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Entries in Vaccinations (20)

Wednesday
Sep192012

Non-Medical Vaccination Opt-Outs on the Rise

Joe Raedle/Getty Images(NEW YORK) -- An increasing number of parents are getting state approval to allow their children to opt out of school-mandated vaccinations for non-medical reasons, according to a new analysis published Wednesday.

Dr. Saad Omer, author of the correspondence published in the New England Journal of Medicine, warned that this trend is leaving large populations of children at risk for developing potentially deadly illnesses that haven't been seen in the United States in many years.

"Rates of exemption are substantially higher today than several years ago," said Omer, assistant professor of global health, epidemiology and pediatrics at Emory University in Atlanta. "Previously, rates were only rising in states with easy exemption policies, but now they are even rising in states that make it more difficult."

Exemption policies vary from state to state and can range from not allowing any non-medical exemptions to allowing opt-outs for religious or philosophical reasons. Some states make it very difficult to get approval for exemptions by requiring notarized letters from clergymen, letters written by parents with specific wording, or completion of standardized forms that can only be obtained from special locations such as health departments. Others make it very simple to skip vaccinations: Parents need only check a box on a short, standardized form.

Omer and his colleagues analyzed data compiled by the U.S. Centers for Disease Control and Prevention on vaccination exemption rates for school years 2005 to 2011. They compared vaccine opt-out rates in each state to the ease with which exemptions could be obtained.

They found that parents were 2.5 times more likely to opt out in states that permit philosophical reasons compared with states that require religious objections. They were also more than two times more likely to opt out in states with easy exemption processes.

In most cases, fears among parents over vaccines -- many of them unfounded -- may be at play.

"The CDC and health departments are doing a good job of increasing vaccine coverage," Omer said. "Therefore, rates of vaccine-preventable disease are going down substantially. Parents aren't seeing the actual diseases, so when they hear about real or perceived adverse effects of vaccines, their perception of the risks versus benefits is shifted."

Dr. William Schaffner, chair of preventive medicine at Vanderbilt University, agreed.

"Parents are just more skeptical about benefits of vaccines," he said. "Most young parents today have never seen a case of polio or measles, and they didn't learn about the seriousness of these diseases and importance of the vaccinations in school."

Schaffner added that he finds it interesting that some states do not allow exemptions while others "really oblige parents wishing to opt out."

Past research has shown, though, that in states with a substantial proportion of unimmunized or incompletely immunized children, many kids are susceptible to these classic diseases. A 2006 study showed a 50 percent higher incidence of pertussis -- commonly known as whooping cough -- in states where it is easier to get exemptions. There have been similar findings with respect to measles.

Schaffner said he is very concerned that unvaccinated children who go abroad will bring back diseases, such as measles, that are still a major problem in other parts of the world. Not only will they suffer, but they will spread the illnesses to children who are unable to be vaccinated for medical reasons.

Schaffner said that part of the solution to the problem is that "states with easier process need to tighten up." However, he said, this is not a fool-proof approach. He said some research has shown an increase in medical exemptions in states that have tightened up their policies -- suggesting that parents are pressuring doctors to give medical exemptions. He encourages doctor to not let themselves be "brow-beaten into providing dubious excuses."

Copyright 2012 ABC News Radio

Wednesday
Sep122012

Whooping Cough Vaccine Protection Short-Lived, Study Warns

iStockphoto/Thinkstock(OAKLAND, Calif.) -- Protection against whooping cough declines during the five years after the fifth dose of vaccine is given to 4- to 6-year-old children, a new study suggests -- leading some experts to urge teens and adults to make sure they are up to date on all recommended booster shots.

An outbreak of whooping cough in California led experts to conclude that the current diphtheria, tetanus, acellular pertussis (DTaP) vaccine for children has not worked as well as the older version from nearly two decades ago, according to the study in Thursday's New England Journal of Medicine.

Whooping cough -- formally called "pertussis" -- is deadly for infants, with outbreaks occurring every few years despite vaccinations.

