How My Sister Helped Save My Daughter From Whooping Cough 

June 19, 2017 11 comments

TamaraSheffieldHeadShotBy Tamara Sheffield, MD, MPA, MPH, Medical Director, Community Health and Prevention, Intermountain Healthcare

In my role as a medical director at Intermountain Healthcare in Salt Lake City, Utah, I am responsible for Community Health and Prevention.  You could say that I’m a professional advocate for immunizations, since they prevent many illnesses, hospitalizations and even deaths.  In fact, maternal immunizations are one of today’s most promising new preventive health strategies.

By vaccinating pregnant women against certain diseases – like whooping cough (pertussis) and influenza – we are reducing the amount of illness, hospitalization, miscarriage and pre-term labor these women experience as a result of these diseases.

Additionally, maternal vaccines enable pregnant women to pass on protective antibodies to their unborn babies.  These antibodies provide newborns with early, short-term protection against pertussis or flu, during the time when they are too young to receive their own vaccines to prevent these diseases.

For instance, children must be six months of age before they can receive their first flu vaccination, and the DTaP vaccine, which helps prevent whooping cough in children, is administered as a series of five shots (with doses at 2, 4, 6, 15-18 months, and 4-6 years of age). Sadly, there are about 100 pediatric deaths due to influenza each year, and 90% of all deaths associated with whooping cough are among infants, mostly because the thick mucus that accompanies the infection has a severe impact on a baby’s ability to breath.

For an expectant woman, changes in the immune system, heart and lungs during pregnancy make them more prone to illness.  When a pregnant women gets ill, it raises her risk of complications, such as premature labor and delivery.  But research shows that mothers can help protect themselves and their babies by getting vaccinated during pregnancy.

The flu vaccine is recommended at any trimester of each pregnancy. An adult Tdap booster vaccine is recommended during each pregnancy as well – and studies show that the best time for optimal transfer of protective antibodies is at 27-to-36 weeks gestation. The ongoing research continues to indicate that these maternal immunizations are effective at reducing the number of flu and whooping cough-related illnesses, hospitalizations and deaths among infants.

The abundance of scientific evidence on this matter is one reason I am a strong advocate for maternal vaccinations.  However, I have a very personal reason to advocate for maternal vaccinations as well.

You see, I know an amazing 25-year-old young woman who nearly died from whooping cough when she was just three weeks old. 

Alicia Outside ICU at Phoenix Childrens' Hospital

Like many infants who suffer with whooping cough, this beautiful baby girl contracted it from a family member.  During the weeks before delivery, her mother developed a persistent cough that went undiagnosed, and she unknowingly passed whooping cough on to her baby.  Three weeks later, after a couple of incidents where the baby stopped breathing and turned blue, her parents rushed her to the hospital. Read more…

Contact Your Senator to Prevent Devastating Cuts to Immunization Programs

June 15, 2017 1 comment

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Every Child By Two has a long history of advocating for immunization funding and strong immunization policies. As the Senate is now considering two crucial pieces of legislation — the American Health Care Act (AHCA) and the Fiscal Year (FY) 2018 budget — we are calling upon the public to speak out in support of #PreventionProtection. Both of these pieces of legislation could impact vaccine programs in a way that limits access for millions of Americans.

It is critical that we help Senators understand the impact of their legislation on public and individual health before they finalize the bill language. Time is of the essence, so we are encouraging everyone to take action this week.

Please call AND email your Senators TODAY with this critical message:

Call your Senators to say:

I am a constituent and am calling to urge Senator X to ensure CDC’s immunization programs continue to be fully funded, both through direct appropriations and through preservation of the Prevention and Public Health Fund.

It is also critical to preserve first dollar coverage in private health plans and Medicaid. Coverage for vaccines is critical to our nation’s health and integral to accessing cost-saving and potentially life-saving vaccines.

Please support public health funding and oppose any aspects of the American Health Care Act which would slash these critical investments.

To ensure your Senator is getting the message, follow-up with an email that reads:

I am writing to express my concern about public health funding. While vaccines may not be specifically targeted, the American Health Care Act and the president’s budget will have consequences for immunization efforts.

