Vaccines

All Articles in the Category ‘Vaccines’

Mumps! What To Know During An Outbreak

There is a mumps outbreak here in Washington State, as well as various other outbreaks across the nation. The CDC reports that mumps infections are currently at a 10-year high. This post is a quick update on the outbreak and why they occur, an explanation about the mumps virus, the infection and symptoms that are typical, and what parents should know now to avoid mumps.

Mumps Outbreaks In 2016

  • Numbers This Year: For the calendar year 2016 through early December, 46 states and the District of Columbia have reported a total of 4,528 mumps infections — well more than double the mumps cases reported in 2015 and creeping up in ways similar to 2006 when we had the last big mumps year. That outbreak was primarily housed in the midwest among college students.
  • Mumps In College Students: In general, we often hear more about outbreaks on college campuses in part because of students living in close quarters. Mumps is easily spread when those are in close contact who share cups, talk closely together and share respiratory droplets more readily. The intensity of these environments allows mumps to spread more rapidly and it’s also possible that during college some students have lost immunity from the vaccine they received as a child. In general college students are at higher risk because of how they relate. I love how CDC details the conditions, “certain behaviors that result in exchanging saliva, such as kissing or sharing utensils, cups, lipstick or cigarettes, might increase spread of the virus.”
  • Washington State Outbreak: As of 12/23/16 there have been 101 cases in King County (cases updated here by the Public Health Dept). In total, 32 cases are confirmed and 69 probable with additional cases under investigation. The majority of cases are in children under age 18. Some 65% of those cases are in people who are reported as up-to-date on Measles Mumps & Rubella (MMR) vaccine. This occurs in part because although the MMR vaccine works well, it still will leave some vulnerable to an infection if exposed. The MMR vaccine provides protection against mumps to about 88% of us after we get two shots, so it consequently leaves more than 1 in 10 of us vulnerable during outbreaks. We typically don’t know who is in that 12% so during outbreaks we make sure students are up-to-date in immunizations and those with suspicious symptoms are seen, diagnosed, and while infectious, they stay home.
  • Schools Send Children Home If No MMR Shots: The outbreak has been of big enough concern that The Auburn School District told more than 200 non-immunized students to stay home so they wouldn’t get the virus and go on to infect others. Public health officials sent letters to the students’ homes saying kids would only be allowed back once they had proof they’ve received the MMR vaccine. Otherwise, the students will be kept from school for at least 25 days after the last mumps case in the Auburn district.

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One Mom Shares Her Story: It’s Not Just the Flu

serese-families-fighting-fluThanks to Serese Marotta, Chief Operating Officer, Families Fighting Flu for sharing this vulnerable and truthful story about losing her son to influenza. Talk about gorgeous peer-to-peer health care. I hate that this story exists and yet I’m so thankful for Serese’s bravery in sharing it. May we all benefit from her experience and her wisdom ~ Dr. WSS

So often we hear “it’s just the flu”, but we need to take the flu seriously. How do I know this? Because my healthy, 5-year-old son, Joseph, lost his life to H1N1 flu in October 2009. I have always been pro-vaccination and Joseph and his sister received their annual flu vaccinations in September 2009, but H1N1 wasn’t in the vaccine that year. Sadly, the H1N1 vaccine didn’t become available in our community until two weeks after Joseph’s death.

Joseph’s Story

Joseph’s story began innocently enough. He was attending kindergarten in the fall of 2009 and threw up on the school bus. Later that day, Joseph continued to throw up and became increasingly lethargic. We called our pediatrician who suggested we take Joseph to the local urgent care. Upon arrival, they found Joseph’s blood oxygen level to be very low and immediately transported him to the local children’s hospital. The rapid flu test came back negative and Joseph was eventually diagnosed with pneumonia.

Several days into his hospital stay, the doctors informed us that Joseph’s culture was growing influenza, which was likely H1N1, but not to worry—it was “just the flu” and they’d start him on antiviral medications. Joseph’s condition over the next several days was relatively stable. Various specialists came and went; all of Joseph’s tests appeared normal and we were even discussing his discharge with the doctors. All of that changed on the ninth day of our hospital stay. Joseph’s blood pressure suddenly plummeted, and we were sent back to the ICU. The doctors couldn’t really figure out what was causing Joseph’s low blood pressure, but they didn’t seem overly alarmed. More testing went on throughout the night, while I tried to distract Joseph with cartoons and discussions about his Halloween costume.

