‘immunizations’

All Articles tagged ‘immunizations’

Something In The Air: It’s Measles

Something is in the air right now. There’s a strange mix of vaccine-preventable illness sweeping the country (measles) and a strange bump in media coverage for celebrities and vocal opponents to tested and recommended vaccine schedules. Part of me thought we might be done with that but pageviews, clicks, and views all sell.

My hope is the coincidence of coverage and outbreaks is just that, a coincidence. But as a mom, pediatrician, author and media reporter, the view from here is unsettling. We can’t prove that mishandled media coverage is changing the way we immunize our children (or at least I haven’t seen the data) and how parents protect them, but there are moments like this it feels it’s possible that trust is simply being eroded with this 24-hour online/TV/print news cycle. Parents might be vulnerable to bad medicine when gowned as good business. A couple of examples:

Two weeks ago Kristin Cavallari (a wife to an NFL player and reality TV star) went on Fox News to discuss her career (and parenting) and ended up discussing her theories on a group of vaccine refusers and autism. Perhaps talking about medical theories is a really good model for accelerating a career? Next up was Huffington Post where she dropped the bomb, “’I’ve read too many books’ to vaccinate my child.” I suspect she’s yet to read mine. Particularly chapter number 57 entitled Measles In America. Read full post »

Pain Is Inevitable But Suffering Is Optional

This is a guest blog from Lisa M. Peters, MN, RN-BC (in the video above). Lisa is mom of two children and a clinical nurse specialist for the Pain Medicine Program at Seattle Children’s Hospital. She holds a clinical faculty appointment in the Department of Family and Child Nursing at the University of Washington School Of Nursing. She is board certified in pain management from the American Nurses Credentialing Center and is a Mayday Pain & Society Fellow. Lisa has a passion for improving the lives of children in pain. I’ve learned so much from her already!

~~~~~~~~~~~~~~~~~~~

Pain is inevitable; suffering is optional. That’s a key message when I partner with parents who bring their kids in for procedures and hear them recount stories of standing by, feeling helpless, as they watch their kids suffer with pain and distress.

It does not have to be that way.

Parents seldom realize the power they have as advocates and as partners with doctors and nurses in managing, and even preventing, their children’s pain. Could that shot at the doctor’s office really be a different experience? Do a few moments of pain really matter in the long run? If I speak up, will they label me and my kid as “troublemakers”?

As a parent, you can make a big difference in your child’s experience with pain. Knowledge is power.

3 Things To Know About Pain:

Poorly treated pain is harmful, both immediately and long term.
Science continues to teach us about the consequences of poorly treated pain on our bodies and minds. There is evidence that it can change how our bodies process pain signals, especially during critical periods of development in childhood. This can lead to highly sensitive areas of our bodies or a generally louder experience of pain. Memories of painful experiences have been shown to shape how we respond; studies show that 10% of the adult population avoids seeking medical care when needed due to fear of needles. Read full post »

2013-2014 Flu Is Here

Influenza December 2013

Influenza currently has widespread activity here in Washington and fortunately the news media has really picked up the story the last couple of days. I say fortunately, because as we know more about flu in our community, the better we can work to protect our families. There’s no question clinic was full of coughs and colds yesterday!

At of the end of last week, the CDC reported that 25 states in the US have widespread influenza (see above map). In addition, public health officials confirm that H1N1 Influenza A is causing more serious, sometimes deadly disease in young adults. This post is simply a reminder that flu is here in our communities, work, and schools. The best way to reduce the risk of serious influenza infection is still to get a flu shot. Particularly if you’re a middle-aged adult (!!), as young adults are bearing a particular burden of serious disease this season. In fact,there have already been a number of deaths in WA state. Many of the individuals who died were unvaccinated.

This is still true: pregnant women, young children, those over 65 years, and anyone with underlying medical conditions are at higher risk for serious infection from influenza. Read full post »

Simply Not Factual

No-SymbolSimply not factual. That’s really all that needs to be said in response to Michael Edwards’ opinion piece entitled “Vaccine Side Effects and Why You Shouldn’t Vaccinate” published in Organic Lifestyle Magazine last week. This is clearly a non-peer reviewed, non-fact-checked online publication that Mr Edwards edits and owns. Fortunately, the magazine is reported to get about the same amount of traffic as my blog so it’s not exactly the Washington Post…

That being said, Edwards’ piece is so egregious I’m unable to hold my breath. Although I’m no watchdog, the dangerous writing demands physician attention partly because it’s been published amidst a noteworthy week in the world of vaccine misinformation:

  1. A segment aired last week by a local TV station in Las Vegas claimed doctors debating a need for vaccines. The TV station reported false information and misrepresented a chiropractor as a “holistic physician.” There was a noted uproar online, especially when original comments from physicians were, at first, taken down. Here’s more from news watchdog Gary Schwitzer, “Back To School Anti Vaccination Woo.”