The President’s proposed budget would cut vaccination programs by $82 million. Should Congress eliminate the Prevention and Public Health Fund (PPHF), this would further compound the problem, eliminating another $324.4 million the CDC utilizes to combat vaccine-preventable diseases. The CDC uses this money to: purchase vaccines and manage supply; monitor vaccine safety; educate; conduct disease surveillances and respond to outbreaks; and support funding for state, territory, and city immunization programs.

Pair this loss of funding with the American Health Care Act’s proposed cuts to Medicaid and we could face a public health crisis.

We are already facing costly outbreaks of vaccine-preventable diseases: the country is dealing with ongoing outbreaks of measles in California, Florida, Maryland, Michigan, Minnesota, Nebraska, New Jersey, New York, Pennsylvania, Utah, and Washington.  In Minnesota over 7,500 people were exposed and 70 cases were confirmed in the past two months. Since 2014, over 1,000 cases of measles were detected here in the U.S. The CDC estimates that it costs approximately $140,000 to contain each individual case of measles ($143.5 million since 2014). And every single measles case requires follow up.

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Measles is the “canary in the coal mine.” Because the disease is so highly contagious, when measles immunization rates begin to slip below 95 percent, we begin to see outbreaks. It is often the first sign of other serious vaccine-preventable outbreaks.

Pertussis, or whooping cough, cases are on the rise. And several universities in the U.S. experienced outbreaks of meningococcal serogroup B disease, a devastating illness that causes lifelong debilitation or death.

Gaps in vaccine infrastructure also leave us susceptible to emerging threats such as the Zika virus, which can cause devastating birth defects when a woman contracts the disease while pregnant. It is essential that we not only develop more and better vaccines, but also maintain a sound infrastructure and capacity to deliver and track those vaccines within the healthcare system.

It has been reported that the U.S. spends nearly $27 billion annually treating just four vaccine-preventable diseases that afflict adults over 50 years of age: influenza; pertussis; pneumococcal disease; and shingles. The majority of these avoidable costs are borne by federal health insurance programs.

Vaccinating, however, is cost saving. For each dollar invested in the childhood immunization program, the U.S. saves over $3 in direct medical costs and $10 ten dollars in societal costs. Government programs play a key role in the success of immunization programs. For example, over the past 20 years the Vaccines for Children program has prevented 322 million illnesses, 732,000 deaths, and nearly $1.4 trillion in societal costs.

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The solution is in your hands:

  • Ensure CDC’s immunization program continues to be fully funded, both through direct appropriations and through preservation of the PPHF.
  • Continue first dollar coverage in private health plans and Medicaid. Coverage for vaccines is critical to our nation’s health and integral to accessing cost-saving and potentially life-saving vaccines.

To find the contact information for your Senators, please use Who Is My Representative?

Please also consider participating in Trust for America’s Health “Day of Virtual Advocacy” in support of the Prevention and Public Health Fund (PPHF) by clicking here.

They are requesting that those individuals or organizations with Twitter accounts consider tagging their Senators in any of these sample tweets using the #ProtectPrevention hashtag:

  • The Prevention Fund is 12% of CDC’s Budget. Eliminating it decimates core public health programs #ProtectPrevention
  • Chronic disease = 70% of deaths & 86% of healthcare costs. Reduce spending by investing in prevention. #ProtectPrevention
  • The Prevention Fund has invested > $6 billion in resources to states & local organizations to promote good health #ProtectPrevention
  • Oppose the AHCA, which would eliminate the Prevention Fund #ProtectPrevention
  • The Prevention Fund helps prevent deadly infectious disease outbreaks; would be eliminated by AHCA #ProtectPrevention

For more background information about the proposed cuts to prevention funding, refer to the following partner resources:

Association of Immunization Managers: Potential Impact of the Elimination of PPHF Funds (on the 64 State, Local and Territorial Immunization Programs)

Adult Vaccine Access Coalition:  Health Reform Fact Sheet, Health and Economic Benefits of Adult Immunizations

Thank you again for your support of immunizations!

