Vaccines

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School Nurses on Front Lines to Raise Vaccine Rates

(Jane Meredith Adams/EdSource)

Robyn Ettl, Grass Valley Unified school nurse, gives a vision test to second grader Chase Littlejohn at the Grass Valley Charter School. (Jane Meredith Adams/EdSource)

By Jane Meredith Adams, EdSource

In her 33 years as a school nurse, Robyn Ettl has listened, sometimes quietly, sometimes not, to parents in rural Nevada County explain why their children don’t need vaccinations against contagious and potentially fatal diseases, including polio, diphtheria, measles and pertussis.

Parents must now meet with health provider before opting-out of vaccines for their children.

Now, with nearly a half a million children in California registering for kindergarten in the fall, school nurses like Ettl are more invested than ever in a delicate task: trying to change the minds of parents intent on opting out of school-entrance immunizations.

Under a state law that took effect Jan. 1, parents may no longer simply file a letter to opt-out of vaccines. Instead, they are required to consult with a health practitioner –- doctor, naturopath or credentialed school nurse –- before they’re allowed to obtain what’s known as a “personal-belief exemption” from their child’s required immunizations. Continue reading

California Measles Cases Jump Dramatically; 49 So Far in 2014

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images)

The state is reporting 49 confirmed cases of measles so far in 2014.

Last year at this time there were just four.

This is the first year since 2000, when officials declared measles eliminated in the U.S., that the number of cases in California climbed above 40. And it’s just April.

The California Department of Public Health says the highest number of cases – 21 – have been reported in Orange County. Other affected counties in Southern California include Los Angeles County with 10, Riverside with 5 and San Diego County with 4.

In Northern California the cases were spread out between Alameda, Contra Costa, Santa Clara and San Mateo. Continue reading

Measles Cases on Rise Statewide

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images

Vial of Measles Mumps and Rubella (MMR) vaccine. (Geoff Caddick/AFP/Getty Images

The California Department of Public Health says that California has 32 confirmed cases of measles so far this year. At this time last year, only three cases had been reported.

The cases are reported in both Northern and Southern California. Measles was declared to be eliminated in 2000 in the United States and CDPH says that many cases are linked to travel to parts of the world where measles is circulating. Of the cases reported so far this year, seven people had traveled to the Philippines where a large outbreak of measles is ongoing, two had been to India and one had traveled to Vietnam.

Health officials recommend that anyone planning travel outside of North or South America and has not been vaccinated to make sure they get the MMR (measles, mumps, rubella) vaccine before they go. Continue reading

Contra Costa County Maps Schools by Vaccination Rates: Find Yours

The red dots mark a school or childcare facility where the vaccine opt-out rate is 10 percent or more.

The red dots mark a school or child care facility where the vaccine opt-out rate is above 9.9 percent. The statewide average is 3 percent. (Contra Costa Health Department)

In response to the troubling number of children whose parents opt out of vaccines for them, Contra Costa Health Services (CCHS) has published an interactive online map of vaccine rates for schools and licensed child-care facilities with at least 15 children at each site across the county.

“There’s not much wiggle room. We need about 90 percent of our community to be immune.”
The screen shot above shows the map. When you visit the site you can click on any of the dots, and a box appears to show you the name of the school, its address and rate of “personal belief exemptions.” While state law requires that every child be fully vaccinated to enter kindergarten, parents can opt out by filing a personal belief exemption (PBE), a signed statement that vaccines are against a parent’s beliefs.

Paul Leung, immunization program manager for Contra Costa Public Health, said the goal of producing the map was to increases awareness. “Many community members may not realize this dangerous, disturbing trend of parents choosing to skip vaccines for their children,” he said. “It not only puts these kids at greater risk of serious, dangerous diseases like measles and polio,” but it also puts others at risk, he said, including those who cannot be vaccinated, such as babies, and children or adults too sick to be vaccinated.  Continue reading

Whooping Cough Vaccine: Does Its Effectiveness Wear Off Faster?

A vial containing the acellular pertussis vaccine. (Robyn Beck/AFP/Getty Images)

A vial containing the acellular pertussis vaccine. (Robyn Beck/AFP/Getty Images)

A new rise in whooping cough cases in California is raising questions among doctors about whether there are problems with the current vaccine. California public health data show a spike in whooping cough cases in 2013 compared to the year before, and last week officials confirmed the first death from the disease since the major outbreak of 2010: an infant in Riverside.

“The attempt at making vaccines safer has created a potential lapse in protection.” 

Whooping cough, or pertussis as it is referred to in medical circles, is cyclical in nature and tends to peak every three to five years. But doctors are now finding evidence that the new vaccine may start to wear off on a similar timeline, despite medical recommendations that allow for a span of eight years between booster shots.

“The efficacy of the new vaccine is really good, it works. It’s just that it wanes, and it wanes more quickly,” said Dr. Michael Witte, a pediatrician in Pt. Reyes, north of San Francisco.

