Shot of Prevention

Most of the topics I post about on this blog are intended to encourage conversation about solutions to immunization challenges.  However, more often than not, the comment section on each post is inevitably derailed by those who wish to discredit the value of vaccines.  These visitors often make repeated claims about the thoroughly debunked vaccine/autism link, or they suggest that the immunization industry is plagued with corruption, or even that there is some large government conspiracy in which they claim that toxins in vaccines are intended to poison us all.  This is not to say that this blog is the only place where this type of conversation occurs.  Sadly it is not.  In fact, for every article that attempts to credit vaccines in some way, you can pretty much bet that there will be negative comments in response.

Fortunately, there are plenty of well-educated people out there who spend a great deal of time and effort diligently responding to these inaccurate claims.  They consistently defend the science that supports vaccinations and try to correct the logic of those who consistently criticize vaccines.  They are much more eloquent than I and no doubt, have far greater patience.

But I must acknowledge that there are also a great number of people who read these posts, and lots of other immunization information, in an effort to learn more about vaccines.  They may be curious about something they read elsewhere online, or they may be concerned about something they heard from a friend or family member.  They may even be inquiring about an immunization recommendation they received from their doctor.  Each of these readers have valid concerns and questions and we hope that this blog will help them get the information they are seeking.

However, as I was recently reviewing the varied comments on this blog, I realized that many comments may be confusing to those who don’t engage in immunization conversations on a daily basis.  Then, as I was discussing critical thinking with my high school daughter the other day, I remembered these insightful videos that a friend shared with me.  As basic as they may be, I believe they can offer us some points to consider as we read through the various comments on this blog.

Take for instance this first video, which expands upon the way in which we use logic in formulating an argument.

The second video introduces how broken logic, or “logical fallacies”, can easily be mistaken for logic. Read more…

The California Immunization Coalition (CIC) is proud to be a co-sponsor of AB 2109 (Pan) Vaccine Preventable Diseases along with the American Academy of Pediatrics – CA District, the California Medical Association, and the Health Officers Association of California which has the goal of improving vaccination rates and reducing the use of the personal belief exemption out of convenience in the state of California.

After speaking with the CIC, they explained that their main focus in on ”reducing the number of exemptions by convenience with a goal of keeping our schools and our community safe for children”.

Their primary message on this bill is NOT that they want to stop families from obtaining a personal belief exemption.  This bill does not prevent a family from refusing one or more school entry vaccines. Rather, it introduces an “information step” into the process, which is accomplished by the family and a physician, nurse practitioner or physician assistant signing a simple form that indicates the parent received information on the benefits and risks of vaccines from that health care provider.  This information step was introduced based on the following considerations:

• Parents deserve to have reliable information to support the healthcare decisions they make for their family.
• Children who are exempted from vaccines are at significant risk for diseases.
• It’s important that the state ensure that requests for exemptions from immunization are based on conviction, not convenience.

You will find the AB 2109 Fact Sheet here and the current text of bill here where you can also subscribe to bill updates. Read more…

Last week, Dr. David Katz, the founding director of Yale University’s Prevention Research Center, wrote an article for the Huffington Post.  He explained his concern about the future of public health, stating that if we continue a trend towards rising rates of preventable diseases, coupled with declining rates of vaccination, that we may be taking a step backwards in the future.

One of my favorite quotes from this article pertained to Dr. Katz’s comments on the prevalence of vaccine misinformation in which he states,

“But in the internet age, crazy, paranoid nonsense and hard-earned, thoughtful, evidence-based expertise have the same megaphone.”

I particularly love his use of the word megaphone.  But I disagree with his statement.

Yes, crazy, paranoid nonsense is often amplified online, much like being broadcast with a megaphone.  However, in my opinion, the hard-earned, thoughtful, evidence-based expertise is barely audible in comparison.  Sure, Dr. Katz is doing his part by contributing to the Huffington Post, but I believe that many more megaphones are needed  if we are to adequately address certain public health challenges such as a possible decline in vaccination rates.

The way I see it, the majority of people who support vaccination (illustrated by the fact that they are themselves vaccinated) aren’t engaged in the conversation.  Sure they recognize the dangers of disease.  They even understand the benefits of vaccines.  That is why they comply with the recommendations of their doctors and other experts.  But that is often where there their engagement ends.  It’s not a selfish thing; it’s just that they don’t feel the need to be involved in the discussion.  I believe there are many people who don’t even realize that vaccine hesitancy exists.  Which helps explains why people don’t really understand the threat that vaccine hesitancy has on our public health.  It’s not that they don’t want to help.  It’s just that they don’t see the need.

Yet, if you visit a parenting chat group these days you’ll find that there are plenty of parents who come to these forums seeking information about vaccines.  Just as they have questions about breastfeeding, developmental milestones and discipline techniques, these parents often rely on the “expertise” of other parents who’ve “been there”. Read more…

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.

Shots aren’t just for babies.

