States getting tough about requiring childhood vaccinations

19 May

Michaeleen Doucleff reported in the NPR story, How Vaccine Fears Fueled The Resurgence Of Preventable Diseases:

For most of us, measles and whooping cough are diseases of the past. You get a few shots as a kid and then hardly think about them again.
But that’s not the case in all parts of the world — not even parts of the U.S.
As an interactive maphttp://www.cfr.org/interactives/GH_Vaccine_Map/index.html#mapfrom the Council on Foreign Relations illustrates, several diseases that are easily prevented with vaccines have made a comeback in the past few years. Their resurgence coincides with changes in perceptions about vaccine safety….
http://www.npr.org/blogs/health/2014/01/25/265750719/how-vaccine-fears-fueled-the-resurgence-of-preventable-diseases?utm_medium=Email&utm_campaign=20140202&utm_source=mostemailed

There are many myths regarding vaccination of children.

Evie Blad reported in the Education Week article, States Tightening Loopholes in School Vaccine Laws:

As outbreaks of preventable diseases have spread around the country in recent years, some states have been re-evaluating how and why they allow parents to opt their children out of vaccines required for school attendance.
Requiring vaccines before school admission has been a key component of a decades-long campaign that had nearly rid the United States of some of its most severe illnesses, from the measles to whooping cough, public-health experts say. But they also warn that broad “personal belief” exemptions that don’t relate to a child’s medical condition or a family’s religious beliefs have made it too easy to bypass vaccines, poking a sizable hole in the public-health safety net.
While some parents act out of a sense of personal conviction, others do so simply because they don’t have time to schedule an appointment, said Stephanie L. Wasserman, the executive director of the Colorado Children’s Immunization Coalition, an Aurora, Colo.-based group that seeks to increase vaccine coverage in the state.
“We want to close that convenience loophole,” she said. “When you choose not to immunize, there are consequences not only to your child and your family; there are consequences to your community as well.”
Since 2011, Washington, Oregon, California, and Vermont have revised their personal exemption processes.
In Colorado—a state with one of the highest opt-out rates in the country and the most recent one to examine its vaccine-exemption policies—a bill passed this month would draw schools into the public health fight….
Laws at a Glance
While all states have school vaccination laws on the books, states vary on how much leeway parents have to opt their children out of required vaccinations.
50 states require specified vaccines for students, but allow exemptions for medical reasons.
48 states grant exemptions for people who have religious beliefs against immunizations. (Mississippi and West Virginia do not allow this exemption.)
19 states allow exemptions for those who object to immunizations for personal or moral beliefs.
SOURCE: National Conference of State Legislatures
http://www.edweek.org/ew/articles/2014/05/14/31vaccines.h33.html

Dina Fine Maron wrote in the Daily Beast article, 6 Top Vaccine Myths:

To sort through the onslaught of information and misinformation about childhood immunizations, we asked Austin, Texas-based pediatrician Ari Brown, coauthor of “Baby 411: Clear Answers and Smart Advice for your Baby’s First Year,” to debunk some of the most common vaccination myths.

Myth 1: It’s not necessary to vaccinate kids against diseases that have been largely eradicated in the United States.
Reality: Although some diseases like polio and diphtheria aren’t often seen in America (in large part because of the success of the vaccination efforts), they can be quite common in other parts of the world. The Centers for Disease Control and Prevention warns that travelers can unknowingly bring these diseases into the United States, and if we were not protected by vaccinations, these diseases could quickly spread throughout the population….

Myth 2: Mercury is still in kids’ vaccines.
Reality: At the center of this issue is a preservative called thimerosal (a compound containing mercury) that once was a common component in many vaccines because it allowed manufacturers to make drugs more cheaply and in multidose formulations. But public concern, new innovations and FDA recommendations led to its removal from almost all children’s vaccines manufactured after 2001. (More thimerosal background can be found at the FDA’s Web site) Since flu vaccines are not just for children, manufacturers still put thimerosal in some flu-shot formulations. You can ask your pediatrician for the thimerosal-free version, says Brown.
If your child does not have asthma and is at least 2 years old, Brown recommends the FluMist nasal-spray vaccination over the flu shot. “It seems to have better immune protection and it could help your child avoid another shot,” she says. (Caveat: the spray does contain a live version of the virus, which can result in a slight increase in flulike symptoms).

