Every Child By Two’s online platforms have reached over 11 million people with evidence based vaccine messaging in 2016. As we look back at the record number of views and shares there have been on Shot of Prevention blog posts this past year, we’re especially grateful to our blog readers, contributors and subscribers.
Whether you have shared a post, shared your story, or shared your expertise, know that our growth and success would not have been possible without your support. Thanks to you, people are referencing our content before making important immunization decisions for themselves and their families. In these final days of 2016, we hope that you will revisit these top five posts from the past year and share them with others in your social networks. Together, we can continue to engage more people in these important immunization discussions.
In 1949, Judith contracted polio along with 42,000 other people in the U.S. Judith survived five months in the hospital and multiple surgeries, but sadly 2,720 people died from polio that year. As Judith bravely shares her story, she explains that it represents an inconvenient truth to people who are in denial about the risks of polio. She is continually shocked by people who refuse vaccines, who refuse to believe she ever suffered with polio, or who actually believe the polio vaccine is part of a government or “big pharma” conspiracy. By sharing Judith’s story we hope to encourage continued polio vaccination and support of polio eradication worldwide and applaud people like Judith who are courageous enough to speak out in support of vaccines. To read Judith’s story, click here.
Emily Stillman was pronounced brain-dead just 30 hours from the onset of a severe headache. What they though was a migraine turned out to be meningococcal disease. In this post Emily’s mother Alicia explains that although Emily received a meningococcal vaccine, the MCV4 vaccine she received only protected her against meningococcal serogroups A, C, W and Y. It did not protect her against serogroup B, which is what caused Emily’s death. Since Emily’s death, a MenB vaccine has been approved for use. However, most parents still don’t know it exists and therefore, most students are still not protected.
As the Director of The Emily Stillman Foundation, Alicia Stillman helps educate people about the importance of “complete and total” protection against all serogroups of meningococcal disease. This means ensuring that teens and young adults receive both meningococcal vaccines; the MCV4 vaccine that protects against serogroups A,C, W and Y, as well as a MenB vaccine series. To learn more about fully protecting our youth against meningococcal disease, read Alicia’s guest blog here.
Although the HPV vaccine is one of the most effective ways we have to prevent numerous types of cancer, it is still being grossly underutilized. As a result of persistent but inaccurate myths circulating on the internet, some parents are more fearful of the HPV vaccine than the human papillomavirus itself. This is causing them to refuse or delay HPV vaccination for their children.
In this popular blog post, we highlight ten critical facts that address the most common misconceptions about HPV infection and the vaccine that can help prevent this very common infection. To learn more, be sure to read the post here.
There are many misconceptions about hepatitis B and how the infection is transmitted. Because of this, many parents don’t consider their children to be at risk of infection and so they question the need for a hepatitis B vaccine at birth. In this post, the Prevent Cancer Foundation explains the connection between hepatitis B and liver cancer and discusses ways in which infants and children can unknowingly contract hepatitis B. Their Think About the Link™ education campaign suggests that vaccinating infants before they leave the hospital is a critical first step in protecting your newborn from a virus that can lead to cancer later in life. To learn more about Hepatitis B and the vaccine to prevent it, click here.
Back in the 1980’s, Barbara Loe Fisher claimed that the whole cell pertussis vaccine (DTP) was dangerous and causing too many adverse events. Her complaints prompted the development of the more purified (acellular) pertussis vaccines that we use today; DTaP for infants, and Tdap for adolescents and adults. While studies have shown that these newer vaccines are not as effective as the old whole cell pertussis vaccine, they are the best protections we have against the dangers of pertussis.
Unfortunately, those who need protection the most are those who are too young to be vaccinated. Infants are at high risk of severe complications from pertussis, to include hospitalization and death, but babies don’t begin receiving pertussis vaccine until two months of age. After newborn Calle Van Tornhout contracted pertussis from a hospital nurse at birth, she died at just 37 days of age. Callie’s death has had her home state of Indiana considering a bill that would mandate pertussis vaccination among health care workers. But Barbara Loe Fisher is opposed to that as well. To read more about the history of pertussis vaccines, click here.
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Thanks again for your continued support and best wishes for a happy and healthy new year!
This guest post was written by Carolyn who works as a Home Health Community Nurse and who originally shared her son’s story on the Nurses Who Vaccinate blog to help raise awareness of the symptoms and dangers of pertussis.