"We found that the effectiveness of the vaccine wanes 42 percent on average each year during the five years after the fifth dose," said Dr. Nicola Klein, the study's lead author and co-director of the Kaiser Permanente Vaccine Study Center in Oakland, Calif.

A new and longer-lasting vaccine has yet to become available.

Until then, "the current vaccine is safe and effective; it just doesn't last as long as we would like," Klein said. "And parents should know that some protection is better than no protection."

A tetanus booster shot is recommended starting around age 11 or 12 -- about five years after administration of the fifth dose. Health care workers, individuals age 65 or older, pregnant women and anyone with exposure to infants should get a booster shot, according to the U.S. Centers for Disease Control and Prevention.

As of Aug. 11, 46 states and Washington, D.C., reported increases in whooping cough compared with the same time period in 2011, according to CDC statistics. Provisional counts from the CDC's surveillance system showed that nearly 25,000 cases of whooping cough were reported through Aug. 24, with 13 deaths noted.

The majority of deaths continue to occur among infants younger than 3 months of age. The incidence rate among infants surpasses that of all other age groups. The second highest rates of disease are seen in children ages 7 through 10. Rates are also increased in 13- and 14-year-olds, according to the CDC.

In many states, five doses of the whooping cough vaccine are mandatory before a child enters school, Klein said. The first three doses in the series are typically given when an infant is 2 months, 4 months and 6 months old. The fourth dose is generally administered between the first and second years of life, usually at 15 months. And the fifth dose is recommended between ages 4 and 6, typically before kindergarten.

Despite the requirements, a large outbreak of whooping cough occurred in California in 2010 -- its peak incidence since 1958. The outbreak spurred Klein and colleagues to measure the degree to which protection wears off over time in school-aged children who had received the most recent version of the vaccine.

While this study focused on school-aged children in northern California, localized outbreaks of whooping cough have occurred elsewhere as well. In April, an epidemic was declared in Washington state. Other states with high rates of the disease this year included Wisconsin, Montana, Minnesota and Colorado, the CDC reported.

The disease tends to begin with cold-like symptoms and perhaps a mild cough or fever. A severe cough can take over one to two weeks after disease onset. Unlike the common cold, though, coughing fits can persist for weeks, until air has left the lungs and a loud "whooping" sound accompanies attempts to inhale.

An older form of the vaccine offered longer protection, but it was linked to more cases of fever and injection-site reactions. What's needed is a stronger vaccine.

On a positive note, "the findings have raised the attention of the manufacturers," Klein said of the study she led.

She hoped the results would encourage the development of more effective alternatives.

"Prevention of future outbreaks will be best achieved by developing new pertussis-containing vaccines that provide long-lasting immunity," the authors concluded in the study.

Copyright 2012 ABC News Radio

Thursday
Aug232012

Donald Trump Plays Doctor on Twitter with Autism Claims

Mike Stobe/Getty Images(NEW YORK) -- Mostly quiet since his last birther allegation, Donald Trump Thursday to went on Twitter to peddle a theory that claims vaccinations cause autism in young children.

“Massive combined inoculations to small children is the cause for big increase in autism,” Trump wrote. “Spread shots over long period and watch positive result.”

The Romney campaign, for whom Trump has raised millions this campaign season, would not comment on his latest offering.

Doctors and medical research findings were not so circumspect.

Dr. Richard Besser, ABC News’ chief health and medical editor, called Trump’s remarks “shameful.”

“The autism-vaccine link has been disproven. Spreading shots out over a long period of time will not reduce the number of children who develop autism but it will leave more children vulnerable to infectious diseases for a longer period of time than necessary,” he said. “That can kill children.”

While it’s true that autism diagnosis rates have risen over the years, there is an ongoing debate about whether the numbers can be taken at face value. Many doctors believe a broadening of diagnostic criteria has led to more confirmed cases.

What is unquestioned, though, and confirmed by serious medical studies, is that there is no known connection between the condition and having received childhood vaccinations.

“As we know from political campaigns, stating a claim repeatedly can lead to a public belief in the concept since these conclusions are not always based on rational thought processes but also on emotional thinking and preconceived notions,” Dr. Max Wiznitzer, associate professor of pediatric neurology at Rainbow Babies and Children’s Hospital in Cleveland, Ohio, told ABC News in March.