What Parents of Every Teen Should Know About Meningitis

The most important thing parents of teens need to know about meningococcal disease is that it can be very serious.  And by serious, we mean debilitating and often deadly.

Even with prompt medical treatment, about 1 in 10 people with meningococcal disease will die from it. Of those who survive, about 1 to 2 will have permanent disabilities such as brain damage, hearing loss, loss of kidney function or limb amputations.

The best thing parents can do to protect their children from meningococcal disease is to get them vaccinated against all of the preventable forms of the disease.

 What causes meningitis and meningococcal disease?

Meningitis refers to a swelling of the protective membranes that cover the brain and spinal cord.   While meningitis is commonly caused by a bacterial or viral infection, it can also be caused by injuries, cancer, certain drugs, and other types of infections.

Meningococcal disease is specific to any illness caused by the bacterium Neisseria meningitidis (also referred to as meningococcus or meningococcal meningitis).  These types of infections can cause meningitis, but can also cause bloodstream infections (known as bacteremia or septicemia).

It’s possible to have meningitis without having meningococcal disease, and it’s possibly to have a type of meningococcal disease that isn’t necessarily meningitis.  The specific cause of illness is important to identify because the treatment differs depending on the cause.

  • Bacterial forms of meningitis can be extremely dangerous and fast-moving and have the greatest potential for being fatal. The long-term effects of bacterial meningitis can include multiple amputations, hearing loss and kidney damage. Many, but not all, forms of bacterial meningitis can be prevented by vaccination.
  • Viral meningitis has similar symptoms to bacterial meningitis, but for the most part is neither as deadly nor as debilitating. There is no specific treatment available for viral meningitis, but most patients fully recover over time.
Meningococcal Disease Facts

Who is at risk?

While anyone can contract meningococcal disease, adolescents and young adults are among the population who have a higher risk for the disease due to their lifestyle factors.  For instance, the risk of meningococcal is higher for those who are living in crowded settings such as college dormitories, boarding schools, sleep-away camps or military barracks. Other factors that can raise the risk of infection include:

  • Attendance at a new school with students from geographically diverse areas
  • Irregular sleeping patterns
  • Active or passive smoking
  • Social situations where there is crowding
  • Moving to a new residence

How is it spread?

About one in ten people carry meningococcal bacteria in their nose or throat without showing any signs or symptoms of the disease. These people can unknowingly transmit the bacteria to others through the exchange of respiratory secretions during close or lengthy contact with someone’s saliva, such as through kissing or coughing, especially if they are living in close quarters.  Although meningococcal bacteria are very dangerous, they cannot live outside the body for very long.  This means that while contagious, the infection is not as easily spread as a cold virus.

How can it be prevented?

Currently, vaccination is the best defense against meningococcal disease. There are five major serogroups of meningococcal disease (A, C, W, Y and B). The three most commonly seen in the United States are B, C and Y, with one-third of all cases in the U.S. being of serogroup B.

In order to be protected against all the preventable strains of meningococcal disease, teens need to receive multiple doses of two different kinds of meningococcal vaccines.

Meningococcal Conjugate Vaccine (MenACWY):  Routine vaccination with the conjugate is recommended at age 11-12 to protect against serogroups A, C, W and Y. Adolescents should also get a vaccine booster dose at age 16.

Meningococcal Serogroup B Vaccine (MenB): This vaccine is recommended for people 10 years or older who are at increased risk for serogroup B meningococcal infections including:

  • People at risk because of a serogroup B meningococcal disease outbreak.
  • Anyone whose spleen is damaged or has been removed.
  • Anyone with an immune system condition known as “persistent complement component deficiency”.
  • Anyone taking a drug called eculizumab (Soliris).
  • Microbiologists who routinely work with N. meningitidis isolates.

The CDC also recommends permissive use of the MenB vaccine for adolescents and young adults age 16-23, with a preferred age of 16 to 18. A permissive recommendation means that it is at a doctor’s discretion whether they will recommend the vaccine to those who don’t fall into the categories listed above.  If a provider doesn’t feel the patient is at risk, they may fail to mention the availability of the vaccine.