The doctor came to me early on the morning of Oct. 18 to say she wanted to put Joseph on a ventilator because his heart and respiration rates were so high and his little body needed a rest. The doctor emphasized it was not a big deal, but Joseph would be unconscious while on the ventilator. I calmly called my husband, who was at home with our young daughter, and asked him to come to the hospital. Minutes later, while I was standing next to Joseph’s bed, he suddenly coded. The next scene was like something on a TV show—doctors and nurses rushing into Joseph’s room. I backed into the hallway so they could do their job, but honestly, I had no idea what was happening. As the minutes ticked away, I began to realize that something was seriously wrong. I continued to wait outside Joseph’s hospital room and finally, the attending doctor came to me, sobbing, and asked me to follow her into Joseph’s room because she needed me to talk to him. Looking back, I think she thought if modern medicine couldn’t save this child, perhaps the sound of his mother’s voice could. I entered Joseph’s room and held his hand as the doctors and nurses continued to work on him. Finally, the doctor turned to me and said “I’m so sorry.” My precious son lost his life to influenza that day, and my life was irrevocably changed as a result.

My story is not unique. I have met many parents who’ve lost a child to the flu or had a child suffer serious medical complications as a result of the flu. I want parents to understand how critically important it is for all children and their families to get their flu vaccinations each and every year. The flu vaccine is the best protection we have in our fight against influenza. The Centers for Disease Control and Prevention (CDC) recommends annual flu vaccination for everyone six months of age and older. I also want people to understand that getting an annual flu vaccination not only protects you and your family, but it also helps protect others in your community by limiting the potential for an outbreak. Read full post »

Vaccination Nation: How Healthy Is Your School?

aap-vax-mapFrom the moment we become parents, we work to keep our children’s environment safe. We child-proof our homes and make sure poisons and dangerous objects are secured wherever our kids spend time. But we aren’t always as diligent about making sure the community spaces where our children learn and play are protected from threats we can’t see, like infectious diseases.

Just this fall there was a vaccine-preventable disease reported in my son’s 2nd grade cohort. When he started kindergarten a couple years ago we were told the class was 100 percent up-to-date on immunizations, so I got done worrying about things like exposures to chicken pox, measles and mumps from his classmates. We know vaccines aren’t 100 percent protective, of course, but I took stock in knowing that his class of children was protected as best they could be.

So, when I heard about the case of chicken pox, it reminded me I needed to check back in.

Because he’s fully immunized, I wasn’t worried when I heard the news about this case of chicken pox (varicella vaccine has a high vaccine effectiveness, with 98 percent of children protected after two doses). But it got me thinking that I needed to contact the school and see how we’re doing. Not just on the state-mandated vaccines, where we scored 100 percent a couple years ago, but on influenza vaccine, too. Often we have no idea the percent of a class that is protected on this essential, every-year vaccine.

Influenza and complications from the infection are hardest on infants and young children, pregnant women, the elderly and those with underlying health conditions that make it harder to deal with the infection. Depending on the season, influenza causes anywhere between 4,000 and 50,000 deaths a year in the US. Thankfully, each year only a couple hundred of those deaths are children. The flu vaccine is recommended for ALL infants and children ages 6 months & up to protect them from the infection, their community, and severe complications. Even though the nasal flu mist isn’t recommended this year, now is still a great time to get your children and family immunized leading up to the holidays.

More than ever before, clearly articulating that you vaccinate your child and that you want your child amid a group that does the same is essential.”

Every parent should know if their child resides, learns, and plays in a safe environment, and knowing their child’s “world” is up-to-date on vaccines is an important data point. Knowing where your community stands just got a little easier. The new AAP interactive infographic is a great, high-level view into knowing how your state fares with status on vaccines and protections from outbreaks of infections like measles and pertussis, as well as influenza. 

Although we know 9 out of 10 parents immunize their children based on the AAP and CDC schedules, we know the public often feels like many more children aren’t getting vaccines. I’m haunted by the data published in Pediatrics in 2011 that found that more than 1 in 4 parents (28%) who followed the recommended schedule seemed to think those children whose parents who didn’t – who delayed vaccines or followed an alternative schedule — were safer. Not a single study finding a delayed or alternative schedule is safer and yet here we are with many parents following our recommendations but not entirely trusting them. Yuck. All those parents who immunize need to speak up.

To me, there is no question that pediatricians’ time and passion communicating truths and opportunities with vaccines will always be time well spent. Recent data out this year proves it: a third of vaccine-hesitant parents change their mind and agree to have their child receive a vaccine after their doctor provided vaccine education. But there is something else in me that knows, over time, we’ll tighten the gap on trust with parents when their peers step up and demand higher vaccine rates in their schools, their playgrounds, their communities, and even their play dates. When pro-vaccine parents share their feelings of trust, support, and desire to have a community up-to-date, that’s when we’ll reach the 95 percent level we want.

