Vaccines

All Articles in the Category ‘Vaccines’

Influenza Hitting Hard: OTC Medications For Symptoms

Image courtesy: http://www.cdc.gov/flu/weekly/#S5

Image courtesy: CDC

Influenza is hitting hard this year thanks to a drifted influenza strain (H3N2) causing a more serious illness and one that is not included in our annual vaccine. Because of the hard hit, public health officials are reminding us to get high-risk patients into see physicians early if they have symptoms of “the flu” or influenza infections. Reason being, those at high-risk for complications may benefit from a prescription anti-viral medicine that can lessen the burden of illness and decrease risk for complications. Over-the-counter medicines you buy don’t fight influenza.

What Is “The Flu” And What Is Influenza

In general, in healthcare we use the term “the flu” when discussing an infection with influenza, a virus that causes widespread body aches, high fever, cough/cold symptoms, headache or even leg aches. Some children vomit with influenza infections as well (incidentally many patients with lab-confirmed influenza that I’ve seen this winter have also been vomiting) although in general influenza infections are upper and lower respiratory infections, and not the “stomach flu.” We worry about influenza as it’s in the list of top ten causes of death in the US and because it can cause severe symptoms, even in children. Infants and young children are at particular risk for serious infections as their bodies and their immune systems haven’t fought off influenza before.

High risk patients: 

  • Children 2 years & younger (their immune system not as robust and not as much “memory” to fight off severe influenza infections).
  • Adults age 65 year & older (their immune system is aging and not as robust fighting off severe influenza infections).
  • People with underlying health problems (including asthma) or other lung problems, other chronic health conditions (like diabetes, heart disease).
  • Pregnant moms or newly postpartum moms.
  • Those people immunosuppressed.

The Numbers So Far

According to the CDC, widespread influenza activity is being reported in 46 states. The most common strain is that drifted virus H3N2, accounting for over 90% of the more than 5,000 reported influenza-positive tests recorded last week (ending January 10). It’s still too soon to tell whether we’ve reached the peak of flu season, however there are early signs that the virus is lessening in parts of the country. So far, this year the influenza vaccine is estimated to be about 23% effective, clearly not as effective as usual but still providing some protection.

What Over-The-Counter Medicines Can Help With Influenza?

It’s important to remember that over-the-counter (OTC) medications cannot cure “the flu” nor shorten your suffering with symptoms. They’re designed simply to help you get through the illness and should be taken within the proper guidelines. In general children under 4 should not be given OTC cough and cold medicines. 

That being said, there are four types of medications that can make getting through the flu a little more bearable. Read full post »

Speaking Up At School

CS Mott graphicIs it partly our responsibility, as parents, to ensure our kids are in an immunized, safe environment? Maybe so.

Unsurprisingly, most parents want to make sure their children attend a school or daycare with children up-to-date on immunizations. This week is National Influenza Vaccination Week and provides a hearty reminder. Established by the CDC in 2005, it began as a way to raise vaccination rates during the month of December. Vaccinations historically tend to drop at the end of November (we get busy, we don’t go to the doctor), but this is only the beginning of flu season and it’s not too late to get yourself and your family protected. Influenza peaks in February and March so December is still a great time to get immunized for anything, including flu.

Although many daycare facilities are mandated to check immunization status at entry, not all keep up on the records as children age. New data finds many preschoolers are late to get their shot leaving about 1/4 of them in daycare/preschool not fully protected at any given time.

In a scenario where 1 in 4 children in their daycare center were not up-to-date with vaccinations, 74% of parents would consider removing their own children from that childcare center; another 11% would consider removal of their children only if an outbreak occurred.  ~National Poll on Children’s Health

Enter parent-to-parent healthcare… Read full post »

H3N2 And An Update on Flu

Lots of information floating around this past week about influenza. Of anything, remember this: it’s easiest to predict that influenza can be unpredictable and it’s also still true that a flu shot is the best way to protect your family from flu. I’ll explain why, along with a recap of what you should know about new data, here.