The scientific paper that once served as the driving force behind the theory has long since been discredited and rejected by its original publisher, The Lancet, which wrote in 2010 that “it has become clear that several elements of the 1998 paper by [Andrew] Wakefield et al are incorrect.

“In particular, the claims in the original paper that children were ‘consecutively referred’ and that investigations were ‘approved’ by the local ethics committee have been proven to be false.”

The British Medical Journal published an editorial in January 2011, calling the Wakefield report “fraudulent,” adding that “clear evidence of falsification of data should now close the door on this damaging vaccine scare.”

Closed, that is, until Trump opens it up again.

Copyright 2012 ABC News Radio

Thursday
Jul192012

Pertussis Outbreak May Be Worst in 50 Years, CDC Says

Hemera/Thinkstock(ATLANTA) -- Reported cases of pertussis are at their highest level in 50 years, a top official with the U.S. Centers for Disease Control and Prevention (CDC)  said Thursday, adding that outbreaks in several states should encourage all children and adults to get vaccinated.

Dr. Anne Schuchat, director of National Center for Immunization and Respiratory Diseases, said doctors across the nation have reported more than 18,000 cases of pertussis so far this year. That is more than twice as many cases as there were at this time in 2011 and the first time since 1959 that so many cases have been reported by this time in the year.

Pertussis, or whooping cough, is a bacterial infection involving the respiratory tract that is easily spread by coughing and sneezing. It can start out like the common cold, but can be a very serious infection, particularly for infants under the age of 1, who are too young to complete the full vaccination series.

While some doctors say that part of the surge in reported cases can be credited to better diagnostic tests and increased awareness, the casualties thus far underscore a very real problem. Nine infants have died from pertussis so far this year in the United States. The 13-to-14-year-old age group has been hit particularly hard. In Washington State, the number of cases this year has surpassed 3,000 -- already more than three times as many as all of last year. Washington State Secretary of Health Mary Selecky declared a statewide pertussis epidemic on April 3.

The vaccine for pertussis, known as DTaP, should be given to all children as a series at ages 2, 4, and 6 months, 15-18 months, and 4-6 years, according to the CDC. An additional booster, known as TDaP, is needed at age 11-12.

"Unvaccinated kids are at eight times higher risk to getting pertussis compared to kids who have been vaccinated," said Schuchat. "Vaccinated kids who do develop pertussis have a milder course. They're also less infectious than unvaccinated children."

Health officials added that all adults who have not been vaccinated against pertussis should receive the TDaP vaccine, especially pregnant women and those who will have contact with babies. Pertussis outbreaks generally occur in peaks and waves. Even with vaccination, immunity tends to wane over time.

An estimated 84 percent of toddlers in the U.S. have received their complete course of vaccination. However, only eight percent of adults are currently vaccinated.

What's unusual is the fact that so many 13 and 14-year-olds are falling ill with the infection. The CDC is looking into whether this could be attributed to a change implemented in 1997 when the vaccine used to immunize children changed from a version that was taken off the market in the U.S. because of possible neurologic side effects.

The CDC is launching an investigation to find out what is contributing to the unusual features of this outbreak. Researchers are also looking at why the protection offered from the current vaccine is not complete.

Dr. Gregory Poland of the Mayo Clinic has had personal experience with pertussis, not only as a physician, but also as a father of a child who suffered through pertussis at the age of 13 despite being fully vaccinated.

"When I first heard my son cough, I knew he had pertussis," Poland said. "Even though I treated him immediately, the cough lasted for 100 days. He literally kept the family awake for months."

Dr. Len Horovitz, an infectious disease specialist at Lenox Hill Hospital in New York, is frustrated that despite the prevalence of media coverage, adults are not requesting the vaccine.

"How much relentless coverage and repetition of medical information [does it take] for the public to finally grasp an epidemic?" he asked. "People aren't listening, aren't watching or aren't paying attention."