My son is a healthy 16-year-old, middle linebacker for his Varsity football team. He jet skis, is an avid boater, plays lacrosse, and enjoys working out, eating healthy and exercising. I never suspected he would suffer with a vaccine preventable disease.
His cough was mild at first. Not a nagging cough, not a wet cough, just a mild cough. I asked my son if he was feeling well and although he said he was fine, I gave him cough syrup and took his temperature. It was normal (hint #1) and we both went to sleep, although I did hear him cough occasionally through the night.
This marked the beginning of the longest 7 weeks of our lives.
The occasional cough continued for a week, but then I noticed it was worsening, and it was making him very short of breath. One day he called me from school and asked me to pick him up. I took him to urgent care, where they diagnosed him with bronchitis, gave him amoxicillin, put him on a five-day dose of prednisone and gave him an inhaler.
That night was the beginning of the nightmare. He coughed so violently that he became short of breath. He was gasping and choking and even began vomiting (hint #2). This continued through the next day and night. He was exhausted. I was exhausted. And even though I am a nurse, I felt helpless.
I took him to the local Emergency Department where the pediatric physician prescribed an albuterol nebulizer and a chest X-ray. The chest x-ray came back crystal clear (hint #3). When I questioned the doctor about the vomiting, they suspected it was due to a gag reflex, but they decided to give him saline for dehydration and take blood and urine samples.
All of his blood work came back fine except for his neutrophils and his monocytes which were only slightly elevated (hint #4). They treated him as a case of atypical pneumonia and put him on a five-day dose of Zithromax and advised us to continue the prednisone until finished.
During the next 10 days, as he completed the medications, my son continued to have these bouts of uncontrollable violent coughing, always resulting in vomiting, choking on phlegm and gasping. He was eating, but also losing weight, and he was in and out of school, often due to being up all night coughing.
One evening he vomited in the basin where I noticed black stringy flecks. I immediately thought it was blood, but he assured me it was something he had eaten. The next morning he vomited again, and this time it was phlegm with blackened red strings (hint #5). I put the vomit in a baggie, put him in the car and took him back to the emergency room.
His sample tested positive for blood and so they gave him several nebulizer treatments, upped his prednisone, repeated the chest x-ray (which again came back clear), prescribed the inhaler every four hours and released him. With the increased prednisone, the cough did slow down a bit, but he still was vomiting phlegm and gasping, so I made a follow-up appointment with his physician where they did a thorough exam and diagnosed him with pertussis.
Pertussis? Really? How did my healthy kid get whooping cough? I was diligent in getting him vaccinated. How did three different doctors miss this?
Last week, the Advisory Committee on Immunization Practices (ACIP) held it’s third and final meeting of 2016. The agenda included presentations pertaining to hepatitis B, pertussis, HPV, meningococcal, herpes zoster, pneumococcal and RSV vaccines, and surveillance updates on Zika and influenza viruses.
During the two-day meeting, the committee took nine votes on newly proposed vaccine recommendations that addressed vaccination timing, number of doses needed, and dosing intervals for hepatitis B, pertussis, HPV and meningococcal vaccines. They also approved the child, adolescent and adult immunization schedules.
This post provides a recap of each agenda item in the order they occurred.
Hepatitis B Vaccine
The recommended first dose of the three-series hepatitis B vaccine is often referred to as “birth dose” and is typically administered to infants in the hospital after birth. At this meeting, the Hepatitis B Work Group asked that the Committee consider removal of the permissive language that appears at the end of the recommendation which allows for a delay of the birth dose until after hospital discharge.
When hepatitis B vaccine is administered within 24 hours of birth it can help prevent transmission of the hepatitis B virus from an infected mother to her child. The intent of the birth dose is to provide an additional safety net to prevent transmission from HepB positive mothers that are not properly identified due to errors in maternal testing or reporting. In these instances, when the mother is not properly identified as HepB positive before birth, the HepB vaccine alone is 75% effective in preventing prenatal transmission, and 94% effective when used in conjunction with Hepatitis B immune globulin.
Since delaying hepatitis B vaccination can interfere with the prevention of Hepatitis B – especially in a child unknowingly born to a HepB positive mother – the HepB Work Group proposed that the reference to delaying vaccination be removed from the recommendation. It had originally been added in 2005, but the data suggests that administering the birth dose in the hospital leads to timely completion of the series. The current birth dose coverage was stated to be 72.4% of children, which remains below the Healthy People 2020 goal of 84%.
