Is everyone skipping vaccines?

We're immunized! Are you? by Pixabay

We’re immunized! Are you? by Pixabay

This post originally appeared on the Disease Daily on Aug 25, 2014. It has been republished here with permission from the authors. 

By Jane Huston and Robyn Correll Carlyle

August is National Immunization Awareness Month. To celebrate, we are going to tackle a myth about vaccination every Monday throughout the month. View previous posts here, here, and here.

In our last myth-busting post of the month, we’re taking on the impression you might get from reading blogs or news online about vaccines: that droves of parents are deciding not to vaccinate their kids anymore. We know that with all the anti-vaccine chatter on social media or in the news, it often feels like everyone and their next-door neighbor is delaying, cherry-picking, or downright refusing vaccines.

But vaccination is very much still the social norm. In 2012, among US children ages 19-35 months, 92.8 percent were fully vaccinated against poliovirus. Ninety-four percent were vaccinated against diphtheria, tetanus, and pertussis (three diseases prevented with the DTaP shot). Overall, 80 percent completed three important childhood series: DTaP, polio, and MMR.

If the majority of kids ARE getting vaccinated, why do we seem to only hear about those who aren’t? It’s a case of a silent majority versus a very vocal minority.

The fact is that nationally, vaccination coverage is relatively high — but not high enough. We need exceptionally high immunization coverage against exceptionally infectious diseases, like measles. And worst of all, national averages can hide some local variances that create dangerous powder kegs for infectious disease outbreaks.

For example, in California in the 2007-2008 school year, 92.1% of kindergarteners were fully immunized — not bad, right? Well, unfortunately it’s not that simple. Someplace like Glenn County reported 98.5% immunization rates — you go, Glenn Co! But… on the other hand, Nevada County reported that just 75.5% of its kindergarteners were fully immunized. That’s not high enough to ensure herd immunity against many diseases, like measles or whooping cough. One infectious traveler entering that under-protected community could be the spark to start an outbreak.

One potentially overlooked factor is why those kids are not fully immunized. And here the story gets a little more nuanced. There’s a big difference in being unvaccinated and undervaccinated. Unvaccinated children haven’t received a single vaccine; undervaccinated children have received one, some or even most of the vaccine schedule but are still missing some important shots. And it turns out these two groups are pretty different.

Researchers looked at a random sample of over 20,000 children, from 1995-2001 to learn a little more about those two groups of children. What they found was that only 0.3 percent were completely unvaccinated (here’s that vocal minority– these parents were more likely to report concerns around vaccine safety). It’s actually an incredibly small amount of people who are refusing all vaccines (good news!).

But… over 35 percent of children were undervaccinated to some degree. These children were statistically more likely to be racial or ethnic minorities, have a mother with low educational attainment, and live in poverty. These likely aren’t kids whose parents are refusing to let them get vaccinated, but they might be having trouble seeing a provider regularly or paying for vaccines. They’re falling through the cracks of the health system. This group is arguably the most important group for public health officials to focus on for outreach and more services.

Those who choose to delay or skip vaccines by choice — because of safety concerns or worries about the schedule — are still only a tiny portion of our population.

Almost everyone IS vaccinating. But to keep it that way, the silent majority needs to get louder about their support for vaccination.

Jane manages the Vaccine Finder project at Health Map, the host site of the Disease Daily. Robyn is a contributing writer for the Disease Daily and works as a project manager for a non-profit focused on vaccine education. Both are fully up-to-date on their immunizations.

Flu shots are for everyone – not just you.


by Daniel X. O’Neil

This article originally appeared on the Disease Daily on December 2, 2013. 

By Jane Huston and Robyn Correll Carlyle

Two out of five.

When public health officials make their rounds to encourage everyone six months of age and older to get the flu vaccine this year, two out of every five of you won’t.

Maybe you’re too busy. Maybe you don’t think it’s that important. Maybe you think that the flu vaccine would give you the flu (which it can’t).

“I’m young and healthy,” you might say. “I never get sick. And even if I do, it won’t be that big of a deal.”

But here’s the thing: It’s not just about you.

If you have influenza, you can pass the virus on to other people, sometimes without even realizing you’re sick. The communicable period (the time during which an infectious agent may be transferred from an infected person to a susceptible person) for influenza is between five and seven days, but can start one full day before you feel any symptoms. Some people infected with the virus never develop any symptoms, but are still contagious. That means you are able to infect others with influenza without feeling sick yourself. It seems incredibly unfair, but hey, all’s fair in love, war… and infectious disease.