Flu season is just getting started in the United States (circulating infections in nearly all states) and this past week the CDC announced new information about a strain of Influenza A, H3N2. This is exactly what the CDC is supposed to do: keep us informed and help us prepare for an influenza season. This year the information standing out is risks surrounding the strain of H3N2 that has “drifted” and the reality that when H3N2 is the most common strain of flu going around it tends to cause more serious infections.
Did you know? Every year an estimated 20,000 children younger than 5 years old are hospitalized for flu complications. Like pneumonia. Everyone in your family who is 6 months and older should get a flu vaccine. This year, Next year, Every year. #getafluvax

When Influenza Virus “Drifts”

  • Vaccines for each year’s flu are formulated months in advance to allow time for vaccine manufacturing and distribution.
    • 100 centers around the world provide influenza surveillance and predict which strains will circulate to the US and North America. Decisions are made in February each year for the next year’s vaccine. Researchers look at trends to determine which viruses may be more prevalent.
    • The vaccine protects against three (trivalent vaccine) or four flu viruses (quadrivalent vaccine), based on the world’s predictions. Typically each flu vaccine has at least two strains of Influenza A and one or two strains of Influenza B. Of anything that is consistent it’s that flu seasons are unpredictable.
  • H3N2 is one strain of Influenza A in this year’s vaccine. The “drifted” vaccine is just another form of H3N2 that has different characteristics.
    • Flu viruses often “drift,” this happens every few years. The drifted H3N2 virus is one specific type selected for the 2015 southern hemisphere influenza vaccine (point being: this isn’t an unknown virus, it was just unknown how much it would spread in the US).

Read full post »

Has Your Babysitter Had The Whooping Cough Shot?

Mama Doc w baby girlA Seattle high school recently announced a minor outbreak of whooping cough: 13 students were diagnosed with laboratory-confirmed pertussis. None of the teens are contagious as of today, but it poses an interesting question about protecting our children and communities. A health advocate and friend on twitter suggested a savvy reminder: we can help teenage babysitters get up to date to protect young babies and children. Yes! Is it our parental responsibility to make sure babysitters, nannies or even sweet grandmas are properly vaccinated? Should it be the question we ask before we inquire if they’ve completed CPR training? Perhaps.

It’s hard enough to ask grandparents and friends to vaccinate or “cocoon” to protect our youngest and most vulnerable. It may be a challenge with the neighbor babysitter as well. I’d suggest just saying, “Hey, did you get your 11 year-old shots and your flu vaccine this year?” Thing is, one hurdle may be that your 15 year-old sitter may not know if they’ve had their teen pertussis shot. As a reminder, all children are given immunizations for whooping cough (DTaP) at 2, 4, 6, and 15 months. They then receive another dose at age 4. Then a tween booster dose (the Tdap shot) at age 11 years.

Many children prepare for the big job of babysitting by taking classes. At Children’s our next Better Babysitters class is November 22nd. I’m working to ensure that instructors make sure they help teens determine if they’re up-to-date on immunizations during the course!

What Is Whooping Cough?

  • Highly contagious bacterial infection (pertussis) of the nose and throat causes “whooping cough.”
  • Easily spread by coughing and sneezing. Symptoms appear 7-10 days after exposure (on average)
    • Symptoms differ by age, babies & young children may have severe coughing spells or even pauses in breathing. We worry most about newborns, young infants under 2 months of age but also consider babies under 6 months of age “high-risk.”
    • Adults and older children could have fever, runny nose and bad cough that progresses into coughing fits, “whooping” sounds with cough, or even a cough that lasts over 100 days (even if treated). Treatment prevents spread, not the cough.

Is Whooping Cough Serious?

Read full post »

Becoming an Impatient Optimist, One Mother’s Words

Alok post photo

Photo courtesy of Ananda Bandyopadhyay


Today’s post is written by Dr Alok Patel, a third year resident at Seattle Children’s. I met him last year as he immersed himself in training. Since then we’ve been syncing up, learning together about ways he can use his voice, his teeming passion, and his media channels to improve the health of populations everywhere. He’s peppered with ideas, brimming with ent
husiasm (it’s possible he speaks faster than I do) and diligently working to carve out his path as a public advocate, storyteller, and pediatrician. He’s a self-described, “wannabe medical journalist [working] to bridge the gap between public health and everyday.” He’ll finish his training this summer and begin his career officially; I suspect we’ll hear lots from him. In the past year we’ve both attended powerful social media summits at The Gates Foundation. And we’ve both stepped away inspired to do more. Dr Patel is starting to tell his stories publicly. Take a peek at his story below – the final quote left me slightly breathless… 

Turn on the news these days and it’s easy to feel like the world is falling apart. Globally, people are suffering from different diseases and even though public health officials are making great strides internationally, I often find my self wondering “what can I do to help?” And then I get overwhelmed by the idea of where to start.