The Committee voted to remove the permissive language as well as include new language to clarify that the first dose of vaccine should be administered within 24 hours of birth, which is more explicit than “before hospital discharge”.
The anticipated changes to the previous recommendation are indicated below, however the exact wording may differ once published by the CDC:
“For all medically stable infants weighing 2,000 grams or more at birth and born to HBsAg-negative mothers, the first dose of vaccine should be administered
before hospital dischargewithin 24 hours of birth. Only single antigen HepB vaccine should be used for the birth dose. On a case-by-case basis and only in rare circumstances, the first dose may be delayed until after hospital discharge for an infant who weighs 2,000 grams or more and whose mother is HBsAG-negative”.
*It should be noted that for those infants with birth weight of less than 2,000 grams, the birth dose is not counted as part of the vaccine series.
There was some discussion concerning the removal of the option to delay vaccination and it was emphasized that having a clear recommendation from the ACIP is not a vaccine mandate. Rather, practitioners, public health professionals and parents rely on the ACIP recommendations as expert guidance and best practice. The Hepatitis B “birth dose” has been a successful strategy to help eliminate hepatitis B virus transmission in the U.S., and the ACIP’s revised recommendations only emphasize the importance of vaccinating within the 24 hours timeframe that will help prevent further transmission.
Other key updates to the hepatitis B vaccine recommendations included:
- Providing examples of chronic liver disease, including recommending HepB vaccine for persons with HCV infection.
- Post vaccination serologic testing for infants who’s mother’s HBsAg status remains unknown indefinitely.
- Testing HBsAg-positive pregnant women for HBV DNA.
For more information as to why babies need a Hepatitis B vaccine at birth, read these Shot of Prevention blog posts here.
The Committee reviewed the history of Tdap vaccination in pregnant women and reviewed studies that found that maternal Tdap vaccination to both safe and effective at preventing infant pertussis. Read more…
Every Child By Two’s State of the ImmUnion campaign is honoring National Immunization Awareness Month (#NIAM16) with a Blog Relay highlighting the importance of vaccines across the lifespan and across the nation.
In this guest post, we hear from Heidi Parker, MA, Executive Director of Immunize Nevada. She reminds us that promoting health and preventing disease is not just a cause to recognize during the month of August; instead, it is something we need to do each and every day.
By Heidi Parker, MA, Executive Director of Immunize Nevada
Dr. Donald A. Henderson passed away recently, with little media attention or fanfare. This is alarming, considering “saving millions of lives” was listed as one of his life accomplishments.
In case you’re wondering who he is, Dr. Henderson led the global effort to eradicate smallpox — a disease that, in the 20th century and before it was extinguished, was blamed for at least 300 million deaths. Clearly, his triumph over smallpox proved the power of vaccines.
During National Immunization Awareness Month, we are reminded that promoting health and preventing disease is not just a cause to recognize during the month of August; instead, it is something we need to do each and every day.
We must be relentless, much like Dr. Henderson was. Why? Because our news feeds continue to be filled with stories of vaccine-preventable diseases – a teen dies from meningococcal disease; a summer camp closes due to a whooping cough outbreak; college campuses battle mumps; measles spreads at music festivals; an infant too young to be vaccinated dies from pertussis; the list goes on.
In the United States, vaccines have reduced — and in some cases, eliminated — many of the diseases that killed or severely disabled people just a few generations ago. My great-grandfather died during the 1918 Influenza Flu Pandemic, along with millions of others; but decades later, our family is protected from this deadly virus when we get our annual flu shot. By vaccinating children against rubella (German measles), the risk that pregnant women will pass this virus on to their fetus or newborn has been dramatically decreased, and birth defects associated with that virus are now rarely seen. Countless examples like these demonstrate, day after day, vaccines are one of public health’s greatest achievements.
Unfortunately, tens of thousands of Americans still suffer serious health problems, are hospitalized, and even die from vaccine-preventable diseases. Read more…
Every Child By Two’s “State of the ImmUnion” campaign is honoring National Immunization Awareness Month (#NIAM16) with a Blog Relay highlighting the importance of vaccines across the lifespan. In this second guest post we hear from a California colleague who has a particular interest in Maternal-Child Health.
Dr. Elizabeth (Betsy) Rosenblum, who is a Professor of Clinical Medicine at UC – San Diego Health System, with joint appointments in the Departments of Family Medicine & Public Health and in Reproductive Medicine, works hard to help protect pregnant women and their babies from pertussis.
