Breaking News: Flu season is just getting started, as flu activity continues to increase across the country. (see below)
Flu season remains elevated, despite a dip in ILI at the beginning of flu season.
While flu season typically peaks in February, it is very important to understand that there are few things that are typical about the flu.
Since 1982, while we have been twice as likely to see a flu activity peak in February than other winter months, we have been just as likely to get that peak in December, January, or March. That makes it important to get your flu vaccine as soon as you can.
You really never know if it is going to be an early, average, or late flu season. That’s why it is best to not try and time your flu vaccine and to just get it as soon as you can.
Flu Season Facts
There will likely be some surprises this flu season – there always are – but there are some things that you can unfortunately count on.
Among these flu facts include that:
there have been over 1,660 pediatric flu deaths since the 2003-04 flu season, including 185 flu deaths last year
of the average 118 kids that die of the flu each year – most of them unvaccinated
antiviral flu medicines, such as Tamiflu, while recommended to treat high-risk people, including kids under 2 to 5 years of age, have very modest benefits at best (they don’t do all that much, are expensive, don’t taste good, and can have side effects, etc.)
a flu vaccine is the best way to decrease your child’s chances of getting the flu
FluMist, the nasal spray flu vaccine, is once again available for healthy kids who are at least 2-years-old
You can also count on the fact that even in a mild flu season, a lot of kids get sick with the flu.
What about reports that the flu shot won’t be effective?
Don’t believe them. The flu vaccine works and besides, it has many benefits beyond keeping you from getting the flu
This Year’s Flu Season
As of early-January, the CDC reports that flu activity is increasing.
The CDC has also recently reported that:
30 states, Alabama, Arizona, California, Colorado, Connecticut, Delaware, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Utah, Vermont, Virginia, and Wyoming, are now reporting widespread flu activity (up from 24 last week)
17 states, Arkansas, Georgia, Illinois, Maine, Maryland, Michigan, Minnesota, Missouri, Montana, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Washington, West Virginia, and Wisconsin (down from 18 last week)
only 2 states, Hawaii and Mississippi, are still reporting local flu activity (down from 6 last week)
only 1 states, Alaska, and the District of Columbia are still reporting sporadic flu activity (down from 2 last week)
no states are still reporting no flu activity
the proportion of people seeing their health care provider for influenza-like illness (ILI) was 3.5% (down from 4.1% last week), which is still above the national baseline of 2.2%, but far below the 7.5% we saw last year
The overall hospitalization rate was 9.1 per 100,000 population (up from 7.1 last week). The highest rate of hospitalization was among adults aged ≥65 (22.9 per 100,000 population), followed by children aged 0-4 (19.1 per 100,000 population) and adults aged 50-64 (11.5 per 100,000 population).
there have already been 16 pediatricflu deaths this year, including 3 new deaths this past week
Some good news?
So far, influenza A(H1N1)pdm09 viruses are most common (that’s good, because H3N2 years are typically more severe), and the “majority of the influenza viruses collected from the United States during September 30, 2018 through January 5, 2019 were characterized antigenically and genetically as being similar to the cell-grown reference viruses representing the 2018–2019 Northern Hemisphere influenza vaccine viruses.”
While such a good match doesn’t guarantee that this year’s flu vaccine will be effective, it is a very good sign.
Everyone should get a flu vaccine each year, as long as they are at least six months old and have no true contraindications.
Everyone needs a flu shot. When will you get yours? Photo by Gabriel Saldana (CC BY-SA 2.0)
That has been the recommendation since at least the 2010-11 flu season.
And while most kids get vaccinated, not all do.
Are Your Kids at High Risk for Flu Complications?
