Baltimore’s Example in Stark Contrast to California’s Epidemic
Jul 23, 2010

By Christine Vara
There are times when I feel so fortunate to live in this country.  Then there are days when I wonder what some Americans are thinking.  Yesterday, the vaccine related news gave me an equal sense of hope vs. despair. 
In Baltimore yesterday, there was a celebration announcing the city as one of six American cities that have been the most successful in improving childhood immunization rates.  Yet, in CA, news persisted regarding an epidemic of pertussis, the resulting death of the sixth infant this year as a result of this disease, and the concern that low vaccination rates in the state are a significant contributor to the epidemic.   
The hope came in reading an article in the Baltimore Sun, in which Dr. Beilenson details how the city of Baltimore went from a 60% immunization rate for school aged children in the mid-90’s, to an impressive 99.5% rate today.  Knowing the low immunization rates resulted from a lack of enforcement of state law by the school system, Dr. Beilenson, who was the health commissioner at the time, collaborated with the mayor and the Superintendent of Schools to enforce automatic exclusion of un-vaccinated students.  Support from the State’s Attorney pressured parents of kids who were not in school to also adhere to the school vaccine requirements.  These steps were combined with massive citywide immunization clinics, and their efforts proved successful. 
Within a matter of months, Baltimore’s school-age immunization rate jumped to 99.5 percent.  The gains, he claims, have been maintained by strong immunization programs, such as community-based centers and outreach vehicles.  With the current high immunization rates in Baltimore, public health officials no longer worry about the mini-epidemics of measles and mumps that had affected hundreds of Baltimore kids and families in years past.  The formula for success, according to Dr. Beilenson, was the determination of public health advocates who were able to effectively work with political leaders to influence immunization coverage.
In another example, organizations like the GAVI Alliance (Global Alliance for Vaccines and Immunisation), have also had a major influence on improving children’s health worldwide.  Their accomplishments are impressive.  In their first ten years, they have enabled 250 million children to be vaccinated, thereby averting an estimated 5 million early deaths.  This alliance is a successful strategic global partnership: a collaboration between private and public sectors.  Various governments, private sector philanthropists (such as the Bill & Melinda Gates Foundation), the financial community, vaccine manufacturers, research and technical institutes, organizations like the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF) and the World Bank, all play a role in this alliance which helps to improve children’s health worldwide.  It is very promising to see the progress they have made and their successes should give us hope. 
But, like turning the pages of history, we continue to see despair.  There are still many children in various countries who are suffering, while recent headlines out of California continue to raise concerns over a pertussis outbreak here in the states.  Health officials expect this to be the worst epidemic of the contagious disease in the stateof CA  in 50 years.  The pertussis epidemic has already claimed the life of six infants this year, and nearly 1,500 whooping cough (pertussis) cases have been reported this year, which is  nearly five times the number of cases reported last year.  Health officials warned that low vaccination rates among U.S. adults (less than 6 percent nationally) and vaccine refusal from parents for their children, are contributing factors that are endangering the lives of infants too young to be immunized.
Although we live in a country where we have the money, the means and the education to know how to protect ourselves and our children, diseases it is obvious that diseases like pertussis continue to infect our population and claim the lives of infants.  The city of Baltimore and the GAVI Alliance are clear examples of how public health advocates can effectively work with political leaders to influence immunization coverage and protect children from vaccine preventable diseases.  Hopefully areas, like those in CA and other states, who are witnessing a rise in pertussis, can use these examples as a model to quickly address the issue with a boost in immunization rates. 
Listed below are a few recent articles that detail the CA pertussis epidemic.  Share this information to help us spread the word that adolescents and adults should be getting a Tdap booster and let us know what you are doing to get the word out by commenting below.    

 “Whooping Cough Epidemic Hits California” WebMD  (July 21, 2010)
Infant dies of whooping cough, third confirmed death this year in L.A. County, sixth in state” Los Angeles Times (July 20, 2010)
 “Marin Vaccine Fears May Be Linked to Illness Outbreak” NBC – Bay Area (July 20, 2010)
“California Whooping Cough Outbreak May Be Worst In 50 Years” U.S. News (MD) (July 20, 2010)
“Whooping cough epidemic grows; California, Monterey County officials urge vaccine for women, seniors” The Californian (July 20, 2010)
 “Whooping Cough: Low Adult Vaccination Rates Makes Infants More Vulnerable” New America Media  (July 17, 2010)
 “Coughing Up the Facts on Pertussis (Whooping Cough) – Dr. Glenn D. Braunstein” The Huffington Post (July 12, 2010)

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