Giving Every Child a Shot at Life
I recently had the opportunity to attend the Shot@Life Champion Summit, a gathering of vaccine advocates from across the country who come together each year to learn about the crucial role the U.S. plays in supporting global immunizations. Advocates also learn the powerful impact of advocacy through trainings and meetings with Congressional offices on Capitol Hill.
Shot@Life, a campaign of the United Nations Foundation, aims to ensure that children around the world have access to life-saving vaccines. The campaign works to build a group of Champions (advocates), who will dedicate their voices, time, and support to standing up for childhood in developing countries.
At the Summit, I heard from several Champions who are experts in the areas of vaccines, global health, and international development. The most powerful speaker for me was Geeta Rao Gupta, a senior fellow at the UN Foundation who has worked to improve the lives of women and girls around the world. She focused on the value of vaccines for women, and not just in the obvious ways, like preventing cervical cancer. “When we talk about the statistics of infant mortality, we rarely talk about grief,” she said. She shared the heartbreaking story of her great-grandmother, who died of tuberculosis in her early thirties after losing five of eleven children in their infancies. I don’t think many of us living in Washington today can imagine how painful these losses must have been for her. And while it can be easy, in our day-to-day work, to focus on the numbers and rates, it’s a powerful reminder of why those numbers and rates matter. Dr. Gupta reminded us that vaccines don’t just “save lives” – they prevent grief, and allow mothers to focus their energies on caring for healthy children.
Dr. Gupta emphasized how fortunate we are to live during the age that we do, with advancements in vaccines and general health. However, developing countries are still in need of these valuable resources. And where vaccines could prevent an estimated 2.5 million deaths among children younger than age 5 around the globe, 1 child still dies every 20 seconds from a disease that could have been prevented by a vaccine. Therefore, the U.S. strives to provide access and education around vaccines through a variety of ways. Did you know the U.S. Centers for Disease Control is key in leading worldwide efforts to eradicate polio and measles? Or that USAID is a key partner of Gavi, the Vaccine Alliance, which creates immunization access for the world’s poorest countries, immunizing half a billion children? Even the U.S.’s contribution to UNICEF helps save lives, as they deliver vaccines to 45% of the world’s children. The U.S. is a leader in providing vaccine assistance globally, as well as here at home by providing funding to various organizations working at the community level.
Being a local organization that promotes immunizations, our work at WithinReach is also part of a global community. We’re reminded of that every year, as American travelers bring back vaccine-preventable diseases from across the globe. “Disease anywhere is disease everywhere” with our interconnected world and the ease of travel. Diseases that have been long rare at home are still prevalent in many other areas of the world. That is why it is important that we advocate and create awareness around vaccine-preventable diseases through our community members, our partners and state leaders. If you’re interested in learning more about how you can help every child have a shot at life, check out shotatlife.org.
Vaccines Are Safe. Vaccines Are Effective. Vaccines Save Lives.
You may have heard in the news about the possible development – and the possible non-development – of a new vaccine safety commission by the executive branch. Vaccines have been proven to be one of the safest and most effective ways of preventing illness ever developed, and have saved the lives of hundreds of thousands. Their safety is paramount, especially because they are so widely used by healthy children and adults. But the creation of a federal commission on vaccine safety seems unnecessary because we already have a robust system to monitor and detect problems with the use of vaccines. The creation of such a commission would cast doubt on the use of these life-saving treatments and decrease utilization of vaccines, causing significant harm to individuals and the community at large. We stand with our partners in healthcare, public health, and many parents and community members when we say: Vaccines are safe. Vaccines are effective. And vaccines save lives.
We asked Neil Kaneshiro, MD, for his thoughts. He’s been a pediatrician in Washington for more than twenty years, and is currently serving as chair of the Immunization Action Coalition of Washington. Here’s what he had to say:
“As a practicing pediatrician, I have recommended, administered and personally used standard vaccines for over 20 years in thousands of patients and have not seen any reason to hesitate using vaccines when given appropriately according to national guidelines. If you really look at the data, there are far less significant adverse reactions to vaccines than to antibiotics given for ear infections or pneumonia. The diseases prevented through the use of vaccines are not as well-known now because of our preventive effort, but they are real and can return with a vengeance if immunization rates wane. Few people today remember the fear parents had that their healthy children might contract polio and suffer in an iron lung machine. You just don’t see that anymore precisely because of vaccines. Rumors and conspiracy theories are rampant on the web, but the scientific evidence is clear that vaccines are safe and effective and they do save lives. We need to do everything we can to promote increased use of vaccines and not scare people away.”
