Tag: herd immunity

When Parents Disagree About Vaccines

Parents likely aren’t going to agree on every single decision about their kids.

This is especially true when parents actually have different parenting styles.

Whether it is about discipline techniques, what time the kids should go to bed, or how much allowance they should get, disagreements are bound to come up at some point if both parents are actively involved in parenting.

What Does Your Significant Other Think About Vaccines?

What happens if you disagree about vaccines?

Do you even know what your SO thinks about vaccines?

  • Does your SO ever talk about a Big Pharma conspiracy?
  • Do they buy into the myths that vaccines are full of toxins or that they don’t even work?
  • Are they afraid that vaccines will damage your baby in some way?
  • Instead of going to the doctor when they are sick, do they instead grab some essential oils and head to their chiropractor, acupuncturist, and a naturopath?

Ideally, like most other parenting issues, you would have had a talk about vaccines way before you started planning a family and you would know what your significant other thinks.

Unfortunately, we often hear about disagreements about vaccines after a couple already has a baby.

In some cases, they not only have kids, but have already split up. Then, in addition to fighting about child support, visitation schedules, and who gets the house, you might have separated or divorced parents trying to convince a judge that only one of them should be allowed to make vaccination decisions.

That could mean that an unvaccinated child gets vaccinated over one parent’s objections or that a child stays unvaccinated, even though the other parent wants him to be vaccinated and protected.

When Parents Disagree About Vaccines

While it is hard to know the best thing to do in this situation, there is one thing that you absolutely shouldn’t do.

Don't get your child secretly vaccinated if your SO is opposed to vaccines.
Don’t get your child secretly vaccinated if your SO is opposed to vaccines.

Don’t vaccinate your child behind the other parent’s back.

Instead, help them understand that vaccines work and are safe and necessary.

What if they still don’t agree?

Ask what exactly they are worried about and make sure to get them answers for those specific concerns. It might also help to have them come to your next appointment and talk to your doctor.

Can you just agree to disagree about vaccines? I guess, as long as the one who didn’t get their way is going to agree to not be upset about it. If that’s the parent who wanted their child vaccinated, then that also means their is child is left at risk for getting a vaccine-preventable disease while they try to “hide in the herd.”

Can they just compromise?

While there is no benefit to skipping or delaying any vaccines over being fully vaccinated and protected, it is better than being unvaccinated. Hopefully, learning to compromise and lots of counseling can get you both to where you aren’t in a situation when a judge makes your vaccination decisions for you.

What to Know When Parents Disagree About Vaccines

It is best to know what your partner thinks about vaccines before you start planning on having kids.

More on When Parents Disagree About Vaccines

Why Didn’t Everyone Die with Our 1980s Level of Vaccination Rates?

This is actually a real question that someone recently asked:

“Can someone please explain how we survived the 1980s with vaccination rates well below “herd immunity” thresholds and far fewer vaccines? Why didn’t everyone die?”

J.B. Handley

Mr. Handley even provides a nice chart to give his question some context.

Vaccination rates for 2 year old children in 1985.
The chart shows vaccination rates for 2 year old children in 1985.

So why didn’t everyone die?

That’s easy.

While vaccine-preventable diseases can be life-threatening, they certainly don’t kill everyone who gets them. They are not 100% fatal. Well, rabies usually is, but not surprisingly, rabies wasn’t on his little chart…

Deaths from Vaccine-Preventable Diseases, 1985

What else does Mr. Handley miss?

“Comparisons between rates obtained from immunization records versus the total sample (records and recall) conducted on data collected between 1979 and 1983 showed that the USIS, which accepted parental recall, underestimated the true vaccination rate in preschoolers by as much as 23% for some antigens.”

Simpson et al on Forty years and four surveys: How does our measuring measure up?

The vaccination rates he is citing were based on a phone survey that wasn’t thought to be very accurate, underestimating true vaccination rates. It was last used in 1985.

While vaccination rates weren’t great at the time, they just weren’t as horrible as he makes it seem, but we still had some deaths from vaccine-preventable diseases. Not as bad as the pre-vaccine era though, when hundreds of people died with measles each year.