It can be normal, everyday interactions that you wouldn’t think twice about. You touch doorknobs after discreetly wiping your nose. You squeeze onto mass transit and give out a little cough. You stand next to people in line at the grocery store and chat with them in close proximity. All of which are prime opportunities for influenza to jump from one person to another.

When you leave yourself open to the flu, you also leave yourself open to spread that flu to other people. And what might not be “that big of a deal” to you, can be a very big deal to someone you care about.

Every year between five and 20 percent of Americans will be affected by influenza, and at least 200,000 people are hospitalized annually because of it.

“Hang on now,” you might say. “Can’t we just vaccinate the people most likely to die or be hospitalized from the flu?”

Here’s the thing. Not everyone can be immunized against the flu. Babies under the age of 6 months and those who are seriously ill, for example, are not able to get the vaccine. And even older adults (the population most likely to die or be hospitalized due to flu) might not develop a strong enough immune response even after they’ve been vaccinated.

That’s where you come in. Something as simple as getting your flu vaccine helps to avert an average of 2 million cases of the flu and 18,000 flu-related hospitalizations every year. Because you can’t spread the flu if you never get infected.

But if we can’t appeal to your sense of civic duty, how about your pocketbook? Every year, the flu results in an estimated 31.4 million doctors visits and direct medical costs averaging $10.4 billion annually. Because people are too sick to go to work — or in some cases lose their life to the flu — we forfeit an average of $16.3 billion every year in projected lost earnings.

If you get infected with the flu and pass the virus onto another unsuspecting soul, that could mean days of lost pay — or longer if they have a family that becomes infected as well. After all, each infected person is likely to infect an average of 1.3 more people.

So for two out of five of you, this is our plea. Please don’t be that guy. Don’t be the one who could have received the flu vaccine but didn’t and now everyone in your office/kid’s school or daycare/grandmother’s assisted living facility has come down with it, too. You’re better than that. Besides, no one likes the sick guy.

Get your flu vaccine.

Jane manages the Vaccine Finder project at Health Map, the host site of the Disease Daily. Robyn is contributing writer for the Disease Daily and works as a health educator for a non-profit focused on vaccine education. Both are fully up-to-date on their immunizations.

The Summer My Dad Got Pneumonia

Angelina with her father, Larry

Angelina with her father, Larry

By Angelina Albert, MPH

In The Immunization Partnership office in Houston, there is a wall covered with large canvas print photographs. Each photo has a story connected to it of someone impacted by a vaccine-preventable disease. These stories remind us why we do what we do. I look at those photographs every day and reflect on what those families had gone through – what could have been prevented.

This past summer, our family experienced a vaccine-preventable disease story of our own.

It all started in July. Like many afternoons, I called my dad on my way home from work. He sounded weak and hoarse when he picked up the phone. I asked him how he was doing, and he told me how terrible he felt. He had woken up in the middle of the night gasping for air; he had never felt so bad. He wondered if he was possibly allergic to my mom’s recently adopted cat. I just assumed he had been working too hard and needed to rest. Even so, I was still very concerned. When I was young he had an emergency quadruple bypass.  Now – 22 years later – he is very healthy. He goes for long walks each morning and maintains a low-fat diet. But like any doting daughter, I still consistently worry about him.

I thought about him that evening and texted my mom to see how he was doing. She was coming to Houston that weekend and would bring the cat with her to see if his symptoms improved. We chatted about other things, and I assumed he would get better. She called me the next day from the emergency room. My dad couldn’t breathe.

When they took him into the ER, he was immediately diagnosed with pneumonia. They admitted him into the hospital, where he was put on oxygen and antibiotics and stayed for several days. His case was quite severe. The nurse asked him if he had received the pneumococcal vaccine, and he was pretty certain he hadn’t. Knowing where I worked, he called me to ask about it. After learning more about the vaccine from my colleagues, I told him that adults older than 65, especially those with chronic diseases (such as heart disease), should get the vaccine. He wasn’t even aware it existed, let alone that he needed it. He was annoyed that his doctor had not recommended it.