The new acellular whooping cough vaccine was introduced in the 1990s. It has fewer side effects than the earlier whole-cell vaccine that had been in use since the 1940s. By 2001, the old vaccine was completely phased out. So while many adolescent kids have received boosters of the new vaccine, they would have gotten shots when they were babies that included the old vaccine. Continue reading

How California’s Law to Encourage Vaccination Could Backfire

Baby cries after receiving a vaccine. (Dan Hatton: Flickr)

(Dan Hatton/Flickr)

By Nancy Shute, NPR

California has a new law that’s supposed to get more of the state’s children vaccinated against measles, whooping cough and other infectious diseases.

But the law has taken a strange turn on its way to being put into action, one that may instead make it easier for parents to exempt their children from required vaccinations.

In recent years the number of parents who request so-called personal belief exemptions from vaccines has been rising. It’s gotten to the point that public health officials fear that there could be disease outbreaks in parts of California. Same goes for other states where exemption rates are high.

On Sept. 20, 2012, California Gov. Edmund G. Brown Jr. signed a bill aimed at boosting childhood immunization rates. His signing letter included these instructions: Continue reading

Vaccine Refusals Fueled California Whooping Cough Epidemic

Students leaving a vaccine clinic after being vaccinated against whooping cough at a middle school in Los Angeles. (Kevork Djansezian/Getty Images)

Student leaves a vaccine clinic at a Los Angeles middle school after being immunized against whooping cough. (Kevork Djansezian/Getty Images)

By Nancy Shute, NPR

When the whooping cough vaccine was invented in the 1940s, doctors thought they had finally licked the illness, which is especially dangerous for babies. But then it came roaring back.

In 2010, a whooping cough outbreak in California sickened 9,120 people, more than in any year since 1947. Ten infants died; babies are too young to be vaccinated.

Public health officials suspected that the increased numbers of parents who refused to vaccinate their children played a role, but they couldn’t be sure.

Vaccine refusal was indeed a factor, researchers now say. They compared the location and number of whooping cough, or pertussis, cases in that outbreak with the personal belief exemptions filed by parents who chose not to vaccinate for reasons other than a child’s health. (Some children with compromised immune systems aren’t able to be vaccinated.)

Pertussis is very contagious, spreading quickly through a community. So the researchers had to map not only the location of outbreak clusters, but also when they appeared. Continue reading

5 Things You Should Know About Vaccines

Young girl with partial paralysis, caused by polio. (Courtesy Boston Children's Hospital)

Young girl with partial paralysis, caused by polio. (Courtesy Boston Children’s Hospital)

Take a hard look at the picture. These are images we don’t see in this country at all anymore. But until the polio vaccine came along in 1955, children and adults paralyzed from polio were fairly commonplace. (FDR, anyone?) Today, vaccines are now a victim of their own success. Because they’ve so successfully wiped out devastating childhood illnesses, people seem not to fear those illnesses anymore. Now we have parents who decide not to have their children vaccinated.

As KQED News has reported this week, the number of parents in Marin County opting out of vaccines for their children is climbing. Last year, 7.8 percent of Marin parents opted out, 1 percentage point higher than the previous year. At present, California has one of the most lenient laws in the country to allow parents to decline vaccinating their kids: the “personal belief exemption.” It’s a short statement that says vaccinations are against a parent’s beliefs. (A new law amends this exemption somewhat; more on that below.)

On Thursday, KQED’s Forum took up the question of vaccines, and it was clear that many people remain confused on some key points.

1. What is herd immunity? Continue reading

Today’s Whooping Cough Vaccine May Be Safer, But Less Effective than the Old One

Each green circle shows a whooping cough outbreak. (Map: Council on Foreign Relations)

Each green circle depicts a whooping cough outbreak this year. (Map: Council on Foreign Relations)

As the map illustrates, many areas in the country are in the grip of whooping cough outbreaks, everywhere but California. More on California in a minute. Let’s first take a look at a new(ish) vaccine and see how its limitations might be contributing to the outbreaks.

In the 1990s, the U.S. and other developed countries switched from one kind of vaccine against whooping cough (also called pertussis) to another. The older vaccine was very effective but there were concerns about a rare side effect, a neurological disorder, which may (or may not) have been connected to the vaccine. More commonly, the vaccine caused the same minor side effects that we traditionally associate with shots: redness, soreness at the injection site, etc. Except that with the old pertussis vaccine, the side effects occurred more frequently.

In her wired.com blog noted science reporter Maryn McKenna recaps the research and wonders if there could have been an unexpected trade-off with this new vaccine — that it is less effective and therefore contributing to the outbreaks we’re seeing now. From McKenna’s blog Superbug: Continue reading

No Whooping Cough Deaths Last Year in California

Pharmacist administers whooping cough vaccine. (Robyn Beck/AFP/Getty Images)

Pharmacist administers whooping cough vaccine. (Robyn Beck/AFP/Getty Images)

You know public health is working when nothing bad happens. Last year, for the first time in 20 years, California had no deaths from whooping cough, a highly contagious illness also called pertussis.

The California Department of Public Health credits a statewide vaccination effort which followed a 2010 outbreak when 9,000 Californians were diagnosed and nine infants died. In 2011, in addition to no deaths, the number of cases of the illness dropped to 3,000.

As the Los Angeles Times reports: Continue reading