Tag: quarantines

Can Schools Remove Unvaccinated Kids?

Why do parents think that their intentionally unvaccinated kids can not or will not be removed from school?

This school in Michigan was right to send unvaccinated kids home during a chickenpox outbreak.
This school in Michigan was right to send unvaccinated kids home during a chickenpox outbreak.

After all, when available, part of their choice when signing their child’s immunization waiver is to accept that their child could be excluded from school “as a disease control measure.”

Keeping unvaccinated kids out of school during an outbreak is the only way to keep more kids from getting sick. It is not a form of discrimination or segregation.

Well, I guess accept is a strong word…

Can Schools Remove Unvaccinated Kids?

Why is this coming up again?

“Last week, Marysville High School forcibly removed over 37 students from the high school due to an alleged outbreak of chicken pox, which consisted of two students.”

Parent: School wrong to remove unvaccinated students

Why send unvaccinated kids home when someone at the school has chickenpox?

Once upon a time, with no treatment or vaccine, families would just be quarantined when they had chicken pox.
Once upon a time, with no treatment or vaccine, families would just be quarantined when they had chicken pox. Photo by Howard Liberman.

Because chickenpox is very contagious!

For every case of chickenpox, up to 12 others who are not immune will catch it, which used to lead to large outbreaks in the pre-vaccine era.

“Homecoming events are happening all week long. The school has barred any Marysville student who cannot provide immunity status from attending these week long events including the homecoming parade and the homecoming dance. This group of banned students consists of band members, cheerleaders, and football players. HOWEVER, the school is allowing students from other school districts to attend without checking immunity or vaccination status of the visiting student.”

Parent: School wrong to remove unvaccinated students

To be clear, any of the kids with non-medical exemptions could have gone back to school if they had just gotten a chickenpox vaccine. It was their parent’s choice to avoid vaccinating and protecting them and that is what is keeping them out of school.

Why allow students from other school districts to visit the school?

Those students, even if they are unvaccinated, would not have already been exposed to the Marysville kids with chickenpox! They aren’t a risk to keep the outbreak going.

That is unlike the unvaccinated kids at Marysville High School. They could have already been exposed and could come down with chickenpox anytime over the 10 to 21 days following that exposure. If they stayed in school, they could then expose others, especially as you can be contagious even before you know that you have chickenpox.

“The Marysville School District released the private health, educational, and personal records of these students to the health department without parental consent. This is a clear violation of federal law.”

Parent: School wrong to remove unvaccinated students

And while the Family Educational Rights and Privacy Act (FERPA) does protect student privacy, there are exceptions for health or safety emergencies, including “the outbreak of an epidemic disease.”

As St. Claire County has a high rate of vaccine exemptions, it is not surprising that they are being so pro-active in trying to prevent the outbreak from growing.

“According to Michigan state law, there are three ways to provide immunity to a school. One, is a vaccination record. Two, is a titers blood test that shows immunity. Three, is an affidavit signed by a parent, guardian, or doctor that states the child has had the chicken pox. Despite the fact that at least one parent submitted an affidavit, the school has admitted they will not follow state law, but instead continue based on what the heath department recommends.”

Parent: School wrong to remove unvaccinated students

What about the idea that the school should have accepted the parents affidavit that their child is immune to chickenpox?

“(4) When a local health officer confirms or reasonably suspects that a student or individual attending school or a group program has a communicable disease, the health officer may, as a disease control measure, exclude from attendance any individuals lacking documentation of immunity or otherwise considered susceptible to the disease until such time as the health officer deems there to be no likely further risk of disease spread.”

MDHHS Communicable and Related Diseases Administrative Rules

Because chickenpox is now becoming more and more uncommon, many states are requiring titers to confirm immunity if a child is unvaccinated.

So what happens next?

When an intentionally unvaccinated Kentucky teen was banned from school during a chickenpox outbreak his family sued. They lost and he ended up getting chickenpox! Although he is now at increased risk to get shingles, he didn’t expose anyone else at his school.

We will see what happens in Michigan…

Parents of children affected by the quarantine and removed from school did choose. Their choice was to leave their kids unvaccinated and unprotected.
Parents of children affected by the quarantine and removed from school did choose. Their choice was to leave their kids unvaccinated and unprotected. Hopefully no one at their protest gets exposed to chickenpox.

Unless there is a new case, there is less than a week left to go and of the original 37 students, only 14 students are still being quarantined.

More on Removing Unvaccinated Kids from School

Is SB 276 a Civil Rights Issue?