There are some kids, those at high risk for flu complications, who definitely shouldn’t skip or delay their flu vaccine.
all children aged 6 through 59 months (younger than age 5 years);
children who have chronic medical conditions, including pulmonary (such as asthma and cystic fibrosis), cardiovascular (excluding isolated hypertension), genetic (Down syndrome), renal, hepatic, neurologic (cerebral palsy, epilepsy, stroke, muscular dystrophy, and spina bifida, etc.), hematologic (sickle cell disease), or metabolic disorders (including diabetes mellitus and mitochondrial disorders);
children who are immunocompromised due to any cause (including immunosuppression caused by medications or by HIV infection);
teens who are or will be pregnant during the influenza season;
children and adolescents (aged 6 months through 18 years) who are receiving aspirin- or salicylate-containing medications (like for Kawasaki disease) and who might be at risk for experiencing Reye syndrome after influenza virus infection;
residents of nursing homes and other long-term care facilities;
American Indians/Alaska Natives;
children who are extremely obese (body mass index ≥40).
You also shouldn’t skip or delay getting a flu vaccine if your:
kids are household contacts of children aged ≤59 months (i.e., aged <5 years) and adults aged ≥50 years, particularly contacts of children aged <6 months;
kids are household contacts of someone with a medical condition that puts them at higher risk for severe complications from influenza.
Again, since everyone should get a flu vaccine, these higher risk classes shouldn’t determine whether or not you vaccinate your kids, but they might influence the timing.
Again, don’t skip your child’s flu vaccine because they aren’t in a flu high risk group.
In most flu seasons, about 80% of children with the flu who die are not vaccinated. And many of them will be otherwise healthy, without an underlying high risk medical condition.
Get your child vaccinated against the flu. And if they are in a high risk group, make sure you do it well before flu season starts and maybe as soon as flu vaccine becomes available in your area.
For most the folks, the real question isn’t if they should get a flu shot, but when.
When Should I Get My Flu Shot?
The original flu shot recommendations were based on the fact that flu vaccine became available for distribution in September, but was not completed until December or January. And that high-risk folks should get vaccinated “to avoid missed opportunities for vaccination” if flu vaccine was available in September and they were already at a doctor’s appointment or in the hospital.
Everyone needs a flu shot. When will you get yours? Photo by Gabriel Saldana (CC BY-SA 2.0)
But for most people, the original recommendation was really that “the optimal time for vaccination efforts is usually during October–November.”
“Persons and institutions planning substantial organized vaccination campaigns (e.g., health departments, occupational health clinics, and community vaccinators) should consider scheduling these events after at least mid-October because the availability of vaccine in any location cannot be ensured consistently in early fall. Scheduling campaigns after mid- October will minimize the need for cancellations because vaccine is unavailable.”
Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2006)
What was the problem with this strategy?
Early flu seasons.
And trying to vaccinate over 100 million people in such a short time.
While it might work fine if flu season doesn’t hit until January or February, waiting until mid-October could leave a lot of folks unvaccinated if you had an early flu season that was peaking in November or December.
Fortunately, we don’t have to rush to get people vaccinated so quickly anymore. For one thing, manufacturers have gotten much better at distributing flu vaccine and are able to get a lot of the doses out at the very beginning of flu season. And with more manufacturers, we are seeing fewer delays and shortages of flu vaccine than we used to.
That’s why the recommendation on the timing of flu vaccination has changed over the years.
“In general, health-care providers should begin offering vaccination soon after vaccine becomes available and if possible by October. To avoid missed opportunities for vaccination, providers should offer vaccination during routine health-care visits or during hospitalizations whenever vaccine is available.”
Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2010)
That nice, simple message has changed yet again though.
To balance the concerns that getting a flu shot too early might leave you unprotected at the end of a late flu season, but getting a flu shot too late might leave you unprotected at the beginning of an early flu season, the latest recommendations from the CDC on the timing of flu vaccination aren’t so clear cut:
Balancing considerations regarding the unpredictability of timing of onset of the influenza season and concerns that vaccine-induced immunity might wane over the course of a season, it is recommended that vaccination should be offered by the end of October.