Promoting trusted sources of information about vaccines is crucial. Read what the American Academy of Pediatrics and the American Academy of Family Physicians have to say in response to the recent news on vaccines.
Don’t Panic: Zika, the Summer Olympics, and You
If you only read this paragraph, here’s why the Olympics happening in the midst of Rio’s Zika outbreak shouldn’t worry you: First, Zika is primarily spread by two species of mosquito–known as Aedes aegypti and Aedes albopictus–that don’t live in Washington, so the chance that it could spread widely here is pretty close to nil. Second, for most adults it’s a pretty mild illness. Pregnant women need to be most cautious because their babies are at the highest risk of severe consequences.
If you travel anywhere impacted by Zika, like Rio or even Puerto Rico, you can prevent mosquito bites – and therefore Zika – by using bug spray (DEET, picaridin, IR3535, OLE, and PMD have been proven safe and effective). Just as important, wear clothing that covers your arms and legs, and “mosquito-proof” your accommodations by closing or screening doors and windows and/or using a mosquito net.
Zika is typically a mild illness in adults, marked by fever, rash, joint pain, and red eyes. But it’s linked to a serious birth defect in newborns called microcephaly – an unusually small brain and skull. So if you’re pregnant or planning to become pregnant, extra precaution is recommended, including postponing travel to impacted areas if possible. Because Zika can also be spread through sex with a man, always use a condom with a male partner who has recently traveled to an area with Zika (even if they’re not showing any symptoms). This may mean using a condom throughout your pregnancy, or waiting to conceive for at least eight weeks if your male partner has no symptoms of Zika.
Chances are, most of us in Washington won’t be exposed to Zika. So why should it matter? Well, our immunization team at WithinReach can think of a few reasons. It’s a good reminder that in an age of global travel, infectious diseases are only a plane ride away. Already, 15 cases in Washington have been confirmed among recent travelers (as of July 20th). Many of the diseases we vaccinate against are equally easy to import into Washington – and without the need for a vector, like a mosquito, they can spread much more easily when they do arrive. That’s why it’s so important to protect our communities through immunization.
Zika also has one thing in common with a disease we routinely vaccinate against: rubella. When a pregnant mom becomes ill with rubella, it can have terrible consequences for her developing fetus. In 1964, the U.S. experienced a huge rubella outbreak that affected 50,000 pregnant women and led to thousands of miscarriages and 20,000 cases of congenital rubella syndrome, in which babies are born with symptoms including blindness, deafness, heart defects, and cataracts. Now that we have the MMR (measles, mumps, rubella) vaccine, very few American babies are born with congenital rubella syndrome – primarily only when their mother is infected during international travel. Sound familiar? With Zika, like rubella, we know that protecting pregnant women is our biggest priority. Hopefully, one day we will have a vaccine to help us do so.
So whether you enjoy watching the world’s top athletes compete in Rio or on your TV, have a safe and healthy summer! And if they inspire you to get out and be active, all the better – just don’t forget your bug spray.
Congratulations to Washington’s Immunization Award Winners!
Every other year, the Immunization Action Coalition of Washington (IACW) recognizes people and organizations in our state that are truly going above and beyond to protect our communities from vaccine-preventable diseases. This year, we presented the awards at a special coalition meeting on April 20, during National Infant Immunization Week.
The 2016 IACW Collaborator award goes to the Auburn School District School Nurses, represented by Jan Schneider, Jill Olson, and Tami Petrina. Together with the district’s health technicians, they reduced the number of students in their district who were out of compliance (meaning their immunization paperwork wasn’t submitted properly) by two-thirds, from 852 to 295. These numbers represent countless hours spent researching immunization records and contacting students, parents, guardians, and health care providers. In one example of how far-reaching this work can be, when one student visited their health care provider to catch up on their immunizations, they also received a much needed eye exam and glasses. Thank you, Jan, Jill, Tami, and your colleagues for your hard work to ensure that Auburn’s students are protected from vaccine-preventable diseases.