This does not mean that a parent can’t request or receive the vaccine for their child.    

It’s critical that parents understand that serogroup B meningococcal disease is not only the most common cause of meningococcal disease in adolescents and young adults, but it has also cause several outbreaks on college campuses over the past few years.

Meningococcal Disease on U.S. College Campuses, 2013-2017

Graphic compiled by the National Meningitis Association

The vaccine has been deemed safe by the FDA, and has been recommended by the CDC, so parents should feel comfortable getting the vaccine for their child, especially if they feel they are at risk of exposure.  If a child is attending college, parents may want to take the precaution of getting them vaccinated before they arrive on campus.  In the case of an outbreak, the vaccine will be recommended.  However, if your child is exposed before the outbreak is identified than it may be too late to benefit from the vaccine.

What are the symptoms and can it be treated?

The symptoms of meningococcal disease are the same for all of the serogroups.  Unfortunately, it is not easy for healthcare professionals to identify and diagnose the infection in its early stages and it’s often mistaken for the flu or other viral infections.  Symptoms tend to develop over several hours or over one or two days, and may include:

  • Sudden high fever
  • Severe headache
  • Stiff neck
  • Vomiting or nausea with headache
  • Confusion or difficulty concentrating
  • Seizures
  • Sleepiness or difficulty waking up
  • Sensitivity to light
  • Lack of interest in drinking and eating
  • Skin rash

Meningococcal disease can be treated with antibiotics, but treatment must begin early to be effective. Even if treatment is started as soon as possible, it might not prevent death or serious long-term complications such as hearing loss, brain damage, kidney disease or limb amputations.

Today we are grateful for moms like the ones featured in this video who are helping to raise awareness about the two available meningococcal vaccines for adolescents and young adults. May their stories help parents to make educated decisions about disease prevention.

Visit the following websites for more information on the dangers of meningitis and how it can be prevented.

Vaccinate Your Family – PreTeens & Teens Meningococcal Disease

National Meningitis Association

The Kimberly Coffey Foundation

The Emily Stillman Foundation

Meningitis Angels

Why Should Vaccinated Individuals Worry About Measles Outbreaks?

The United States is well on our way to a record year for measles cases.  So far in 2017, we’re on track to see more cases this year than last year.

In the state of Minnesota alone, where a Somali-American community was encouraged to refuse MMR vaccine during visits from Andrew Wakefield and other vaccine critics, a drop in vaccination rates has resulted in a dangerous measles outbreak.  So far, the Minnesota Department of Health has identified 66 total cases spread among four counties, with many cases involving the hospitalization of children.

SOTI-MeaslesCasesIG As the number of measles cases in MN is expected to climb, health departments across the U.S. are beginning to identify other measles cases as well.

For instance, the Maryland Department of Health is investigating a potential outbreak after a patients was admitted to Children’s National Medical Center in the District.  The patient had previously sought medical treatment at Prince George’s Hospital Center in MD, exposing countless people in that area as well.  Meanwhile, a teenaged tourist staying in a NJ hotel contracted measles, and now the New Jersey State Health Department fear other people may have been exposed before the patient was treated at The Valley Hospital in Ridgewood, NJ.

With measles cases emerging across the U.S., and large-scale outbreaks of measles being reported by the World Health Organization in places like Romania and Italy, it’s important to ask if measles outbreaks should be a concern to those who are vaccinated.  

Aren’t vaccinated individuals protected during outbreaks?  And if so, why should we care if others remain unvaccinated?

When it comes to infectious diseases like measles, one person’s decision not to vaccinate can negatively impact the health of others.  There are plenty of unvaccinated individuals who rely on protection from the vaccinated, to include children under one year of age who are too young to be vaccinated for measles, individuals who have medical reasons that restrict them from being vaccinated, or people with compromised immune systems.  These individuals are all at great risk of contracting measles and suffering serious complications and the only protection they have comes from those who are vaccinated.