Community vaccination programs should balance maximizing likelihood of persistence of vaccine-induced protection through the season with avoiding missed opportunities to vaccinate or vaccinating after onset of influenza circulation occurs.
Revaccination later in the season of persons who have already been fully vaccinated is not recommended.
Vaccination should continue to be offered as long as influenza viruses are circulating and unexpired vaccine is available.
To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizations.
Optimally, vaccination should occur before onset of influenza activity in the community.
Although vaccination by the end of October is recommended, vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons.
What’s the problem with these recommendations?
If everyone waits until the end of October to get vaccinated, then you might have a hard time getting a flu vaccine. And you might get stuck if you try and time your flu shot with the onset of flu activity. Unless you have a crystal ball, you don’t know when flu season is going to start.
Still, it is important to note that the CDC doesn’t actually say to wait until the end of October. They say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.
Could getting a flu shot early leave your kids unprotected at the very end of flu season?
Maybe, but that’s typically when flu activity is low. And we have that same type of low flu activity in early October, well before flu season peaks.
So just remember that your child could end up unvaccinated and unprotected if you mistime their flu vaccine.
What to Know About the Best Time to Get a Flu Vaccine
Experts say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.
There is plenty of evidence that the standard immunization schedule is safe and effective.
What about the alternative vaccine schedules that some folks push?
Is there any evidence that is safe to delay or skip any of your child’s vaccines?
Alternative Vaccine Schedules
Many people think of Dr. Bob Sears when they think of alternative vaccine schedules.
Bob Sears appeared on Fox & Friends for the segment “Vaccines: A Bad Combination?”
He created both:
Dr Bob’s Selective Vaccine Schedule
Dr Bob’s Alternative Vaccine Schedule
He didn’t invent the idea of the alternative vaccine schedule though.
Well before Dr. Bob appeared on the scene, Dr. Jay Gordon had been on Good Morning America with Cindy Crawford to discuss vaccines and how she had decided to delay vaccinating her baby.
Where did she get the idea?
After the segment, Dr. Jay stated:
“They edited the segment to make me sound like a vaccination proponent. We also have to understand the impact of a person as well-known as Cindy Crawford delaying vaccines for over six months.”
Jay Gordon
Dr. Jay has long talked about only giving infants one vaccine at a time and waiting until they are “developmentally solid” before vaccinating.
When Bob Sears came out with his vaccine book, Jenny McCarthy was also pushing the too many too soon myth and rallying folks to go back to the 1983 schedule that left kids at risk for meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.
Similarly, other folks have pushed ideas about delaying and skipping vaccines before Dr. Bob, including:
Donald Miller and his User-Friendly Vaccination Schedule – no vaccines until age two years and no live vaccines and when you begin vaccinating your child, give them one at a time, every six months (first published in 2004)
Stephanie Cave – starts at 4 months and delays many vaccines
homeopaths with immunization schedules that say to wait until six months and then start giving nosodes every five days
chiropractors with immunization plans that say to get regular chiropractic adjustments instead of vaccines
Of course, Dr. Bob is the one who popularized the idea of the alternative vaccine schedule in 2007, when he published The Vaccine Book: Making the Right Decision for Your Child.
That’s when parents started to bring copies of his schedule into their pediatrician’s office, requesting to follow Dr. Bob’s schedule instead of the standard immunization schedule from the CDC.
What’s the Evidence for Alternative Vaccine Schedules?
There is no evidence that following an alternative vaccine schedule is safe for your kids.
“No alternative vaccine schedules have been evaluated and found to provide better safety or efficacy than the recommended schedule, supported by the Advisory Committee on Immunization Practices of the CDC and the Committee on Infectious Diseases of the AAP (the committee that produces the Red Book).
Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”
American Academy of Pediatrics
What’s the first clue that these so-called alternative vaccine schedules have absolutely no evidence behind them?
They are all different!