Last month I had the opportunity to attend the Gates Social on Science Innovation, a workshop that unites people with two common interests, a love for social media and desire to enhance global health. Surrounded by “impatient optimists,” a software engineer, film director, marine biologist and elementary school teacher I was struck by the fact that we all have innovative ideas… and we all need help getting them off the ground.

I can’t speak for the other attendees, but my “awakening” of sorts took place during a presentation of New York Times Columnist, Nicholas Kristof. He was discussing the variety of stories he’s told, from the harsh realities of child prostitution, to the innovative games that are teaching anti-parasite practices on your phone. Then he said something that really resonated with me. Read full post »

3 Shots: Protect Against Cancer

It’s 2014 and it’s a reality that you can protect a child, teen or young adult from a cancer-causing virus with a series of just three shots. About 79 million Americans are currently infected with Human Papillomavirus (HPV), a virus that can cause warts but also lead to cancer (anogenital and/or throat cancers). Most data find 14 million new people are infected with the virus every year. Most of the time, HPV enters our body and our immune system gets rid of it on its own, however sometimes HPV causes trouble at the cellular level. Fortunately there’s a safe and effective way to stop the spread of HPV, prevent some strains of the virus from ever causing cellular changes in our body and ultimately prevent the related cancers it triggers: the HPV vaccine.

HPV Vaccine Is Safe

The HPV vaccine isn’t really “new” anymore. Between June 2006-March 2014, approximately 67 million doses of HPV vaccines were distributed. The vaccine is made from one protein from the HPV virus, designed to trigger a protective immune response; the vaccine cannot cause HPV infection or cancer. A recent study by Pediatrics found the HPV vaccine to be not only effective, but long-lasting. The study followed vaccinated girls and boys for eight years and showed evidence of durability; the HPV-antibodies remained at high levels over the years after immunization. Read full post »

Ouchless Flu Vaccine In 2014-2015

Influenza spray finalIt’s Flu “shot” season but thankfully not every vaccine hurts going in. This year your child may be offered either the “flu shot” or the flu nasal spray vaccine (ouchless!). This year most nurses and docs will encourage young children to get a nasal flu spray over the shot as recent data has found the nasal flu vaccine protects younger children better. Every year the flu vaccine is created to protect against influenza viruses predicted to spread and circulate in North America. We need the shot every year for two main reasons:

  1. Typically, different influenza virus circulate around the world from year to year. Over 100 international centers maintain year-round surveillance to determine and predict which strain will cause human infections. The information is used to forecast the recipe for the vaccine here at home. This year the strains (types) of influenza in the shot and nasal spray are the same as last year (2013-2014).
  2. Protection Fades. When you get a flu vaccine you stimulate the immune system to create protection against the strains of the virus in the vaccine. That immunity (the antibodies that are created) tends to fade and wane in your bloodstream after about 6-12 months. Therefore, even if you got the flu vaccine last year you really want your family to have it again this year so it protects you through the winter influenza season which can continue late into the springtime but tends to peak in February or March.

The flu vaccine contains either three (trivalent) or four (quadrivalent) strains of influenza. There is no official recommendation for one over the other. Flu vaccine is recommended for all children over 6 months of age who have no contraindication to the vaccine.

Worth noting: If the thought of needles deters you from getting the vaccine for your child or your family, Live Attenuated Influenza Vaccine (LAIV), a nasal spray, is a great option for those age 2 to 49 years. In fact, there’s data to suggest the nasal flu vaccine is more effective in protecting children from influenza in young childhood. Recommendations this year include a push to have children between 2 and 8 years of age immunized with the nasal spray whenever possible. If the nasal isn’t available, the shot should be given — no reason to wait.

About 20,000 children younger than 5 years old are hospitalized from flu every year  — form CDC “Which Flu Vaccine Should Children 2 to 8 Years Old Get?”

Information about nasal flu spray from CDC, Healthy Children and my “Debunking 5 Myths about the Flu

Who Can Get The Nasal Flu Vaccine?