Copyright 2012 ABC News Radio

Monday
Jul022012

Rob Schneider Speaks Out Against Childhood Vaccinations

Gustavo Caballero/Getty Images(SACRAMENTO, Calif.) -- You can add Rob Schneider to the list of celebrities speaking out against childhood vaccinations.  The former Saturday Night Live star was among those attending a hearing last week on California bill AB2109. The bill, if passed, would require parents who decide not to vaccinate their kids to provide a signed statement from a doctor or qualified healthcare professional certifying that mom and/or dad were informed of the risks and benefits of childhood vaccination.

Speaking at the hearing to ABC News affiliate KXTV in Sacramento, Schneider -- who noted that his wife is pregnant -- declared that mandating informed consent to opt out of childhood vaccinations is "illegal.  You can't make people do procedures that they don't want. The parents have to be the ones who make the decisions for what's best for our kids. It can't be the government saying that."

Schneider went on to say that AB2109 was against the "Nuremberg Laws."  The Nuremberg Laws were antisemitic laws passed in Nazi Germany that paved the way for the Holocaust.  Schneider may have meant to say the Nuremberg Code, a set of post-WWII principles governing human experimentation.  The first principle is, ironically, informed consent.

Schneider also alleged that there's a link between childhood vaccinations and the rise in autism, as have others including fellow celebrity Jenny McCarthy. "The toxicity of these things -- we're having more and more side effects. We're having more and more autism," declares Schneider.  Any link between childhood immunizations and autism has been repeatedly discredited.

Schneider further says most children today are required to get some 70 vaccines, and declares, "The efficacy of these shots have not been proven."  The Centers for Disease Control and Prevention recommends children by the age of two receive 28 total doses of vaccine to be protected against 15 potentially fatal diseases, including polio, hepatitis A and B, diphtheria and measles.

As it stands now, non-immunized kids in California can attend public school if their parents obtain a personal exemption, meaning they object to immunizations for religious or other philosophical reasons.

Copyright 2012 ABC News Radio

Thursday
Jun142012

FDA Approves Meningitis Vaccine for Infants

iStockphoto/Thinkstock(WASHINGTON) -- The U.S. Food and Drug Administration Thursday approved an infant vaccine that experts say will protect small children from two potentially fatal bacterial diseases.

Menhibrix, manufactured by the Belgium-based company GlaxoSmithKline Biologicals, is said to prevent the potentially life-threatening Haemophilus influenza type b (Hib disease) and Neisseria meningitidis (meningococcal disease) from occurring in children who are particularly susceptible when under 2 years of age. The combination vaccine is to be administered to infants in four doses beginning as early as 6 weeks of age with the last dose being given as late as 18 months of age.  

The FDA says that without the vaccination, the Hib and meningococcal diseases are especially dangerous to children because their symptoms can be difficult to detect or distinguish from other common childhood illnesses. Additionally, Hib and meningococcal disease often progress quickly and can lead to long-term health conditions such as blindness, mental retardation or amputations.  The diseases can even be fatal in some cases.

These bacteria, the FDA says, can lead to sepsis once the bloodstream becomes infected.  Meningitis follows the bacteria's infection of the lining surrounding the brain and spinal cord.

Common side effects of Menhibrix include pain, redness and swelling at the injection site, irritability and fever, the FDA cautions.

Copyright 2012 ABC News Radio

Wednesday
Jun062012

Are Doctors Improperly Storing Vaccines?

Joe Raedle/Getty Images(NEW YORK) -- As many moms do, Julie Dilensky of Washington, D.C., takes her 1-year-old daughter to the doctor for her recommended vaccinations.

"It's protective and preventative in my mind and anything I can do to keep her as safe and healthy as possible," Dilensky said.

But a new government report obtained exclusively by ABC News has her a bit worried about the efficacy of the immunizations her daughter is getting.

An investigation by the Department of Health and Human Services' Office of the Inspector General (HHS OIG) found that many providers of immunizations meant for low-income children don't store the vaccines at proper temperatures, potentially rendering them ineffective and placing children at risk for contracting serious diseases.