Here’s the data from the CDC for 1985:

https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/E/reported-cases.pdf

  • 23 deaths from tetanus
  • 4 deaths from pertussis
  • 4 deaths from measles
  • 1 death from rubella
  • 2 cases of congenital rubella syndrome

Unfortunately, it got worse. This was just before the large measles outbreaks from 1989 to 1991, when 123 people died. During those three years, there were also 28 deaths from pertussis, 6 deaths from mumps, 13 deaths from rubella and 77 cases of congenital rubella syndrome!

But then we learned our lesson and we got kids vaccinated. But most of the problems then were about access to vaccines, not parents who intentionally skipped or delayed vaccines for their kids.

Deaths from non-Vaccine-Preventable Diseases, 1985

The CDC Morbidity and Motality Weekly Report includes summaries of notifiable diseases in the United States.Many of the diseases on J.B. Handley’s chart weren’t yet vaccine-preventable in 1985. They were quite deadly though, which is why vaccines were being developed and were eventually added to the schedule to protect our kids from getting them.

But in 1985 (*or in the years before the vaccine was introduced), tragically, the CDC lists:

  • 80 deaths from hepatitis A
  • 490 deaths from hepatitis B
  • 68 deaths from chicken pox
  • 219 deaths from Hib meningitis in children and about another 45 deaths from Hib epiglotittis
  • at least 200 deaths from pneumococcal disease in children*
  • 257 deaths from meningococcal infections
  • 20 to 60 deaths each year from rotavirus infections*

Want us to Turn Back the Clock and go back to an immunization plan (the Jenny McCarthy schedule) that didn’t include vaccines against any of these diseases? We would end up back to when kids still died of meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.

And the answer to Mr. Handley’s question becomes even more obvious.

How did we survive the 1980s with vaccination rates well below “herd immunity” thresholds and far fewer vaccines?

Many people didn’t.

What to Know About Deaths and Vaccination Rates

Poor vaccination rates and fewer vaccines led to more deaths from now vaccine preventable diseases in the mid-1980s.

More on Deaths and Vaccination Rates

 

National Infant Immunization Week 2018

This year, from April 21 – April 28, 2018, we celebrate the 24th annual National Infant Immunization Week.

History of National Infant Immunization Week

The last week in April was first designated as National Infant Immunization Week in 1994, by President Bill Clinton.

“Under our plan, every one of the things we could ever think of to do to get kids immunized will be done.”

President Bill Clinton on Remarks on Signing the National Infant Immunization Week Proclamation

The theme of the first NIIW?

Immunize on Time, Your Baby’s Counting on You

Other themes have included:

  • You Gave Them Life…Protect It. (2000)
  • Vaccination: an Act of Love. Love Them. Protect Them. Immunize Them. (2004)

In addition to NIIW, during the last week of April, we also observe World Immunization Week and Vaccination Week in the Americas.

National Infant Immunization Week 2018

What’s the theme of this year’s National Infant Immunization Week?

Power to Protect.

We have the power to protect our kids from more than 16 vaccine preventable diseases.

National Infant Immunization Week 2018

Thinking of skipping or delaying your child’s vaccines? Know that immunization is a responsibility we all share. We all must work together to help protect everyone in our community, including those who are too young to be vaccinated and those who can’t be vaccinated.

WIW-2018-poster-en-tn

“We must not tolerate a world in which a child dies from a disease that can be easily prevented with a low-cost vaccine.”

Dr Tedros, WHO Director-General on World Immunization Week 2018

Vaccination Week in the Americas 2018

Vaccines are safe and necessary. Vaccines work.

Get vaccinated and protected.

What to Know About National Infant Immunization Week

National Infant Immunization Week is a great time to learn more about the importance of vaccinating and protecting your kids.

More on National Infant Immunization Week

How Can the Unvaccinated Spread Diseases They Don’t Have?

Folks who are intentionally unvaccinated often have a hard time understanding why the rest of us might be a little leery of being around them.

That’s especially true if we have a new baby in the house, younger kids who aren’t fully vaccinated and protected, or anyone with a chronic medical condition who can’t be vaccinated.

Why? Of course, it is because we don’t want them to catch measles, pertussis, or other vaccine-preventable diseases.

“How can you spread a disease that you don’t even have?”

It’s true, you can’t spread a disease that you don’t have.

But infectious diseases don’t magically appear inside our bodies – we catch them from other people. And if you have skipped or delayed a vaccine, then you have a much higher chance of getting a vaccine-preventable disease than someone who is vaccinated and protected.

