Shot of Prevention

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…

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…

Calling All Vermont Families!! – A bill has been introduced in your Legislature that will remove the clause that allows parents to casually check off “philosophical exemptions” as a reason for waiving school vaccination requirements for children in public schools.

If you are from the state of Vermont, we urge you to write to your Senator today to ask that he/she support this important bill (Senate Bill 199 or SB199).  Below is a letter sent yesterday on behalf of Every Child By Two.  Many of our partner organizations have also sent letters to express their support for this important change.  Feel free to borrow from the letter below to create your own letter.  You can also call and leave a message in support of SB199 with Senator Claire Ayer who serves as the chair of the Senate Committee on Health and Welfare at (802) 545-2142

Please also take a moment to add your signature to our petition at Change.org

You can also send your own letter to your Vermont State Senators by using this template Read more…

Science continues to fascinate me!  Personally, I have been grateful for modern medicine many times throughout my own life.  I have seen a premature baby, who arrived weighing  just a few pounds, grow into a thriving child.  I have seen courageous men return from war as amputees, who go onto run marathons.  I have had family members live long lives after having triple bypass surgery.  So to say that I value medicine and science is an understatement.

I guess that is why I can’t seem to understand why some people question the number of vaccines on the current immunization schedule.  I consider it a blessing that medical advancements can now protect our children from such a large number of dangerous diseases.  And today, I’m reminded that modern medicine continues to offer a great deal of promise for people who already suffer from various diseases.  It’s based upon the idea that vaccines can actually help us heal.

For the past 30 years, researchers have been working on therapeutic vaccines.  As today’s Boston Globe explains, ”Just as conventional preventative vaccines use the immune system to prevent disease, therapeutic vaccines use the immune system to target and kill a disease already in progress.”

The article acknowledges that there have been ”major failures and minor victories” in this area of research over the years, but that now, “researchers may at last have a deep enough understanding of the immune system to make a difference.”

“Right now, we’re finally at a point where at least the preliminary tools exist for us to deliver something that will start a new trend in medicine,’’ said Garo H. Armen, chief executive of Agenus Inc., a Lexington biotechnology company that is developing a therapeutic herpes vaccine.

In addition to vaccines that attack herpes, therapeutic vaccines are currently under development for hepatitis C, chlamydia, HIV, diabetes, other autoimmune disorders, and there are even vaccines that target nicotine and various cancers.

While I’m sure there will be critics of these advancements, I hope people will be encouraged to learn more about these advancements, as mentioned in today’s Boston Globe.

I am grateful that scientists are working hard to discover new ways we may be able to supplement our own natural defenses.  But I wonder, what are your thoughts and opinions on therapeutic vaccines?

Three times a year the National Vaccine Advisory Committee (NVAC), which is an advisory group to the U.S. Department of Health and Human Services (HHS), meets to discuss vaccine related topics.  This week the Committee met and discussed a number of issues, including the Healthy People 2020 goal to reach 90% influenza vaccination rates among health care personnel.   Since flu vaccination rates among health care workers is currently around  63%, the Assistant Secretary of Health requested that the Committee propose recommendations for hospitals and other health facilities to help achieve the goal outlined by the Health People 2020 document.   After a year of deliberation among NVAC subcommittee members, representing a wide variety of views on this issue, the full committee voted on the following five recommendations:

1. Establish comprehensive influenza infection control programs in hospitals that include education on how to prevent flu transmission with tools such as hand hygiene, cough etiquette, free access to flu vaccines, and information on the benefits and misconceptions of flu vaccines.
2. Health care employees and facilities should integrate flu vaccination programs into existing flu prevention and occupational health programs.
3. Continue efforts to standardize methods on how to measure health care worker vaccination rates.
4. Facilities that can’t reach and  maintain 90% vaccination level without the first three steps should strongly consider mandatory flu vaccination policies and may consider exemptions.
5. Develop new and improved flu vaccines and vaccine technologies.

Prior to adopting these recommendations, the Committee received extensive written public comments.  Additionally, during the meeting several health care workers  presented verbal testimony in opposition of the fourth recommendation that suggests facilities consider mandatory flu vaccine policies if they can’t raise vaccination levels after completing the first three steps.  With each comment, those opposing these recommendations focused on the rights of the individual nurse and health care worker.  However, no mention was made of those who may suffer from the actions of health care workers who may unwittingly spread deadly influenza virus to at-risk patients.

Executive Director Laura Scott is pictured here along with Families Fighting Flu Board Members

Fortunately, after about 30 minutes of comments made in opposition to this specific recommendation, Laura Scott, Executive Director of Families Fighting Flu, stood and addressed the Committee.  She strongly supported all the recommendations on behalf of the members of Families Fighting Flu.  She spoke of how concerned they were about unvaccinated health care workers and she reminded the Committee that these workers are not only a threat to themselves, but to the most vulnerable in our society, including our children.  Her public comment went as follows: Read more…