Shot of Prevention

My husband and I both grew up as fans of the NY Giants.  Over the years, as we’ve moved from state to state, we’ve discovered that there are a lot of people out there that just love to hate New York teams. Despite the criticism and abuse we’ve received, we’ve always remained loyal to our team.  So last night, as we celebrated the NY Giants, I took a few moments to consider what a champion really is.  In addition to being somebody who competes in and wins a competition or tournament, I found these other definitions quite fitting.

DEFENDER:  As in defender, supporter, or promoter of somebody or something (such as a “champion” of human rights)

REMARKABLE PERSON:  As in a personal example of excellence or achievement

There are plenty of critics who have said that the NY Giants did not even deserve to compete in the Super Bowl since they didn’t have the best record in the league.  But the reality is that they have won it all.    Their perseverance, skill and determination in the face of adversity is what ultimately elevated them to championship status.

As I sat down at my computer this morning, still giddy from last night’s big game, I began to realize that true champions come in many forms.  Day in and day out, whether it’s baseball season or football season, I’m faced with vaccine critics on this blog and on our Vaccinate Your Baby Facebook page who are often relentless in their attacks.  However, we’re fortunate to have the support of many loyal champions who participate in this forum, tirelessly defending and supporting childhood immunizations.    Some are health care workers, physicians, nurses and medical assistants.  Some are scientists, researchers or public health workers.  Many are parents.  And all are concerned citizens.

These champions remain engaged on this issue because they know that immunizations protect children and communities from dangerous and sometimes deadly vaccine preventable diseases.  While they deserve the equivalent of a Super Bowl trophy and championship ring, their hard work rarely gets any recognition.

This is why I would like to call upon you to nominate these special champions for a new award from The Centers for Disease Control and Prevention (CDC) entitled the CDC Childhood Immunization Champion Award.  Individuals from each of the 50 states and the District of Columbia, who make a significant contribution toward improving public health in their communities through their work in childhood immunization will be honored with an award during National Infant Immunization Week (NIIW), April 21–28, 2012.

To learn more about the award, review eligibility criteria, and see deadlines associated with award, visit www.cdc.gov/vaccines/champions.  Nominations are due to State Immunization Programs by February 10, 2012 so please consider nominating friends and colleagues from across the country before the end of the week.  We want these immunization champions to know just how much we appreciate them and all their efforts to support childhood immunizations.

It’s important for doctors, nurses, health care professionals and parents to keep informed about changes to the recommended immunization schedule.    Today’s report from the American Academy of Family Physicians (AAFP) details the changes to the 2012 schedule as suggested by the CDC’s Advisory Committee on Immunization Practices (ACIP).  Some of the more significant changes concern the following:

Tetanus, diphtheria and acellular pertussis vaccine administration among health care personnel and pregnant women.  Specifically, if pregnant women have never received the Tdap vaccine, it is recommended that they be immunized during their second or third trimester rather than in the immediate postpartum period.  Addionally, for children who received Tdap as a catch-up dose at age 7 through 10 years, “an adolescent dose should not be given.”

Routine administration of hepatitis B vaccine in people with diabetes. 

The addition of the quadrivalent human papillomavirus vaccine for boys and young men.  In regards to boys, the HPV4 vaccination is recommended in boys 11 to 12 years of age, with catch-up vaccinations at age 13 to 21.  However, it is acceptable to begin HPV4 vaccination in boys as young as 9 years of age. 

A booster dose of the meningococcal vaccine for children at age 16 is now recommended.  The previous schedule recommended immunization at age 11 or 12, but due to waning immunity and higher risk in the late teen years, the new booster recommendation is intended to ensure that protection is maintained through the high-risk window, which occurs between 16 and 21 years, when many are living in close quarters, such as in college dormitories.

It also should be noted that the ACIP recommends that children 6 months to 8 years of age receive two doses of influenza vaccine during the current season if they did not receive at least one dose of the vaccine during the 2010-11 season.  It also clarifies the guidance for clarifies the guidance for giving the flu shot to kids with egg allergies. For more complete details on the changes, please refer to the following resources:

2012 Immunization Schedule for Children 0-6 years

2012 Immunization Schedule for Adolescents 7-18 years

2012 Adult Immunization Schedule

If you should have any questions, let us know and we will attempt to direct them to our scientific advisory board for clarification or response.

As I was preparing to leave for a brief business trip on Sunday evening I heard these words:

“God comes to us disguised as our life.”

Little did I know that over the next two days I would come to a fuller understanding of what these words mean to me in regards to my life at this moment.

In my faith, I believe that the choices we make and the actions we take should be guided by our love for our neighbor who encompasses all of humanity.  With that vision, it’s my personal opinion that there’s nothing more compassionate than saving the life of a child.

