How strong are the country’s defenses against vaccine-preventable diseases and how well are U.S. citizens protected? What we can do to make our “ImmUnion” stronger and more resilient in the face of emerging health threats?
Every Child By Two (ECBT) has shared a special report on the State of Our Nation’s “ImmUnion” with members of congress to highlight the power of vaccines and suggest areas of action to fortify the health of our nation. While the medical community has the ability to protect Americans of all ages from deadly infectious diseases, public health workers continue to battle disease outbreaks across the nation that threaten the health and wellbeing of our citizens. Many Americans continue to lack access to life-saving vaccines that can protect themselves, their families and their communities from preventable diseases, while others fail to realize that vaccines are available to protect them from many different life-threatening diseases.
This comprehensive 2017 State of the ImmUnion Report highlights the successes of vaccines, the economic and societal savings incurred from vaccines, challenges facing the public health system, and key areas we must focus on to achieve optimal protection for all Americans.
ECBT is hopeful that this report will not only help congressional leaders learn more about the vaccination rates in their home states, but that it will also help public health advocates prioritizing the benefits of immunizations in the years ahead.
ECBT is committed to working with all stakeholders to ensure this message reaches every level of state and federal government – from the local public health department, to the President of the United States. But we need your help!
You are an important part of the equation. Join us in helping to make sure that immunizations remain a public health priority by taking these simple steps:
1. Support critical public health funding.
Having an adequate public health budget ensures that the Centers for Disease Control and Prevention (CDC), the states and the territories are all prepared to:
- respond to existing and emerging vaccine-preventable disease outbreaks,
- conduct community outreach,
- educate providers and the public
- maintain immunization registries, and
- provide vaccine services to the community.
The report highlights the success of vaccines and discusses the economic and societal saving that occur as a result of a well-vaccinated population.
Unfortunately, federal vaccine appropriations have not met the levels requested in annual justification reports from the CDC, and state appropriations are nearly non-existent. This has resulted in a loss of personnel and the disbanding of several highly effective statewide coalitions which had supported immunization efforts for decades.
Additionally, if and when the Affordable Care Act is repealed, nearly $600 million in funds that currently support the CDC and state immunization activities may be eliminated. You can learn more about the critical funding issues here, and if you want to ensure legislators reallocate these funds, take a moment to add your name to Every Child By Two’s Vaccine Funding Support Statement here.
2. Support the science behind vaccines and the CDC’s recommended immunization schedule.
The public must be continually reassured that the timing of vaccines is carefully considered prior to CDC recommendation, and that vaccine safety is heavily monitored with pre and post licensure procedures. There are many disproven myths about the safety of vaccines and we need immunization champions who are well-informed and ready to respond to concerns with evidence-based responses. This report includes specific resources that can be helpful in addressing vaccine safety and policy concerns and even provides links to state specific immunization rates.
3. Join your local immunization coalition to see how you can work to advance the State of the ImmUnion in your local area.
Learn more about the vaccination rates in your state, and the impact vaccine-preventable diseases are having there, by accessing the resources cited in the State of the ImmUnion report, such as the American Academy of Pediatrics’ interactive map and the CDC’s VaxView. If you want to connect with other immunization advocates in your state, simply send an email to us at email@example.com and we can help connect you with your local immunization coalition.
4. Communicate directly with your state and federal legislators to encourage them to support a strong State of the ImmUnion.
Whether you call, email or Tweet your state and federal legislators, grab their attention by including any of the informative graphics from this special report. Simply include a link to the PDF report of the 2017 State of the ImmUnion along with some of the images we’ve compiled in our State of the ImmUnion social media toolkit and you’ll be helping to get the message out. (And don’t forget to tag @ShotofPrev in your tweets so we can help amplify your message.)
Every Child By Two’s Vaccinate Your Family campaign is an initiative aimed at raising awareness of the critical importance of vaccines across the lifespan. We are encouraged by the actions of so many devoted immunization champions all across the nation, and we hope you will join our efforts to ensure a strong “State of the ImmUnion”. Be sure to subscribe to our Shot of Prevention blog, like our Vaccinate Your Family Facebook page, and follow us on Twitter at @ShotofPrev to continue to receive updates on how you can join us as a voice for positive change!
Founded in 1991 by Former First Lady Rosalynn Carter and Former First Lady of Arkansas Betty Bumpers, Every Child By Two works to protect families and individuals from vaccine-preventable diseases by raising awareness of the critical need for timely immunizations for people of all ages, increasing the public’s understanding of the bene ts of vaccines, increasing con dence in the safety of vaccines, ensuring that all families have access to life-saving vaccines, and advocating for policies that support timely vaccination. Learn more at ecbt.org.