Paul Thomas, for example, doesn’t even offer his patients the rotavirus vaccine. Dr. Bob, on the other hand, has it on his list of vaccines that “that could protect a baby from a very potentially life-threatening or very common serious illness” and is sure to give it at 2, 4, and 6 months.
How slow should you go?
Both Dr. Bob and Dr. Paul give two vaccines at a time with their schedules, but Dr. Jay and Dr. Miller say to give just one at a time.
“Would any scientist give SIX vaccines at once to a baby? Asking for trouble. One at a time makes so much more sense.”
Jay Gordon
And while some start their schedules at 2 or 4 months, others delay until 6 months or 2 years.
There is also the fact that the folks who create these schedules admit that there is no evidence for what they are doing…
“No one’s ever researched to see what happens if you delay vaccines. And do babies handle vaccines better when they’re older? This is really just a typical fear that parents have when their babies are young and small and more vulnerable. Since I don’t know one way or the other, I’m just happy to work with these parents, understand their fears and their worries, and agree to vaccinate them in a way that they feel is safer for their baby.”
Unvaccinated kids aren’t healthier – they just get more vaccine preventable diseases. Most of which are life-threatening, even in this age of modern medicine, with access to good nutrition and sanitation.
So whether you only get one or two vaccines at a time; delay until four months, six months, or two years before you get started; skip all live vaccines or just wait until your child is “developmentally solid” to give them; or go with some other non-standard, parent-selected, delayed protection vaccine schedule, the only things that you can be sure of is that there is no evidence to support your decision and that you will leave your kids unprotected and at risk for getting a vaccine-preventable disease.
“…when I give your six-week-old seven different vaccines with two dozen antigens, I am supposed to try to convince you that the adverse reactions you have heard about are just coincidences.”
Jay Gordon
Better yet though. Find a pediatrician who will listen and answer your questions about vaccines, concerns about vaccine myths and misinformation, explain that no vaccine is optional, and not just simply pander to your fears.
What to Know About the Evidence for Alternative Vaccine Schedules
There is no evidence that skipping or delaying any vaccines with an alternative vaccine schedules can keep your kids safe from vaccine preventable diseases.
More on the Evidence for Alternative Vaccine Schedules
If you are following the latest immunization schedule and your kids are up-to-date on all of their vaccines, then they will likely be ready to start daycare, kindergarten, high-school, or college.
There aren’t usually any extra vaccines that they will need to start school.
Of course, if you have skipped or delayed any vaccines, then they might have to catch up on some immunizations before starting school.
Another situation where you might need to do some catching up is if you move, and instead of following the CDC schedule, you were just getting the minimum number of vaccines that were required to attend school where you used to live. For example, your kids could have been all set to start kindergarten in Arkansas, but if you suddenly moved to Texas, they might need a second MMR, a booster dose of Varivax, and two doses of hepatitis A vaccine, as none of those are required in Arkansas.
Immunization Requirements to Start Daycare and Preschool
Daycare rules in Idaho give parents a month to stay on schedule with all of the CDC immunization requirements.
Since many new parents have to go back to work when their baby is only about two to six weeks old, they won’t have time to get their first set of vaccines at two months.
That won’t keep them out of daycare, but delaying too much longer, usually more than a month, probably will.
To start daycare or preschool, infants and toddlers need to get most of the vaccines on the CDC immunization schedule. This includes DTaP, hepatitis B, Hib, Prevnar, and IPV (polio), and then once they are 12 months old, booster doses of the primary series of vaccines and the MMR, Varivax (chickenpox), and hepatitis A vaccines.
The only vaccine that is missing from many state mandates is the rotavirus vaccine. And that simply has to do with the strict timing requirements of when you need to start (before 15 weeks of age) and finish this vaccine (by 8 months).
Some states do require rotavirus though, and simply state that kids must follow “age appropriate dosing.” That way, if they are too old, they just don’t need to get it.