Read full post »

Calling The Shots

Tonight, after President Obama speaks, PBS airs a NOVA documentary about vaccine science and safety. Vaccines: Calling The Shots. It’s told through the parent, pediatrician, and community lens. If you’ve ever wondered about vaccines in America, it’s time to tune in. I’ve been in touch with the team producing this documentary. Seriously excited to hear this story unfold tonight.

(update Sept 11: watch Calling The Shots online)

I think this is a big deal. This is an investigation on the science of vaccines.

The less the disease exists, the safer I am.

It’s a balancing act. The risks happen to be minuscule… the benefits are enormous

If inclined, follow a team of parents, pediatricians, and communities tonight on Twitter while it airs:  #vaccinesNOVA

Knowing The Benefit Of MMR Shot

A new study out today in Pediatrics reminds us that parents want information about the direct benefits shots have on their baby’s health and wellbeing. Not surprising, of course, but a good reminder for pediatricians, parents, and those who speak out on the value of vaccines to remember that primary motivation for parents in getting immunizations is to protect their child, not just protect the community. As a mom I feel the same way. As vaccination rates have decreased in pockets around the US these past few decades, and as non-medical vaccine exemptions (refusing immunization on philosophical grounds) increase, and as media coverage around the benefits of immunizing “the herd” remain a mainstay, returning to the individual benefit of vaccines makes sense. Parents really want to do what is best for their baby. They want to hear how and why to protect their baby. Vaccines do that.

The MMR vaccine protects your child from getting the diseases measles, mumps, or rubella or the complications caused by these diseases. After receiving this vaccine, your child will not miss school or activities due to these illnesses and will be able to play with friends during an outbreak.   — The message shared with parents in the research study

I like this study for two reasons:

  1. Parents Want To Know Why: In the study researchers went right to parents, mostly moms (80% of participants) between age 18 and 65 years of age, to share messages about MMR shot benefits to their baby and society and then gauged their intention to immunize their baby with MMR at 1 year of age. What I also really liked was the way the benefit was framed around a child’s wellness and their ability to play and be with friends!
  2. It Serves Up a Great Reminder:  We pediatricians, nurse practitioners, family docs, RNs, and MAs need to tell families what shots children are getting and we really need to stress WHY they are getting them in the context of life. We need to make the protection a shot provides relevant every time we order and administer the vaccine!

Pediatrics Study:

In the study, researchers compared about 800 parent responses in 4 groups (each group had about 200 parents). In one group parents got information only from CDC Vaccine Information Statement (VIS) about benefits/risks of MMR vaccine. In another group, parents got information about benefits of MMR shot to their baby and the VIS information. In a third group, parents got information about MMR benefit to baby and to population, along with VIS. And in the last group parents got information only about benefits of the shot for protecting the community along with the VIS.

Results: Parents were more likely to report their intention to get their infants the MMR shot when they heard about the benefit of the shot directly to their baby or when they heard about benefits directly to their baby and the population. When they heard only about risks/benefits of shot and risks/benefit to society, the information presented did not increase their intention to get the shot.

Conclusions: Parents are more likely to want to get their child up to date on immunizations if they know direct benefit on their child’s ability to go to school and play and be with friends.

Let’s focus on what matters to parents to young children when we talk about vaccine benefits — health, wellness, play, friendship, and opportunity.

For more on benefits of MMR shot for children and the diseases it prevents read here. Immunizations do cause optimism…

The Link Between Vaccines And Optimism

Yesterday morning there was a public Freudian slip. It was perfect. During an interview on the Today Show about “hot button” health issues the team addressed concerns about myths related to the causes of autism. Autism spectrum disorder, now estimated in 1 of 68 children, is a brain condition causing challenges with how children communicate, behave and relate with others. Autism spectrum disorder is thought to be caused by a mix of genetic risk, potentially starting inutero, and potentially influenced by environmental factors. There is so much more research needed to understand causes (for cures). In the past some have pointed to vaccines as a cause of autism although that theory has been debunked, disproven, and refuted again and again. But here’s what happened on the show. The interviewer addressed the topic and said, “We hear a lot about it in the media, that is, vaccines causing optimism….”

Now it was a misspeak, which of course happens to us all, all the time. But it got me thinking, we need to share this real link  like wildfire — the link between vaccines and optimism. We moms, we dads, we pediatricians, we nurses, we family doctors, we community members, we must speak up. Share this incredible fortune, peer-to-peer, the reality that indeed living now in the 21st century that yes, vaccines are linked to optimism.

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