It’s not uncommon for healthy adults to skip their annual flu vaccine. In fact, it’s estimated that only about 40% of adults receive an influenza vaccine each year – a preventive measure that the CDC recommends for everyone age 6 months of age and older, with rare exception.
While adults tend to understand that the flu can be dangerous and sometimes even deadly, they often don’t get vaccinated because they just don’t consider themselves at risk.
I imagine it’s because we’re living in a time when modern medicine is so advanced. The average American just doesn’t consider it likely that a healthy adult could die from something so common as the flu? One would imagine that those at greatest risk of death from flu would be young children, the elderly or people who have underlying health conditions, right?
While it is true that there are certain demographics of people who may be more likely to suffer severe consequences from flu, it does not mean that a healthy adult is not also at risk of hospitalization or death. As Michael Pulgini explains, the flu is “aggressive, sneaky, and potentially deadly” and “no one is invincible” just because you are young, strong, or healthy.
You see, Michael is one of those healthy adults who refused the flu shot last season, citing that he felt it wasn’t necessary and suspecting it might make him sick. Michael ended up contracting the flu, but recovered after about five days of body aches, fever, runny nose and cough.
But what continues to haunt Michael today is the fact that his wife also fell victim to the flu – but sadly, she never recovered.
Michael now lives with the horrifying memory of watching his beautiful wife Cecilia suffer and die from the very disease that he had previously trivialized.
After Michael had recovered, Cecilia started to show signs of illness, such as runny nose, body aches and pains, and a weird symptom that caused her upper lip to swell. She made several visits to the doctor, and the last visit occurred about eight or nine days after her first symptoms appeared. This time, she was complaining of shortness of breath. The doctor gave her an injection to help open up her airways, but within 30 hours Cecilia was in terrible distress and her breathing was very rapid and shallow. A chest x-ray at the hospital showed one lung was completely covered in puss and fluid from an infection.
Doctors explained that the influenza virus continued to replicate, hitting Cecilia full force and completely overpowering her body’s ability to fight off the infection.
They also told Michael something he will never forget;
“If she had been vaccinated against influenza, there was a 90% chance she wouldn’t be here [in the hospital] like this.”
Sadly, Cecilia was put into a medically induced coma. They intubated her and put her on a ventilator since she was unable to breathe on her own. All the while, Michael believed in his heart that she would pull through because she was young and strong.
But Michael was wrong. He explains,
After losing her son Evan to meningococcal disease, Lynn Bozof’s life became a mission to prevent other families from experiencing similar tragedies. She has since co-founded the National Meningitis Association (NMA), to help educate people about the dangers of meningococcal disease. In this special State of the ImmUnion post, Lynn addresses some of the most common questions parents have asked her about meningococcal disease and the ways it can be prevented.
How would you describe the current “State of the ImmUnion” for meningococcal disease? How many cases of meningococcal disease are there in a typical year? Are enough people protected?
In the 14 years since NMA was founded, vaccination rates have climbed steadily while disease incidence has declined. Although we are pleased with this progress, there is much more work to be done to strengthen the State of the ImmUnion.
Annually, there are approximately 800-1200 cases of meningococcal disease in the United States. As an organization comprised of survivors and families who have lost children to this devastating disease, we at NMA know that one case is too many.
While the Centers for Disease Control and Prevention (CDC) routinely recommends meningococcal vaccines beginning at age 11-12, one in five U.S. teens are not vaccinated as recommended and one-third of those who get the first dose don’t go on to get their booster dose. This leaves adolescents unprotected as they enter some of their most vulnerable years.
What can parents do to protect their families from meningococcal disease?
As a parent who lost my college-age son, Evan, to meningococcal disease, I urge all parents to make sure their child is vaccinated. Vaccination offers the best protection against this disease, and parents should understand that to be fully vaccinated against meningococcal disease, your child should receive two kinds of meningococcal vaccines.
There are five major serogroups of meningococcal disease: A, C, W, Y and B.
MenACWY Vaccine: The Centers for Disease Control and Prevention (CDC) recommends meningococcal vaccination against serogroups A, C, W and Y for all children at 11-12, with a booster at age 16.
MenB Vaccine: After the FDA approved this vaccine in 2014, the CDC made a permissive recommendation for children ages 16-23, with a preferred age of 16 to 18 years.
Because it behaves somewhat differently, the B serogroup was not included in the ACWY vaccine, and it took longer for scientists to design an effective vaccine.