Inspectors visited the offices of 45 providers in five states who offered free immunizations as part of the government's Vaccines for Children (VFC) Program.  Nationwide, about 44,000 offices and clinics participate in the program.  The Centers for Medicare & Medicaid Services pay for the vaccines, and the Centers for Disease Control and Prevention distribute them.

The investigation found that 76 percent of the providers stored the vaccines at temperatures that were either too hot or too cold.  They also found that 13 providers stored expired vaccines along with nonexpired vaccines.  In addition, they said they found that none of the providers properly managed the vaccines according to VFC program requirements.

"As a result, the 20,252 VFC vaccine doses that we observed during site visits may not provide children with maximum protection against preventable diseases and may be vulnerable to fraud, waste and abuse," according to the report.  "These doses were worth approximately $800,000."

The storage problem could potentially lead to less effective vaccines, but doesn't pose a safety risk, the HHS OIG said.

In 2010, about 40 million children received 82 million VFC vaccines at a cost of approximately $3.6 billion, and providers must meet certain requirements for storage and management.

While the report is concerned with vaccines offered under the VFC program, doctors say the government's investigation is an important reminder to all clinicians about the need to properly and carefully store all vaccines.

"The temperature has to be monitored throughout the entire time, from the time it leaves the manufacturer to the time it spends in transit to the time it's delivered to the clinic and it's used in the clinic," said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center.  "We want every dose given to every child to provide the optimum protection as it's intended."

Dr. Anne Schuchat, director of CDC's National Center for Immunization for Immunization and Respiratory Diseases, told ABC News the vaccination program has helped protect many children from preventable diseases, but acknowledged there was a breakdown in the vaccine management process.

"We're doing our root cause analysis right now to try and understand the key factors that lead up to these issues," she said.  "There have been changes in the equipment, the refrigerators.  There are many vaccines recommended now, and maybe there are more doses being stored in the average office than there used to be."

The CDC says disease rates haven't gone up because of vaccines affected by temperature problems, but they are investigating a rare whooping outbreak in the state of Washington.

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Copyright 2012 ABC News Radio

Wednesday
May092012

One in Six Cancers Caused by Infection 

Ingram Publishing/Thinkstock(NEW YORK) -- Roughly one in six cancers is caused by an infection, according to a global study highlighting the power of vaccines in cancer prevention.

French researchers pooled data on 27 cancers from 184 countries to calculate the fraction of cases attributable to viral, bacterial and parasitic infections.

“Around 2 million cancer cases each year are caused by infectious agents,” the researchers wrote in their report, published Tuesday in The Lancet Oncology. “Application of existing public health methods for infection prevention, such as vaccination, safer injection practice, or antimicrobial treatments, could have a substantial effect on the future burden of cancer worldwide.”

Human papillomavirus (HPV), hepatitis B and C, and the ulcer-inducing Helicobacter pylori caused 1.9 million cancers worldwide in 2008, according to the study. HPV and hepatitis B infections are largely preventable through vaccination, and H. pylori can be treated with antibiotics.

“Most of the infection-attributable cases occurred in less-developed countries and were due to preventable or treatable infections,” Goodarz Danaei, assistant professor of global health at the Harvard School of Public Health in Boston, wrote in an editorial accompanying the study. “Since effective and relatively low-cost vaccines for HPV and [hepatitis B] are available, increasing vaccine coverage should be a priority for health systems in high-burden countries.”

HPV is a sexually transmitted infection that causes cervical cancer as well as cancers of the throat, vagina, vulva, anus and penis, according to the U.S. Centers for Disease Control and Prevention. The CDC recommends the HPV vaccine for teenage girls and boys as well as some men and women up to age 26, but few end up getting all the necessary doses.

“Our vaccination program is gaining momentum but very slowly, and one reason is it’s hard to get teenagers in for all three doses,” said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn. “The other reason is that because HPV is sexually transmitted, it’s evoked a whole bunch of hullaballoo over whether the vaccine promotes promiscuity. Of course, there’s no evidence to support that at all.”

The hepatitis B vaccine is also given in three doses, but in the first 18 months of life.