Immunization Requirements to Start Kindergarten
In addition to most of the vaccines they needed to start daycare or preschool, to start kindergarten, kids need their 4 to 6 year old boosters:
the fifth dose of DTaP to protect them against diphtheria, tetanus, and pertussis
the fourth dose of IPV to protect them against polio
the second dose of MMR to protect them against measles, mumps, and rubella
the second dose of Varivax to protect them against chicken pox
If using combination vaccines, these four immunizations can be combined into just two shots – Proquad (MMR + Varivax) and either Kinrix or Quadracel (DTaP + IPV), which your preschooler will appreciate to help reduce the pain from getting these shots.
If your kids were missing any vaccines, they will also need to get caught up on those before starting school.
Immunization Requirements to Start Middle School
Preteens and teens get a few vaccines when they start middle school when they are around 11 to 12 years old, including:
a dose of Tdap to protect them against diphtheria, tetanus, and pertussis
a dose of Menactra or Menveo to protect them against meningoccocal disease
Although not required by most schools, the HPV vaccine is also usually given around this time.
Immunization Requirements to Start College
And then, before going off to college, at around age 16 years, kids will usually need:
a booster dose of Menactra or Menveo to protect them against meningoccocal disease
They can also get the MenB vaccine, although it isn’t yet required for all students. This vaccine (Bexsero or Trumenba) has a “permissive” recommendation, in that parents are told they can get it if they want their kids to avoid meningococcal B disease, but it is not required yet.
While an extra dose of the MMR vaccine is now being given in some situations, it is mainly if your child is at high risk because of a current mumps outbreak. A mumps booster shot is not currently recommended just because your child is going off to college.
What to Know About Immunization Requirements for Incoming Students
If you have been following the latest immunization schedule and your kids are up-to-date on all of their vaccines, then they will likely be ready to start daycare, kindergarten, high-school, and college without needing any extra vaccines.
More on Immunization Requirements for Incoming Students
From the nurses who refuse to get vaccinated, even though they are routinely around high risk children, to other health care providers who push the idea that it is okay to skip or delay some vaccines, they all put our kids at risk.
“One would anticipate that this medical advance would be universally embraced by both parents and health care professionals. Sadly, however, the antivaccine movement, fueled by a lack of respect for the evidence and a profound paranoia, remains alive and well. It is not an overstatement to lay the blame for a resurgence of deadly childhood infections, stemming from declining vaccination rates, at the feet of this movement. Nurse practitioners (NP) also bear some degree of the blame. While certainly not scientific, the anecdotal evidence from letters to JNP documents that some proportion of our readers buy into the pseudoscience of the antivaccine movement. Comments have ranged from bafflingly uninformed (“I don’t think there is enough evidence to support widespread immunizations”) to profoundly unethical (“I recommend to my patients that they not vaccinate their children”).”
Laurie Scudder, DNP, NP on The Importance of Vaccinations
They are often joined by one or more vaccine-friendly nurse practitioners…
Nurse Practitioners on Vaccines
Of course, most nurse practitioners support getting kids vaccinated and protected though.
That’s reflected in the position statement of the National Association of Pediatric Nurse Practitioners (NAPNAP):
“NAPNAP supports the prioritization of immunization education for parents, guardians and other caregivers of infants, children, and adolescents. This education must include the most current scientific evidence related to vaccine safety, risk, benefits and current resources available to ensure that parents and caregivers receive adequate information about immunizations. This includes, when necessary, relaying the risk of not immunizing their child and potential devastation that can occur when a child is infected with a vaccine-preventable disease. It is incumbent that a PNP also be aware of misinformation in the public domain and provides the correct information to the public as well as the health care community.”
Fortunately, most NPs do a great job educating parents and getting kids vaccinated.
Not all of them though.
You can still find some pushing classic anti-vaccine propaganda about vaccines being made in China, that vaccines don’t work, that vaccine-preventable diseases aren’t dangerous, and that natural treatments work are safer – including many, like essential oils and vitamins that they will be very happy to sell to you.