His hospital stay was extended when he developed an unusual swollen pain on his shoulder. My dad has his own business, and his anxiety level increased as he sat in the hospital room unable to work.  Now, months later, my dad is back at work, but still lacks energy.

Though my dad had made sure to receive the flu shot each fall, he had never received – or even been aware of – the pneumococcal vaccine for adults. He is older than 65, but is not frail or sickly, and to him developing pneumonia seemed to come out of nowhere. Seemingly healthy or not, it is strongly encouraged that adults his age (65+) receive the vaccine. I made him promise he would protect himself, and as soon as he was well enough, he went to the doctor to get the vaccine.

In 2010, 1.1 million people were admitted into the hospital for pneumonia in the United States, with a length of stay averaging 5.2 days. Among those with pneumonia in 2010, 49,597 people died from it.

My dad is one of the lucky ones; he pulled through. But my family will never forget that experience.

Angelina is a Development Specialist with The Immunization Partnership.

Six Signs the Article You’re Reading is Bad Science

by Vmenkov

by Vmenkov

This article originally appeared on the Disease Daily on Jul 16, 2014. It has been reposted with permission from the authors.

By Jane Huston and Robyn Correll Carlyle

One reason we feel so strongly about the role of vaccines in public health is because of the massive amount of good data and quality studies that support them. And that’s why it’s frustrating when media, the Twittersphere, or the internet in general circulate rumors and poorly designed studies attacking vaccines.

The thing is– science is hard. Like, really hard. People study for up to 10 years to be a qualified researcher. And reading scientific literature can be a bit tricky. We can’t catch you up to the guy or gal who’s devoted an entire career to vaccinology or epidemiology, but here’s a handy cheat sheet to help you spot the “junk science” when it comes across your news feed:

1. It confuses correlation and causation.

This is a big one, and possibly a mantra you’ve heard before: correlation does not equal causation. Correlation is a statistical term that simply means the way two variables fluctuate appear to be related in some fashion. Any fashion. Maybe variable A going up happens at approximately the same rate as variable B going down. Maybe they increase together. Maybe it’s not a linear relationship (but that’s a bit more complicated). What’s most important to remember here is we absolutely cannot assume that one is causing the other. We simply don’t have enough information since all we know is how the variables are changing.

Take this example of Nicolas Cage films and drowning deaths. That plot looks pretty good right? And the correlation coefficient is a fairly solid 0.66. Could it be that Cage’s action-packed thrillers are inexplicably driving people towards backyard swimming pools? Anything’s possible. But the two almost certainly have nothing to do with each other and are, instead, a total coincidence. Often when two variables are correlated, there is actually an unknown third (and potentially fourth and fifth) variable that is affecting both of the events you’re examining.

2. Its sample size is small.

People suffer from a wide range of medical issues every day — sometimes they are caused by what you’re studying, but sometimes it’s just by chance that the participants being studied develop an issue. Out of a study sample of three, having one guy get hit by a bus would look like a significant trend. The larger the sample size, the less impact those random occurrences will have on your data.

3. The study is uncontrolled.

Not uncontrollable like your two-year-old nephew on a sugar-high, but uncontrolled as in lacking a control group. A control group provides a researcher something to which to compare results; it’s the closest way to estimate the counterfactual. Did the subjects get better over the course of the experiment because of a drug being tested, or would they have improved anyway? A control group that is similar to the experimental group in every way EXCEPT for the intervention can help you answer that question.

4. The results are not replicable.

One study alone (even a well designed, large-scale one) can’t prove anything. All it can do is contribute to the body of work already done by the scientific community. It takes several studies coming to the same conclusion to say anything with confidence — and even then we can’t be 100% certain. Science is purposefully self-correcting. Researchers rely on each other to validate their results. If no other researchers have been able to replicate a study’s findings, that’s a red flag.

On a related note, beware of those researchers who are only citing themselves. If an author says that there is “substantial evidence to support” a given link or a particular cause, check out the citations. Have several different research groups provided evidence to support the link? Or is it just one name (the author’s) that keeps popping up? If that author is the only one who seems to be providing that “substantial evidence,” it’s worth taking with a fistful of salt.

5. There’s a conflict of interest.

This is a sensitive but important point. When publishing a paper, authors must disclose the source of funding for their work as well as any other relevant conflicts of interest, such as ownership of a related private company. This does not necessarily invalidate the results of the experiment, but you should definitely be aware of any potential bias when reading results. If the author has a lot to gain from the study and the results seem glowing with no down-sides or limitations, be suspicious.