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In fact, in order to keep measles from spreading, about 92-95% of the population needs to be immune to the disease.  Unfortunately, in the case of measles, even small pockets of un-immunized individuals can threaten the herd immunity threshold.  This is exactly why we are seeing an outbreak in Minnesota.

What’s the big deal?  Is measles even that dangerous? Read more…

10 Things Parents Who Don’t Vaccinate Their Kids Should Know

It’s not uncommon for a parent who has lost a child to a vaccine preventable disease to try to spare other families from the same agonizing heartache. 

In some cases, these children may have suffered with a preventable disease because they were unvaccinated.  This could be the result of parents who did not have access to certain vaccines, parents who willfully refused a particular vaccine, or in the case of Riley Hughes, infants who were too young to be fully vaccinated.

Riley was a healthy baby boy born in Australia on February 13th, 2015.  At three weeks of age he started exhibiting cold-like symptoms with an occasional cough. When he was just 32 days old, Riley passed away in the arms of his parents.  

pertussis112315While in the hospital, Riley was diagnosed with pertussis, also known as whooping cough.  At that time, the U.S., the UK, Belgium and New Zealand, were already advising expectant women to get an adult Tdap vaccine at 28-32 weeks of pregnancy in order to transfer protective antibodies to their unborn babies.  This practice helps protect infants from pertussis at a time when they are most vulnerable to infection and subsequent complications.  It’s also the only way newborns can benefit from some protective antibodies before they are two months of age and begin receiving the first of five doses of DTaP vaccine to become fully vaccinated against pertussis.

Unfortunately, the Australian government hadn’t adopted this practice until shortly after Riley’s death. Since then, Riley’s parents have made it their mission to educate people about the dangers of whooping cough, and promote the need for vaccination so that no other family would have to suffer like they did.

Sadly, there are still some parents who choose not to vaccinate.  In a plea to these parents, Riley’s mom posted the following list of “things to know” on the Light for Riley Facebook page:

 


Ten things I want parents who don’t vaccinate their kids to know:

1. There are no cures for most of the diseases we vaccinate against.

2. Even if you choose not to vaccinate, please, please, please make yourselves aware of the symptoms of these potentially fatal diseases. Infections like meningococcal can kill within 24 hours, and every minute counts.

12244586_1518881475089295_4527321516860468835_o3. If you’re really worried about vaccine “toxins”, you don’t want to see what the toxins from Bordetella Pertussis (the bacteria responsible for whooping cough) can do. Trust me – I watched my newborn son die from it. Read more…

Comprehensive Vaccine App Available on iPhones and iPads

If you’re looking for a comprehensive source of vaccine information, look no further than The Vaccine Handbook App, now available for Apple iPhones and iPads.

This free downloadable App serves as an enhanced digital version of the new 2017 (6th) edition of The Vaccine Handbook: A Practical Guide for Clinicians (often referred to as “The Purple Book”).  

This book, written by Dr. Gary Marshall, professor of pediatrics and chief of the Division of Pediatric Infectious Diseases at the University of Louisville, was first published in 2004.  Each edition of The Vaccine Handbook compiles a wide variety of information on vaccine science, guidance, and practice into one easily accessible user-friendly resource.

The App, which was first released a little over a year ago, was updated in April 2017 to contain the new 6th edition of the book and the program has been enhanced in many new ways. The electronic version of The Purple Book is fully searchable, with functionality that includes bookmarking, highlighting, user annotation and active links to content on the Internet. There is also a resource section in the App that complements the book with links to vaccine websites, governmental organizations, manufacturers, and various advocacy groups, including Every Child By Two.

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Dr. Marshall elaborates on the intent of the project by saying,

“From the beginning, the purpose of The Purple Book was to distill down the complex world of vaccine science and practice into something that practitioners could use, not just for optimizing implementation, but for deepening their understanding as well. It’s not just a “how to” guide; it’s a “how to and here’s why” book.”