Pediatricians and parents can partner unlike ever before and with tools unlike we’ve ever had to make sure the spaces where our children spend their days is as safe as possible.”

Knowing where you live and how your community is doing on vaccines and speaking up about what you believe matters. More than ever before, clearly articulating that you vaccinate your child and that you want your child amid a group that does the same is essential. Check out your state’s data in the AAP infographic. Get even deeper into the data with online resources like School Digger that allow you to peruse the data on vaccine status at the school level.

Pediatricians and parents can partner unlike ever before and with tools unlike we’ve ever had  to make sure the spaces where our children spend their days is as safe as possible. Speak up, ask about rates at your schools and tell other parents how much you value vaccines that protect your children and their friends. 

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HPV Vaccine On Time: Only 2 Doses

hpv-2-doseWelcomed news out this fall about immunizations. If children and teens get their HPV vaccine on-time between the age of 11 and 14 years, they won’t need to do 3 doses as previously recommended. HPV vaccine given, starting at age 11, can be just 2 doses now, spaced 6 months apart! Celebration.

This new HPV shot recommendation from the CDC is based on research that has found when younger children are immunized, their immune response is greater at younger ages (age 11 versus age 16, for example). It’s also based on data on durability of the vaccine response — data has found teens immunized in the “tween” years continue to be protected years and years after the vaccine is given. So don’t wait to get teens immunized! In fact, waiting isn’t safer in any way, just leaves your child open to exposure for a longer period of time and the vaccine has the same side effects (most notably pain at the injection site!). Plus, you’re now reducing the amount of shots your child needs from 3 –> 2. Huge win!

The hope in this new recommendation is three-fold: more teens will get immunized on-time, they’ll be better protected from HPV infections and cancer risks early, and it will be easier to complete the entire series. Last year, for example, about half of boys ages 13 to 17 had gotten at least one of the recommended three doses, while about 63 percent of girls had gotten at least one dose, according to the CDC. However, not all teens finish the series and the new recommendation may help. In some areas only about 1/3 complete it.

HPV vaccine is an anti-cancer vaccine.

If your child has started the HPV series but not completed it, there is no reason to re-start the series — those shots still count. Just schedule a visit to finish what they started. If your child is between age 11 and 15 and there has been 6 months since their last HPV shot, under the new recs they will only need one more dose.
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Online Easy Access To Immunization Records

The digital health world recently took a step in the right direction when it comes to supporting access to your health care information. You can now be in charge of both your own and your family’s immunizations records in several states through a tool and online resource called MyIR (think “my immunization registry”). You can register yourself and your dependents and access to your official, consolidated immunization records on any device, any time. How great is that? No more calling your doctor’s office and asking them to fax your records over. Waiting for snail mail to deliver a copy is a thing of the past. For procrastinators with school paperwork, this is for YOU! With back to school rapidly approaching, now is the time to get your children up to date on their vaccines. And a great time for you to have unfettered access to the records.

New Immunization Record Access: MyIR

  • MyIR gives you access to your official, consolidated immunization records on any device, any time
  • Records get updated immediately after any new vaccine is given
  • Can be printed to give schools, athletic clubs and day cares
  • Available in: Alaska, Arizona, Louisiana, Washington & West Virginia

Here’s How To Get Your Immunization Record:

  • Visit: www.myir.net and register.
  • You can register yourself and any other family members
  • Verify: click Auto Match to have the site match your account with your state records
  • If Auto Match can’t find an exact match, click State Assisted Registration and follow steps (I had to do this and it was very efficient!).

myir auto matchmyir verify

2016 Vaccine Updates In Washington State

  • Last year, 85% of WA State kindergarteners had all required immunizations. Ideally we’ll get that up closer to 95%
  • Need 2 chicken pox shots documented this year. This year, schools are requiring documentation for all children in K-12 fro varicella vaccine. Parents need to make sure the school has the record to prove children have had both doses (given typically at 1 year and 4 year well child check-ups).
  • The flu vaccine is not required for school, but is safe and essential — flu vaccine is recommended for all children over 6 months of age.
  • Nasal flu vaccine not recommended this year — only option is the poke, but it’s the best bet at protecting your children from influenza!

