Tag: chicken pox outbreaks

Vaccine-Preventable Diseases – Year in Review 2018

Does it seem like we are moving in the wrong direction?

The eradication of smallpox shows just what vaccines can do!
The eradication of smallpox shows just what vaccines can do!

No, smallpox isn’t coming back, but many other vaccine-preventable diseases are.

Vaccine-Preventable Diseases – Year in Review 2018

With the availability of new vaccines and the expanded use of other vaccines, many of us were hopeful of the progress that was being made against vaccine-preventable diseases so far this decade.

Remember, it was just four years ago that the WHO certified India as a polio free country. And after years of declining numbers of wild polio cases, 2018 will be the first year with a higher number of cases than the previous year.

This hasn’t been a good year for measles either. The WHO Region of the Americas has lost its status as having eliminated measles!

In Bolivarian Republic of Venezuela, endemic transmission of measles has been re-established, with spread to neighbouring countries. As a result, the Region has lost its status as having eliminated measles. The Regional Technical Advisory Group, which met in July 2018, emphasized the importance of Regional action and an urgent public health response to ensure re-verification of measles elimination in Bolivarian Republic of Venezuela.

Meeting of the Strategic Advisory Group of Experts on Immunization, October 2018 – Conclusions and recommendations

After years of declining rates, global measles cases and deaths began to jump in 2017, a trend that continued in 2018.

“Outbreaks in North America and in Europe emphasize that measles can easily spread even in countries with mature health systems. Due to ongoing outbreaks, measles is again considered endemic in Germany and Russia.”

2018 Assessment Report of the Global Vaccine Action Plan

And no, this isn’t just a problem in other parts of the world.

Vaccine preventable diseases are just a plane ride away.
Vaccine preventable diseases are just a plane ride away.

More cases in other parts of the world mean more cases in the United States because unvaccinated folks travel out of the country and bring these diseases home with them, getting others sick.

But it wasn’t just measles outbreaks, including the second largest number of cases in 22 years, that we were seeing in 2018:

  • chicken pox – although the 41 cases involving a North Carolina Waldorf school got the most attention, there were at least 6,892 cases of chicken pox last year, which continues to trend down from recent highs of over 15,000 in 2010
  • hepatitis A – clusters of outbreaks in 15 states with at least 11,166 cases, many deaths, with exposures at popular restaurants
  • mumps – from recent highs of over 6,000 cases the last few years, we were “back down” to just over 2,000 mumps cases in 2018
  • pertussis – cases were also down in 2018, with a preliminary count of about 13,439 cases last year
  • meningococcal disease – isolated outbreaks continued last year, with cases at Smith College, Colgate University, and San Diego State University

And of course, we had one of the worst flu seasons in some time last year, with 185 pediatric flu deaths.

Fortunately, there were no cases of diphtheria, neonatal tetanus, polio, or congenital rubella syndrome. At least not in the United States.

Why are some disease counts down when so many folks say the anti-vaccine movement is more active than ever?

Remember, the great majority of people vaccinate and protect their kids!

And vaccines work!

It is best to think of the anti-vaccine movement, which has always been around, as a very vocal minority that is just pushing propaganda to scare parents away from vaccinating and protecting their kids.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad these diseases are, allow themselves to be influenced by anti-vaccine propaganda, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

Also remember that many of these diseases occurred in multi-year cycles in the pre-vaccine era. When an up year hits a cluster of unvaccinated kids, we get bigger outbreaks. And then more folks get vaccinated, starting the cycle all over again. At least until we finally get the disease under better control or finally eradicated.

Want to avoid getting a vaccine-preventable disease this year?

Get vaccinated and protected and encourage everyone else to get vaccinated too.

More on Vaccine-Preventable Diseases – Year in Review 2018

Seven New Year’s Vaccine Resolutions for 2019

If you’re making New Year’s resolutions, here’s one for the top of your list:

  1. I won’t complain about my kids being kept out of school during an outbreak, if I intentionally didn’t vaccinate them.

Yes, apparently that was a thing this past year…

Not surprisingly, parents lost their challenge to get their unvaccinated kids back into their Waldorf school during a chicken pox outbreak.
Not surprisingly, parents lost their challenge to get their unvaccinated kids back into their Waldorf school during a chicken pox outbreak.

It is an important reminder that there are consequences if you choose to not vaccine your kids.

