As most mothers will admit, this role often takes priority over their own health care.  There are countless times when a mother will suffer with her own illness, while continuing to make the meals, fold the laundry, help with homework and shuttle the kids to soccer practice.  Personally, I don’t feel like I have time to get sick and even when I’m not feeling up to par, I don’t typically make the time to go to the doctor.    

In fact, my most frequently visited doctors are my dentist and my OB-GYN.  Of course, after giving birth to five children, it makes sense that I have a closer relationship with my gynecologist than my family practitioner.  So when I recently read about a new health initiative to improve immunization rates among women by incorporating vaccinations into OB-GYN visits, it seemed to make perfect sense. 

The article, which appeared in the Dallas Morning News,  discussed a study being conducted by Duke University.  Preliminary research results were obtained from three different pilot programs set up at OB-GYN offices in North Carolina.  What they discovered was that vaccination rates for the Tdap shot among postpartum patients soared from 16.7 percent to 85.7 percent when these immunizations were administered at the OB-GYN office. 

What is interesting to note is that mothers are often the primary source of infection amongst infants.  In fact, the CDC statistics show that 32% of infant pertussis cases were a result of an infected mother.  With such an increase in the adult vaccination rate – as reflected in this study – one can only speculate the positive impact these immunizations might have on the health of our children.   While this study shows promise, questions remain as to whether the obstetricians and gynecologists will be receptive to administering these, and possibly other vaccinations, during routine OB-GYN visits.  

In discussing the subject with obstetrician gynecologist Dr. Amy Tuteur of SkepticalOB, she comments, “It certainly sounds like a good idea. It’s basically a recognition that many women of reproductive age get all their medical care from an OB-GYN. There’s bound to be higher uptake at a postpartum visit when a mother learns that if she doesn’t get vaccinated she could make her newborn very sick.” 

As with all good ideas, the challenge will be to find a way for the results of this study to be incorporated into general practice.  In researching current obstetrician gynecological practice, Dr. Amy directed me to an article published in the American Journal of Preventative Medicine that concluded, “Immunization is an important part of women’s health care and has been, at least partially, incorporated into obstetrician-gynecologist practice.”  However, it also recognized that in regards to OB-GYNs, “Financial burdens and knowledge regarding vaccine recommendations remain barriers to vaccine administration.” 

For instance, while 91% of OB-GYNs indicated that they stock the human papillomavirus (HPV) vaccine and 66.8% stock the influenza vaccine, less than 30% of practices stock any other vaccine.  Since the Duke study showed promise in offering the Tdap shot, which will provide immunization against pertussis, it is particularly disappointing that this report indicates that Tdap vaccine is not typically stocked or administered by OB-GYNs. 

Additionally, the article cited that a majority of OB-GYNs agreed that financial factors, such as inadequate reimbursement, were barriers to vaccine administration.  Others believed their immunization training was less than adequate and felt their practice would benefit from continuing medical education courses.  In conclusion, while the obstetricians and gynecologists see the obvious benefit of vaccinations, there are a myriad of challenges presented in making vaccination administration a part of routine practice.   

In moving forward with health care reform in this country, I believe it is important that we address these issues.  Vaccines are arguably an important preventive measure that could be administered by a variety of doctors. However, if insurance plans will not reimburse all doctors for vaccines, than obstetricians and gynecologists won’t offer them, no matter what positive results are reported as part of the Duke study.

In the meantime, our educational efforts will need to focus on empowering the patients. Women should be made aware of the benefits of adult vaccinations for themselves and their children.  It is my hope that our voices, as mothers caring for our children, will become a vital part of encouraging a shift in policy, and that women will begin to request vaccination from all their doctors and in turn help protect the health of their children.

By Christine Vara

Last month I posted an article that discussed the spread of measles as a result of low immunization rates.  One reference I made was in the case of young boy who traveled home to San Diego from a trip to Switzerland and subsequently exposed 839 people to the infection.   Another article by Amy Tuteur, MD of the SkepticalOB blog, expanded on this case in her post entitled “How Vaccine Rejectionists Hurt the Rest of Us” .  She makes a clear correlation to the rising rate of disease with the choices of some to forego vaccination.  The reality is that many diseases that we vaccinate against will continue to present a risk to our society if people continue to refrain from receiving the suggested immunizations. 

Since I posted the original piece regarding measles, I continue to read reports each week that indicate more of the same – higher rates of disease linked to unvaccinated children.  On the one hand, I am concerned about these specific examples of measles, mumps, and pertussis (or whooping cough).  On the other hand, I am encouraged that the media is attempting to spread the word regarding the risks and suggesting precautionary measures be taken.  Amazingly, the public health agencies are there to investigate and track these diseases in an effort to contain them.   

Just last week vcstar.com published an article with news that local whooping cough cases in Ventura County have more than quadrupled over the past year.  Although the California Department of Public Health stopped short of calling it an epidemic, they issued an April news release saying reported pertussis cases increased by more than 50 percent in California in the first quarter of 2010 compared with the same period of 2009.  Sadly two infants have died as a result.  The article took the time to explain the importance of receiving childhood vaccinations and booster shots for adolescents and adults in an attempt to prevent further disease. 

