‘vaccines’

All Articles tagged ‘vaccines’

Speak Up, Share Your Values About The Vaccine Schedule

Ever wonder how the CDC makes the vaccine schedule? For example, how they decide when to start a dosing series (at birth versus a year of age versus age 11) or why pediatricians and other clinicians recommend the number of shots that we do?

Ever want to let them know your thoughts about how the schedule feels to you and what values you feel should contribute to changes?

This is your moment. For real. Read full post »

2 Questions For School On Community Immunity?

My phone wasn’t working well today so I stood in line at the “genius” bar this afternoon to resolve the problem. To be clear, that was 2 1/2 hours ago and I’m home with the promise from a very nice genius that it would be activated by the time I reached my home. It didn’t happen and I’m phoneless (a new thing for me) so it’s quiet around here. In lieu of being able to communicate by phone, I’ll share something I learned while waiting for help. It turns out to have shaped my thoughts for the afternoon.

While at the store, I ran into a researcher who works at the interface of vaccine hesitancy and immunization rates. We got to talking about his work, my writing and work in clinic, and what will ultimately help families. I mentioned what I really want is for families to get good information from their pediatricians (online and off) so when they immunize their children, they rest easy knowing that their children are protected. He asked a question, well two questions, that I didn’t have the answer to in my own life. I wonder, do you? Read full post »

Pile On The Paperwork: Vaccine Exemption In WA State

I’m happy about a new pile of paperwork coming my way. To be clear, I’ve never said this before. But I’m serious. Instead of stewing controversy, I suspect a new bill around here could open up lines of communication. I’m not living under a rock; I understand that some feel this new bill requiring signatures for vaccine exemption is heavy handed. I wholeheartedly disagree.

Yesterday Governor Gregoire signed a new bill into law that will demand families talk with a health care worker about the risks when exempting from immunizations. It turns out, WA state lags in their vaccination rates compared to national averages. In the last 10 years there has been a doubling in the number of students with exemptions for vaccinations in our schools. The biggest reason may be a convenience factor. The state suggests that 95% of exemptions are not for a medical reason, but one for convenience. Seems like you’d never opt out of immunizations for convenience putting your child or another child at risk. Right? But then think about how nuts your life is, how chaotic it is to raise children, and work, and pay bills and and and….

Imagine this: you’re a busy mom/dad, your child is about to start Kindergarten or 6th grade. The records you have for their immunizations are incomplete. You didn’t keep the book and like me and everyone else, your paper work isn’t filed perfectly. You’re pretty sure your child is “up to date.” You’re standing at registration at the school. You’ve been waiting in line and your left heel hurts. Come to think of it, your head hurts, too. Your daughter just tugged on your pant leg; she’s hungry. Quickly, when you realize you’ve got an incomplete record, you call your daughter’s doctor office while still in line. No one picks up when you call and you’re put in a queue waiting to talk with someone in medical records. You have a choice, would you rather just sign your name, exempting your child from vaccines, or go on a hunt for the records to ensure your child truly is up to date? Sure, the answer for most any parent is clear.

You sign your name. Read full post »

Guest Blog: Dr. Ari Brown on Dr. Oz

Dr Ari Brown, a pediatrician and author (books in photo), was on Dr Oz yesterday. She was asked to join a discussion about autism. Dr Brown is a board-certified developmental pediatrician, a mom to two, and an advocate for science. She is passionate and clear about what she believes. She is speaking all over the country about how to protect children from illness, particularly when making decisions about vaccines. She contributed ideas in my series in late 2010 entitled, “Do You Believe in Vaccines: part I, part II, and part III.” On Dr Oz, she was asked to contribute to a discussion about autism that ultimately focused on fears about vaccines. I worry the discussion wasn’t a representation of most American families and even Autism Speaks refused to join the show.