  2. Mr. Edwards published false information claiming families shouldn’t vaccinate. More below.
  3. Jenny McCarthy’s credibility erodes further as it’s announced she is now advertising e-cigarettes. A pediatric colleague wrote a blog post entitled, “Jenny McCarthy continues tireless crusade to kill us all.”

Back to the piece in “Organic Lifestyle” though. What is so dangerous is not just Mr. Edwards’ misinformation but the way his article appears to the eye. Mr. Edwards published his vaccine opinion in a structure that misleads a reader to believe it’s based in fact. There are sections with headers, subtitles with supposed historical reference, and a list of resources at the end. All the while Mr Edwards warps truth and paints a picture of a fictitious world—one where those diseases now eradicated (small pox) or nearly so (polio) thanks to vaccines, aren’t.

Small pox has been eradicated by worldwide vaccination and thanks to vaccines married with a remarkable commitment from the Gates Foundation, polio is nearly gone too. Read full post »

Hepatitis A Outbreak: A Vaccine For That

frozen smoothie berriesThe CDC declared an outbreak of Hepatitis A over the weekend that has affected over 30 people in 5 states. Preliminary information confirms the source of the outbreak stems from organic frozen berries that were sold at Costco stores (including stores in Washington) yet sickened people thus far are in Colorado, New Mexico, Arizona, Nevada, and California. No cases have been reported in Washington to date. The berries: Townsend Farms Organic Anti-Oxidant Blend, a frozen berry and pomegranate seed mix, have now been pulled from shelves and people who purchased these berries from February through May are being contacted.

The amazing thing about this outbreak: there’s been no reported cases of Hep A in children under age 18.

In the United States, Hepatitis A typically spreads through contaminated food handled by someone with the infection. Rates of Hepatitis A infection tops 5,000-10,000 cases annually in the US while they are far higher in the developing world because city water sources can get contaminated (see below). Hepatitis A vaccine is recommended before international travel.

The lack of children with infections from this outbreak is logical and potentially illustrative.

Read full post »

Modern Parenthood, Vaccines, And Myth With Mnookin

panicThis Tuesday evening, I’m joining Seth Mnookin at Town Hall in Seattle to discuss vaccines, modern parenthood, and (mis)information about vaccinations online. Although you may know Seth Mnookin secondary to his crucial role in the Boston Marathon Bombings story this past week, at his other day job he’s the co-director of the graduate program in science writing at MIT. He’ll be here in Seattle because he is also the author of a powerful book, Panic Virus, that details the history of vaccine hesitancy in the US.

A True Story of Medicine, Science, and Fear.

Although the book sits on the nonfiction shelf, it reads like a thriller. Think Contagion meets John le Carre´.  I’m not exaggerating here: when I first read the book 2 years ago, I pulled a near-all-nighter because I couldn’t put it down. I don’t think that’s because I’m a pediatrician, I believe I couldn’t put it down because I’m a mom.

I met Seth nearly 2 years ago and he signed my scribbled-in copy of his extraordinary book. Panic Virus changed my understanding of vaccine hesitancy. There are parts of the book that caused my stomach to drop and certainly parts of the book that made me worry. Read full post »

A Voice For Vaccines

Karen ErnstThis is a guest blog from Karen Ernst. Karen is the mother of three boys and a military wife.  She sometimes teaches English and enjoys advocating for and working with children. She is the co-leader of Voices for Vaccines and one of the founders of the Minnesota Childhood Immunization Coalition.


The preschool class party was one of the last hurrahs for my then five year old. The entire family attended, including our ten-day old newborn, whose only interest was nursing. His lack of other interests turned out to be good fortune because another mother-son duo at the party were contagious with chicken pox and began showing symptoms the day after the party. Had the mother held my newborn or the child played with him, the results could have been fatal for our son.

Having immunized my older child, who played with his contagious friend, I was relieved that no one in our home contracted chicken pox and no one passed it on to our new baby.

While I was angry when the mother revealed that she’d purposely left her son unvaccinated against chicken pox, I felt proud that I had chosen well, I had protected both my children, and I had understood and agreed with what public health officials had proposed: that children need the varicella vaccine. I had both done what I was supposed to, and nothing bad happened. So that’s the end of the story, right?

Read full post »

Chickenpox Parties

pox party de-identifiedToday a Seattle mom advertised on an online parenting community that both of her children had chickenpox and then invited (non-vaccinated) children over for exposure. That’s the invite from 1:19pm today.

It turns out people are still having chickenpox parties.

Part of this makes my head spin. I just don’t get it, despite having had many families in my practice decline or hesitate or delay the chickenpox shot. I don’t think parents know what virus they are dealing with. After I posted this invitation on Twitter, I had physicians all over the country sharing stories (some included below).