In fact, it is recommended that children receive booster shots for various preventable diseases throughout their adolescent years.  And recently, since bacterial meningitis has proven to be a serious, sometimes fatal, disease that is easily spread on college campuses, several states have begun requiring a meningitis vaccine for college students living in dorms.  However, as a direct result of Senate Bill 1107, the state of Texas has now taken these precautions one step further. As of January 1st, a new law has taken effect that makes Texas the first state to require a bacterial meningitis vaccine for all college students under the age of 30, even if they are not living on campus.

Students will be required to provide evidence of vaccination by Friday, Jan. 27 by providing an official immunization record, school vaccination record or the signature or stamp of a physician or health official showing the month, day and year the vaccination or booster was administered.  Though other states often require meningitis vaccinations for 11- and 12-year-old students – with a recommended booster dose at 16 – none go as far as Texas law. Most states only attempt to make students aware of the vaccine, but Texas will be the first to require the vaccination during the five-year period before, or at least 10 days prior to, the first day of the semester for all students.

In a recent article, published in The Monitor, Kim McKay, interim dean of enrollment at South Texas College is quoted as saying, “…we are trying to take all of the proper precautions to protect the health and well-being of our students.”

As you can see in the video below, meningitis often strikes quickly and aggressively.  Since many people are unaware of just how serious the consequences can be, it’s best to hear about the implications of this disease from families who have had first hand experience to share.

While this video was compiled by the National Meningitis Association, there are numerous other stories like these compiled on the Shot by Shot website.

If you know a college student who is currently home on winter break, suggest that they be vaccinated before they return to campus.  We also encourage you to share these stories with friends and  family and check the immunization records for your younger children as well.  A simple vaccine can help save the lives and limbs of those you love.

For more information, please check out these great resources:

National Meningitis Association

Meningitis Angels

The Centers for Disease Control and Prevention:  Meningitis Questions and Answers 

When I was first approached to contribute to this blog, I wasn’t sure I would have enough material to contribute on a regular basis.  Since then, I’ve recognized that when it comes to immunization issues, there is just so much to discuss.  Now, as I reflect on the past year, I realize that one of the greatest gifts I’ve received has been becoming part of this special community.  

Throughout the past year, we have seen continuous growth among the readers of this blog and the participants on our Vaccinate Your Baby Facebook page.  We continue to attract a caring community of parents, medical professional, health care workers and public health advocates who actively participate in immunization discussions by offering their thoughts, opinions, experiences and expertise.  We hope that we can continue the momentum, and ask that you suggest your family, friends and work colleagues join us for more lively conversations in the new year. 

As we “wrap” up 2011, we will be highlighting our most popular posts of the year.  If you’ve read them before, you can now share them with others and encourage them to join us for more immunization discussions.  If you’ve yet to see these posts, than you may be interested in seeing what issues have captured the attention of our regular participants.   

Today I’ll be highlighting a post that addresses a recurring question I hear from parents; “Why Worry About the Unvaccinated?”  Without the proper understanding of both the benefits and limitations of vaccines, it’s difficult to understand how the unvaccinated population could ever pose a threat to anyone but themselves.  However, this post encourages readers to consider the unintended consequences for all.  

Why Worry About the Unvaccinated?

Time and again, we hear this from parents who choose not to vaccinate their children.

“If your child is vaccinated, why are you worried about them catching anything from my child?”

This is a common response from parents when it is suggested that a purposely unvaccinated child poses a threat to others.

One thing that many parents may not understand is that while vaccinations are highly effective, and greatly decrease the chance of contracting preventable diseases, no vaccine is 100% effective.    According to CDC reports, “most routine childhood vaccines are effective for 85% to 95% of recipients.   For reasons related to the individual, some will not develop immunity.”

This explains why, during an outbreak of a vaccine preventable disease, an unvaccinated child can increase the risk of disease for everyone that may be exposed, even if the people who have been vaccinated vastly outnumber those who have not.  It is not uncommon for a small portion of the vaccinated population to be infected, However, that does not prove that vaccinations are not effective.  To truly understand the risks, you need to know more than just the number of vaccinated vs. unvaccinated who have become infected.  You have to appreciate the percentages that are involved.  For instance, this example offered on the CDC website, explains this concept quite clearly:

“In a high school of 1,000 students, none has ever had measles. All but 5 of the students have had two doses of measles vaccine, and so are fully immunized. The entire student body is exposed to measles, and every susceptible student becomes infected. The 5 unvaccinated students will be infected, of course. But of the 995 who have been vaccinated, we would expect several not to respond to the vaccine. The efficacy rate for two doses of measles vaccine can be higher than 99%. In this class, 7 students do not respond, and they, too, become infected. Therefore 7 of 12, or about 58%, of the cases occur in students who have been fully vaccinated.

As you can see, this doesn’t prove the vaccine didn’t work – only that most of the children in the class had been vaccinated, so those who were vaccinated and did not respond outnumbered those who had not been vaccinated. Looking at it another way, 100% of the children who had not been vaccinated got measles, compared with less than 1% of those who had been vaccinated. Measles vaccine protected most of the class; if nobody in the class had been vaccinated, there would probably have been 1,000 cases of measles.”

When we consider this in relation to what is currently happening in our own communities today, we see why there is reason for the vaccinated to be concerned.  (To continue reading this blog post, click here.)