‘vaccines’

All Articles tagged ‘vaccines’

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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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 »

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 »

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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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?

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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 »

2013 Immunization Update

Screen Shot 2013-01-30 at 7.03.42 AMNew immunization recommendations come out every February. They’re released to assist parents and clinicians in keeping all children up to date and protected from life-threatening infections. The update reflects new science and discoveries, while improving the schedule of vaccines due to outbreaks of infection or improved understandings of how to protect children better amidst a potential resurgence.

This is relevant to every parent: every year the rules for what-children-need-which-shots-when can change. Just when we think all of our children are “up to date,” new science evolves that potentially changes their immunization status. For example, read about new information published this year for the Tdap shot–how & why our children’s immunity fades.

We have to do our best to avoid making false promises to children about “not needing a shot” when they go in to see the doctor.  Just when we do, we find our child is due for a necessary booster or missed vaccine. Commonly, children are missing the last shot in a series of immunizations (for example, to protect children and teens from HPV, they need 3 total shots or children haven’t had the second chicken pox shot). In my opinion, the promises broken break trust with our children and amp fear around going to the doctor. Much of the anguish around shots is the anticipation of them. So an update…

2013 Immunization Recommendations And Reminders:

  • This 2013 immunization recommendations have been simplified into one chart for all children from birth to age 18 (used to be 2 charts). It details  the timing for shots and the necessary intervals between doses for all children. The detailed footnote section explains rationale for all the rules. In my opinion the 2013 schedule is easier to read and easier to understand.
  • Tdap for every pregnant woman, every pregnancy: the biggest change to the schedule is the recommendation that all pregnant women get a Tdap shot (protecting against tetanus-diphtheria-pertussis or “whooping cough”) in the 2nd half of each and every pregnancy. This recommendation was made due to surges in whooping cough infections, epidemics, and a 50-year high in positive cases. Because whooping cough is most risky to newborns we want pregnant women protected. Ninety percent of those who die from whooping cough are infants. The strategy to vaccinate during every pregnancy takes into count how quickly protection from the vaccine fades after we get it. And the reality the vaccine isn’t 100% effective. About 80% of those who get it are protected. The best way to protect us all is to have all children and adults up to date on their Tdap. Read full post »