Vaccines

All Articles in the Category ‘Vaccines’

10 Things To Know About 2017-2018 Flu Shots

The flu season is soon to be upon us and I hate to be so prescriptive but when it comes to influenza I feel like I have to be. I immunize my entire family and I think you should, too.

Hard to believe, but with our children going back to school and swapping snot around the classroom, it’s time to get fall flu immunizations on your radar. Last year during the 2016-17 season, more than 100 U.S. children died of the flu (influenza), and thousands more were hospitalized for severe illness or complications from the virus. Historically, more than 80% of children who died of influenza were not vaccinated. The flu shot is the best way to teach your own immune system to fight back if exposed to the virus. The flu vaccine “recipe” was changed this year (one different A strain compared with last year’s vaccine) to accommodate for predicted viral strains that will likely come and circulate around our neighborhoods.

The recommendations this year are the same as last year. Every child over 6 months of age should be immunized.

10 Things To Know About Flu Shots:

Here’s what you need to know based on my experience as a pediatrician, The Centers for Disease Control and American Academy of Pediatrics policies:

  1. All Children Over 6 Months: The flu vaccine should be given to everyone 6 months and older. Babies and young children (6 months to 8 years) who have never had a flu shot will need 2 doses of the vaccine, given at least 4 weeks apart. Young children under age 5 years of age at higher risk of hospitalization and serious illness as are children with underlying medical conditions.
  2. Pregnant Moms High Risk: Flu vaccine should be given to all women who are pregnant, considering pregnancy or are in the postpartum period or are breastfeeding during the flu season. The vaccine is safe to get at any time during pregnancy. Mom’s immune response (making antibodies to the virus) are passed onto the baby in the final stages of pregnancy and protect newborns too young to get the shot. A double win!
  3. Only The Shot: This year, like last year, the nasal flu spray is not recommended because data showed that it was less effective in protecting children and their families from the most common strains of flu circulating. It’s a sincere bummer, in my mind, that we don’t get to offer the spray but it sure is good news to only use an effective vaccine backed by decades of safety research. Another reason to avoid promising “no-poke” visits.
  4. Timing: Get your vaccine as soon as it becomes available, and ideally by the end of October before Halloween. No reason to try to “game the system” and wait as there isn’t a lot of convincing data that the vaccine fades before the flu season does. Influenza peaks in early winter typically but of anything that’s predictable, it’s that influenza is unpredictable. Being immunized 2 weeks prior to an exposure is the best way to be protected. Most doctors and nurses and hospital workers will all have their vaccine in September and October.
  5. Children With Egg Allergies: are OK to get the shot and do not need to go to an allergist to get the vaccine.
  6. Flu Shot Can’t Cause Influenza: The flu shot doesn’t cause flu infection. The shot is not a live virus vaccine, it’s an inactivated vaccine, and it can’t replicate in the body.
  7. Lots Of Vaccine Available: Flu shots will likely be at your pediatrician’s office soon. There will be about 150 to 166 million doses of the vaccine produced.
  8. Side Effects: most commonly are pain in the arm or leg at the injection site. About 10-30% of children under age 2 years will get a fever whereas fever is rare after flu shots in older children and adults.
  9. Thimerosal: is a preservative used in multi-dose vaccines like influenza. There are thimerosal-free formulations, as well, if you’re concerned about the preservative. Thimerosal has never been shown to cause health problems.
  10. You Don’t Want Influenza, Get The Shot: Families, in my experience, who have experienced influenza in their home always get the flu shot thereafter! In my 11 years of practice I’ve taken care of critically-ill patients with influenza, patients with severe pneumonia, severe ear infections, dehydration, seizures, and respiratory distress requiring oxygen all from flu. The vaccine effectiveness for flu vaccine varies from year to year based on what specific strains are in the vaccine (3 or 4 strains, depending on the manufacturer) and what strains of influenza virus actually circulate between people. On average, most years the vaccines anywhere from about 50 to 60% effective. That means if 100 people got the shot about 50 or 60 people, on average each year, would be protected from getting the infection when exposed to influenza.  Some people feel it’s not good enough — but remember if you don’t get the vaccine you have absolutely zero added protection when exposed. Some studies find that anywhere between 10-40% of children are exposed to influenza every year so every layer of protection helps.

When you immunize your kid, you first and foremost protect them, you secondarily protect your family, and third, you protect those kids who can’t get the shot, those older people who won’t mount a great response to the vaccine and can get really sick when they’re exposed, and those babies who are too young to be immunized.        ~From an NPR Interview on 2017 Flu Vaccine

As A Pro-Vaccine Parent You Can Change Your Community’s Protection:

One of the ways you can change your family’s level of protection is to make sure other families in your community also get their flu shot so their family doesn’t share flu to you and those you love. In general, one of the reasons we have a lot of circulating flu is that only about 50-75% of people get the flu vaccine (depends on your age range, toddlers typically are well immunized!). What if parents were the ones to endorse protection from influenza? What if we drove our schools and playgroups and community protection by helping make sure families remembered it was an important step?