Sunday, an article posted from the LA Times went into great detail to explain how an East Coast outbreak of mumps has spread to Quebec and now LA county.  The outbreak began in June 2009 when an unvaccinated 11-year-old boy visited Britain, where mumps outbreaks remain high.  He then attended a summer camp for Jewish boys in New York where the disease was unknowingly transmitted to other campers.  According to the article, the New York State Department of Health has indicated that there have been more than 2,800 confirmed and probable mumps cases in New York and 315 in New Jersey as a result.  The outbreak is also linked to 20 mumps cases in Quebec, and to more than 2,600 infected in Israel.  Now, in Los Angeles, nine reported cases are believed to be linked and the media attention is highlighting the concern. 

Then yesterday I read an Omaha.com article that included a warning from the Douglas County Health Department in Omaha which cautioned people that a visitor had been diagnosed with measles.   I was impressed that they reported the specific days that the visitor was contagious and what locations were of concern.  The article went so far as to pinpoint exact exhibits within the local zoo, a specific mass at the Catholic church, as well as the time and location of other possible public exposure at various retail establishments.  These details, along with the media’s assistance in getting the news out to the public, will hopefully help to contain the spread of disease there. 

If these examples prove anything, it is that we live in a global community.  Some people may argue that it is unnecessary to vaccinate against these diseases – that it is unlikely to contract them and that they are not a serious health risk.  However, one must only read the news to understand that these diseases are becoming more prominent because there are people who choose not to vaccinate.  My hope is that these unfortunate stories, broadcast throughout various media forums,  will help to ensure that a large majority of our society will remain vigilant and continue to choose immunizations as an effective means of protection.  Hopefully, people will be educated enough to take the steps necessary to protect themselves and others.  One can start by have a conversation with their physician or by referencing the various resources listed on the Vaccinate Your Baby site.  If you should have any other information regarding this subject, please share in the comments below.    

By Christine Vara

When I began my affiliation with Shot of Prevention, I encouraged readers to join me on my journey as I learned about vaccines and their effect on public health.  What I knew previously came from my personal experiences with my own five children.  However, in the 13 years since my oldest was born, new vaccines have been developed, the immunization schedule has been modified and the scope of the vaccine dialogue has broadened immensely.

I knew that there would be much to discover.  What I didn’t realize was how limited my view was.  Previously, I had considered vaccination to be an issue pertaining to children.  Interestingly enough, I am now beginning to understand the importance of vaccines at every stage of life.

A few months ago, I found myself in a discussion with my pediatrician regarding the HPV vaccine for my eldest daughter.  Just last week, a family member and I were discussing shingles and the painful and lasting symptoms that people suffer with as a result of this illness.  Then, the other day, my husband received multiple vaccinations in preparation for an upcoming trip overseas.  While this is a common occurrence required of his military occupation, I had never really considered it much before now.  He travels to various places where there is a lot of disease.  It just made sense that he would be vaccinated.  I had never even thought about how I may benefit from adult vaccinations.

Then today I came across a new online article entitled “Adults Need Vaccines Too” at Parenting.com.  It urged adults to be vigilant regarding immunizations and presented some surprising statistics regarding the extremely low percentage of vaccinated adults.  It went on to explain that some adults may never have had access to certain vaccines or never completed the recommended schedule as children.  Perhaps adults may not consider themselves at risk, or they may believe that their mature immune systems could adequately fight them off.  Others, like me, may inaccurately assume that the vaccines they received as children are still protecting them – not realizing that immunity can fade over time and that booster shots can prevent disease in adults.  The article has made me stop and question myself.  “Why is it that I haven’t received adult vaccines?” I wondered.

Surprisingly, throughout my entire adult life and through all five of my pregnancies, I have never had a doctor suggest I receive any vaccinations.  Since the subject was never raised, I never really considered that it was necessary.  Like many other adults, I guess I just associated vaccinations with infants and world travelers.  What I’ve learned now is that I need to be proactive and begin the conversation with my doctor.  While I rely on my doctor to make suggestions, I am ultimately responsible for maintaining my own health.

The Parenting.com article provides a good starting point by explaining the various vaccines that are most typically recommended for adults.  I urge you to review the article and share other references that our readers may find helpful by commenting below.  Together, we can empower one another by sharing our knowledge.

By Christine Vara

As we prepare to celebrate Mother’s Day this weekend, mothers around the nation will be honored by their children.   Some will receive flowers; some breakfast in bed.  Some will treasure a handprint on a card or a homemade crafted flower pot.  However, the gift most treasured of all will be the gift of love and life – the gift of having a child and becoming a mother.

What amazes me the most about becoming a mother is the abundance of love that you feel for your child from the moment of birth.  It is immeasurable.  Indescribable.  And so remarkably powerful.  A mother wants nothing more than peace, health and happiness for their child – which is why it is so unimaginable for a mother to have to watch their child suffer from, and sometimes even lose their life to, vaccine preventable diseases.

This is the reality for Belinda Duvall, Katie Van Tornhout, Brendalee Flint, Frankie Milley, Denise Palmer, Danielle Romaguera and countless others.  Each of these mothers has a very different story to tell.  Yet, each of their stories involves pain, suffering and tragedy.

Fortunately, these mothers, as well as the Vaccinate Your Baby spokeswoman Amanda Peet, have the strength and courage to speak out to help educate others and spread the word that vaccines can save lives.  In honoring these special mothers, I hope you will take some time to read their stories here and express your gratitude in comments below.  Their actions will help prevent further loss and suffering and we want them to know how much we appreciate all that they do as mothers and advocates for vaccines.