Our 2016 IACW Advocate is Becky Doughty, Health Services Coordinator of Spokane Public Schools. She has worked diligently to coordinate, review, and update immunization records for each student in her district – a total of 35,000! Working closely with school staff, Becky achieved a decrease in kindergarten out of compliance rates from 24.6% to 0.9%. Additionally, she supported the development of pop-up clinics to provide immunizations to students in schools. In addition to her work in schools, Becky is founder and director of the Inland Northwest Transitional Respite Program, which provides shelter-based respite care to men and women experiencing homelessness. Typically, medical respite care involves acute and post-acute care for those too ill to recover on the streets, but Becky has ensured that preventive measures, including vaccines, also reach this very vulnerable population. She also implemented a program to ensure that all staff at the Respite Program are fully up to date with hepatitis B and influenza vaccines.
Finally, we partnered with the Washington State Department of Health to recognize Dr. John Dunn as the 2016 CDC Childhood Immunization Champion for Washington. Whether it’s appearing on local news segments, answering colleagues’ questions about vaccines, providing care to patients and their families, or serving on numerous local boards that make decisions about vaccines in the state of Washington, Dr. Dunn steps up to support vaccines. He serves on the Washington Vaccine Association, the Vaccine Advisory Committee, and the Vax Northwest Oversight Committee. He also chairs the Immunization Program at Group Health. In these positions, he ensures that policies and practices are in place to keep state immunization levels high. Through his research work at Vax Northwest, Dr. Dunn continues to learn about vaccine hesitancy and apply his findings to his everyday interactions with children and their families.
The work that Jan, Jill, Tami, Becky, and John do every day touches each of us – when we go about our daily lives in a Washington State that is safe from the diseases that vaccines prevent. Personally, I’m grateful for the opportunity we have at WithinReach to collaborate with, support, and recognize such fabulous partners!
MyIR makes accessing immunization records easy
Now, you too can access your own and your child’s immunization records online through a portal called MyIR. It’s never been so easy to view and print your immunization records! It’s simple (and free) to sign up. The secure system even allows you to print out a pre-filled Certificate of Immunization Status (CIS), which is the form required for entry to schools and child cares, without an additional visit or call to your healthcare provider. This makes it so much more convenient to provide required immunization records. If your little ones are headed to camp this summer or starting school in the fall, try it out!
I signed up recently, and MyIR showed me that I’m due for a second dose of Hepatitis A vaccine – I got the first dose before some travel last year, and two doses are needed for full protection. Plus, now I’ll know when it’s time for that tetanus booster!
However, there’s one caveat: there may be some vaccines you or your family received that don’t appear on the immunization record in MyIR, such as the human papillomavirus (HPV) vaccine. HPV vaccine is sometimes given by a healthcare provider confidentially. Since MyIR doesn’t know which HPV vaccines were given confidentially or not, all HPV vaccinations are hidden on immunization records in MyIR. Contact your healthcare provider if you think you need a more complete record of your or your family’s immunization history.
You can get started today at https://wa.myir.net/.
Good Neighbors: Why We Love School Nurses
School nurses may also put a lot of time into following up with parents who haven’t provided either immunization records or an exemption form. For families who are struggling to find healthcare for their children, they connect them to local resources including immunization clinics so that students can get the care they need. They answer parents’ questions about immunizations and the school requirements. And even once they have all the documents in order, the nurses must enter the data and report it to the Washington State Department of Health. And finally, they must keep all those records organized so that unimmunized students can be quickly identified in the event of an outbreak. When next fall rolls around, they do it all over again. Whew!
With a little funding, we can improve the technology that school nurses use to gather and report immunization information, making the process more efficient and accurate for everyone involved. With many school nurses responsible for multiple schools and thousands of children, there’s no time for redundant data entry. At WithinReach, we are grateful for the dedication and hard work that school nurses across Washington put into protecting our children’s health. Let’s support our school nurses by putting the best tools we can into their hands, so they can do their best work keeping kids safe, healthy, and learning.