6. It’s published in a journal that’s not peer-reviewed.

Whenever possible, try to read the original journal article instead of relying on the popular press. Articles in general news media can be a great source to find out about new and interesting research, but remember they are necessarily interpreted by a reporter (in best cases by a science writer with a background in science; in the worst cases it’s a press release). While you’re reading the original article, make a note of the journal it appears in. Is it a reputable publication, like Nature, Journal of American Medical Association or the New England Journal of Medicine? Did articles have to pass a peer-review process, meaning that other experts read the manuscript, asked probing questions, pointed out any errors, and addressed limitations? This process is by no means perfect; mistakes can certainly still get through peer review and show up in reputable sources. But on the whole, a study appearing in a respected, peer-reviewed academic journal carries more weight than one published on a personal blog.

There’s another deadly threat — single-issue shill “journals” published entirely to push an agenda. This is the worst possible abuse of the scientific process. Some people, after being spurned by reputable journals, will go so far as to create their own journals to fabricate a veneer of legitimacy for their flawed ideas. These biased publications are a wolf in sheep’s clothing. Avoid them at all cost.

In the age of the internet, it’s getting harder to tell good science from bad. But if you follow this guide, and approach scientific articles with a healthy dose of skepticism, you’ll do fine.

Jane manages the Vaccine Finder project at Health Map, the host site of the Disease Daily. Robyn is a contributing writer for the Disease Daily and works as a project manager for The Immunization Partnership. Both are fully up-to-date on their immunizations.

Adults Vaccinations – Protecting Yourself Later in Life

imageA few months ago, as I was chatting with my mom, she casually mentioned that a family member had come down with shingles. I was concerned about him, but went about my day. All of a sudden (hours later), my concern turned to distress – this family member had held my daughter for about 30 minutes the previous weekend. Did this expose my daughter to shingles? And what were the risks? I knew very little about shingles at the time – only that it develops from the chickenpox virus – a virus that my daughter had not yet been vaccinated against.

Although she wasn’t a newborn anymore, my daughter’s little system still seemed so fragile and vulnerable to me. I thought back to our months in the hospital and got a pit in my stomach. I hated to be an alarmist, but I was worried. I immediately went to Google and researched whether or not shingles could spread from an adult to a child. (Sidenote: terrible idea. A lot of non-science-based sites pop up on Google’s search results list.) My next move was to put down the laptop and pick up the phone. I calmly called our pediatrician who reassured me everything was probably fine.

After getting some answers, I figured other parents might be interested in the information I found. So here it is:

How does a person develop shingles, and is it contagious?

Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant (or inactive) in the body. For unknown reasons, the virus can reactivate years later, causing shingles. Because the varicella zoster virus is already inside a person’s body, the infected individual cannot pass shingles along to someone else.

What if my child was exposed to someone with shingles?

Although shingles itself is not contagious, a person with shingles can expose others to the chickenpox virus from their rash, so those who have not had chickenpox before (or the vaccine that provides protective immunity) are at risk of developing it. My daughter was not old enough for the vaccine (she had yet to turn 12 months old), so our pediatrician told us to keep an eye on our daughter, as she was at risk. Thankfully, she did not contract the virus.

Who should get the Varicella (chickenpox) vaccine?

The CDC recommends two doses of chickenpox vaccine for children, adolescents, and adults who have not had the chickenpox. Children should receive two doses of the vaccine — the first dose at 12 through 15 months old and a second dose at 4 through 6 years old. Adolescents aged 13 years or older (who have never had chickenpox and who have not received the chickenpox vaccine) should get two doses at least 28 days apart. Anyone else who is not fully vaccinated, and never had chickenpox, should receive one or two doses of the chickenpox vaccine. The timing of those doses will depend on the individual’s age, and a doctor should be consulted.

How can adults prevent getting shingles?

They can get vaccinated! For adults, the shingles (herpes zoster) vaccination reduces the risk of developing shingles and the long-term pain from post-herpetic neuralgia – an extremely painful complication caused by shingles. The CDC recommends the shingles vaccine for people aged 60 years and older. Even those who have had shingles in the past can receive the vaccine to help prevent future occurrences of the disease. Ask your healthcare provider about getting vaccinated today.