She’s shared with me a blog post she wrote after being on the show. Many other pediatricians are writing about the show; read Dr Natasha Burgert’s post, too. On the show, Dr Brown sat next to Dr Bob Sears, a pediatrician who deviates from the recommended AAP schedule and had a chance to discuss her take. She sheds light on what we can do as parents to really understand. Thanks, Dr Brown.

I am thankful, Dr Oz, for the opportunity to participate in your autism show. Both the American Academy of Pediatrics and I hoped the show would help educate the public and move the conversation forward.
As a pediatrician who talks with families everyday in my office, I know parents want to know more about both vaccine safety and about autism. I’m also a mom. Like you, I need accurate information to protect my kids as best as I can.
I am concerned that viewers took away a very inaccurate view of vaccines. The most vocal audience members represent a small minority. Most parents of children with autism agree with the scientific evidence and do not believe that vaccines cause autism. Read full post »

Influenza: Still Time For A Flu Shot


It’s not too late to protect yourself and your family from influenza. Influenza peaks during February and March in the United States. Now is the time to be vigilant in protecting against and preventing the spread, of flu. Washing your hands, staying home from work/school, and covering your cough can be incredible steps. BUT:

The most effective way to prevent influenza is to get vaccinated. If you haven’t had a flu shot, get one this week. Your child can be immunized if over 6 months of age, and remember that many children under age 9 will need a second dose (booster shot). Read about how to determine if your child needs a second dose <—-here.

10 Things To Know About Influenza:

  1. Influenza peaks in February and March in the United States. Look at the CDC data that reflects ongoing influenza activity
  2. Vaccination is the best way to protect you, your family, and your community from the flu.
  3. Children under age 5 are at higher risk from complications from the flu. Children under age 2 are at even higher risk. Children with asthma and with some underlying medical conditions are at high risk as well.
  4. Pregnant women are at exceptionally high risk from influenza and complications from the infection due to changes in their immune, cardiac, and pulmonary (lungs) systems. While pregnant women make up only 1% of the US population, they accounted for 5% of the country’s deaths from H1N1 (Swine flu) in 2009. All pregnant women are recommended to get a flu shot. However we know that only about 30% of moms are immunized at the time of delivery. The bonus of protecting themselves? New research shows how vaccinating pregnant women protects babies. When moms protect themselves by getting flu shot, they also prevent spreading flu to their babies. Babies born to vaccinated moms have a lower risk of flu (and hospitalization) under 6 months of age when they are too young to get the flu vaccine.
  5. The best way to protect a newborn baby from the flu is to have all caregivers (parents, grandparents, nannies) get the flu shot.
  6. People can spread the flu to others before they even now they’re sick. People also spread the infection after they have had it; they can continue to spread flu for 5-7 days in mucus, sneezes, and cough. The best way to protect yourself is to get a flu shot, and second to that: wash you hands, cover your cough, and stay home from school or work when sick with fever and cold symptoms.
  7. Each year 20,000 children under age 5 are hospitalized with flu or complications of the flu. 11 children died from influenza during the week of January 30-Feb 5th in the United states.
  8. Although flu is reported as widespread in 37 states, nearly all areas have circulating flu right now. See the most recent CDC data on influenza around the country.
  9. Overall flu vaccination rates are less than 50% for people under 65 years of age. To best protect our communities, vaccination coverage rates should be about 90%. We’re not there. Immunizing yourself and your family protects those who are too sick (or too young) to get the flu shot and are also at higher risk of complications.
  10. Flu shots for children under age 3 do not have thimerosal. Nasal Flumist doesn’t have thimeroal. Read National Network for Immunization Information (NNii) page on mercury in vaccines. I don’t believe you need to find a thimerosal-free flu shot.

2011 Immunization Schedule Recommendations

This week, Pediatrics published their yearly update to the recommended immunization schedule. Each year, the immunization schedule is reviewed, and when necessary, guidelines are changed to improve protection for children. Changes stem from new studies that provide insight into immunization spacing, infectious disease experts’ analysis of data from new trends in infection, or epidemics, like that from H1N1 or Whooping Cough. All of this data changes our understanding of how and who we need to protect as time unfolds.