Myth 3: Childhood vaccines cause autism.
Reality: There is no scientific evidence that this link exists. Groups of experts, including the American Academy of Pediatrics and the Institute of Medicine (IOM), agree that vaccines are not responsible for the growing number of children now recognized to have autism…..

Myth 4: Getting too many vaccines can overwhelm the immune system and cause adverse reactions or even serious illness.
Reality: Children’s immune systems are capable of combating far more antigens (weak or killed viruses) than they encounter via immunizations. In fact, the jury is still out on if there’s an actual limit on how many the body can handle—though one study puts the number around a theoretical 10,000 vaccines in one day.(Visit the American Academy of Pediatrics’ site or the Network for Immunization Information for more information)
Currently, “There is even less of a burden on the immune system [via vaccines] today than 40 years ago,” says Edgar Marcuse, a professor of pediatrics at the University of Washington who works on immunization policy and vaccines…..

Myth 5: It’s better to let my kid get chickenpox “naturally.”
Reality: Before the chickenpox vaccine was licensed in 1995, parents sometimes brought their child to a party or playground hoping that their child might brush up against a pox-laden kid to get their dose of chickenpox over since cases were usually less severe for children than adults. But pediatricians say severe complications are possible with chickenpox—including bacterial infections that could result in a child’s hospitalization or death….

Myth 6: The flu shot causes the flu.
Reality: The flu shot does not contain a live virus, so your child can’t get the flu from this shot. But, after the shot, it’s not uncommon to feel a bit achy while the immune system mounts its response. Remember that for two weeks following the shot, your child can still get the flu, so be sure to help your child avoid that feverish kid next door.http://www.thedailybeast.com/newsweek/2009/02/22/six-top-vaccine-myths.html

A question in the current climate is what can be done to make parents responsible for putting other children at risk.

Jed Lipinksi wrote in the Slate article, Endangering the Herd: The case for suing:

As you’d expect, the growing anti-vaccination movement responded in fury. After Caplan wrote a related post for the Harvard Law Blog, angry comments poured in. “This article is industry propaganda at its worst,” one commenter declared. Another wrote: “Caplan would have familiar company in fascist Germany.” The blog eventually shut down the comments for violations of the site’s policies against “abusive and defamatory language” and the sharing of personal information.
Here’s why the anti-vaxxers are wrong and Caplan and his co-authors are right to raise the idea of suing or criminally charging them: Parents who choose not to vaccinate their kids for reasons of personal belief pose a serious danger to the public.
Measles vaccines are about 95 percent effective when given to children. That leaves a 5 percent chance that kids who are vaccinated will contract measles. This means that no matter what, the disease still poses a public health risk, but we rely on others to get vaccinated to hugely reduce the likelihood of outbreaks. That’s the process known as herd immunity.
Unvaccinated children threaten the herd. Take the San Diego measles outbreak of 2008. After unknowingly contracting the disease on a trip to Switzerland, an unvaccinated 7-year-old boy infected 11 other unvaccinated kids, according to the Centers for Disease Control and Prevention. The majority of the cases occurred in kids whose parents had requested personal belief exemptions (or PBEs) through the state of California, one of 17 states to allow them. But three of the infected were either too young or medically unable to be vaccinated. And overall, 48 children too young to be vaccinated were quarantined, at an average cost to the family of $775 per child. The CDC noted that all 11 cases were “linked epidemiologically” to the 7-year-old boy and that the outbreak response cost the public sector $10,376 per case.
Today, several states blame a rise in preventable diseases on the declining child vaccination rates. In Michigan, less than 72 percent of children have received their state-mandated measles, mumps, and rubella (MMR) vaccines. In New York, as Caplan noted in his blog post, pockets of Brooklyn’s Hasidic Jewish community are experiencing a mini measles epidemic. Thirty cases have been confirmed so far. According to Dr. Yu Shia Lin of Maimonides Medical Center, some members of the community avoid the measles vaccine because they think it causes autism. The most visible proponent of this idea, former Playboy Playmate Jenny McCarthy, will receive a giant new platform for her viewpoints when she joins the daytime gossipfest The View on Sept. 9.
The belief that the MMR vaccine causes autism goes back to a 1998 study published in the Lancet by a British gastroenterologist named Andrew Wakefield. In 2010, after years of criticism, the journal finally retracted Wakefield’s study, announcing that it was “utterly clear, without any ambiguity at all, that the statements in the paper were utterly false.” Britain’s General Medical Council later revoked Wakefield’s medical license, noting that he’d failed to disclose his role as a paid consultant to lawyers representing parents who thought vaccines had harmed their kids. The CDC makes clear there is no connection between vaccines and autism.
Yet this dangerous idea persists. Often, it persists among people who are simply doing what they think is best for their kids. Which is why it’s necessary to take extra measures to ensure nonvaccinators understand the risk they pose to other people’s children….
There are legal obstacles to penalizing parents who don’t vaccinate their kids. Courts are generally less likely to impose liability on someone who fails to act than they are on someone who acts recklessly. Also, proving cause and effect will sometimes be difficult. Then again, to win damages, a plaintiff would only have to prove that it’s “more likely than not” that a nonvaccinated child infected another person.parents who don’t vaccinate their kids—or criminally charging them….http://www.slate.com/articles/news_and_politics/jurisprudence/2013