Both the shingles and chickenpox viruses can be very painful and dangerous, so parents – ensure your child gets the chickenpox vaccine when they are old enough, and adults – protect yourself from a bad case of shingles and get vaccinated. Again, the idea is to prevent what is preventable. In this case, the whole family can get on board for the greatest protection possible.

Sharing Immunization Information in Everyday Conversations

Christine Vara with her daughters

Christine Vara with her daughters

By Christine Vara

As a parent who keeps up with the latest immunization news, I feel obligated to share information about vaccines and infectious diseases.  My efforts are not just limited to my contributions on the Shot of Prevention blog, but rather expand to include everyday encounters I have with friends and family.

Of course, no one wants to be that person who only talks about one thing, even if it’s something as important as vaccines.  But as a parent to five children, I have plenty of opportunities to discuss immunizations in ways that are entirely appropriate to my conversations with other parents.

And in honor of National Immunization Awareness Month, I challenge you to do the same.

Don’t be hesitant to talk about vaccines.  In fact, consider it a necessity.  You’re not reluctant to tell others about the doctor you love or the delicious restaurant you found.  Why not be as generous with the information you have about vaccines?

Even if people aren’t well versed on the subject of vaccines, they still want to know how to protect themselves and their loves ones from dangerous illnesses.  We must remember that the overwhelming majority of people vaccinate.  They do not need to be convinced that vaccines are safe and effective.  However, they do sometimes need to be reminded.

By suggesting vaccine recommendations in your casual conversations, you can help give people the information they need to make informed decisions.  Why not tell them about the measles and pertussis outbreaks in their communities or explain the risk of rising exemption rates in your local schools?  There are so many ways to introduce the topic in your everyday conversations.  Consider these personal experiences of mine:

At the Bus Stop

A neighbor mentioned that her son suffered with asthma so I asked if he received a seasonal flu vaccine.  Although his doctor recommended it, her husband didn’t trust the CDC and therefore they never got him vaccinated.  After providing statistics on the dangers of the flu and referring her to an abundance of scientific research on flu vaccine safety, she realized they had been lucky and decided to revisit her decision to get her son and all other family members vaccinated. 

At a Family Function

When my expectant cousin mentioned she wouldn’t be attending a family wedding because she was hesitant to travel with her newborn, she opened the door for a discussion about health precautions for expectant moms and newborns.  I explained the importance of flu and Tdap vaccine during pregnancy and also suggested her husband and anyone else who would have close contact with the baby be vaccinated.  When her mother insisted that she wouldn’t need any shots because she had been vaccinated as a child, I talked about waning immunity and the need for adult Tdap boosters.   By the end of the night every family member knew that their vaccination status was critical in helping to protect her baby and every other baby they came in contact with.    

Out to Dinner

As we enjoyed a meal with some friends the conversation turned to our children’s summer activities.  One couple mentioned that their

Christine's daughter after getting a vaccine this past summer

Christine’s daughter after getting a vaccine this past summer

daughter was attending science camp and learning about infectious diseases.  That was just the opening I needed.  Throughout the night I learned that one of the men had meningitis as a teenager, one of the women had a bone marrow transplant that prevented her from being vaccinated, and several of the other parents failed to understand the need for HPV vaccine for boys.  When I mentioned that HPV-related throat and penile cancers could be transmitted to men in ways that they may not have thought of, I referred to Michael Douglas’s case as an example.  By the end of the night parents were planning meningitis boosters for their college-bound kids and asking if it was too late to get the HPV vaccine series for their boys.

These examples illustrate how easy it is to walk the walk and talk the talk.  If you’re someone who is well-versed in current immunization practices, I encourage you to share your knowledge with others.  Why not see how many different conversations can lead to a discussion of immunizations in one week?

Start with something as simple as commenting on social media.  If you see a Facebook post about bringing kids to college suggest a meningococcal vaccine.  When people discuss their concerns about the health of their elderly parents, suggest shingles, pneumococcal and influenza vaccines.  When someone announces that they are expecting, make sure they know Tdap and flu vaccines are recommended for pregnant women.   Of course, sharing posts from The Immunization Partnership and Vaccinate Your Baby Facebook pages will also raise awareness about recent outbreaks, changes to immunization policies and vaccine safety studies.

