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Measles Outbreak in MN Shows King County is Vulnerable, Too

Guest post by Neil Kaneshiro, MD

Neil has been a pediatrician in Washington State for over two decades, and is currently serving as chair of the Immunization Action Coalition of Washington, which works to improve the health of the community by minimizing the incidence of vaccine preventable diseases through the optimal use of immunizations across the lifespan.

Vaccines have made a huge impact in protecting us from preventable diseases. But in some communities, immunization rates have dropped dramatically, creating the opportunity for diseases to return. A current outbreak in Minnesota shows what could happen in Washington.

Hennepin County in Minnesota is in the midst of a large outbreak of measles which is primarily affecting the Somali community there. There are over 60 cases at this point in time and the count is expected to rise because vaccination rates against measles in that community have plummeted from 92% in 2004 to just 42% in 2014. Measles is highly contagious and vaccination rates need to be well over 90% to prevent the spread of this horrible disease. It appears that the community was misinformed about the risks and benefits of measles vaccine by anti-vaccine celebrity Andrew Wakefield* who visited there on several occasions. Even in the face of overwhelming evidence based medicine showing vaccines are safe and effective, pediatricians and family physicians are confronted every day with parents who question vaccine safety and delay, defer or refuse one or more recommended vaccines.

Vaccine advocates are concerned about families who delay or decline vaccination because of outbreaks like the one currently active in Minnesota. With similar pockets of low immunization rates and regular measles exposures, King County is vulnerable to a similar outbreak. Although measles is much more likely to affect those unimmunized by choice, the vaccine is not 100% effective and measles can occur in a small percentage of people who did the right thing and got their vaccine. Also, there are those who are unimmunized because of medical condition or age since the vaccine is not recommended until 1 year of age.

First and foremost, vaccines protect those who receive them. But receiving vaccines in many cases also helps to protect your family, friends and neighbors from disease as well. Talk to your doctor about keeping up to date in child and adult vaccinations (yes, adults need vaccines too). If everyone eligible for vaccines got immunized, we would be a healthier community.

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*For those who don’t know, Andrew Wakefield is the researcher from the United Kingdom who tried to link MMR (measles, mumps and rubella) vaccine and autism. But his research has been discredited and his medical license revoked. Extensive research has shown that there is no link between vaccines and autism. Leading autism advocates including Alison Singer, president of the Autism Science Foundation have concluded that vaccines do not cause autism

Tags: families   healthy communities   Immunization   King County   Measles   Minnesota   preventable disease   Protect   vaccine   Washington   

Vaccine Education Across Language and Culture

By Judith Pierce, WithinReach Immunizations Graduate Intern.

From April 18-25, we’re celebrating National Infant Immunization Week. Did you know that routine childhood immunization in one birth cohort prevents about 20 million cases of disease and about 42,000 deaths? It’s pretty awesome. That’s why we work to ensure that all children in Washington have access to immunizations, and their parents have the information they need to make a good decision. Unfortunately, not everyone has the same access to health information. Below, our graduate intern, Judith Pierce, describes her work with us to help address one of these gaps.

In summer of 2014 I had just completed my first year of public health school, and was in search of a year- long project for my capstone requirement. I knew I wanted to practice skills in evaluation and data analysis, but I also wanted a project with content that would be able to hold my interest for a year. When I initially approached WithinReach’s Immunization program, I was really interested in their work with provider training and the Immunity Community, and assumed I would work on those projects. Instead, they gave me the opportunity to develop a community forum for Russian speakers. Through speaking with the Immunization team I learned that Russian speakers have the lowest childhood immunization rates of any population in Washington, and have had the lowest rates since 2008. This was incredibly interesting and I grew curious to learn more.”

Over ten months I researched the literature and spoke with key informants to better understand the historical context and social connections in Russian speaking populations that contribute to low immunizations rates.  Much of the vaccine hesitancy we find in Russian speakers stems from confusion and frustration with the US immunization schedule, concerns of adverse reactions to the vaccines and an inability to find a Russian speaking provider to answer their questions. The Washington State Department of Health conducted a series of Russian speaking focus groups to identify major themes, and all four groups requested an event with a Russian speaking provider to address immunization concerns in a community forum. With help from Spokane-based health service providers, we were able to develop the community forum parents asked for. At the forum, parents expressed their frustration and fears about childhood immunizations to a Russian speaking pharmacist who was able to answer their questions and explain why the US immunization schedule is different from their home countries.  At the end of the meeting, the majority of surveyed participants said they enjoyed the forum and were able to have their questions answered by someone they trusted.  40% said the forum changed their minds about immunizations.