So, just avoid other people when you are sick, right?

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

That works great in theory, but since you are often contagious before you show signs and symptoms and know that you are sick, you can very easily spread a disease that you don’t even know that you have.

An infant hospitalized during a measles outbreak in the Philippines in which 110 people died.
Children with measles are contagious 4 days before through 4 days after their rash appears, but you often don’t recognize that it is measles until they get the rash! Photo by Jim Goodson, M.P.H.

There’s the trouble:

  1. being unvaccinated, you or your child are at higher risk to get sick
  2. when you get sick, you can be contagious several days before you have obvious symptoms
  3. you can spread the disease to others before you ever know that you are sick, or at least before you know that you have a vaccine preventable disease

This makes intentionally unvaccinated folks a risk to those who are too young to be vaccinated, are too young to be fully vaccinated, have a true medical exemption to getting vaccinated, or when their vaccine simply didn’t work.

measles-santa-clara-county
Folks with measles often expose a lot of other people because they don’t yet know that they have measles and aren’t showing signs and symptoms yet.

In fact, this is how most outbreaks start. Tragically, kids too young to be vaccinated get caught up in these outbreaks.

Keep in mind that these parents didn’t have a choice about getting them protected yet. Someone who decided to skip their own vaccines made that choice for them.

And remember that while you can’t spread a disease that you don’t even have, you can certainly spread a disease that you don’t realize that you have.

What to Know About The Unvaccinated Spreading Disease

If you aren’t going to get vaccinated or vaccinate your kids, understand the risks and responsibilities, so that you don’t spread a vaccine-preventable diseases to others that you might not even know that you have yet.

More on the Unvaccinated Spreading Disease

How to Avoid a Quarantine During an Outbreak at Your School

Believe it or not, hundreds of kids get caught up in quarantines for vaccine-preventable diseases in the United States each year.

Quarantines were routine in the pre-vaccine era.
Quarantines were routine during pre-vaccine era epidemics.

Wait, what?

Caught up in quarantines for vaccine-preventable diseases?

Then why do we have vaccines?

How to Avoid a Quarantine During an Outbreak at Your School

Is it fair that unvaccinated students need to stay home when there is an outbreak of a vaccine-preventable disease?
Is it fair that unvaccinated students need to stay home when there is an outbreak of a vaccine-preventable disease?

As you have probably already guessed, these aren’t usually vaccinated kids that are getting sick or quarantined in these outbreaks of measles, meningococcemia, and chicken pox, etc.

That’s right, they are unvaccinated.

Typically intentionally unvaccinated, although they are sometimes too young to be vaccinated or may have a medical exemption.

And that brings up to a few very easy ways to avoid getting quarantined during an outbreak:

  1. make sure you are always up-to-date on all of your vaccines
  2. if you think that you have natural immunity (already had the disease) or were vaccinated, but don’t have your immunization records, then getting a titer test might keep you out of quarantine if you can prove that you are immune
  3. get vaccinated, if possible, at the first sign of the outbreak, which might help you avoid quarantine in the case of measles and chicken pox

“Persons who continue to be exempted from or who refuse measles vaccination should be excluded from the school, child care, or other institutions until 21 days after rash onset in the last case of measles.”

Manual for the Surveillance of Vaccine-Preventable Diseases

That’s right, especially in the case of measles, you can often avoid being quarantined if you simply get vaccinated.

Unvaccinated children exposed to measles are quarantined for at least 21 days.
Unvaccinated children exposed to measles are typically quarantined for at least 21 days.

Why are quarantines important?

Can’t you just isolate yourself if you get sick?

The problem with that strategy is that you are often contagious before you develop symptoms. That’s especially true of measles, when you likely won’t even realize that you have measles until you get the measles rash, after having a high fever for three to five days. That’s why people with measles are often seen at clinics and emergency rooms multiple times, exposing many people, before they are finally diagnosed. It is the classic signs of a rash with continued fever that helps to make the diagnosis.

Without quarantines of unvaccinated people, especially those who are known exposures to other cases, today’s outbreaks would be even bigger and harder to control.