Sharing immunization information in everyday conversations is not as hard as you may think.  Make a concentrated effort to do it day after day, and you’ll be amazed at the difference you can make in the lives of others.

Vaccines for young adults? It’s not just about you.

imageLet’s be honest. As young adults prepare to enter college, immunizations are not generally the first thing that comes to mind. They are young and healthy, fresh out of high school, and excited for a new adventure. Often times, they feel invincible – like they could take over the world. (Oh, to be young again!) Many young adults do not feel that vaccinations are something that applies to them.

In reality, the need for vaccination does not end when your childhood does. Vaccines are recommended throughout an adult’s life based on age, lifestyle, job, travel, health conditions and vaccines you received as a child. Even healthy young adults can contract (and get very sick from) vaccine-preventable diseases. Too few young adults are receiving the recommended vaccines, leaving themselves and their loved ones vulnerable to serious diseases.

Thanks to social media, and our culture’s current obsession with “selfies,” it’s easy to see why this generation of young adults thinks: “it’s all about me.” When it comes to vaccinations, the complete opposite is actually true. It’s NOT all about you.

Think about it. Young adults might not be the most at-risk for severe disease themselves, but they are likely to be in contact with those who are, such as:

  • Aging parents or grandparents
  • Very young nieces/nephews/cousins
  • Pregnant friends or relatives

Not to mention, this age group is likely to be in crowded living conditions (like college dorms) or come into contact with massive amounts of people every day on mass transit, in offices or in stuffy lecture halls.

Everyone older than 6 months should get the flu vaccine every year. Yet only about 1 in 3 adults under the age of 50 do. This matters because even if they don’t feel sick themselves, young adults are prime candidates for transporting disease to other people.

So what vaccines might a young adult need?

Tdap Vaccine:

  • One dose of Tdap is recommended if you have never received it after age 18.
  • After receiving that first dose of Tdap vaccine, a Td vaccine is recommended once every 10 years.

HPV Vaccine:

  • Three doses of HPV vaccine protect against the most common types of human papilloma virus known to cause cancer later in life. The vaccine is recommended for 11-12 year olds, but if young adults never received it, they have until they’re 26 to get the vaccine.

Meningococcal Vaccine:

  • Some states require students entering colleges and universities to be vaccinated against certain diseases like meningococcal disease. This is due to the slightly increased risk of contracting these diseases in close quarters like residence halls.

And of course, last but not least, the flu vaccine.

When my daughter came home from the hospital in the midst of flu season, I remember being so scared to come into contact with someone who had not gotten their flu shot, because her immune system was so weak. As a healthy adult, it is your responsibility to remain up-to-date on your adult vaccinations, to protect others who cannot protect themselves.

Remember, it’s not just about you! The vulnerable populations in our communities depend on you to keep them healthy too.

Reorganize The To Do List: Make Vaccines A Priority For Your Family


This blog post originally appeared on the Texas Children’s Blog on August 11, 2014. It has been reposted with permission from the author.


As parents, we are bombarded every day with responsibilities, chores, and decisions.  What’s for dinner? Did I set the trash out for pick up? Should I sign my daughter up for gymnastics or soccer? It’s a never-ending stream, some more important than others, that often leaves us feeling as if we are barely treading water.

For new parents, all of the preparation that goes into having a baby is overwhelming so it’s natural to focus on the big things – what kind of car seat to buy, picking a name, and taking that labor and delivery class.

For parents of multiple children, we prioritize and let certain things fall to the wayside – feed kids, bath kids, get homework done, pick up diapers, you get the idea. As a working mother of two active little girls, I understand the balancing act that many parents face.  There simply isn’t time for everything.

Wherever you are in your parenting journey – it’s easy to let a “chore” like getting vaccinated fall low on the proverbial “to do” list.  It’s human nature to tell ourselves, “My child won’t get sick,” or “We can push it off for awhile.” Or maybe it’s not on your “to do” list at all.  Maybe you tell yourself, “If my child or I get a vaccine-preventable disease, it’s not that big of a deal.” Well, is it really that simple? Let’s think this through.

You or your child could be the one who gets sick.  And yes, it could be a big deal.

Let me explain why:

Currently, the U.S. is experiencing a resurgence of pertussis, or “whooping cough.”  Right about now you may be thinking – “isn’t whooping cough a disease that my grandparent’s had?” Yes, they very likely did and sadly, it’s a disease that’s making a comeback.