The Purple Book is ideal for pediatricians, family physicians, internists, obstetrician/gynecologists, nurses, nurse practitioners, physician’s assistants, and clinical staff. Additionally, Dr. Marshall believes the publication can also be used as the basis for a vaccine curriculum for students and residents.  It can even be a useful resource to parents and patients. He explains,

“The content is expansive but the language is plain, simple, and accessible. It covers the rationale behind authoritative immunization recommendations as well as the many contingencies encountered in everyday practice. Beyond this, it provides a readable foundation on how vaccines are developed, tested, and licensed; how vaccine policy is made; what constitutes the vaccine safety net; standards and regulations; billing; office logistics; and much more. It can be read cover-to-cover, or section-by-section.”

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The book is divided into two sections. 

The first section includes, among other things; 

  • basic principles of vaccine immunology;
  • background on vaccine development, infrastructure and policy;
  • vaccination standards;
  • general vaccine recommendations and implementation;
  • vaccination schedules;
  • vaccination in special circumstances;
  • and most importantly, tips on addressing concerns about vaccines.

The second section contains details about every vaccine currently licensed in the United States, as well as; 

  • the burden and epidemiology of the respective diseases,
  • history of the immunization program,
  • vaccine constituents,
  • vaccine efficacy,
  • vaccine safety,
  • and vaccine recommendations.

MaryBeth Koslap-Petraco, Pediatric Nurse Practitioner and Adjunct Clinical Assistant Professor at Stony Brook University School of Nursing, had this to share about her recent experience using the App:

 “The App is perfect for accessing vaccine information without having to carry around the book. I was preparing a lecture for school nurses about vaccine hesitancy and I used the app on my phone. It was incredibly quick and easy to locate the information I was looking for in the index and then scroll to the specific pages I needed.  Upon opening the App I found the section buttons right on the first page.  I then went directly to the “Addressing Concerns” section which included information on vaccine refusal, communicating risks and benefits, and other topics related to vaccine concerns.  All of the information I needed, along with a complete list of references, was right in one place. If you’re someone who wants to have a full array of vaccine information at your fingertips, than I highly recommend that you download this App.” 

VaccineHandbookDr. Marshall adds,

“There are many vaccine resources, but The Purple Book is unique. It is replete with scientific background but it is not an academic textbook—at the same time, it is much more than just a compilation of facts and recommendations.”

The most recent version of this free downloadable App is sponsored by the Immunization Action Coalition and can be found by searching the iTunes App Store for “The Vaccine Handbook App” or by clicking the link here.  Download it today and let us know what you think in the comments below.

For anyone still interested in a hard copy of the book, they can be ordered directly from the App, in bulk from the publisher, or from the Immunization Action Coalition website at a cost of $34.95 each.

Educational Materials For Daycare Centers To Inspire Vaccination

April 27, 2017 7 comments

niiw-blog-a-thon-badgeSince 1994, communities throughout the United States have joined together during National Infant Immunization Week (NIIW) to celebrate the critical role vaccination plays in protecting our children and our communities.  As we continue to recognize the achievements of immunization programs all across the country, as part of this year’s National Infant Immunization Week celebration, we’ve heard parents ask,

“What can I do to spread the word about the value of vaccines in my community?” 

One way parents can help promote healthy communities is by sharing materials that  help educate others about the benefits of timely immunizations for all ages.  Today, we invite parents to promote Every Child By Two’s Vaccinate Your Family program to local daycare centers through the use of specially designed educational materials.

Materials to Inspire Vaccination of Children in Daycare and their Families

In an effort to teach young children,  their parents,  grandparents, and other caregivers about the importance of immunizations, Every Child By Two (ECBT) has collaborated with Young Minds Inspired (YMI) to develop an educational program for daycare providers.  The materials don’t just focus on getting children their recommended vaccines, but also help to explain how parents, grandparents and caregivers can keep young family members healthy by keeping their own vaccinations up-to-date.

The materials were designed to be a combination of:

  • fun activities for children;
  • take-home handouts for parents, grandparents or other caregivers;
  • a wall poster for the daycare centers;
  • and an educator’s guide to raise awareness of the importance of vaccines for people of all ages.

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Read more…