The shattering loss of a child is something no family ever wants to experience. Unfortunately, this year in California, two families have suffered this loss in a particularly devastating manner. These two children, both under six months of age, died from a vaccine-preventable illness: whooping cough.
Whooping cough? Isn’t that a disease from the past, like bubonic plague or smallpox?
The unfortunate answer is no. Whooping cough, or pertussis, is a disease that is still very much with us. It can infect both children and adults. It is most dangerous, however, for young infants. When whooping cough infects babies under two months of age, 90% will be hospitalized, 2-4% will suffer seizures, and 1 in 100 will die from complications of the disease.
How do infants get whooping cough?
The sad fact is, they get it from those around them. The disease is spread by infectious droplets in the air and is highly contagious. Adults with pertussis infection, who may only have a mild cough, may not realize they have the disease. And, tragically, adults have been shown to be a frequent source of infection to infants with whom they have close contact.
Is there any way to prevent pertussis in infants?
Fortunately, we have a vaccine, called Tdap. We know that when pregnant women are vaccinated during mid-pregnancy, their body has time to pass protective antibodies to their babies. These antibodies can help protect infants from the disease, until they are old enough to mount an immune response to their own pertussis vaccine.
I am a family physician, and care for many pregnant women and young families. I know from experience that some pregnant women are hesitant to get a vaccine, wondering if this might harm their growing baby. I try my best to explain that the opposite is true: that getting Tdap vaccine during pregnancy is far safer for their baby than NOT getting the vaccine. If born without protective antibodies, babies risk getting sick and dying from a potentially preventable disease.
Some of my patients tell me “I’ll get the Tdap vaccine, but I want to wait until after the baby is born.” Certainly, getting the vaccine is better than never getting it. However, this plan offers far less protection. In order for a baby to have protective antibodies circulating in his/her system from the moment of birth, the vaccine must be given at least 3-4 weeks prior to delivery. Currently in the United States, the recommended time of Tdap vaccination for pregnant women is between 27-36 weeks (6-8 months of pregnancy).
I care for some pregnant women whose children are closely spaced in age. When these women reach 27 weeks in a given pregnancy, I recommend Tdap. On occasion, they will tell me “I don’t need it, because I had it last year in my prior pregnancy.” However, in order to protect a newborn from whooping cough, a pregnant woman needs Tdap in each and every pregnancy. It is only when a woman receives the vaccine in a current pregnancy that she sends an abundant and protective amount of antibodies into the baby growing inside of her.
In order to protect infants from whooping cough, do other family members need to be vaccinated?
The answer to this question is a resounding YES! All family members, caregivers, and others who will be around an infant should be certain they are up-to-date with Tdap vaccine. When everyone around a baby is vaccinated, this provides a ‘cocoon’ of protection, greatly minimizing the chances a baby will get sick from the disease.
Children need five DTaP vaccines(the pediatric form of Tdap) at 2, 4, 6, 15 months and between ages 4-6. They need a Tdap booster at age 11. Adult men only need a single lifetime Tdap. Adult women only need a single lifetime Tdap, unless they are pregnant, in which case they need a Tdap in every pregnancy.
If a murderer was on the loose in California, intent on harming babies, there would be an immense outcry and demand for protection. Well, that murderer is pertussis. And, the best way to protect every infant from this disease is to spread the word of the importance of both maternal Tdap vaccination and vaccination for all members of our communities.
To determine what vaccines are needed before, during and after pregnancy, take a brief Pregnancy and Vaccination Quiz or visit the Pregnancy section of the Vaccinate Your Family website.
Dr. Rosenblum has completed a fellowship in Vaccine Science and Safety through the American Academy of Family Physicians. She chaired the Tdap Working Group in 2010, which coordinated UCSD’s response to the California pertussis epidemic. Her innovative work in designing and implementing a Tdap Cocooning Clinic led to her receiving the APhA Immunization Champion Award in 2011. She was chosen by the CDC to be the Childhood Immunization Champion for the State of California in 2014, in part due to her work in educating pregnant women and their families regarding the importance of childhood immunizations. She currently serves on two Advisory Committee on Immunization Practices (ACIP) work groups; the Tdap Work Group and the Combined Vaccine Work Group. She is also on the Steering Committee of the San Diego Immunization Coalition.
National Immunization Awareness Month is a reminder that we all need vaccines throughout our lives. This week we are focusing on the importance of vaccines during pregnancy. These vaccines help protect expectant mothers while also passing immunity to babies that can help protect them from disease before they are old enough to receive their own vaccines.