In addition to the risk of getting a vaccine-preventable disease, the risk of getting a vaccine-preventable disease and getting someone else sick, there is the chance that your kids will be quarantined and kept out of daycare or school until the outbreak is over.

Six More New Year’s Vaccine Resolutions for 2019

Need some more?

  1. I will not travel out of the country without getting caught up on my vaccines. Remember, most outbreaks are started when an intentionally unvaccinated person travels out of the country, gets exposed to a vaccine-preventable disease, comes home while they are still in the incubation period and not showing symptoms, and then eventually get sick, exposing others.
  2. I won’t let a small, yet vocal anti-vaccine minority scare me into a poor decision about my child’s vaccines
  3. I will not lie to get a religious vaccine exemption. Is your religion really against vaccinating and protecting your child?
  4. I will avoid anti-vaccine echo chambers when doing my research about vaccines.
  5. I will learn about the cognitive biases that might me keeping me from vaccinating and protecting my kids.
  6. I will not repeat an anti-vaccine point that has already been refuted a thousand times.

Vaccines are safe, effective, and necessary.

This year, resolve to make the right choice and get your kids vaccinated and protected.

More on Seven New Year’s Vaccine Resolutions for 2019

Vaccine Requirements for College Entry

Most of our kids are up-to-date on their vaccines by the time they are ready to start college.

That’s likely why few of us give college vaccine requirements much thought.

Will this chicken pox outbreak in Ohio spread?
Will this chicken pox outbreak in Ohio spread?

But maybe it is something we should start thinking about more, as it seems that many colleges do not have actually require their students to be vaccinated and protected!

Vaccine Requirements for College Entry

The one vaccine that is the most often associated with going to college is the one that protects our kids against meningococcal disease.

That’s actually two vaccines though:

  • MCV4 – Menactra or Menveo
  • MenB – Bexsera or Trumenba

Which other vaccines should kids get before going to college?

They should get whatever vaccines they might have missed when they were younger, including MMR, chicken pox, hepatitis A, hepatitis B, Tdap, HPV, and polio vaccines.

Plus they should get a flu vaccine every year.

Vaccine Recommendations for College Entry

Unfortunately, in many cases, instead of requirements to attend college, we really just have recommendations that students can choose to ignore.

What’s the likelihood that your fellow students are vaccinated and protected?

How many are unvaccinated?

Which school do you plan on attending?

“Immunizations are recommended to protect your health and the health of others, but they are not required by the university.”

Welcome to the University of Michigan!

Fortunately, most schools do require at least some vaccines.

In addition to either Menactra or Menveo, many require two doses of MMR.

Some also require three doses of hepatitis B vaccine.

A few, like the University of Michigan and the University of Wisconsin don’t require any vaccines though.

These are the ten of the biggest colleges in America, at least in terms of enrollment, and their immunization rules:

TdapMMRVarHepA/BMCV4MenBHPVIPV
OSU12
2X/31XX4
FlaR2RR/31RRR
Minn12XXXXXX
ASUR2XXRXRX
UTRRRR/R1XRX
UCFR2RR/RRRRR
A&MXXXX1XXX
MichRRRR/RRXRR
PSU
R2RR/RRRRX
WiscRRRR/RRX
RR

On the bright side, Ohio State University, with one of the largest combined graduate and undergraduate enrollment, has the strongest immunization requirements.

On the other hand, it is quite sad that many of the others either have weak requirements, only recommend (R), but don’t actually require many common immunizations for enrollment, or don’t even mention them (X).

Why don’t more colleges have stricter immunization requirements for enrollment?

It is likely that they haven’t caught up with the problem of parents skipping or delaying their kids’ immunizations.

“While many infectious diseases such as meningitis are rare, it is not uncommon for hundreds of students at a large university to contract the flu each season.”

Contagious on campus

Which brings us to a problem – how can colleges hope to control outbreaks well if they don’t even know which students are vaccinated or not, and so can’t easily quarantine unvaccinated students? They seem to manage mumps and meningococcal outbreaks, but neither are as contagious as measles or chicken pox. 

Do we really need to wait for more outbreaks on college campuses before we start requiring that kids be vaccinated and protected before going to college?

At the very least, can we at least start tracking vaccine-preventable disease rates in college kids, make flu deaths in college students reportable, and report vaccination exemption rates by college campus?

More on Vaccine Requirements for College Entry