While parents in the United States often have the luxury of waiting for hours in line for that magical Dumbo ride at Disney, the reality remains that in many other countries mothers walk for miles and wait for hours for a simple vaccine in hopes that their own princes and princesses will have the hope of a healthier life.  While many of us readily acknowledge that such disparity exists, children all over the globe continue to suffer and die from vaccine preventable diseases.  As individuals we often feel powerless to do anything about it.   However, by supporting global vaccination programs we can save the life of a child every 20 seconds and stop the nearly 2 million unnecessary deaths that happen every year.

One way in which I personally plan to evoke change is through supporting a new campaign called Shot@Life.  By helping to educate, connect and empower people, Shot@Life is launching a powerful initiative that promotes vaccines as one of the most cost-effective ways to save the lives of children in developing countries.  This new UN Foundation project focuses on ways in which every day people can help give children around the world the shot at life they deserve, no matter where they live.  As you can see in the video below, some children may never experience the milestones that many of us take for granted; like saying their first words, losing their first tooth, or even getting their first vaccine.

After attending a special Shot@Life volunteer summit earlier this week, it became quite clear to me – as well as to each of the other volunteer champions in attendance – that there are as many ways to help, as there are people who want to be a part of the solution. Read more…

When it comes to issues regarding disease prevention, our choices impact our children now and throughout their adult life.  Whether we choose to vaccinate our children or not, or delay certain vaccines or not, we are making decisions that have consequences.

A child who falls ill with a vaccine preventable disease may end up just fine.  However, others will have to endure permanent health problems.  And still others will suffer and die, like the many whose stories appear on sites like Vaccinate Your Baby and Shot by Shot.

Earlier this week a comment on the Vaccinate Your Baby Facebook page that made me think about the challenges parents face.  A concerned mother, seeking guidance states:

“I have a 28 month old son and have been delaying and selectively vaccinating. I am looking for a neutral page where I can find information to help me make decisions about what vaccines to get. This page appears to be a page that will deliver only one side of the story. Where can I go to get information both positive and negative about vaccinating? I am faced with some decisions very soon and wish to make an informed decision. I have read some information about vaccines, but not enough to be comfortable just yet.”

I have heard these sentiments echoed time and time again.  When faced with uncertainty, parents often delay or selectively vaccinate until they can feel more comfortable with the idea.  While I understand this rationale on an emotional level, I believe that parents must begin by understanding the importance of research, science and statistics in order to make an informed decision.  In other words, it’s not that parents should look for a “neutral page”, as this mother suggests, but more importantly, an accurate one that uses scientific evidence to support their recommendations. Read more…

Last week, there was quite a lot of discussion about a YouTube video entitled, “Why This Nurse WON’T Vaccinate” that was posted by a woman who refers to herself as the “Patriot Nurse”.  I wrote a blog post here on Shot of Prevention that included the video, along with a point by point commentary from a vaccinating nurse who I refered to as the Canadian Nurse.  Since the Patriot Nurse didn’t allow comments on her YouTube video, my intent was to generate an open discussion here on Shot of PRevention, where we are proud to allow differing views in our comments.  As you can see, the post received quite a few comments and since it’s never been our policy to censor them, you can understand the debate that this video has sparked.

Well today I want to update you on some recent developments with The Patriot Nurse.

It appears that the statements made in the video by The Patriot Nurse were troubling to many people, including blog writer Martine O’Callaghan who writes for Autismum and Nerditorial. She too wanted to write about this video and bring it to the attention of her readers. However, she first tried to verify the identify of The Patriot Nurse, in order to establish her educational and occupational background and experience. That prompted her to write a letter to a birthing center in TN where she believed Ms. Greene (aka The Patriot Nurse) has been employed.

Ms. O’Callaghan explains in her recent blog post that she was in no way calling for the dismissal of The Patriot Nurse.  She simply wanted to verify whether this person representing herself as a nurse on the video was currently working for the birthing center.  She also inquired as to whether the Patriot Nurse’s views on vaccination coincided with the policies of the birthing center.  After all, if a member of the birthing center’s staff has opted out of vaccination, shouldn’t the pregnant women giving birth there be informed of this?  After all, there are dangerous vaccine preventable diseases that can be life threatening to an infant who is still too young to be vaccinated and many cases where infants have died as a result.

It appears that since our last posting, The Patriot Nurse took down the YouTube video and has since made a statement on her Facebook page that suggests that her employer had some questions for her in regards to it.

Certainly, there is nothing wrong with a woman sharing her personal opinions regarding vaccines on YouTube, right?

Unless you are a nurse who attempts to speak as an authority on the subject of vaccines and you happen to have direct contact with pregnant women and newborns, is that it?