With the measles outbreak at Disneyland and whooping cough on the rise in Washington, media pundits and bloggers often lay the blame squarely on a mythical homogenous anti-vaccination group. The reality is people have a variety of concerns, and those of us doing immunization work should not assume why a particular group has fears about vaccines. This project allowed me to not only develop skills and learn new content, but also develop an appreciation for programs, such as Washington State Department of Health’s focus groups, that actively seek to understand health disparities and find culturally appropriate ways to address concerns within a community.

For additional information on how to develop a community forum addressing vaccine concerns for Russian speakers, contact Sara Jaye Sanford, WithinReach’s Immunization Action Coalition of Washington Program Coordinator at: (206) 830-5175 or sarajayes@withinreachwa.org.

 

Tags: childhood immunizations   Community Health   Immunity Community   immunizations   Measles   Public Health   Russian Speakers   Spokane   vaccines   Washington state   Whopping Cough   WithinReach   

Giving Kids a Shot@Life in Washington, D.C.

Earlier this month, Mackenzie Melton and I had traveled to Washington, D.C., where we learned a great deal about the legislative process through a partner organization, Shot@Life. Shot@Life is the arm of the United Nations Foundation that advocates for childhood immunizations across the globe, saving millions of lives annually by securing funding for life-saving vaccines. Shot@Life is currently emphasizing the importance of four vaccines that have the chance to dramatically reduce childhood morbidity and mortality: rotavirus, polio, measles, and pneumonia.
In addition to being a phenomenal learning opportunity where we heard from immunization, public health, and elected leaders, from, for instance, the Bill & Melinda Gates Foundation, the State Department, the United Nations, and other esteemed organizations, we were also exposed to the legislative process. We even met with staff members from four legislators’ offices in Washington State: Senator Patty Murray, Representative Jim McDermott, Representative Dave Reichert, and Representative Derek Kilmer. Exploring Capitol Hill and promoting immunizations at home and abroad was a profoundly eye-opening experience that expanded our capacity to do powerful immunization advocacy.
We were stunned that, upon arriving in Senator Patty Murray’s office, her staff members knew not only of the work of Shot@Life, but had read and learned about Vax Northwest on their own accord! It was a thrilling confirmation of our work and its value on the national scene as we seek to protect families everywhere from vaccine-preventable disease. We have long known that there are tremendous resonances between our local work and that happening at larger scales, and we couldn’t be more excited about making these connections.
And in case you need some evidence of the effect of vaccines, a child dies every 20 seconds globally from a vaccine preventable disease, meaning 1.5 million children die per year from deaths that could be prevented with a modest investment. This is a stark reminder of why immunizations are so critical to the health of populations, and why we at WithinReach promote them with such passion. Thanks again to Shot@Life for this opportunity!

 

Tags: Bill & Melinda Gates Foundation   Capitol Hill   immunization advocacy.   Measles   Pneumonia   polio   Representative Dave Reichert   Representative Derek Kilmer   Representative Jim McDermott   rotavirus   Senator Patty Murray   Shot@Life   United Nations   United Nations Foundation   vaccines   Vax Northwest   Washington D.C.   

Coloring Isn’t Just for Kids

I have never worked with a more productive group of people.
WithinReach staff get SO much done!

The last few weeks have been insanely busy for us. Responding to a wave of media requests in reaction to the recent measles, coordinating stakeholders across the state to help pass Breakfast After the Bell legislation, helping thousands of families apply for or renew their Apple Health coverage, bringing our experience and expertise with the Affordable Care Act to a Health Benefit Exchange Board meeting, attending listening sessions with the US Surgeon General, Vivek Murthy, MD, during his visit to Washington…..The list goes on and on – and our staff are always ready to step up, to say ‘yes’, to dig in and do more to make the connections WA families need to be healthy. Though this may be a recipe for success, it most certainly creates some stress.

That’s why I decided to share a recent Huffpost article at our staff meeting this week. The article, Coloring Isn’t Just For Kids. It Can Actually Help Adults Combat Stress., says that it has been found that coloring – that’s right, crayons and coloring books – has the power to reduce stress. In fact, the article says coloring “generates wellness, quietness and also stimulates brain areas related to motor skills, the senses and creativity”.

Many of us are ‘yellow pad doodlers’, so this makes sense. Not only did I share the article, but I offered staff the opportunity to color during staff meeting and beyond. Staff jumped in, and the accompanying picture highlights the result of our staff meeting coloring.

I realize coloring will not reduce the demands placed on our staff, or the crazy fast pace with which they work, but perhaps it brought a small moment of quietness to the day – and hopefully, the message that we care about the health and well-being of all WA families – including our own.