If you don’t want to take the risk of being quarantined and missing weeks or months of school or work, then don’t take the risk of being unvaccinated. Tragically, that’s not the only risk you take when you skip or delay your vaccines. In addition to getting sick, you also risk getting others sick, including those who didn’t have a choice about getting vaccinated yet.

What to Know About Avoiding Quarantines During an Outbreak

The easiest way to avoid getting caught up in a quarantine for a vaccine-preventable disease is to simply make sure your kids are up-to-date on all of their vaccines.

More on Avoiding Quarantines During an Outbreak

 

Measles Returns to California

Breaking News – There are now six cases of measles in the San Francisco Bay Area, all unvaccinated, in an ongoing outbreak that has also spread to Nevada.

There are now six cases of measles in the San Francisco Bay Area as the outbreak grows.

Is anyone surprised that a student in California has measles?

Actually, a lot of folks are probably surprised. After all, didn’t lawmakers in California recently pass a law that mandated everyone in school get vaccinated?

Well yeah, but SB277 didn’t apply to all students. Only new students and those transitioning to a new grade span (for example, moving from K-6th to 7th grade) have to meet the new minimum immunization requirements. That means it will take more than a few years until all of the kids already in school whose parents have skipped or delayed any vaccines have gotten caught up or have graduated.

And that means we will still see some of these outbreaks of vaccine preventable diseases.

There is also a little issue with medical exemptions somehow rising being abused after the personal belief exemption was eliminated in the state…

Measles Outbreaks in California

When you think of measles and California, most people probably think of the 2015 Disneyland outbreak, which was linked to:

  • 134 cases in California, including at least 50 cases without a known source
  • 13 cases in Arizona, Nebraska, Utah, Colorado, Washington, and Oregon
  • 1 case in Mexico
  • 159 cases in Canada

The Disneyland outbreak included a lot of intentionally unvaccinated kids and kept unvaccinated kids from school, closed daycare centers, and led to hospitalizations of more than a few people.

“The ongoing measles outbreak linked to the Disneyland Resort in Anaheim, California, shines a glaring spotlight on our nation’s growing antivaccination movement and the prevalence of vaccination-hesitant parents.”

Majumder et al. on Substandard Vaccination Compliance and the 2015 Measles Outbreak

Schools in California were closed for at least two weeks in 1917 because of measles epidemics.

The Disneyland outbreak wasn’t the first big measles outbreak in California in recent years though.

No, I’m not talking about the really big outbreaks from the pre-vaccine era. Or even the outbreaks in the late 1980s, just before we started giving an MMR booster. Believe it or not, 75 people died between 1988 and 1990 with measles – just in California.

More recently, there was the 2008 outbreak in San Diego that was triggered by an unvaccinated 7-year-old boy who had traveled to Switzerland with his family.

He returned with measles and got at least 10 other unvaccinated children sick, including four infants who were too young to be vaccinated and were unknowingly exposed at their pediatrician’s office.

“Almost 100 children (including babies who were too young for the MMR vaccine) were quarantined or hospitalized after they were exposed at the pediatrician’s office, Whole Foods or day care. In all, 11 children caught the measles. As it turns out, the boy who spread measles is a patient of Dr. Bob Sears…”

OC’s Dr. Bob Sears discusses measles outbreak on NPR

One of those infants was hospitalized when his fever spiked to 106 degrees and he wouldn’t eat or drink.

“We spent 3 days in the hospital fearing we might lose our baby boy. He couldn’t drink or eat, so he was on an IV, and for a while he seemed to be wasting away. When he began to be able to drink again we got to take him home. But the doctors told us to expect the disease to continue to run its course, including high fever—which did spike as high as 106 degrees. We spent a week waking at all hours to stay on schedule with fever reducing medications and soothing him with damp wash cloths. Also, as instructed, we watched closely for signs of lethargy or non-responsiveness. If we’d seen that, we’d have gone back to the hospital immediately.”

Megan Campbell on 106 Degrees: A True Story

Measles cases also began rising in 2011, as unvaccinated travelers brought measles back from trips to Europe, Asia, and Africa, where there were large outbreaks.  There were 31 measles cases in California in 2011.

While 31 cases might not seem like much, consider that between 2001 through 2006, there were just 66 cases in California, with only 4 cases in 2005!

Will we ever get to a year with just 4 cases in California again?

It didn’t happen in 2017.