Some of the new recommendations announced this week may require your child to get an additional shot when at the office next. Often we think our kids are up to date when they aren’t. We’re often wrong because of changes made to the recommendations or because our child has missed a dose at some point along the way. Or the records at the office aren’t complete…

Recommendations change yearly to define and hone the best practice for preventing infection in children and in our communities at large. The full recommendations are available in Pediatrics with a nice summary in Health Day geared more for parents.

If you have any questions about your child’s immunization status and their protection from infection, contact the physician’s office.

Talk with your child’s physician about these recommendations to clarify rationale and get their take and opinion. And, bring the immunization record with you! Keeping the book has been shown to protect your child and improves the likelihood of accurate records and thus, staying up to date.

Changing The World: Gates’s 36 Cents

Bill Gates recently said, “Not everyone can go into the field or donate. But every one of us can be an advocate for people whose voices are not heard.”

Ditto to what he said.

Watch Gates’s annual letter (below). This modality for telling stories is delicious and the message here is simple yet full of heart. However, like most things in life, it is not without controversy or a difference of opinion. As reported today in The New York Times, some feel Gates is off target.

I got a boost of energy listening to Gates today. It’s good to hear about progress. And even better to feel hope in the war-torn-rioting world in which we live.
Mr Gates describes efforts needed to complete polio eradication around the globe. He also points out the value of 36 (18+18) cents. Most vaccines are cheap. And although you can’t protect a child from measles for 36 cents in the United States (think co-payments and/or administrative fees), you can elsewhere. Particularly when Bill and Melinda Gates are picking up the tab.

I love to witness those with big dreams and lofty goals; it’s how and why our world progresses.

This video is worth the 4 minutes it takes to view. Both for its message and for the enjoyment that comes in watching the pictures unfold.

An Extra Wince In The Exam Room

Yesterday, results of a survey on beliefs about vaccines circulated on the internet. The survey conducted last week, asked over 2000 adults if they believed vaccines, or the MMR shot, caused autism. I’m not an expert on surveys and I don’t know how reproducible these results are to all parents in the US. But the news caught my eye (along with many others) when they reported: “Just a slim majority of Americans — 52 percent — think vaccines don’t cause autism” That’s a kind-of-odd-double-negative-type way to look at it, I suppose. Or maybe a hopeful one. The results reflect that nearly half of adults in America may suspect or worry that vaccines cause autism; 18% saying they believe a connection exists.

Whew.

The survey reminds us of some of the Why. It seems on some level, it’s a breakdown in our education. While only “69 percent of respondents said they had heard about the autism-vaccination theory — only half (47 percent) knew that the original Lancet study [that linked vaccines and autism] had been retracted, and that some of that research is now alleged to be fraudulent.” And, the details of all the research finding no link between autism and MMR is even more deeply buried, I suspect.

Even so, the numbers surprised me. In light of all the writing in the British Medical Journal this month on the scam behind Andrew Wakefield’s original paper in 1998 making the claim, I’ve been thinking about where we all stand in our understanding of immunizations, science, and trust. More on that next week. But I really wouldn’t have said 1/2 of my patient’s parents believed or suspected in a connection between autism and vaccines. What percentage would you have guessed? Read full post »

The Injustice of Immunization Interviews

When Dr Wakefield interviewed on Good Morning America today, an injustice occurred. For children, I mean. And it occurred inadvertently I suspect. But I believe this injustice happens all the time when it comes to childrens’ health and wellness. What the media covers really changes how we think and feel about protecting and parenting our children. The media’s effort to inform and educate, just like that of physicians and nurses, social workers and ancillary staff, researchers and students, can get lost and misconstrued. ABC worked hard to inform us of the accusations against Dr Andrew Wakefield with a 2 minute introduction by Dr Richard Besser, a pediatrician and medical editor/correspondent. Yet when the interview was over, I was left remembering the myth.