Last year, Texas experienced the highest number of pertussis cases since 1959.  In other words, for the first time in more than 50 years, Texas reported 3,985 cases, 5 of which resulted in death. So far this year, we are on track to report even more cases with nearly 1,400 cases reported to date, 2 of which have resulted in death.

Texas isn’t alone. Outbreaks are occurring throughout the U.S., including California, which declared an epidemic after reporting more than 800 new cases in just the first two weeks of June and 6,170 cases since January 1st.

Sadly, infants are the ones who suffer the most from this devastating disease.  The 6 deaths in Texas in the last two years all occurred in infants less than 3 months of age. Of the 3,985 cases in 2013, 11% were hospitalized, 40% of those hospitalizations were in children less than 1 year of age.  Moreover, babies are most likely to contract this disease from their mother.

This brings me to my first point – get vaccinated. The best way to prevent pertussis is through vaccination. Currently, it is recommended that all adults receive a single lifetime dose of the pertussis booster vaccine, Tdap, unless you had one as an adolescent (after age 11). Pregnant women should receive a dose of Tdap during each pregnancy.

Many parents underestimate the importance of vaccination. For expecting parents, it may seem counterintuitive to get vaccinated when you are avoiding many other medications.  But in fact, getting certain vaccines during pregnancy, including Tdap, is strongly recommended.  Getting vaccinated with Tdap during pregnancy protects both the mother and infant.

This brings me to my second point –we vaccinate not only to protect ourselves but to protect others, especially those who can’t protect themselves.

If you’re an expecting parent, new parent, parent of multiples, grandparent, aunt, uncle, or even a friend to someone with small children, please, make it a priority to get vaccinated.  If not for yourself, then for those you know who may not be able to protect themselves.  Sadly, for the 4 infants who died from pertussis in Texas, none of the mothers were immunized.

It is recommended that pregnant women receive a dose of Tdap during each pregnancy, preferably between 27 and 36 weeks.  Infants should receive a dose of DTaP at 2, 4, 6, and 15 months with a booster at 4-6 years.  Adolescents are recommended to get their booster dose of Tdap at 11-12 years.  And adults who have never received a dose of a pertussis-containing vaccine should receive a dose of Tdap.

As parents, we protect our children whenever we can.  We would never be too busy to buckle the car seat or to put on a life vest.  Please make protecting your child through vaccination a priority.  Prevent what’s preventable and immunize – on time, every time.

To learn more about Texas Children’s Center for Vaccine Awareness and Research, visit here.

Rachel Cunningham, MPH, is the primary author of Vaccine-Preventable Disease: The Forgotten Story. She is also the Immunization Registry and Educational Specialist at Texas Children’s Hospital in the Immunization Project. Her focus is primarily on educating health professionals and parents about the importance of vaccines. She’s been at Texas Children’s Hospital since 2007.

Back to School: Immunized at Every Age

school suppliesAs summer comes to a close, parents of young children prepare a mental checklist to get ready for “Back to School” season. Gather school supplies (check), do a little shopping (check), meet the child’s new teacher (check), and organize the family for their new fall routine. It’s also the perfect time to make sure your kids are up to date on their vaccinations.

Most schools require children to be immunized before enrolling or starting school in order to protect the health of all students, so parents should ensure their kids have had all the school’s required vaccinations before the first day. But it doesn’t stop there. In addition to the required school vaccinations, parents should also consider the entire list of recommended vaccinations for their kids to make sure they are completely protected. Schools are a prime location for transmitting vaccine-preventable diseases because kids are in such close contact with one another throughout the day, and you wouldn’t want your child to be vulnerable to a disease because he or she wasn’t fully vaccinated.

So just what is the difference between required and recommended vaccinations? Are required vaccines more important than those that are simply recommended? For example, the meningitis and Tdap vaccines are required for teens enrolling in school in the state of Texas. The flu and HPV vaccines are not required, but are recommended for this same age group. Does this mean that immunizing against HPV is any less important than immunizing against meningitis? In short – no.