Last year started with a big outbreak in Los Angeles County that grew to include at least 24 cases and a few surrounding counties. There was also a case involving an unvaccinated student at Laguna Beach High in Orange County which led to the quarantine of at least 6 unvaccinated students.

The Latest California Measles Outbreak

What kind of a measles year will we see in 2018 in California?

There is just one case, so far.

Well, it was just one case. There are six cases now… Seven if you count the linked case in Nevada.

Did you eat lunch at the Westgate Center food court on Friday, March 2?
Did you eat lunch at the Westgate Center food court on Friday, March 2?

It started when an unvaccinated student returned from a trip to Europe and developed measles, exposing others between February 28 through March 2 in Santa Clara County at a school in Campbell and at the Westgate Center food court in San Jose.

An infant hospitalized during a measles outbreak in the Philippines in which 110 people died.
The measles rash begins 3-5 days after other measles symptoms, which is why measles is often hard to diagnose.

With an average incubation period of 10 to 12 days, that means exposed people might begin to show symptoms by March 14. Keep in mind that the incubation period can be as long as 21 days though, so be on the watch for measles symptoms until at least March 23 if you could have been exposed.

Since we don’t know when the new cases began to show symptoms, it is hard to know how much longer we can expect to see new cases. Hopefully these folks were already in quarantine and didn’t expose anyone else.

Would you recognize measles?

It is important to understand that the first symptoms of measles don’t include a rash. Instead, you get a high fever, runny nose, cough, and pink eye. The measles rash comes a few days later, as the high fever continues.

It is also important to understand the the MMR vaccine is safe and works very well to prevent measles.

This exposure is a great reminder that vaccines are necessary and that you shouldn’t wait for your kids to get exposed to get them caught up and vaccinated and protected.

What to Know About Measles Outbreaks in California

A recent outbreak of measles in California, this time in Santa Clara County, is a good reminder that the MMR vaccine is necessary to keep your kids protected.

More on Measles Outbreaks in California

Updated April 7, 2018

What Is Vaccine Choice?

Have you heard about the idea of vaccine choice?

The “right to choose” is being pushed by anti-vaccine groups in many states because they think that laws mandating kids to have vaccines to go to daycare, school, and college violates their parental rights and civil liberties.

“Their claim that vaccines are 100% safe and effective for all people all of the time is not based in science and is not supported by facts or evidence, making it more of a religious belief than an adequate basis for their mandate argument.”

Texans for Vaccine Choice

And of course, they use a lot of anti-vaccine talking points to try and scare parents into believing them. Vaccines are safe and they work, but no one says that they are 100% safe or that they are 100% effective.

What Is Vaccine Choice?

Right away, you should see another big problem with the vaccine choice movement.

No one is forcing anyone to get vaccinated. Everyone has a choice. It’s just that some folks don’t like the consequences that come with that choice of not vaccinating their kids – having to home school their kids instead of going to a public or private school.

So basically, vaccine choice is just the anti-vaccine movement moving the goal posts yet again.

“If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the f–king measles.”

Jenny McCarthy

Study after study showed that vaccines are not associated with autism and what did we get, measles outbreaks in unvaccinated kids.

What’s Missing In the Vaccine Choice Argument?

In addition to facts, one big thing that is missing from the vaccine choice argument is that by pushing the idea that unvaccinated kids should be allowed to skip or delay any or all vaccines without consequences, that takes away the choice for the rest of us who want to keep our kids protected from vaccine-preventable diseases.

Can’t we just vaccinate our kids?

Many children with cancer and other medical conditions benefit from herd immunity.
Many children with cancer and other medical conditions benefit from herd immunity. (CC BY 2.0)

We do!

But that doesn’t take away all of the risk if you don’t vaccinate your kids.

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

There are kids who are too young to be vaccinated or fully vaccinated, kids who can’t be vaccinated because of true medical vaccine exemptions, and folks whose vaccine didn’t work, after all, vaccines aren’t 100% effective.

The “choice” folks don’t talk about those things though.

Make an informed choice about vaccines before you think about leaving your child unvaccinated and unprotected.

What To Know About Vaccine Choice

Listen to anti-vaccine propaganda, skip or delay vaccines and leave your kids unprotected or do your research and understand that vaccines work and are safe and necessary and get them vaccinated and protected – that’s your vaccine choice.

More on Vaccine Choice