From the moment you found out you were pregnant, you started protecting your developing baby. You might have changed the way you eat, started taking a prenatal vitamin, or researching the kind of car seat you’ll buy. But did you know that one of the best ways to start protecting your developing baby against serious diseases is by making sure you get the whooping cough (Tdap) and flu vaccines while you are pregnant?
The vaccines you get during your pregnancy will provide your developing baby with some disease protection (immunity) that will last the first months of life after birth. By getting vaccinated during pregnancy, you can pass antibodies to your baby that may help protect against diseases. This early protection is critical for diseases like the flu and whooping cough because babies in the first several months of life are at the greatest risk of severe illness from these diseases. However, they are too young to be vaccinated themselves. Passing maternal antibodies on to them is the only way to help directly protect them.
In cases when doctors are able to determine who spread whooping cough to an infant, the mother was often the source. Once you have protection from the Tdap shot, you are less likely to give whooping cough to your newborn while caring for him or her.
When it comes to flu, even if you are generally healthy, changes in immune, heart, and lung functions during pregnancy make you more likely to have a severe case of the flu if you catch it. If you catch the flu when you are pregnant, you also have a higher chance of experiencing pregnancy complications, such as premature labor and delivery. Getting a flu shot will help protect you and your baby while you are pregnant.
You also can rest assured that these vaccines are very safe for you and your developing baby. Millions of pregnant women have safely received flu shots for many years, and the CDC continues to monitor safety data on flu vaccine in pregnant women.
The whooping cough vaccine also is very safe for you and your developing baby. Doctors and midwives who specialize in caring for pregnant women agree that the whooping cough vaccine is important to get during the third trimester of each pregnancy. Getting the vaccine during your pregnancy will not put you at increased risk for pregnancy complications.
You should get your whooping cough vaccine between your 27th and 36th week of pregnancy. You can get a flu shot during any trimester. You can get whooping cough and flu vaccines at the same time during your pregnancy or at different visits. If you are pregnant during the flu season, you should get a flu vaccine soon after vaccine is available.
If you want to learn more about pregnancy and vaccines, talk to you ob-gyn or midwife, and visit the pregnancy pages at Vaccinate Your Family and the Centers for Disease Control and Prevention (CDC).
Parents who have watched their child suffer from a vaccine preventable disease can often feel blindsided. Prior to their own personal experiences they’re usually unfamiliar with the dangers of these diseases. Sometimes they don’t realize that these diseases are a threat or that they continue to infect people around the country and the world. In cases of influenza and pertussis, we often see children who were unvaccinated because they were too young to start receiving these vaccines. In other cases, like those involving meningococcal serogroup B, parents were simply not aware of the need for, or the availability of, a certain vaccine. There are even times when parents who have lost a child to a vaccine preventable disease are surprised to learn that some people choose not to vaccinate, and in doing so contribute to disease outbreaks that put others at increased risk.
In the 25 years that Every Child By Two has spent trying to protect families from vaccine-preventable diseases, they’ve had the distinct honor of working with many parents who’ve lost a child to a preventable disease. These Parent Advocates want to prevent such a tragedy from happening again and in working with organizations like Every Child By Two, they’re able to use their personal stories to help educate the public about the need for vaccines.
Katie and Craig Van Tornhout are two such people who have turned a tragedy into a personal mission.
After five years and four miscarriages this young couple believed their prayers had been answered when they finally welcomed their precious daughter Callie into their lives. However, their joy quickly turned to sorrow on January 30, 2010, when Callie died of pertussis at only five weeks of age.
Callie was too young to have started her infant DTaP vaccination series, which begins at 2 months of age and helps protect against tetanus, diphtheria and pertussis. In the months that followed Callie’s death, the Van Tornhout’s learned a lot about the dangers of pertussis and the importance of adult Tdap vaccine. They learned that pertussis is especially deadly to infants and that
most infants who contract pertussis are typically exposed by an adult whose own pertussis immunity may have waned from the vaccine they received as a child. And they learned that Callie contracted pertussis in the very hospital she was born in.
In an effort to prevent other children from suffering the way Callie had, the Van Tornhout’s are now helping to educate others about the risk of pertussis. They not only encourage other parents to fully vaccinate their children, but they stress the importance of adult Tdap boosters, which are especially important for expectant mothers as well as the close family members and caregivers of young babies.