“It’s time for NPs to be part of the solution. We must preach the importance of vaccines, and then we must practice what we preach and be appropriately immunized ourselves.”
Laurie Scudder, DNP, NP on The Importance of Vaccinations
Actually, it’s time for everyone to get educated and to be part of the solution!
What To Know About Nurse Practitioners on Vaccines
Like the great majority of other health care providers, most nurse practitioners fully support getting kids vaccinated and protected against vaccine preventable diseases.
“Vaccines protect the health of children and adults and save lives. They prevent life – threatening diseases, including forms of cancer. Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.”
More than 350 medical, professional and advocacy organizations in a 2017 letter to President Trump
It is the hundreds of thousands of experts at every major health organization around the world!
American Academy of Pediatrics
The American Academy of Pediatrics, an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists, has long advocated for the health and safety of our children.
“Vaccines are safe. Vaccines are effective. Vaccines save lives.
Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been disproven by a robust body of medical literature. Delaying vaccines only leaves a child at risk of disease. Vaccines keep communities healthy, and protect some of the most vulnerable in our society, including the elderly, and children who are too young to be vaccinated or have compromised immune systems.”
Fernando Stein, MD, FAAP, President and Karen Remley, MD, MBA, MPH, FAAP, CEO/Executive Vice President, American Academy of Pediatrics
Vaccine friendly pediatricians who are pushing non-standard, parent-selected, delayed protection vaccine schedules are leaving kids at risk for vaccine-preventable diseases.
“Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”
AAP on Countering Vaccine Hesitancy
Vaccines are necessary.
“Because rare medically recognized contraindications for specific individuals to receive specific vaccines exist, legitimate medical exemptions to immunization requirements are important to observe. However, nonmedical exemptions to immunization requirements are problematic because of medical, public health, and ethical reasons and create unnecessary risk to both individual people and communities.”
AAP on Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance
Society of Pediatric Nurses
“Immunizations are safe and effective in promoting health and preventing disease.”
SPN Position Statement on Immunizations
National Association of Pediatric Nurse Practitioners
Established in 1973, with more than 8,500 members, the National Association of Pediatric Nurse Practitioners (NAPNAP) is the professional association for pediatric nurse practitioners (PNPs) and all pediatric-focused advanced practice registered nurses (APRNs).
“NAPNAP supports the prioritization of immunization education for parents, guardians and other caregivers of infants, children, and adolescents. This education must include the most current scientific evidence related to vaccine safety, risk, benefits and current resources available to ensure that parents and caregivers receive adequate information about immunizations. This includes, when necessary, relaying the risk of not immunizing their child and potential devastation that can occur when a child is infected with a vaccine-preventable disease. It is incumbent that a PNP also be aware of misinformation in the public domain and provides the correct information to the public as well as the health care community.”
NAPNAP Position Statement on Immunizations
American College of Preventive Medicine
“Vaccine-preventable diseases were a major cause of mortality and morbidity in the United States in the 20th century. With the advent of immunizations, there have been dramatic rates of decline in these diseases. Clinical studies have shown vaccines to be efficacious and cost effective. ”
ACPM on Childhood Immunizations
American College of Obstetricians and Gynecologists
Founded in 1951, the American College of Obstetricians and Gynecologists (The College) represents more than 58,000 members.
“Health care providers and patients should be aware that the reassuring safety data for use of the aforementioned vaccines in pregnancy are compelling, and there is no link to vaccine administration and miscarriage. An added benefit to immunizing during pregnancy is the potential for disease prevention in newborns by way of passive antibody transfer to the fetus. Hence, offering pregnant patients influenza and Tdap vaccines is an avenue to protect newborn infants at a critically vulnerable time and before neonates can be vaccinated.”
ACOG on Immunization for Pregnant Women
American Public Health Association
The American Public Health Association was founded in 1872, the APHA represents over 25,000 public health professionals.