 

Tags: Affordable Care Act   Breakfast After the Bell   coloring   creativity   Health Benefit Exchange   Huffpost   Measles   stress-relief   vaccines   Washington Apple Health   Washington families   Washington state   WithinReach   

What can parents do to support immunization?

In the wake of outbreaks of diseases like measles, many parents are wondering what they can do to protect their families and their communities from diseases that vaccines can prevent. Here are three steps that any parent can take:
1. Make sure your whole family is up to date on immunizations. To best protect our communities, all of us need to be immunized. For example, when moms and dads are immunized against whooping cough, babies are protected because they are less likely to catch the disease from them. To learn more about what immunizations might be right for you, go to the Washington State Department of Health. Ask your family’s healthcare providers about getting up to date! If you need help finding an immunization provider, contact ParentHelp123.
2. Be a positive voice for immunizations. Speak up for vaccines! Tell other parents in a positive way why you immunize on time and why you think it is important to your community. Posting stories and information about immunization and your own experiences getting vaccinated on social media can also be a great way to show your support for immunization. (Like WithinReach on Facebook or follow us on Twitter for great news and facts to share.) For tips on having respectful and productive conversations about vaccines, check out this blog post.
3. Advocate. Find the immunization rate for your child’s school on SchoolDigger. Consider writing a letter to the editor about news items relating to immunization. If there is a policy change being considered in your school or state that you care about, let your representative know. Connecting with programs specifically for parents, like the Immunity Community in Washington State or Voices for Vaccines, a national organization, can be a great way to get more involved.

 

Tags: Advocate   Community Health   family   immunizations   Measles   parents   Protect   publich health   Support Immunizations   vaccines   

Have a HEART When You Talk About Vaccines

Do you find yourself being inundated with information in the media about immunizations these days? Do you want to speak out, but just don’t know what to say, or how to say it? Measles this, mumps that. Personal belief exemptions – are they good or bad? What do I do if my child’s school vaccination rate is really low? How can I talk to other parents about vaccinations? What can I do?
So many questions are circulating around the internet and social media. Friends that I haven’t talked to in years have been coming out of the woodwork with questions, or wanting to know how to get involved. The silent majority of parents (71% in WA) that immunize are starting to become louder and want their voices to be heard.
At WithinReach, through our partnership with Vax Northwest, we’ve developed a program we call the Immunity Community where we teach parents to become immunization advocates in their communities, schools, child cares, or parents’ groups and to have a respectful, honest conversation about immunizations. We encourage parents to speak from their HEART and we’ve developed and tested 5 simple steps you can take the next time you find yourself in a conversation with your barista, PTA president, etc.
When you are having a conversation about vaccines, try the H-E-A-R-T (Hear, Empathize, Analyze, Resources, Tell) Method:
1. Hear: The first and best thing you can do is to really listen to her concerns and questions. Really hear what her fears are about vaccines. Organize your thoughts before answering her questions.
2. Empathize: Start your response with an emotional acknowledgement of his feelings. Address his investment in the issue. He’s put a lot of thought into this problem. Give him the credit he deserves for being the concerned parent he is. Example: “You’ve put so much thought into this. I think it’s great that you care so much about your child’s health.”
3. Analyze: Ask questions to understand where they are getting their information from and what concerns them. Example: “I’ve been researching vaccines, too. Where did you hear that from?”
4. Resources: Answer her emotional concerns with knowledge and specific information (check out our FAQ page for some of the top questions people have about vaccines). Facts, paired with emotion, win parents over! Example: “That’s very interesting. What I’ve read on the Internet is pretty different. There’s a nonprofit organization called Every Child By Two that talks about how vaccines are safe and how they protect kids from dangerous diseases like whooping cough.”(Then insert talking points from the FAQs page to answer her specific questions.)
5. Tell: Conclude your points with another emotional statement that sums up what benefits you gain from vaccinating your child. Example: “After I read both sides of the argument, I decided to vaccinate my children. I get so worried when my baby’s sick, and I can’t bear the thought of her getting sick with something that could be avoided. For me, vaccines are all about prevention.”
Repeat this method with every concern she raises. Make sure to start over at the “Hear” stage to ensure you are answering her specific questions. Even if she shares an anecdotal story of her own, really listen to her fear and try to understand her root concern.

Vaccines are important, but they are not something to lose a friendship over. Don’t forget to respect your friend’s opinion, and trust that he will do the same. Here is a good phrase to help you get out of a tough conversation: “Thank you for sharing your opinions with me. I’m just glad we both care about protecting our kids’ health. Thank you for being so passionate.”