HPV Vaccine Reminders

  • The HPV vaccine reduces the risk of cancer from HPV for boys and girls. It also reduces the likelihood of getting genital warts and lesions after teens or young women and men becomes sexually active.
  • All teens benefit: girls & boys receive 3 doses of the HPV vaccine starting at age 11. First dose at age 11 years, a second dose 2 months later, and a third dose at least 6 months after the first dose. If you wait a bit longer, the series doesn’t have to be restarted so get in to get the booster if you haven’t finished all three shots in the series!
  • No benefit in waiting!  The vaccine is proven more effective at younger ages (age 11 tends to give a more robust immune response than when giving the vaccine in later adolescence). There is no health benefit in waiting in immunize your teens — same pain with the poke but more time a teen could be exposed to HPV.

 

No Nasal Flu Vaccine This Year: Flu Shot For All Over 6 Months

 

Summer vacation has just started and it feels like the mild 2015-2016 flu season just ended. Here we are already hearing about new recommendations for the 2016-2017 season. Big news in the media today about flu vaccine: recommendations to only offer the shot (and no nasal flu spray) to improve children’s and public protection from the vaccine. Hundreds of children in the US die each year from influenza. We know the best way to protect against complications from influenza is to have families immunized. Flu vaccine is an every-year, essential vaccine as the strains included in the vaccine shift each year based on the types of flu predicted to spread across North America.

Recommendations For Pediatricians And Family Practitioners: Only Flu Shot For Families

Yesterday The American Academy of Pediatrics (AAP) endorsed the Advisory Committee on Immunization Practices (ACIP) recommendations to AVOID use of flu mist vaccine this coming flu season.  The Centers for Disease Control (CDC) will review the recommendations shortly; if CDC accepts the recommendation it will become official US policy.

We all want choice with vaccines and the nasal spray was a great option and a safe one. It was particularly effective during the 2009 H1N1 pandemic flu season and has been safe and very well received (no poke!) by families ever since for children over the age of 2. However, data from the past three years have found that it has been less effective in protecting children and their families from the most common strains of flu circulating (more below).

The nasal flu spray vaccine is still licensed and still safe. Because of recent data, this year to improve protection, ACIP is recommending only using the injected flu shot because it is far more effective at protecting against the strains of flu expected to arrive in the US.

That means a needle and quick poke for our kids. I talked to the TODAY Show about the recommendations this morning. I also talked with influenza and vaccine experts. Read full post »

No Controversy, No Censorship — When Tribeca Got It Right

Screenshot 2015-02-01 12.30.40We don’t know what causes all autism but we do know vaccines don’t. Continuing to elevate myth does NO ONE any good. That’s why the Tribeca Film Festival got it right when pulling a documentary written and co-directed by vaccine science villain, Dr. Andrew Wakefield. Giving him another platform and more voice just isn’t insightful. To me it’s more noise and less what we need. There isn’t controversy here and there isn’t anything new to uncover. Allowing Wakefield more air time and the catapult generated by a film festival just ISN’T going to help us perfect parenthood and it won’t improve our jobs protecting our families, our children, and our communities. The Injustice of Immunization Interviews continues…

Tribeca Film Festival And Vaccines:

Wakefield is a doctor whose work connecting vaccines to autism was retracted from a medical journal (this is nearly UNHEARD of) and a doctor who lost his license to actually practice medicine. He’s not respected nor is his work something for us to learn from. His work may go down as one of the biggest frauds in medical history. Read: Wakefield’s article linking MMR to autism was fraudulent.

The science, on the other hand, is clear and well established. Vaccines have repeatedly and repeatedly been studied with respect to development of neurodevelopment changes and diagnoses on the autism spectrum. Don’t believe the preposterous things the politicians say. The 2011 comprehensive and enormous report from The Institute of Medicine analyzed over 1,000 studies on adverse side effects from vaccines. They concluded, “the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including Type 1 diabetes and autism.” (read more here)

Ongoing research, motivated primarily because of the distrust and fear for vaccine safety propagated in movies, media, and documentaries alike continue to find the very same thing. Science continues to come out on the side of vaccines. Vaccines have adverse effects (fever, pain, seizure, and fainting, for example) but not autism. Read full post »

HPV Vaccine Decreases HPV Infections!

Great news about reducing cancer risk. Nothing controversial here…

There is early evidence from a recent Pediatrics study that the HPV vaccine is doing what it was intended to do: decrease the rates of HPV infection in teens and young adults. The study compared HPV in two groups of teen girls and young women–one group during a time prior to the vaccine being used (pre-vaccine era 2003-2006) and another group of similar girls and young women after the vaccine’s introduction (vaccine era 2009-2012). They evaluated prevalence of HPV infection in both groups (from cervicovaginal swabs) to see the effects of the vaccine on the population. The DNA tests from those swabs identified evidence of HPV infection from HPV strains that have been included in the vaccine and also additional strains of HPV infections not previously in the vaccine. Researchers also had information about the girls’ self-reported vaccine status and behavior (sexual activity).