Today I awoke to the boys asking for breakfast. After getting them to the table with a bowl of Life (always strange to offer a cereal named after our existence), I poured milk in my own bowl. Suddenly I realized that I needed to get the recycling and garbage to the curb. I donned my boots and a coat, ready to haul the can and a number of collapsed boxes to the curb. But just as I headed out of the door, the phone rang. It’s when the day went from the typical day (“making” breakfast and moving garbage) to a day steeped in really trying to understand. My mom was calling, she said Andrew Wakefield was about to be on Good Morning America. I hit my personal fast forward button, flew to the curb with the garbage, and got back inside with enough time to hear the complete interview.

Dr Wakefield interviewed on GMA with George Stephanopoulos who later labeled the interview “combative.” Mr Stephanopoulos was given a terribly difficult task: he was interviewing Wakefield on one of the most complex, emotional, and loaded quandaries of the last few decades: vaccine-hesitancy and Wakefields’s purport linking vaccines to autism. When Wakefield failed to deny any allegations and failed to discuss the significant research that refutes his own work, Mr Stephanopoulos had to defend science. Alone. George Stephanopoulos isn’t gaining popularity (read the comments) with the anti-vaccine crowd and even some who doubt what Dr Wakefield claims. Yet ultimately, the 7 minute interview with Stephanopoulos and Wakefield simply stirs the pot. I trust it will have huge viewership. I worry that this is, in part, why it was done. Read full post »

Do You Believe in Vaccines? (Part III: Experience)

Helping families make decisions about their child’s health takes training, expertise, and experience. The training is standardized (medical school, residency, fellowship), and the expertise confirmed by passing board examinations and maintaining yearly CME (continuing med education). But the experience piece is ultimately unique for each physician. With each day in clinical care, patients teach, instruct, and shape how we understand wellness and illness. Through individual experiences with patients, physicians ultimately become who they are in the exam room. In medicine, despite the huge push to standardization everything from centralized phone calls to how much (or little) time we get with patients, individual doctors will fortunately remain unique. As patients, we still get to enjoy our physicians as people helping us through illness and injury.

This week has been intense. Wednesday, I spent the morning as a patient in the care of my incredible doctor. (I’m fine). She’s entirely instructive for me as a patient and as a physician; her bedside manner astounds. I believe she’s just very good at her job, partly because she’s uniquely experienced. I believe her experience being a nurse for many years before becoming a doctor really colors how she provides care–she gets it.

The week has also been intense because of this series. I’ve been thinking about immunizations, reading comments here on the blog, writing, and witnessing my patients’ responses. I’ve received many e-mails. Yesterday, I was at clinic for over 10 hours and like most days, immunizations were a huge part of my day. But I said things I’ve never said before…True synergy between my clinical self (doctor) and my writer self (Mama Doc), this experience is shaping who I am, in and out of the exam room.

Of course, experiences in clinical care (and living on planet earth) shapes how all pediatricians discuss and listen to families when discussing immunizations. Here’s the final segment in my series on asking pediatricians if they “believe” in vaccines. The 20 or so pediatricians who responded, talked about their experiences in representing vaccines. Additional comments are included in part 1 (emotion) and part 2 (evidence).

Experience:

Dr Kronman, a pediatrician and infectious disease fellow:

We don’t see these diseases anymore. I work at a premier tertiary/quarternary care facility for children. I have seen children die of influenza (seasonal, H1N1), pneumococcus, meningococcus, the late sequelae of measles, pertussis; I have seen Hib meningitis, tetanus, severe debilitating outcomes with varicella, cervical cancer caused by HPV, and severe rotavirus. This list goes on. But most people haven’t seen these things anymore. People don’t have to panic about their children in the summer becoming permanently paralyzed from polio, because we don’t see it anymore. And the reason? Vaccines. Read full post »