Perhaps share with others that you’re immunizing your family? Share a video with your Facebook or Instagram or other social community? I’m hoping this 20-second video can help nudge those who haven’t yet planned to get their family protected. Spread it, not the virus.

 

Quick Video Q & A on Vaccinations

BBC invited me to discuss vaccinations and help answer some popular questions parents have about them. View this short Q&A video on BBC where I share the following answers to these common questions:

  • Can vaccines cause autism? We don’t know what causes all of autism spectrum disorders but we do know that vaccinations do not lead to the development of autism. More info worth reading here on Autism and Vaccinations from Autism Science Foundation — a non-profit working to support families with autism spectrum disorders and the research that helps guide and empower improved prevention and treatment.
  • Is it safer to space out vaccines? It isn’t safer to space out vaccines. Not a single study that finds a delayed schedule is safer than one spaced out. No data, for example, that an MMR shot is safer at age 3 than at age 1. Why wait while measles outbreaks do continue? Waiting only increases overall risk.
  • Should I be worried about the chemicals in vaccines? We know more about the safety of vaccines than we do about some of the foods we eat. The ingredients and rigor around the science of vaccines is tight. See recent post with info about ingredients or this info and Q&A on ingredients in vaccinations.
  • Isn’t it my personal choice? When you get your child vaccinated on schedule you’re not only protecting your child’s health, you’re protecting your community’s health. And your own family’s.

You can also view a BBC story on vaccination hesitancy or listen to a recording of its radio story where they discuss areas with higher levels of families delaying or opting out. As a reminder, in the US about 9 in 10 families do follow recommendations to get their children vaccinated on-time, keeping us all safer. Magic in medicine…

Vaccination Hesitancy: 4 Myths Explained

Vaccination hesitancy or concern about getting your child their shots isn’t new. But it has recently been gaining attention in the media. In February, Robert Kennedy Jr. offered a $100,000 reward for anyone who could turn up a study showing that it is safe to administer vaccines to children and pregnant women. Let me start by saying that there are countless studies and data in support of vaccination safety. So the offer and claim should be given/received over and over and over again.

I mean, COME ON.

However, with politicians using their platform to blast these fallacies and doubts about vaccination, I worry there is a new sense of unease growing among parents. This unease is causing pediatricians to worry about what’s to come in the coming years for families and their safety.

The below chart from the American Journal of Health Behavior and shared by the American Academy of Pediatrics (AAP) depicting the various types of parents and their responses to vaccinations helps frame up who we are. Even with all of the hoopla in the media, studies have found only 16% of parents are fence-sitters or worriers about immunizations. That means there’s a lot of distortion in the voices that are being heard in these conversations, which is causing “health advocates” and others to question if they should continue moving forward with vaccinating their children.

It’s my job as a pediatrician to make sure you hear the other 84%. The following are four of the most common myths that cause parents to worry about vaccinations, and most importantly, why they shouldn’t worry as much with real data to back it up. Read full post »

New Data On Preventing The Flu And Whooping Cough

Many of us have probably experienced influenza (the flu) at some point. Sometimes we really know it, sometimes we don’t. Previous data has even found that in a typical influenza season (winter) as many as 10 to 40% of all children get exposed or actually get influenza in a given year.

Sometimes the infection from influenza is mild (“just a cold”) but sometimes it’s a horrific long-lasting-high-fever-achy-pneumonia-hospital-causing infection. Sometimes it’s worse. Hard to predict why we all don’t experience the same virus the same way each time we’re exposed.

Those under age 5 and those over 65 years of age are at highest risk from influenza. The reason: young children have an unexposed, immature immune system that doesn’t work as well fighting against influenza as a 12 year-old where as the elderly have a tired immune system that just doesn’t work as well as it did during young adulthood. Each year children die from the flu that could have been prevented. The flu vaccine isn’t perfect in protection, and this year it’s got about a 50% chance of totally protecting you — far better than 0% when you don’t get it at all!

New data out proves that flu vaccine helps prevent death in children. News any mom or parent or pediatrician wants to hear and share.

For infants and elders, the flu can be deadly. For new babies, pertussis (whooping cough) can be, too. The good news is that these illnesses are vaccine-preventable. This post is just a reminder of the power of vaccines to prevent pain and suffering and new data that continues to support our use of whooping cough shots during pregnancy for moms and babies and flu vaccines for children every year.

Two studies from the American Academy of Pediatrics (AAP) highlight just this by establishing vaccine effectiveness for reducing death and serious infection. Take these as reminders of why we vaccinate our children and ourselves! Read full post »

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. Read full post »

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.
Read full post »

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.
Read full post »

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 »