Shot of Prevention

Last week I made the nine-hour round trip trek up to beautiful Montpelier, Vermont to testify in front of the House Committee on Healthcare.  As I made my way over the lovely mountain towns and stunning valleys en route to the hearing, I was certain that my testimony could help sway the committee to vote in favor of the Senate’s bill to eliminate “philosophical beliefs” as a reason to override Vermont laws mandating vaccination of children enrolled in licensed daycares and public schools.  With the strength of Every Child By Two’s board and cofounders behind me, and the personal stories of families whose children have suffered the consequences of vaccine preventable diseases, I made my way across the state confident that we could make a difference.

As I sat in front of the committee, the chairman made it clear that the committee had already spent the week reviewing mounds of data on exemption rates and vaccination levels, listening intently to opinions from both sides of the issue and were hoping to hear something new.

With the gauntlet laid before me, I began by explaining why our organization, a national organization based in Washington, DC, would be concerned with the public health mandates of the state of Vermont, or any other state for that matter.  Why would a former first lady and the wife of a retired Senator continue to be concerned about the vaccination policies that exist in every state to ensure the health of school-age children? I explained that our founders, Rosalynn Carter and Betty Bumpers, began their efforts to vaccinate the children of their own home states during their tenures as First Ladies of Georgia and Arkansas in the early 70s.

During the Carter Administration Mrs. Bumpers, whose husband had since been elected to the U.S. Senate, worked side-by-side with First Lady Rosalynn Carter to establish the National Childhood Immunization Initiative with two goals: the attainment of childhood immunization levels of 90% by 1979 and establishment of a permanent system to provide comprehensive immunization services to the 3 million children born each year in the U.S.  During that time, Mrs. Carter and Bumpers were instrumental in the passage of laws mandating school-age vaccination prior to enrollment in public schools in every state. They traveled all over the country to speak to legislatures about this important issue because they knew it would save the lives of children. 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…

I’m always amazed at the clever ingenuity of non-profit organizations and public health agencies that focus on disease prevention.   They typically have a long list of ambitious objectives, and a short list of resources to help accomplish them.  They are often tasked with communicating complicated messages that are of great importance, but are not nearly as entertaining as the flashy campaigns we see for popular consumer products. That is why I’m excited about the various entries in the Awesome Disease Prevention Project Contest that PKIDS (Parents of Kids with Infectious Diseases) is currently sponsoring on Facebook.

Not surprisingly, the recurring theme of each of these entries is one of community awareness. While the projects are designed to be engaging to a variety of audiences, they all illustrate various ways that we can help educate people about disease prevention.

There are two specific programs that I am personally excited about due to my education efforts here on Shot of Prevention. The first is a program suggested by the Autism Science Foundation that will help to eliminate the disturbing trend of reduced immunization uptake among younger siblings of children with autism. The second is the Shot By Shot program which captures personal stories of vaccine preventable diseases and is a wonderful example of how immunization advocates are collaborating in their educational efforts. Shot by Shot has been effective at connecting the resources of various organizations and compiling the media into a comprehensive story library that can be utilized by immunization advocates around the world. The stories not only help to educate people about the dangers of various diseases, they also reminding people about the value of prevention. Read more…

Each year, our local elementary school organizes a Heritage Night to celebrate the global diversity that exists within our school community.  This special event encourages both students and their parents to share their cultural cuisine, traditional dress and honored customs with one another in an engaging and interactive way.

The first year my family and I attended Heritage Night, I knew very little about the cultural diversity of the 500 elementary students who attend my children’s school in northern Virginia, just outside of Washington, DC.  But now, three years later, I feel privileged to know that my children live in such a diverse community with direct ties to dozens of different countries. The fact is that some of my children’s best friends come from Afghanistan, Bolivia, Ethiopia, Korea, India and many other places around the globe.  Even those students who were born in the U.S. still have family ties in other countries and frequently travel overseas to visit.  Many of them have witnessed the differences in living conditions, schooling and health care that occur in these other  countries and they share these experiences at Heritage Night.

Fortunately, as these children forge friendships with their peers, they gain a better understanding and appreciation of what life is like outside of the U.S.  Heritage Night provides an excellent opportunity to educate children about the importance of being global citizens.  That is not to say that we don’t want them to appreciate their citizenship in the United States.  We certainly do.  However, if we can acknowledge the benefits and privileges that we do have, we can also understand how important it is for us to help others.  By cooperating with other nations, both now and in the future, we can work to address the most important and far-reaching international challenges that exist.

That is especially true when it comes to providing children with a shot at a healthy life.  So, in honor of Heritage Night, I called upon the students and parents who were present to join me in advocating for better access to life-saving vaccines by supporting the UN Foundation’s Shot@Life campaign. Read more…

We covered this before and will no doubt cover it again.

The use of philosophical vaccine exemptions available in many states allow children to attend public schools without the state mandated vaccinations.  In some states, such as Vermont, there is concern about the growing use of these exemptions and how an increased number of unvaccinated children may threaten the health of other students.  There are a number of new laws in various states to address these concerns, some even calling for a more comprehensive discussion of vaccinations benefits before allowing parents to opt out of the required vaccines.