Today, nearly half (43 percent) of all meningococcal disease cases among U.S. teens and young adults are caused by serogroup B. Since MenB is a relatively new vaccine, and not routinely recommended, many parents and healthcare professionals remain unaware of this vaccine. This is particularly concerning since it’s the most common cause of meningococcal disease in adolescents and the cause of several outbreaks on college campuses in recent years. This is why we urge parents to have a conversation with your child’s doctor to ensure your child is fully vaccinated.
My doctor never mentioned a separate vaccine for serogroup B? Why is that?
While the MenACWY vaccine has been routinely recommended since 2005, the MenB vaccine received FDA approval in 2014. That is not to say this is a “new” vaccine. The MenB vaccine has been used in other countries for many years already, and safety and efficacy data from these countries has been extensively reviewed by the CDC’s Advisory Committee for Immunization Practices (ACIP). After FDA approval in the U.S., the Committee gave this vaccine a permissive or “category B” recommendation. Unlike a routine recommendation, this recommendation puts more responsibility on parents to request the vaccine, which is why it is important to be proactive and ask your doctor about it.
Are there certain people who should be particularly concerned about meningococcal disease? How easily does it spread?
Vaccines are recommended for adolescents and young adults because they are at higher risk of contracting meningococcal disease.
The following factors increase the risk of disease: being an adolescent or young adult, spending time in large crowds like parties or dorms, and participating in behaviors like kissing or sharing drinks. But, anyone at any age can contract it.
Other people who are at higher risk for the disease include:
- Infants under 1 year of age
- People living in crowded settings like college dorms or military barracks
- People living with HIV
- Those with persistent complement component deficiency or anatomic or functional asplenia
- People traveling to certain areas outside the U.S. such as the meningitis belt in Africa
- Laboratory personnel who are routinely exposed to meningococcal bacteria
- Those who might have been exposed to meningococcal disease during an outbreak
Meningococcal disease is contagious. It is spread through the exchange of respiratory secretions during close contact such as kissing, sharing drinks or coughing on someone. Although meningococcal bacteria are very dangerous, they cannot live outside the body for very long. This means the infection is not as easily spread as a cold virus. 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.
Of those who contract the disease, 1 in 10 will die and 2 in 10 will suffer from long term complications, including deafness, brain damage, or limb amputations.
My child was required to get a meningitis vaccine before middle school. Is she still protected or does she need a booster? If so, when should she get one?
It’s a good question. So often we hear scientific claims about everything from the health benefits of coffee, eggs and wine, to the cancer causing effects of coffee, eggs and wine. The point is that not all studies are good ones and the media tends to oversimplify scientific findings in an effort to create catchy headlines and viral content.
As John Oliver explains in his latest episode of Last Week Tonight with John Oliver, there is a seemingly endless barrage of data being thrown at the public and plenty of BS masquerading as science. In his latest entertaining and informative segment on scientific studies, the satirical commentator made some critical points.
There have been several articles which have reviewed Oliver’s comments, including “How To Spot A Scientific Study That Isn’t Terrible” by Uproxx, “John Oliver teaches us how to interpret medical and scientific studies“ at Respectful Insolence and “John Oliver explains why so much ‘science’ you read about is bogus” in the Speaking of Science section of The Washington Post. This last article detailed four notable points Oliver raised.
1. A single study means basically nothing.
For science to point us in the direction of truth, scientific claims should be supported by duplicate evidence. This has been one of the many reasons Andrew Wakefield’s claims that vaccines cause autism have been dismissed by the scientific community. His single study was unable to be duplicated. Meanwhile, dozens of other studies conducted around the world have indicated that there is no connection between vaccines and autism.
2. Statistics can be very misleading. They can even lie.
This post is part of a blog relay sponsored by the Centers for Disease Control and Prevention (CDC) in recognition of National Infant Immunization Week (NIIW). You can follow the conversation on social media using hashtag #NIIW and join the #VaxQA Twitter Chat Wednesday, April 20th at 4 p.m. ET
Protecting kids from disease requires more than just getting them their recommended childhood vaccinations. It requires the commitment of an entire community.
Thanks to an abundance of evidence based research, we’re constantly learning new and improved ways to protect our children; from safer rear-facing car seats with five-point harnesses, to wearing bike helmets and recommending that babies sleep on their backs. Thankfully, advancements in medical science have also led to safe and effective vaccines that can protect today’s children from as many as 14 potentially deadly diseases.
This commitment to scientific research has provided us with the safest, most effective vaccine supply in history. Today’s vaccines not only contain less antigens than they did years ago, but they have fewer side effects. There is even a system in place to continually evaluate vaccine safety and a process to update and improve vaccine recommendations as new information and science becomes available.