Recommended vaccines are part of a comprehensive list published by the ACIP (Advisory Committee on Immunization Practices). The committee is comprised of medical and public health professionals, many of which have expertise in vaccinology, immunology, pediatrics, internal medicine, nursing, family medicine, virology, public health, infectious diseases, and/or preventive medicine. They meet multiple times during the year to review the latest vaccine safety information and information on new vaccines or vaccine technologies.

Required vaccines are often determined by school entry laws passed by the state legislature, or in some cases, by regulatory bodies, like health departments, who have been given the power to require certain vaccines. Some recommended vaccines are not required, but that doesn’t make them any less important. It just means that the state legislature or state health department (on the authority of the state legislature) has not yet mandated that they be required for kids to attend school.

Flu vaccine is a good example of an extremely important vaccine that’s often not required for school entry. According to the Centers for Disease Control and Prevention, and estimated 38 million school days are lost every year due to the flu. As we mentioned last week [link to last Friday’s post], flu kills an average of 23,000 Americans every year – more than all other vaccine-preventable diseases combined. A total of 106 children have died from the flu so far in the 2013-2014 flu season in the United States.

Flu vaccine might not be required, but it’s certainly important.

The ACIP recommends children ages 4 to 6 should receive boosters of four vaccines: DTaP (diphtheria, tetanus, pertussis), chickenpox, MMR (measles, mumps, rubella), and polio. All 11-12 year olds should receive the Tdap vaccine, the meningococcal vaccine, and the HPV vaccine to protect against cancers caused by HPV. Everyone 6 months and older should get flu vaccines annually.

And remember, these vaccines don’t just protect your child. They protect your family and any other families you may come into contact with, including younger siblings and elderly grandparents.

So, if you haven’t done so already, double check your child’s immunization records or schedule a visit to their pediatrician’s office. Getting prepared now will avoid a last minute rush and will contribute to the health of your child, and that of their classmates and community.

To see a vaccination schedule for ages 7-18, click here

To create a personalized schedule for your teen or preteen click here

For more general information about vaccines, and vaccine-preventable diseases, check out The Immunization Partnership’s resource page.

Ebola Outbreak Stark Reminder to Prevent What’s Preventable

If you’ve been watching the news at all in the past two weeks, then you probably are aware that two Americans contracted the Ebola virus and have been transported to the US for treatment.  And, even though a person cannot become infected with Ebola without coming into contact with bodily fluids of an infected individual, the thought of this virus spreading in the United States has sparked fear across the nation.

Ebola has killed more than 930 people this year globally since March, including countless healthcare workers and Sierra Leone’s leading doctor.  As we watch in horror the gruesome devastation Ebola inflicts on children and adults, our hearts break, and we hope for an Ebola virus vaccine to be developed quickly. Unfortunately, one probably won’t be available until 2015. Why so far away when we need it so desperately?

One reason is the high level of safety standards we have for vaccines here in the United States. The Food and Drug Administration (FDA) is responsible for regulating vaccines in the US.  The vaccine licensing process is extraordinarily rigorous –starting from the first step called “investigational new drug application,” through 3-phased clinical trials with thousands of participants and reviews by medical and scientific experts, and then on to inspections of the manufacturing facilities and continual assessments weighing the benefits of the vaccine with any side effects or risks associated with it.

This meticulous sequence takes years, but it matters because the success of immunization programs hinges on a strong safety record for vaccines. It is because of this process that we can say confidently that vaccines are not only effective, but safe for our children as well. In fact, your child has a greater chance of being struck by lightning than having a severe reaction to the measles, mumps and rubella combination vaccine (MMR).

The development of an Ebola virus vaccine will follow the same daunting (but necessary) process as the vaccines our children receive for polio, pertussis and the rest – diseases that also once sparked great fear and concern in the hearts and minds of parents. And in the case of some diseases like measles and influenza, still do.

Measles is still a leading cause of death in small children worldwide. In 2012, roughly 122,000 people died from measles globally. Influenza kills an average of 23,000 people every year in the US alone. While an Ebola virus vaccine is still beyond our reach, we should take comfort in the knowledge that we are now able to protect our children from more devastating diseases than ever before in human history. And because of the rigorous process by which we secure and assess safety, and advances in vaccine technology, the vaccines we have are safer than they’ve ever been.

So as our thoughts and concerns are with those affected by this terrible Ebola outbreak, let’s continue to encourage and educate our friends on the benefits of the life-saving vaccines we do have.  Immunize.  Prevent what’s preventable!