Promoting a healthy Washington: the Pink Book Course
Fighting health inequities, one shot at a time
Did you know that Latina women in the US are over 1.5 times more likely to be diagnosed with cervical cancer than non-Latinas and, once diagnosed, 1.5 times more likely to die from cervical cancer? To us at WithinReach, inequities like this are unacceptable.
Some of the factors that contribute to this inequity include lack of access to quality care, making Latinas less likely to get regular Pap smears, more likely to have more advanced cervical disease when they are screened, and less likely to receive follow-up care after diagnosis. Without a doubt, Latinas need better access to care and better quality of care when they do have access. But to get to one root of the problem, we need to prevent cervical cancer in the first place. Fortunately, we have a very effective way to do so: the HPV vaccine.
That’s why it’s disturbing to us that Latino parents are less likely to report that their provider recommended the HPV vaccine for their child(ren). Among a group of Latino parents in Yakima, 87% said that they would get their daughter vaccinated if their doctor recommended it, but only 46% had actually ever been offered the HPV vaccine!
We’re working to change that through a project offering targeted training to providers and staff in clinics that serve Latino families in western Washington. We talk about why the HPV vaccine is so important, how to make an effective recommendation, and how to have respectful and helpful conversations with parents about it. Luckily, we found a great partner for this work in the Seattle Cancer Care Alliance.
Inspired by its Community Health Needs Assessment (CHNA), Seattle Cancer Care Alliance (SCCA) launched a Community Health Improvement Grant program to addresses specific cancer screening, early detection, and prevention needs for at risk populations in King, Snohomish, and Pierce counties. Designed to build sustainable collaborations with Washington communities, SCCA selected seven local nonprofit organizations to receive funds in 2015, including WithinReach.
Finally, I can’t end this post without mentioning that the HPV vaccine prevents many different cancers that are caused by the human papillomavirus in both men and women, including cancers of the anus, oropharynx (throat area), and genitals. No one wants those diseases for their children. That’s why it’s important for both boys and girls to be immunized! And for providers out there interested in the latest on HPV immunization recommendations and how to navigate conversations with families, check out our free online CEU course.
What can parents do to support immunization?
“On Immunity: An Inoculation”
It’s not too often that a new book about immunizations hits the shelves. And it’s even less often that a book on immunizations from a National Book Critics Circle Award-winning essayist is published. Much of my reading for work involves publications in medical journals or things like the CDC’s “Epidemiology and Prevention of Vaccine-Preventable Diseases” (say that three times fast) – while full of information that is both useful and fascinating, they’re not exactly page-turners. So I was excited to pick up “On Immunity: An Inoculation” by Eula Biss.
Eula Biss approaches the topic as a mother and essayist, not as a scientist or advocate, and she blends poignant stories from her own experiences of birth and motherhood with philosophical contemplation. Rather than focusing on the science of immunization, she asks the question, what does it mean to be vaccinated? What does it mean to be immune to diseases? What are the cultural implications and contexts of choosing to be immunized, or to forgo immunizations?
The book is short – just 163 pages – and Biss’ prose is tight, so while she touches on sources ranging from her conversations with other mothers to Greek philosophy to Victorian gothic novels, her tangents never ramble. Susan Sontag’s work on illness as a metaphor is a huge influence on her, and Dracula (yes, the vampire) makes several appearances as well. She explores the culture of fear that impacts the choices many parents make, and the constant tension between individual freedom and the collective good that marks American discourse.
On this last note, she addresses the work of a prominent promoter of an “alternative,” un-researched and un-proven immunization schedule who recommends delaying some immunizations and skipping others. A few years ago, one of his patients got measles and went on to infect several vulnerable children and infants in their school and in a different doctor’s waiting room:
“In Dr. Bob’s world, another doctor’s waiting room is not his concern and public health is entirely independent of individual health. ‘This is an important vaccine from a public health standpoint,’ he writes of the hep B vaccine, ‘but it’s not as critical from an individual point of view.’ In order for this to make sense, one must believe that individuals are not part of the public. Public health, Dr. Bob suggests, is not our health.” (p 108-109)
2014 National Conference on Immunization and Health Coalitions Wrap-Up
WithinReach, home of the Immunization Action Coalition of Washington (IACW), hosted the 11th National Conference on Immunization and Health Coalitions (NICHC) in Seattle on May 21-23, 2014. NCIHC is a gathering of coalition leaders, staff and board members; public health staff and experts; and community advocates. The conference occurs every two years and is the product of a national volunteer planning committee. The goal of NCIHC is to improve community health by enhancing the effectiveness of health coalitions, and topics include coalition management, health promotion, and of course, lots of immunization information!