The impact of infant immunizations is monumental.
It is estimated that vaccines administered to American children born between 1994-2013 will prevent an estimated 322 million illnesses, 21 million hospitalizations, and 732,000 deaths. In looking at the incidence of specific diseases like measles, we can see how beneficial childhood vaccines have been. For instance, before the U.S. measles vaccination program started in 1963, about 3–4 million people in the U.S. got measles each year. In comparison, last year we had 189 cases and even that seemed like a lot.
While these successes are to be applauded, there’s still more that can be done to protect today’s children and future generations from dangerous diseases.
Timely childhood vaccinations are critical.
The recommended childhood vaccination schedule is specifically designed to provide immunity at a time when infants and young children are at the greatest risk of contracting potentially life-threatening diseases.
Take Hepatitis B for example. If a child contracts this disease before the age of one, there is a 90% probability that they will develop chronic symptoms later in life. However, only 30% of children who contract hepatitis B between the ages of one and five will go on to develop these chronic issues.
But vaccinating babies isn’t enough to ensure children will grow to be healthy adults.
Keeping children safe from preventable disease requires community immunity.
Because widespread vaccination programs have been so effective in preventing diseases in the U.S., many parents don’t realize that diseases like polio and diphtheria still exist. Some don’t consider diseases like whooping cough, varicella or measles to be a serious threat to their children. This miscalculation of risk can lead to vaccine complacency or refusal.
But the fact is that vaccine-preventable diseases are still circulating in the U.S. and around the world. Even when diseases are rare in the U.S., they can still be commonly transmitted in many parts of the world and brought into the country by unvaccinated individuals, putting entire communities at risk.
This explains the recent resurgence of measles cases in the U.S. , despite measles having been declared eliminated from the U.S. in 2000. Today’s outbreaks are often the result of unvaccinated individuals who contract the disease oversees and then return to the states where they spread it to others. But unvaccinated individuals don’t just put themselves at risk; their choices impact the health of our communities as a whole. Read more…
What Have We Learned From Last Year’s Measles Outbreak?
Last year the United States experienced a large, multi-state measles outbreak that was largely responsible for 189 measles cases that spread across 24 states and the District of Columbia. It’s believed that the outbreak started from a traveler who contracted measles overseas and then visited the Disneyland amusement park in California while infectious. Widespread media coverage of the outbreak helped elevate public concerns related to the dangers of measles infection, the consequences of a growing number of school vaccine exemptions and the risks of disease among those who were too young or medically unable to be vaccinated.
At this time last year, it seemed as though we were experiencing a tipping point; a growing number of people were beginning to realize that vaccine refusal had consequences that could threaten our nation’s public health. The fact that the personal decisions of a select few people was able to threaten herd immunity and the health of many unsuspecting families and communities was worrisome.
It was believed that more parents (including some who had previously refused vaccines) were seeking and accepting vaccination for their children as a direct result of the outbreak. However, to determine whether clinicians were experiencing any real or lasting changes in vaccine acceptance, Medscape conducted a survey of vaccine providers to find out.
The survey, conducted in July of 2015, included 1577 physicians, nurse practitioners and physician assistants who worked in pediatrics, family medicine and public health. Responses confirmed that the measles outbreaks induced more acceptance of the measles vaccine and vaccines in general. The survey also indicated that, for some parents, a greater acceptance of vaccines was directly related to the fear of the disease, the consequence of being denied admission to schools, daycares or camps, and a greater knowledge about vaccines as a result of more reading on the subject. However, in some cases there was no change.
Every Child By Two also experienced a heightened amount of interest in the months during and immediately following the outbreak with a record number of inquiries from parents. Most were asking for information about the dangers of measles infection and for clarification of the MMR (measles, mumps and rubella) vaccine schedule. There were many parents who were specifically inquiring as to the possiblity of vaccinating their children before the recommended age in order to protect them during the outbreak. Shot of Prevention blog posts that included content specific to measles infection and MMR vaccination had record numbers of views in the early months of 2015, and personal stories relating to the outbreak, were widely shared on social media.
One story that drew a lot of attention was an open letter by Dr. Tim Jacks, whose two children had to be quarantined after they were both exposed to measles at a Phoenix Children’s Hospital clinic. His 3-year-old daughter Maggie had a compromised immune system as a result of fighting acute lymphoblastic leukemia (blood cancer), while his 10 month old son Eli had received all his recommended vaccines, but was still too young for his first dose of MMR vaccine. While neither of his children ended up contracting measles, the frustration he expressed in his letter entitled “To the parent of the unvaccinated child who exposed my family to measles” hit a nerve with a lot of people.