Wait, what? SB 276? The vaccine bill in California? Why are some folks thinking that SB 276 is a civil rights issue?

How is SB 276 a civil rights issue?
How is SB 276 a civil rights issue?

Oh, it’s the usual suspects again…

Is SB 276 a Civil Rights Issue?

Surprisingly, this isn’t the first time that Bob Sears has promoted the idea that vaccine laws were the same as segregation and other civil rights issues.

“In my opinion, this is a new type of discrimination at its worst. It’s taking a new class of vulnerable children — the vaccine-compromised — and saying that because they refuse to finish their damn shots, they don’t get school. Forget separate but equal. This is separate … and NOTHING! No school at all. Soon it’s going to be no playgrounds and no drinking fountains either. Hey, the last time our government did this to a group of people, at least they GOT drinking fountains. They even got to ride buses, as long as they sat in the back. Because our government said “those people” were not safe for the rest of us to be around, and our society stood by and let it happen. And the discrimination we perpetrated on our equals so many years ago is one of the great evils our country is still guilty of. Is that what this article, and the California SB 276 bill it’s supporting, is asking us to go back to?”

Bob Sears

Are parents who can’t send their kids to school because they choose to intentionally skip or delay vaccines really the same as kids who are discriminated against because of their race?

SB 276 promotes segregation?
SB 276 promotes segregation?

Is SB 276, which simply eliminates the loophole that allows doctors to write inappropriate medical exemptions, really a civil rights issue?

An upside down American flag to protest a law to get kids vaccinated and protected?
An upside down American flag to protest a law to get kids vaccinated and protected?

Is SB 276 really like racism, human trafficking, LGBT discrimination, gun violence, refugee rights, sexual harassment and assault, and continued discrimination for people with disabilities, etc.?

If anything, SB 276 protects the civil rights of students with disabilities.

Consider kids with true medical exemptions who get quarantined when an intentionally unvaccinated child starts an outbreak.

“During an outbreak or potential outbreak of a vaccine-preventable disease such as measles, school officials should follow existing laws and policies in a non-discriminatory manner, and should seek guidance from and defer to public health authorities in considering whether, for these students with disabilities, school officials can continue to safely make a reasonable modification to a policy, practice, or procedure that otherwise requires vaccinations in order to attend school.”

Addressing the Risk of Measles in Schools while Protecting the Civil Rights of Students with Disabilities

By eliminating unnecessary exemptions and getting more kids vaccinated and protected, SB 276 will help to stop the outbreaks that have been on the rise. It will help kids with true medical exemptions avoid quarantines and stay in school.

More on Vaccine Discrimination

Is There a Plan to Send Unvaccinated People to Concentration Camps to Be Force Vaccinated?

Wait, what?

Someone believes that there is a plan to send intentionally unvaccinated people to concentration camps to be force vaccinated?

Larry Cook joins anti-vaccine folks who use Holocaust imagery to try and scare parents away from vaccinating and protecting their kids.
Larry Cook joins anti-vaccine folks who use Holocaust imagery to try and scare parents away from vaccinating and protecting their kids.

Is that what this bill, which wasn’t even put to a vote, does?

Is There a Plan to Send Unvaccinated People to Concentration Camps to Be Force Vaccinated?

Of course it doesn’t!

“Relates to the removal of cases, contacts and carriers of communicable diseases that are potentially dangerous to the public health.”

AB 99

Anything about forced vaccination?

Just the part that goes out of its away to reassure folks that it doesn’t allow forced vaccination!

Larry Cook didn’t mention this part of the AB 99 for some reason…

The bill, which never made it out of committee, wasn’t even about unvaccinated people.

It was about being able to manage people who have contagious diseases, who might be a danger to the public, either because they refuse to stay in quarantine, get treatment, or have contacts that refuse public health orders to get treatment.

Anyone surprised?

More on the Plan to Send Unvaccinated People to Concentration Camps to Be Force Vaccinated

What Is Your Protocol to Stop Measles Before Kids in Your Office Get Exposed?

Measles outbreaks have reached record levels this year. Unless you’re prepared, with a strict protocol to stop measles, that could mean that someone could get exposed in your office.

“Many of today’s physicians may never have seen a patient with measles— a disease that can cause serious complications in infants, young children, and adults. CDC is urging all physicians to “think measles” when evaluating patients who have fever and rash, and to know what to do to prevent, control, and report measles cases.”

CDC Asking Physicians to “Think Measles” and Help Stop the Spread

Have you ever seen a child with measles?