“And further noting that the Institute of Medicine has recently released a report10 describing the U.S. immunization system as “a national treasure that is too often taken for granted” and calling for substantial increases in federal and state allocation of funds to support immunization infrastructure; therefore
Reaffirms its support for immunization as one of the most cost-effective means of preventing infectious diseases;”
APHA on The Need for Continued and Strengthened Support for Immunization Programs
American Medical Association
The American Medical Association, which was founded in 1847, has just over 240,000 members.
“The AMA fully supports the overwhelming body of evidence and rigorous scientific process used by the Advisory Committee on Immunization Practices which demonstrate vaccines are among the most effective and safest interventions to both prevent individual illness and protect the health of the public.”
William E. Kobler, MD, member of the AMA Board of Trustees.
Immune Deficiency Foundation
“The development of immunizations for common bacterial and viral infections has represented a major advance in the battle against microbial organisms that constantly threaten the welfare of humankind and particularly the pediatric population. However, the alarming increase in nonimmunized persons could lead to a return of the epidemics seen in the past.
…critical need for maintenance of herd immunity in the population at large. It is particularly important for family members of patients with defective T and B lymphocyte–mediated immunity to receive all of the available standard immunizations (excluding live poliovirus).”
Medical Advisory Committee of the Immune Deficiency Foundation on Recommendations for live viral and bacterial vaccines in immunodeficient patients and their close contacts
American Nurses Association
The American Nurses Association (ANA), founded in 1896, represents “the interests of the nation’s 3.6 million registered nurses.”
“To protect the health of the public, all individuals should be immunized against vaccine-preventable diseases according to the best and most current evidence outlined by the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP). All health care personnel (HCP), including registered nurses (RNs), should be vaccinated according to current recommendations for immunization of HCP by the CDC and Association for Professionals in Infection Control and Epidemiology (APIC).
…
As stated in the Code of Ethics for Nurses (ANA, 2015, p. 19), RNs have an ethical responsibility to “model the same health maintenance and health promotion measures that they teach and research…,” which includes immunization against vaccine-preventable diseases.”
ANA Position Statement on Immunizations
Autism Science Foundation
“Multiple studies have been completed which investigated the measles, mumps and rubella vaccination in relation to autism. Researchers have also studied thimerosal, a mercury-based preservative, to see if it had any relation to autism. The results of studies are very clear; the data show no relationship between vaccines and autism.”
The American Association of Immunologists (AAI) is the largest professional association of immunologists in the world, representing more than 7,600 basic and clinical immunologists.
“Recent outbreaks have brought increased attention to vaccine- preventable diseases and have highlighted the need for robust and timely immunization to reduce preventable sicknesses and deaths. AAI strongly urges full adherence to recommended vaccination schedules and views vaccines as efficacious for individuals and crucial to public health.
…
Research has repeatedly confirmed that vaccinations are safe and highly effective for all healthy children and adults, and any suggestions to the contrary have been discredited. Ongoing vaccine research continually reaffirms its safety and efficacy, including the number of vaccines administered at any one time and the recommended vaccination schedule.”
The American Association of Immunologists Statement on Vaccines
American Osteopathic Association
“The American Osteopathic Association supports the Centers for Disease Control and Prevention in its efforts to achieve a high compliance rate among infants, children and adults by encouraging osteopathic physicians to immunize patients of all ages when appropriate ; supports the HHS National Vaccine Implementation Plan; and encourages third- party payers to reimburse for vaccines and their administration.”
AOA on Immunizations
National Association of School Nurses
#TodaysSchoolNurse is “grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential.”
“It is the position of the National Association of School Nurses (NASN) that immunizations are essential to primary prevention of disease from infancy through adulthood.
…
The school nurse is well-poised to create awareness and influence action to increase the uptake of mandated and recommended immunizations. The school nurse should use evidence-based immunization strategies, such as school-located vaccination clinics, reminders about vaccine schedules, state immunization information systems (IIS), strong vaccination recommendations, and vaccine education for students, staff, and families.”