The Focus of Immunization Rates Fades as Cases Dwindle
In reaching out to Dr. Jacks this week, it appears that the attention on vaccinations that was raised during last year’s outbreak appears to have been rather short-lived. He explained,
“As a pediatrician, I regularly discuss vaccines, exemptions, and last year’s outbreak. The cold facts and data only reach so many, so my family’s story adds a personal angle to the issue that questioning parents rarely consider. After the media exposure, many families were aware of our situation. However today, the measles issue is not on as many people’s minds. Vaccine exemption is however a hot issue in Arizona. The Arizona political arena is considering avenues to encourage vaccination and I am hopeful that the coming year will produce progress in that regard.”
Today, a little over a year since the outbreaks began, the good news is that there have only been two reported measles cases so far in 2016. However, it also appears that history may be destined to repeat itself.
Consider, for example, the reports out just this week about a California charter school student who tested positive for measles after returning home from traveling overseas. With just 43% of kindergarteners at the Yuba River Charter School being up-to-date on their MMR vaccine, the California Department of Public Health has attempted to prevent a measles outbreak by first closing the school to all students, and then remaining closed to those without a measles vaccine until April 8 as long as no new cases are documented.
Despite overwhelmingly high vaccination rates across the country, with a mere 1.7% national vaccine exemption rate among kindergartener’s for the 2014-2015 school year, and a 90%+ coverage of MMR vaccine among 19-35 month old children, these small pockets of unvaccinated children continue to present a risk of future measles outbreaks. Read more…
Barbara Loe Fisher may be right about one thing.
We need a better Tdap vaccine to prevent pertussis (also known as whooping cough).
However, her opposition to legislation in Indiana that would require hospital employees be up-to-date on Tdap, flu and MMR vaccines is unsupported. Fisher has publicly defended her position in a FOX28 news clip when she states that Tdap vaccines should not be mandated because they don’t work. However, this is an example of what’s known as a nirvana fallacy.
Tdap vaccines do work. Maybe not 100% of the time, but that doesn’t mean they don’t work.
In fact, data shows that pertussis vaccines protect about 7 out of 10 people who receive them. That’s enough for the World Health Organization to justify using it across the globe to help prevent pertussis, as well as diphtheria and tetanus. Sorry Barb, but in lieu of a better option to prevent a highly infectious and sometimes deadly disease such as pertussis, the Tdap vaccine is the best defense we have. It’s certainly better than the 0 out of 10 people who are protected by avoiding vaccination all together.
Interestingly enough, what Fisher avoids admitting is that her opposition to the whole cell pertussis vaccination (DTP) is why we are in the situation we are in today. Back in the 80’s, Fisher led the charge against the whole cell pertussis vaccine, claiming it had too many adverse events. This prompted the development of a more purified (acellular) pertussis vaccine (DTaP). By 1997, a newly licensed DTaP vaccine was being recommended by the ACIP in place of the DTP vaccine for the full 5-dose pediatric schedule. While the new vaccine appeared less likely to provoke adverse events, studies have since shown that it has not been as effective in providing lasting immunity.
The truth is, Fisher has never really been interested in making vaccines safer. She co-founded the National Vaccine Information Center in 1982 to help organize a movement of vaccine refusal and oppose any public policy that endorses the use of vaccines.
Unfortunately, while we are stuck with a less than ideal vaccine, children like Callie Van Tornhout are dying from pertussis infection.
People of all ages can be affected by pertussis. However, it is most dangerous for babies, as they are at particularly high risk of severe complications, hospitalization and death. About half of babies younger than one year who get the disease need care in the hospital, and 1 out of 100 babies who get treatment in the hospital die. Most unvaccinated children who are living with an infected family member will contract pertussis themselves. There is no real cure for pertussis, only treatments that help address the symptoms.
In the case of Callie Van Tornhout, detailed in the FOX28 news clip out of Indiana, transmission of pertussis from a hospital employee to a vulnerable newborn too young for vaccination proved to be deadly. Callie was only 38 days old and had never been anywhere besides her family home and the hospital. This is why Callie’s mom Katie Van Tornhout is speaking out in support of the proposed Indiana bill (SB 162).
Katie, like the many others who support this bill, believes that hospital employees who have direct contact with patients should take reasonable precautions in order to protect themselves and their patients from preventable diseases like pertussis. That means they should be up-to-date on ACIP recommended vaccines such as Tdap, flu and MMR, that are proven to be safe and effective.
Katie explains, ”If you’re taking care of my child in the hospital and you’re not vaccinated, then what good is that? You’re putting that baby in danger. You’re putting everyone in danger.”