Monday, August 19, 2013

Back to School - Time for Vaccines

As children and parents across the country gear up to go back to school, the Centers for Disease Control and Prevention (CDC) released a report showing high vaccination coverage among U.S. kindergarteners in the 2012-13 school year. Exemption levels remained stable in the report.

CDC used data from federally funded immunization programs to conduct their research. While optimistic about vaccination levels, the CDC did warn that even with high levels of vaccination, vaccine-preventable disease outbreaks can still occur among clusters of unvaccinated people at local levels in schools and communities.

“Vaccination exemptions have been shown to cluster geographically,” the CDC stated. “If exemption levels are high in a school or community, the number of unvaccinated kindergarteners might be sufficient to permit transmission of vaccine-preventable diseases, if introduced. Assessing and reporting school vaccination coverage at the local level is critical for state education and health departments to protect kindergarteners and the community from vaccine-preventable diseases.”

Health departments and schools are encouraged to use the data provided by CDC to develop health communication strategies based on the specific vaccine-preventable disease risk at a local school caused by low coverage or high exemption.

Illinois is now requiring all students in grades 6-12 to have a Tdap vaccination by October 15th. The new rule was caused by the rise in whooping cough cases in Illinois over the last six years. Public health officials in Michigan are worried about their low immunization rate, citing philosophical waivers as one of the issues. The Michigan State Medical Society plans to organize more awareness events across the state.

Unfortunately, the number of teens vaccinated for HPV is not as high as the kindergarten coverage, with only half of U.S. teenage girls vaccinated. “We’re dropping the ball,” said Dr. Thomas Frieden, head of CDC. “This is a huge disappointment.” The CDC worries that family doctors aren’t encouraging patients to get HPV shots as forcefully as they recommend other vaccines.

A letter by Dr. David Horowitz in Contemporary Pediatrics recently stated that pediatricians are providing all the education they can to parents about vaccines and that educating parents isn’t sufficient. While there is a group of parents, known as the worriers, that education reaches; there are other groups of parents for whom education about vaccines will not be enough.

“The simple answer is that if simply educating patients about vaccines were sufficient, then we would not have a problem in the first place,” Dr. Horowitz states.

An earlier study done by researchers in upstate New York and published in Pediatrics cited community partnership as a way to increase vaccination rates in poor children. “Multi-component interventions aimed at increasing immunization coverage rates are more successful than single interventions, perhaps with the exception of patient reminder and recall systems,” researchers wrote. “The most successful interventions described allow families to explain their health concerns, address perceived barriers to vaccination, improve community awareness of services already available, and engage health care outreach liaisons.”

“Future programs should continue to focus on interactive vaccine education, with special attention on the risks of influenza infection and the benefit of influenza vaccination,” the study concluded.

As schools across the country get back into session, Vaccine Watch encourages parents to take necessary steps to protect their children. Education and talking to your child’s pediatrician, school nurse and other health officials is the best way to find reliable information about vaccines.

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