It is just a matter of time before there will be lawsuits regarding whether a parent owed a duty to the public to vaccinate their child.

Here is information from the 6 Top Vaccine Myths regarding vaccination schedules:
For Health Care Professionals
Birth-18 Years and Catch-up
• View combined schedules (birth-18 years and catch-up)
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a2.htm
• Print combined schedules (including intro, summary of changes, references…) [355 KB, 7 pages]
http://www.cdc.gov/vaccines/schedules/downloads/child/mmwr-0-18yrs-catchup-schedule.pdf
• Print combined schedules in color (chart in landscape format) [202 KB, 5 pages] also in black & white [348 KB, 5 pages]
http://www.cdc.gov/vaccines/schedules/downloads/child/mmwr-0-18yrs-catchup-schedule.pdf
• Print full MMWR supplement (birth-18 years, catch-up, adult, adult medical and other indications, adult contraindications and precautions) [1MB, 21 pages]
http://www.cdc.gov/mmwr/pdf/wk/mm62e0128.pdf
• Order free copies from CDC
http://wwwn.cdc.gov/pubs/ncird.aspx#schedules
For Everyone
Easy-to-read Schedules for All Ages
Easy-to-read formats to print, tools to download, and ways to prepare for your office visit.
• Infants and Children (birth through 6 years old)Find easy-to-read formats to print, create an instant schedule for your child, determine missed or skipped vaccines, and prepare for your office visit…
http://www.cdc.gov/vaccines/schedules/easy-to-read/child.html
• Preteens & Teens (7 through 18 years old)Print this friendly schedule, take a quick quiz, fill out the screening form before your child’s doctor visit, or download a tool to determine vaccines needed…
http://www.cdc.gov/vaccines/schedules/easy-to-read/preteen-teen.html
• Adults (19 years and older)Print the easy-to-read adult schedule, take the quiz, or download a tool to
• determine vaccines needed…
http://www.cdc.gov/vaccines/schedules/easy-to-read/adult.html
http://www.cdc.gov/vaccines/schedules/

Here is information from the American Academy of Pediatrics regarding vaccination.
http://www2.aap.org/immunization/ Parents must consult their doctors about vaccinations.

Related:

3rd World America: Tropical diseases in poor neighborhoods
https://drwilda.com/2012/08/20/3rd-world-america-tropical-diseases-in-poor-neighborhoods/

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