What Is Your Protocol to Stop Measles Before Kids in Your Office Get Exposed?

To help everyone understand how important it is to think about measles and prevent unnecessary exposures, it can help to understand what happens when a child with measles does go to their pediatrician, an urgent care center, or the ER.

Part of your protocol to stop measles will be making sure th unvaccinated children exposed to measles are quarantined for at least 21 days.
Unvaccinated children exposed to measles are quarantined for at least 21 days.

Since measles is so contagious and can remain infectious for up to two hours after a person has left a room, with each measles case, you will have to:

  • isolate the person with measles (or suspected measles) in a negative pressure isolation room. If that’s not possible, at least have the person wear a mask in their own private room and/or schedule them at the end of the day, bypassing the waiting room. You might even go out to their car for a quick interview and exam before they come into the office.
  • not use that exam room for at least two hours after the person with measles leaves.
  • report the case to your local health department ASAP, as they will likely have more extra resources to help you manage your patient.
  • locate everyone who could have been exposed, including anyone who was in the same area as the suspected case or entered the area over the next two hours. If they aren’t already immune, these folks might need immune globulin (younger than six months or immunocompromised) or a dose of MMR. They will probably also be quarantined to make sure they don’t develop measles and expose others.
  • only allow those who are immune to measles (two doses of MMR or natural immunity) to take care of the suspected case. Everyone should still wear an N95 respirator or at the very least, a general facemask, just in case.
  • limit anyone else’s exposure as you work to confirm that they have measles (PCR testing of throat swab and urine), provide supportive care as necessary, or quarantine them at home.

Unfortunately, it usually ends up being more than a single exam room that has to be closed when a child shows up with measles. After all, before they got to that exam room, they were probably in the waiting room and other general areas of the office.

And that’s why you will want to have a protocol in place to avoid or minimize these exposures.

Don’t Spread Measles

Of course, that starts with trying to get everyone vaccinated and protected, including an early dose of MMR when appropriate, so that your patients don’t get measles in the first place!

“Failure to promptly identify and appropriately isolate measles cases has led to the investigation of hundreds of healthcare contacts this year. Measles transmission has occurred in emergency departments and other healthcare settings, including transmission to one healthcare worker.”

Recommendations for Measles Case Identification, Measles Infection Control, and Measles Case and Contact Investigations

Next, make sure everyone understands how to recognize the signs and symptoms of measles. Otherwise, some of these kids might unexpectedly end up in your office when they are sick.

The classic measles rash, which begins on the face, typically doesn't begin until these kids have had fever for two or three days.
The classic measles rash, which begins on the face, typically doesn’t begin until these kids have had fever for two or three days. Photo by Jim Goodson, M.P.H.

Think that’s easy? You just watch out for kids with a fever and a rash, right?

Wrong.

If you wait until they have the classic measles rash, you will likely miss the diagnosis the first time they come to your office. Remember, the rash typically doesn’t show up until they have already had a fever for three or four days.

Unfortunately, these kids are contagious well before they have a rash. They are even contagious before they have a fever and know they are sick.

As part of your protocol to stop measles, post a warning sign before parents come into your office.
As part of your protocol to stop measles, post a warning sign before parents come into your office.

So you should suspect measles in kids:

  • with a high fever and cough, coryza, and conjunctivits, even if they don’t yet have a rash
  • with classic measles symptoms who have had a possible exposure. This includes kids who recently traveled out of the country (get a travel history), had contact with international travelers, or just because there are a lot of cases in your area.
  • who are unvaccinated or not completely vaccinated, with two doses of MMR. Keep in mind that even fully vaccinated kids can sometimes get measles though.

And then, if you suspect that a child has measles, work to limit their exposure to others. Patients should know to call ahead. Staff at your office, lab, or the ER should be alerted and ready to see anyone with suspected measles. That way the family knows to wear a mask before going inside.

Ideally, if you have a strong suspicion that the child has measles, this visit will occur in a facility with a negative pressure airborne infection isolation room.

What’s the problem with this kind of protocol?

Lots of kids have fever and rashes! And since you can’t send everyone that calls with adenovirus, roseola, or hand, foot and mouth disease to the ER, part of your protocol should likely be that a health care professional carefully assesses the child’s signs, symptoms, and risks for measles before deciding what to do.

Mostly, be suspicious if a child has returned from a trip oversees, especially if they are unvaccinated, and they have a febrile illness.

More on Your Protocol to Stop Measles Before Kids in Your Office Get Exposed