NASN Immunizations Policy Statement
American Academy of Family Practice
“With the exception of policies which allow for refusal due to a documented allergy or medical contraindication, the AAFP does not support immunization exemption policies.”
AAFP Immunization Policy Statement
American Academy of Allergy, Asthma & Immunology
The American Academy of Allergy, Asthma & Immunology (AAAAI) is a professional organization with over 7,000 members, including allergists/ immunologists, in the United States and 73 other countries.
“Immunization is perhaps the greatest public health achievement of all time, having significantly reduced the morbidity and mortality of many infectious diseases. Routine immunization of children, adolescents, and adults provides substantial protection from a large number of infectious diseases…
Patients who have experienced adverse reactions to vaccines might unnecessarily be advised to avoid subsequent immunization, which could have important adverse personal and population health consequences. Although there are some adverse reactions to vaccines that constitute absolute contraindications to administration of future doses, most such reactions do not preclude subsequent immunization. Patients who have experienced an apparent allergic or other serious adverse reaction after receiving a vaccine warrant evaluation by an allergist/immunologist. Also, patients with preexisting health conditions that might predispose to adverse reactions to vaccines could benefit from such an evaluation. In most cases, a risk-benefit analysis will favor subsequent immunization.”
AAAAI Practice Paramater on Adverse Reactions to Vaccines
CJ First Candle
“There seems to be a common misconception that vaccines are somehow associated with SIDS deaths. This is not true! Experts warn that the risk of leaving your baby unprotected is 1,000 times greater than any increased risk for SIDS. Because infants receive many immunizations during the critical development period from two to six months of age, and 90 percent of SIDS deaths occur within this time frame, it is only logical that many SIDS victims have recently received vaccines. This does not mean that the immunization had anything to do with the infant’s subsequent sudden and unexpected death. The cause and effect of immunizations and SIDS has been comprehensively studied for more than two decades. In fact, in countries where immunization schedules are different from those in the United States, the peak incidence of SIDS is still between two to four months.”
CJ First Candle on Immunizations
Infectious Disease Society of America
Founded in 1963, the Infectious Diseases Society of America (IDSA), with over 9,000 members, represents physicians, scientists and other health care professionals who specialize in infectious diseases.
“The Infectious Diseases Society of America (IDSA) recognizes the great benefits that vaccines provide for the public health. Substantial scientific evidence demonstrates vaccines’ enormous value in protecting individuals and populations from serious and life-threatening infections. Scientific evidence also demonstrates the overall safety of vaccines. Communities are most effectively protected when all are immunized.
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Studies demonstrate that the easier it is to receive an exemption, the higher the rate of exemptions in a particular state. As the number of exemptions increases, the risk of vaccine – preventable disease increases. Therefore, states must make every effort to minimize the number of its citizens exempted from immunization mandates. Such exemptions make the state legislatures who grant them, as well as the individuals who receive them, responsible for placing the remaining state population at greater risk of acquiring potentially fatal infections.”
IDSA Policy Statement on State Immunization Mandates
The Arc of the United States
“Prior to widespread immunization in the United States, infectious diseases killed or disabled thousands of children each year. The near elimination of intellectual disability due to measles encephalitis, congenital rubella syndrome, and Haemophilus influenzae type b meningitis or Hib can be contributed to vaccines.”
The Arc Facts About Childhood Immunizations
American College Health Association
“The American College Health Association (ACHA) strongly supports the use of vaccines to protect the health of our individual students and our campus communities. In recognition of the vital role that vaccine coverage plays in community immunity (herd immunity), ACHA discourages use of nonmedical exemptions to required vaccines.”
ACHA on Immunization Recommendations for College Students
What to Know About Expert Statements on Vaccines
Over the years, hundreds of organizations representing millions of families, health care providers, researchers, patients, and consumers, have repeatedly expressed their unequivocal support for vaccines, because they understand that vaccines work and that they are safe and necessary.