Chickenpox can cause serious infection complications and rarely it can be lethal. Before the vaccine was approved and put into use in 1995, hundreds of children and adults died in this country every year from chickenpox and thousands were hospitalized. Although most young children get chickenpox and recover (only left with pox or scars) some children develop life-threatening secondary infections. Some children develop severe pneumonia (1 in 1000 children), some develop brain infections, and some children develop flesh-eating bacterial infections in their scabs that can even be fatal.

There is a safe, highly effective vaccine for chickenpox: Varicella Vaccine.

After I saw the pox party invite this afternoon I became slightly enraged. I mean, there are NUMEROUS children and adults in our community immunosuppressed and/or on chemo that could develop life-ending complications if exposed to varicella. And some families are intentionally exposing their children to a potentially harmful infection. After 2 doses of the chickenpox shot (varicella) 99% of patients are immune to chickenpox. Although some children can get chicken pox once vaccinated, they typically only have a few pox and do not develop severe side effects or die.

The pox party just shows me how much work we have to do to build trust in vaccines and vaccine-safety. My boys have both had 2 doses of the varicella vaccine. I’m thrilled they are protected and unlikely to ever get chickenpox or spread it to a community member who could be more at risk. They likely won’t get shingles, either.

Chickenpox Facts & Stats:

  • Varicella shots hurt upon injection (children tell me it really stings). We give the shot twice, once at 1 year of age and once at 4 years of age. The shot can commonly cause arm soreness and lowgrade fever. In less than 5% of children, a small rash develops, often around the site of the shot. That’s a good sign the immune system is being triggered to fight off future infections. The rash that can develop after the shot is not contagious. Read full post »

Parents May Hesitate On Teen Vaccines

Since 2005, teen immunizations have been recommended at the 11 year-old well child check-up but rates of teens who keep up to date on their shots lag. In an ideal community, 90% of us would be up to date on shots to prevent disease spread most effectively.  Back in 2007, teen recommendations were expanded to include HPV vaccine for girls. In 2011, both boys and girls were recommended to get HPV shots. Although the majority of teens get the Tdap shot (tetanus and whooping cough booster) only around 1/3 of teen girls are up-to-date on their HPV shot when most recently surveyed.

Teen Shots Recommend at age 11:

  • Tdap (tetanus, diphtheria, pertussis shot)
  • MCV4 (meningitis shot)
  • HPV (human papillomavirus shot, requires 3 doses over 6 months)

A Pediatrics Study on teen shots revealed that parents may not get their teen shots due to concerns about safety or not understanding the shot was recommended. Not all shots are required by schools; I think some families tend to experience that as an endorsement for the shot being less important. In the survey conducted between 2008-2010, researchers sought to understand trends and rationale for lagging shots: Read full post »

Is It Really An Ear Infection?

Screen Shot 2013-02-26 at 9.46.22 AMEar infections cause significant and sometimes serious ear pain, overnight awakening, missed school, missed work, and lots of parental heartache. For some children, infections in the ear can be a chronic problem and lead to repeated clinic visits, multiple courses of antibiotics, and rarely a need for tube placement by surgery. For most children, ear infections occur more sporadically,  just bad luck after a cold. Fortunately the majority of children recover from ear infections without any intervention. But about 20-30% of the time, they need help fighting the infection.

Ear infections can be caused by viruses or bacteria when excess fluid gets trapped in the middle portion of the ear, behind the eardrum. When that space fills with mucus or pus it is put under pressure and it gets inflamed causing pain. Symptoms of ear infections include pain, fever, difficulty hearing, difficultly sleeping, crankiness, or tugging and pulling at the ear. This typically happens at the time or soon after a cold—therefore the fluid in the ear can either be filled with a virus or bacteria.

The most important medicine you give your child when you first suspect an ear infection is one for pain.

Antibiotics only help if bacteria is the cause. When a true infection is present causing pain and fever, antibiotics are never the wrong choice. Often you’ll need a clinician’s help in diagnosing a true ear infection.

Three’s been a lot of work (and research) over the last 15 years to reduce unnecessary antibiotics prescribed for ear infections. There has been great progress. Less children see the doctor when they have an ear infection (only 634/1000 in 2005 versus 950/1000 back in the 1990′s) and they’re prescribed antibiotics less frequently. Recent data finds that less than half of children with ear infections receive antibiotics (only 434 of every 1000 children with ear infections). However, the far majority who go in to see a doctor do still receive a prescription for antibiotic (76%).

The American Academy of Pediatrics(AAP) just released new guidelines to help physicians do a better job treating ear infections. Sometimes children really benefit from using antibiotics and new research has led to an update on the 2004 previously published recommendations. Over-use of antibiotics can lead to more resistant and aggressive bacteria so we want to use them at the right time. These recommendations may help improve care for children.

In my opinion, NPR published the best article I’ve read covering the new recommendations. I especially liked the balance provided: Read full post »