‘vaccine’

All Articles tagged ‘vaccine’

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…

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.

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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 »

Whooping Cough Shot: Does It Last?

A study published today in The New England Journal of Medicine evaluated the duration of protection against whooping cough after children get the DTaP shot.  Researchers wanted to find out how long the shot lasts. DTaP shots are given to infants, toddlers, and kindergarteners (schedule below) to protect them from three infections (Diptheria, Tetanus, and Pertussis –whooping cough). After these childhood vaccines, we give a “booster” shot at age 11. Because we know that many babies who get whooping cough are infected by teens and adults, all teens and adults are now recommended to get a Tdap shot to protect themselves and those vulnerable against whooping cough.

As researchers seek to understand the recent epidemics of whooping cough in the US, they have found more and more that the causes of these epidemics are multifactorial. Not only is it unvaccinated populations that allow epidemics, it may be waning immunity from shots given previously and waning immunity to natural infection, as well. Previously, it’s been estimated that our immunity to whooping cough wanes anywhere between 4 and 20 years after we get whooping cough, and that it may wane 4 to 12 years after the shot.

A little history: back in the 1990’s we switched from using the “whole cell pertussis” shot to using a vaccine that is “acellular.” Some health officials have had concerns that this “acellular vaccine” may not protect children as long. Although it does a great job protecting infants and toddlers, it may not last as long as previous immunizations. Some have wondered how long the kindergarten shot protects our children…

Physicians at Kaiser Permanente reviewed information about children in California during the 2010 whooping cough outbreak. What they found may have significant effects on how to protect our children going forward: Read full post »

Fear Of Needles

Vaccine hesitancy comes in all flavors. It’s not always concerns about safety that causes children, teens, and parents to hesitate or even refuse vaccines. Sometimes it’s about pain. Or simply discomfort. Or anxiety. It’s perfectly natural, of course, to have a fear of needles. It’s rare that a child enjoys the pain of an injection (although those kids, even at young ages, are out there).

Sometimes the fear and anxiety of needles really can manifest itself as a sincere phobia. In those cases, the fear is so overwhelming that it changes family decision-making around vaccinations and leaves children unprotected. It can torture parents when they have to scoop their kids up from under the chair. And parents get embarrassed when their child/teen becomes combative with shots. Sometimes they avoid coming back to clinic simply to avoid the conflict. Makes sense in a hectic world.

However recently in clinic I took care of a teen soon after she’d had a terrible experience with Influenza (the “flu”) and it’s changed how I care for my patients. She was an asthmatic, high school student. Because of her asthma, her doctor had recommended a flu shot. Even though doctors recommend flu shots for all children between 6 months of age and 18 years, we work very hard to get high-risk patients protected. Children and teens with asthma are more likely to have a severe pneumonia after contracting Influenza. We worry about children who wheeze and have asthma (even mild asthma) because it can land them in the hospital and/or can cause a life-threatening illness.

Most parents with asthmatic children get flu shots yearly, early in the season. But not all.

When I saw the girl in clinic she was exhausted and stressed, confused and scared. Through the course of her Influenza illness she had missed 2 weeks of school and lost over 15 pounds. She was still coughing a few weeks later. I looked back to the chart note visit prior to her infection where her pediatrician had recommended the flu shot. “She’d declined,” it said.

“Why?” I asked.

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Cocoon A Newborn, Only An Email Away

This week, Washington State declared that whooping cough (pertussis) has reached epidemic levels. Since the beginning of the year, we’ve had more than 600 documented cases in the state, a dramatic increase since last year. The increase puts our new babies at risk.

In clinic I’ve been urging new parents to cocoon their babies. That is, provide a family of protection by having every single child & adult immunized against whooping cough, influenza, and other vaccine preventable illnesses. By surrounding a baby with only immunized people, you cocoon them against serious infections.

Whooping cough is a highly infectious respiratory illness spread by sneezing and coughing that can be deadly to young infants. Getting a Tdap shot is the best way to avoid getting whooping cough. Amidst an epidemic, we worry most about newborns because they are most vulnerable to complications and lack vaccine-protection. If every child and adult that surrounds a newborn gets a Tdap shot, the likelihood of the baby getting whooping cough approaches zero.

Most newborns get whooping cough from their family or adults around them. That’s where an email comes to play.

You’re going to have to be fairly Mama-Papa-Bear about this. You’ll have to show some strength to create a very safe home, even when it feels somewhat over-the-top. As I said to a number of families in clinic today, “It only seems entirely over-the-top-nuts until we lose another newborn to pertussis.” Being smart now will save lives.

Make a new rule: no visits with a newborn until all visitors have had the Tdap shot. Even Grandparents.

Write an email to family and friends to explain.

A sample email for you to use/copy/share –written today by a friend of mine–mother to that darling baby girl born last week: Read full post »