So, where exactly does the line get drawn?   What are the ethical implications here?  What are the consequences to these actions?  And what should they be? 

I’m curious to hear what you think in regards to this topic?    However, I feel it is only fair to start off with a comment we received from the Canadian Nurse who first attempted to correct some of The Patriot Nurse’s misinformation.  She commented for Shot of Prevention as follows:

Good morning angry supporters of The Patriot Nurse (TPN).

No one is debating your RIGHT to choose whether or not to vaccinate. But if you have the right to NOT vaccinate, then a patient – especially parents who …will be giving birth to a vulnerable neonate under your care – should have the right to choose whether or not you act as their nurse.

NO one is after The Patriot Nurse’s job. A science writer for a legitimate science zine contacted her work to verify her identity. Which is exactly what a responsible writer does before publication – verifies a source.

Non-vaccinating nurses at other hospitals have to take isolation per-cautions(gloves, gown, mask). This is to protect them and protect the patients. Regardless of whether YOU think vaccines work – science sure thinks that they do, and the employers have a right and a duty to protect those under its care.

The Patriot Nurse is a sham. She states in her video that saying this comes as a great cost to her as a nurse. If she so firmly believes in her anti-vaccination rhetoric – so much so that she would post it online AND STATE THAT SHE WAS A NURSE – then she should be well aware of the potential consequences.

All of you crying “free speech” are being deceived. The Patriot Nurse has deleted EVERY SINGLE comment that was not entirely supportive of her. You can’t claim that her free speech is in jeopardy while she refuses that right to others.

The Patriot Nurse made a video. A stupid video. In which she makes very very basic scientific errors. She was called to answer to those errors on her page, on this blog, on Orac’s blog and elsewhere. She refused to do so. She is not interested in having a dialogue. She had her little diatribe and that was that. NO ONE is so special that they can make sweeping, erroneous statements without recourse.

I know that you anti-vaccination activists have a lot of other anti-vaccination friends online. But the fact of the matter is that 94% of people are still vaccinating. You’re a blip on the radar. You’re the new “trendy” thing to be against. But when it comes down to it, all but a handful of people are intelligent enough to realize that:

1) there is NOT a global conspiracy of scientists and doctors trying to poison your children

2) a few bad nurses or doctors do not discount the whole of the scientific method; nor are the opinions of a few more valid than the opinions of millions

 3) researching vaccines on Google is NOT equal to going to post-secondary education for 10+ years to be a physician, pediatrician, immunologist or what have you.

The Patriot Nurse is not a martyr. She is a nurse who is expected to uphold the ideals and principles of her nursing organization and employer. And seeing as those things adhere to evidence-based medicine – and she doesn’t – she now has a problem. She brought it on herself. It was her choice not to vaccinate, and it their choice (and DUTY to the public) to deal with her how they see fit.

A Tribute To Bob Keegan, by Amy Pisani

Bob Keegan at ECBT’s 20th Anniversary Gala in October – I was so thrilled to see him after many years.

This past Monday an my old friend, Bob Keegan, succumbed to his battle with cancer.  Since hearing the news, I’ve struggled to find the words to write about his incredibly selfless efforts to save the lives of literally millions of children; partly because I know that he’d be the first to demand that instead I should go out and take a hike with my bike…literally, or grab a beer and toast him instead.  Yet, I can’t help but wonder whether he was aware that in addition to dedicating his own life towards saving the lives of people throughout the world, that he inspired untold numbers of his peers to strive to also make a difference in the lives of others?  Bob Keegan was the type of man who always gave credit to others for the accomplishments that so often he himself envisioned and facilitated.

When Bob was in his early twenty’s he began his 30 year career with the Centers for Disease Control and Prevention (CDC) within the branch that is known as STD control (sexually transmittable disease control) working as a public health advisor in Newark, NJ, New York City and eventually Atlanta, GA – home of the CDC.  He helped to develop the first pre- and post-test counseling for HIV/AIDS during a time when the nation was first coming to grips with what would soon become a sexually transmitted disease epidemic.  He then spent five years coordinating CDC’s efforts to assure that refugees from Southeast Asia were properly immunized and treated for communicable diseases.

In 1991, Bob joined the newly formed Polio Eradication Activity Section of CDC along with five other dedicated individuals and a budget of only $3 million.  As the deputy director of what is now called the Global Immunization Division, the staff grew to 110 with a budget of $150 million.  Since 1988, the number of polio cases reported worldwide declined by 99 percent!  That translates into a disease that once infected 350,000 people every year in South Africa and Asia, now affects 1,000 children each year.  Yet, as I celebrate the writing of that number; I just felt Bob smack me over the head to tell me that 1,000 children is unacceptable when that number is zero here in the U.S.  Of course he is right, and so the charge continues on. Read more…