The results are exciting and hopeful when it comes to protection from HPV vaccine.

The study shows a 64% decrease in HPV strains found within the vaccine in immunized girls ages 14-19 and a 34% decrease in HPV in girls ages 20-24 who had received the HPV shot. In my opinion, there are 2 big takeaways to this progress and learning:

  1. The vaccine is effective in protecting teens from acquiring HPV, especially so during teen years. When the shot was given in younger teens they were more likely to have better protection — likely because they are immunized early and thus if/when exposed to HPV infections during their life, they were already protected.
  2. The earlier the HPV vaccine is given, the better the hope for protection against HPV during teen and young adult years. No safety benefit in waiting to be immunized — the risks are the same from the injection but waiting allows more time when a teen could be exposed to HPV. The data out last month may also reflect previous research that the immune response is better when the immunization is given to younger girls and boys (age 11 for example, over age 16 years).

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Flu Season Update & OTC Medicines

2016 flu KYOTCs

The flu season is in full swing across America although thankfully, influenza activity is mild in most states. If you click on this interactive US map you can see where your state fairs with ongoing influenza (hit “play” and you’ll see all weeks reported this season).

It’s certainly NOT too late for your family to get a flu shot  (or nasal spray) since that’s the best way to protect against severe complications from influenza. There is no cure for influenza (antibiotics don’t treat the virus), but there are over-the-counter (OTC) products that do help ease symptoms & side effects from viruses (including influenza) that cause cold symptoms. Some doctors are calling for a “symptomatic prescription pad” that would first suggest simple aids like humidifiers, drinking fluids, and OTC products before antibiotic use. No sense in using antibiotics if the infection you or your child has is from a virus like influenza or one of hundreds that cause the “common cold.”

It’s awful when our children are sick, especially when multiple symptoms like congestion, fever, body aches, sore throat or cough interfere with sleep. Salt in the wound for parents everywhere. Sleep disruption is normal during illness, especially cough and colds, and especially with infants and toddlers who are unaccustomed to moving mucus around while they sleep. So parents often turn to multi-symptom OTC products out of desperation! Sometimes these medicines really reduce symptoms that can make the whole family suffer but there are cautions we have to take.

First off, cough and cold medicines are not typically recommended in children under age 4 to 6 years of age.

In addition, we have to use our smarts with medicines that contain more than 1 ingredient that treat different symptoms. Being aware of the ingredients in the OTC product you’re using is very important because you don’t want to take another product that includes the same ingredients as another (doubling-up). This can happen if you give your child acetaminophen, for example, for fever and then give a cough and cold medicine with that same ingredient. Read full post »

Quick Ask This Flu Season: Peer To Peer Protection

If our entire community got the flu vaccine we’d be MUCH less likely to share it. We’d also be much less likely to get influenza. Studies find that about 10-40% of children get influenza each season. Because their immune systems are a bit “naive” to influenza, they are at risk for more serious illness, especially if under age 5 years.

What if parents were the ones to endorse protection from influenza? What if we drove our schools and playgroups and community protection? I want our communities safe and healthy this flu season and our best defense is the flu vaccine, staying home when ill, and covering our coughs. It may be the mom-to-mom-dad-to-dad message that is most powerful…

The match between the flu vaccine (nasal spray and the shot) and circulating strains of influenza are better this year (including the H3N2 strain). That means the flu vaccine will likely be far more effective in protecting our families!

Data has shown us that nearly 1/2 of the adult population does NOT get their flu shot, yet 75% of parents to young children DO get their young children and toddlers vaccinated. Parents really do want their children protected and although pregnant moms are at high risk for flu only about 50% got their flu vaccine last year. Not only does mom get protection of her own health when she gets the vaccine, she passes on antibodies to her baby!

Will you share a video with your community? I created the below series of flu videos in partnership with The American Academy of Pediatrics targeted to specific demographics and age ranges. You can share them via email, social media or in-person. Help me make the case to ensure our kids are healthy and protected this flu season. I’ve provided the videos and links to share them below. Thank you for joining me in avoiding influenza this year. Share one of these videos?

8 & Under: Why Flu Vaccine Is an Every-Year Thing!

Link to share: https://www.youtube.com/watch?v=kS9mgx8Bemg

 

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