Now just smile, squeeze her arm, and divert the conversation to something you both can agree on. Remember, you might not sway your friends today, but you may have sparked a new way of thinking about vaccines. You have become an information source they can turn to with questions later.

If you want to learn more about Vax Northwest and the Immunity Community or want to become involved visit: www.vaxnorthwest.org

 

Tags: Community Health   Immunity Community   immunizations   kids health   Measles   mumps   Personal Belief Exemptions   Public Health   vaccine conversations   vaccines   Vax Northwest   

From Magic Mountain to Measles – Get Vaccinated to Stay Safe!

If you follow the news, you’ve probably heard about the outbreak of measles that started at Disneyland, but has spread to Washington and across the country. It feels particularly unfair that an outbreak of a sometimes-fatal disease is linked to Disneyland, a place where families go for a fun and carefree experience. But the irony is that, in a world where parents are opting out of immunizations in high numbers, Disneyland is a Petri dish for cultivating an outbreak. Because kids and their families visit Disneyland from around the country and world, and because symptoms of the disease don’t manifest for many days after exposure (the disease can be spread before symptoms emerge), situations like this are very dangerous.
Measles is one of the most highly contagious diseases on earth. It is spread easily and rapidly among individuals who are not protected from the disease. In 2014, and now again in 2015, we have had confirmed cases of measles in Washington State—cases both related to and independent of, the Disneyland cases. This disease is different from most other communicable diseases in that it can be contracted through aerosol transmission, meaning simply by breathing air in a space where a measles-infected person has coughed or sneezed recently. In order to prevent individual cases of measles becoming outbreaks, and eventually epidemics, around 95% of us need to be immunized against the disease—it’s that infectious!
Many of the stories about measles have parodied the ride/song ‘It’s a Small World’, which is an iconic Disneyland experience. Besides being somewhat trite, it’s the perfect reference. The human experience is one that invariably involves exposure to other people, sometimes tens of thousands of people at attractions like Disneyland. We must immunize in high numbers to protect ourselves and our families when visiting such sites, but also to ensure we don’t become disease vectors ourselves, spreading to our loved ones and communities.

Our Immunization Team will always advocate strongly for complete, on-time vaccination to protect health. We also recognize that all parents, even those who don’t immunize, do so out of an interest for the health of their children. As such, we’ll continue to foster dialogue about why immunization should be a community priority, especially featuring the voices of parents who choose to immunize, like those enrolled in our Immunity Community program. Many thanks to those parents who are working hard to ensure that children in Washington are protected from disease!

 

Tags: contagious diseases   Disneyland   healthy children   Immunity Community   immunize   Measles   outbreak   Protect   vaccine   Vax Northwest   Washington state   

Measles in the News: What You Need to Know

If you’ve been watching the news lately, you’ve probably heard about measles across the United States, including outbreaks in New York City and Orange County.  And you may have paid particular attention to the fact that we have a couple local cases of measles, including in a woman who was contagious recently while visiting Starbucks, the Kings of Leon concert, Pike Place Market, a local sushi restaurant, and other locations in Whatcom, King, and Pierce counties.  The period of latency for this virus is long, so exposed people without immunity may not start showing symptoms until this week.

Measles is a highly contagious disease spread through respiration. It is characterized by general malaise, loss of appetite, a hacking cough, a runny nose, and red eyes followed by a rash that covers nearly the entire body.  Measles is terribly unpleasant, can be fatal, is and is often accompanied by complications such as pneumonia, permanent hearing loss, and brain damage.

We get alarmed about measles cases because it is one of the most contagious diseases in the world.  Roughly 95% of us need to be immunized or have natural immunity for individual cases to not become epidemics.  In New York and California, health professionals are trying to control epidemics, meaning a widespread occurrence of disease amongst a specific community at a specific time.  A case becomes an epidemic when their is not adequate immunity surrounding the infected individual.  Generally speaking, measles cases do not lead to outbreaks because enough of us are immune (generally through vaccination).  The Department of Health and Human Services has a really helpful infographic that visually portrays this concept.

As our friend, the former Washington State Health Officer, Maxine Hayes, is fond of saying, “We should never waste a crisis.”  We need to learn the lessons that these outbreaks are teaching us: that terrible diseases are never far away, and that our best defense is to be immunized.  In the United States, this means getting the MMR vaccination series in childhood, starting at one year of age.  The vaccine is safe and effective and the reason we don’t see more epidemics.  Please immunize to protect your health and those around you.

For additional questions, contact your healthcare provider or local health jurisdiction.

Tags: immunizations   Measles   vaccines   Washington   

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