Dennis Worsham, Deputy Secretary of Health for Public Health Operations, welcomed attendees from across the country before Dr. Ed Marcuse, recently retired from Seattle Children’s, gave a thought-provoking opening plenary about the current state of immunizations. He addressed topics ranging from the challenge of vaccine hesitancy to the tragic impact of vaccine-preventable disease on the Northwest’s indigenous people, wrapping up with a look at what the vaccines of the future might be. Other highlights of the conference included two very special keynote speakers, Dr. David Williams and Dr. Bill Foege. On Thursday, Dr. Williams, of the Harvard School of Public Health, was introduced by Allene Mares (Assistant Secretary of Prevention and Community Health) and delivered a powerful presentation about the continuing impact of race and racism on health and what we can do to work towards health equity. His talk ranged from the economic disparities that help create the context for poor health, to the unconscious biases that we each must recognize and combat within ourselves. Many conference attendees noted Dr. Williams as the absolute highlight for them. However, it was hard to choose the “best” as Dr. Foege addressed the group with a closing plenary on Friday, after being welcomed by OICP Director Michele Roberts. Dr. Foege, who was a leader in eradicating smallpox in the 1970s, has since directed the CDC, the Carter Center, the Task Force for Child Survival, and led global health at the Bill and Melinda Gates Foundation. His historic perspective on the impact vaccines have had on health around the world was inspiring.
In addition to a wide variety of breakout sessions on topics ranging from social media to policy to quality improvement, other special events included pre-conference workshops and the first-ever film festival. We featured the high-school student-produced “Invisible Threat,” and “Everybody’s Business,” a documentary about immunizations and the dialogue about personal decisions and their impact on community health on Vashon Island here in Washington. Local advocate Celina Yarkin and Vashon school nurse Sarah Day attended to field questions.
WithinReach is proud to have brought this unique learning and networking opportunity to the Pacific Northwest for the first time, and is very grateful to all of the partners that helped make it happen, including the Washington State Department of Health – Office of Immunization and Child Profile, IACW members, and Immunize Oregon! Presentations from the conference can be downloaded at healthcoalitionsconference.org/program.
Recognizing Our Immunization Partners
First, the IACW Advocate Award is given to an individual active in the IACW who has given tremendous amounts of time and been successful in enhancing statewide immunization efforts. There were many inspiring and inspired nominees this year, but our team of reviewers selected Celina Yarkin, a tireless immunization advocate living on Vashon Island. We admire Celina for her willingness to have courageous conversations about immunization, especially in a community where there are many vaccine hesitant individuals and where she has faced some harsh rebukes for her position on vaccines. Celina’s work has been featured in books, documentaries, and various media outlets—and we thank her for being such a credible, passionate, and consistent advocate of vaccines as a means to protect the health of our community. As her nominator, Rebecca Dubin at Seattle-King County Public Health wrote, Celina’s voice “has encouraged others to reconsider what they believe about vaccines, and to add their voices in favor of immunization.” Thank you, Celina!
Second, the IACW Collaborator award is given to an organization active in the IACW that has impacted their community through collaboration to help promote, educate, and increase immunization rates. Among the many nominees, our team selected Tieton Village Drug, led by Nancy Hecox, PharmD, in Yakima, WA in recognition of their exceptional work to get free vaccines to adults in the Yakima area. Collaborating with many partners, Tieton Village Drug created a unique program to allow pharmacy access to free vaccines for the uninsured and underinsured.” We are deeply impressed with the commitment demonstrated by Tieton Village Drug, which has administered thousands of doses of vaccine since this program’s inception three years ago, including more than 6,000 doses of Tdap. Thank you, Nancy, and the Tieton Village Drug team for your incredible work to protect our community.
Achieving better health outcomes requires collaboration and concerted effort from a broad group of stakeholders. The winners of these awards maximize the potential for residents of our state to be healthy and free from vaccine preventable disease, and we thank them for their support of the efforts of the IACW.