In Vermont a recent bill to remove philosophical exemptions has passed the Vermont State Senate with a 25-4 vote in favor of the new legislation.  However, even with overwhelming support in the State Senate, there may still be a struggle to get it through the House.  Currently, the bill has been assigned to the House Health Care Committee for further review, who are already hearing from opponents of the bill.

A recent op-ed from Dr. Lou DiNicola, a pediatrician at Gifford Medical Center in Randolph and the president of the American Academy of Pediatrics Vermont Chapter ran in the Valley News and the Rutland Herald.  It highlighted the concerns that parents and pediatricians have in regards to the use of philosophical exemptions in Vermont, stating,

“Last year 5.4 percent of all kindergarteners, or more than 1 in 20, were enrolled in public schools by parents who used the philosophical exemption to avoid immunizations. The recent surge in the potentially deadly but preventable disease whooping cough is an indicator of how Vermont’s reduced immunization rate is leading to real-world consequences. Last year the Department of Health reported 91 cases. In 2010 it was only 18.”

If you would like to help protect the health of children in Vermont by supporting the removal of the philosophical exemptions, it’s important that you take action by contacting the Speaker of the House Shap Smith,  the House Health Care Committee and your representative or all representatives.  You can also call and leave a message at the State House for a committee member to call you back at 802-828-2228.

The committee may also be planning a public hearing one evening next week and we will be sure to keep you updated on any further information we receive.  If this bill is to proceed it can not be accomplished without your involvement at this critical time.

Of course, we welcome your comments about this bill and hope you will let us know if you plan to take action to support it.

Representative Shap Smith, Speaker of the House
(802) 828-2245 or speaker@leg.state.vt.us

House Health Care Committee
Mike Fisher of Lincoln, Chair  – (802) 453-5517 or mfisher@leg.state.vt.us
Sarah Copeland-Hanzas of Bradford, Vice Chair – (802) 222-3536 or scopelandhanzas@leg.state.vt.us
Paul Poirier of Barre City, Ranking Member - (802) 476-7870 or ppoirier@leg.state.vt.us, paulpoirier33@gmail.com
Leigh Dakin of Chester, Clerk  – (802) 875-3456 or ldakin@leg.state.vt.us
Jim Eckhardt of Chittenden – (802) 342-0140 or jeckhardt@leg.state.vt.us
Patti Komline of Dorset - (802) 867-4232 or pkomline@leg.state.vt.us
Mary Morrissey of Bennington – (802) 442-2092 or mmorrissey@leg.state.vt.us
Chris Pearson of Burlington – (802) 860-3933 or cpearson@leg.state.vt.us
Kristy Spengler of Colchester – (802) 864-6567 or seashre@msn.com
George Till, M.D. of Jericho – (802) 899-2984 or gtill@leg.state.vt.us
Mark Woodward of Johnson – (802) 635-7166 or mwoodward@leg.state.vt.us

States all across the country are becoming battle grounds for vaccine exemption laws.  As some grow concerned about the ease in which people can obtain immunization exemptions, they are calling for the tightening of philosophical exemptions that currently allow unvaccinated children to attend public school.  In the past few weeks, we’ve seen vaccine related legislation in states such as Vermont, Kansas, South Dakota and West Virginia and people on both sides of the issue are voicing their concerns.

In order to weigh the implications of any proposed legislation, it’s important to first understand the reasoning behind state vaccination requirements and exemptions.

Contrary to what anti-vaccination groups say, vaccines are not forced upon anyone.

While the Food and Drug Administration (FDA) regulates vaccines to ensure safety and effectiveness, there are no federal vaccination laws.  However, just as the government requires immunizations for those who volunteer to join the military, and health providers may require employees to be vaccinated in a medical setting, immunization requirements for public school enrollment are determined by individual states.  Parents are not forced to vaccinate their children.  Rather, they’re given a choice as to whether they want their children to attend public school and therefore be vaccinated according to state admission policies.

All states offer vaccine exemptions.

According to the Institute for Vaccine Safety, as of August 2011, all 50 states and the District of Columbia permitted medical exemptions from immunization requirements.  In instances of cancer, immune disorders and allergy to vaccine components, vaccination is medically contraindicated and necessitates the use of a medical exemption since vaccination could be detrimental to the health of a child.   However, non-medical exemptions are also available through religious exemptions in 48 states and philosophical/personal belief exemptions in as many as 20 states.   While exemptions often differ by state, the process by which parents can obtain these exemptions has recently been cause for concern among public health professionals.

For example, in some states the current exemptions are exercised by simply signing a pre-written statement on a school immunization form or writing a personal letter explaining one’s reasons for refusing vaccination.  More recently, in states like Washington, new laws are suggesting that non-medical vaccine exemptions must be accompanied by the signature of a medical professional.  The intent, as I understand it, is to ensure that parents aren’t using the exemptions as a matter of convenience.  By requiring a discussion with a trained and qualified medical professional, health departments can make certain that parents aren’t using exemptions to avoid a trip to the doctor’s office.  The requirement also helps to ensure that parents are properly informed regarding the benefits of vaccines and the risks of vaccine refusal.

There is reason to be concerned about high exemption rates. Read more…