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.
*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.
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 email@example.com.
Giving Kids a Shot@Life in Washington, D.C.
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
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?
Have a HEART When You Talk About Vaccines
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
From Magic Mountain to Measles – Get Vaccinated to Stay Safe!
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!
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.