“We vaccinate all children against hepatitis B, so their risk of liver cancer down the road will be very much reduced,” said Schaffner. “If we look back 20 years from now, we will see the occurrence of liver cancer dropping precipitously.”

The realization that infections like HPV can trigger cancer is relatively new, earning virologists Harald zur Hausen, Françoise Barré-Sinoussi and Luc Montagnier the Nobel Prize in 2008.

“Every time we make an advance like that, the opportunity exists to make a vaccine that could prevent those kinds of infections and thus prevent another proportion of cancers that occur in our population,” said Schaffner.

But, he added, choosing not to smoke, eating a healthy diet and keeping physically active also reduces the risk of cancer.

“We have to remember that in our country behavioral risk factors still loom large,” he said. “There are a number of strategies we can all employ to reduce our risk of cancer even more.”

Copyright 2012 ABC News Radio

Monday
May072012

Study: Mandatory Vaccines Lead to Higher Immunization Levels

Joe Raedle/Getty Images(WASHINGTON) -- States that require immunizations for students entering middle school have significantly higher numbers of adolescents who actually get recommended vaccinations compared with states that simply require that parents be informed about the vaccinations, according to a new study.

The Advisory Committee on Immunization Practices currently recommends pre-teens and teens receive the tetanus-diphtheria-pertussis vaccine, the vaccine against meningitis and the HPV vaccine.

Researchers from the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases (NCIRD) wanted to determine if state requirements and parental education had an impact on vaccination rates, so they analyzed data from 13- to 17-year-olds who participated in a national survey.

The vaccination coverage in states requiring immunization against meningitis was 71 percent compared with 53 percent in states with no requirements and 51 percent in states with education-only requirements.  The rate of tetanus-diphtheria-pertussis vaccination was 80 percent in states requiring the shot and 70 percent in states with no requirements.  There were no states reported that only required education about the tetanus vaccine.  There was no difference in vaccination rates for the HPV vaccine.

"The education finding was interesting.  I think that it didn't really have any effect," said Shannon Stokley, a co-author and researcher at NCIRD.  "That doesn't mean that education isn't working, but education materials may not be reaching its audience.  They may not be getting to parents."

This study comes just days after Washington State tapped into emergency funds to help get a whooping cough outbreak under control.

Washington Gov. Chris Gregoire freed up $90,000 of emergency money to ramp up vaccination awareness efforts.

"Pertussis is very serious, especially for babies.  It's vital that teens and adults are current on their immunizations because they're often the ones who give whooping cough to babies," state Secretary of Health Mary Selecky said in a statement.

Oregon, Washington and Vermont all have high exemption rates, and all three states have had outbreaks of whooping cough.

Copyright 2012 ABC News Radio

Thursday
Apr262012

Vermont Debates Vaccines: Should Parents Be Able to Opt Out?

Jeffrey Hamilton/Thinkstock(MONTPELIER, Vt.) -- The debate over a bill that would make vaccines mandatory for school-aged children by eliminating "philosophical exemption" as a reason to opt out of the shots, has divided Vermont's families over the benefits and risks of vaccines. 

It has also pitted the state House -- whose majority voted down the bill -- against the state Senate, which voted to approve it.

Twenty states, including Vermont, currently allow philosophical exemptions for those who object to vaccines for personal or moral reasons.

"It's been clearly demonstrated that the broader (the) exemptions, the more loosely it's applied -- and the less likely children will get vaccinated," said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University School of Medicine in Nashville, Tenn.

Fewer than 70 percent of children in Vermont between the ages of 18 months and 3 years received all of the recommended vaccines, according to a 2010 National Immunization Survey by the Centers for Disease Control and Prevention -- a rate lower than the 73 percent national average.  Vermont has one of the highest philosophical exemption rates among those 20 states, Dr. Harry Chen, health commissioner for Vermont's Department of Public Health, told ABC News.

Measles and pertussis, also known as whooping cough, are the fastest growing vaccine-preventable diseases nationwide.  Just last year, Vermont had an outbreak of pertussis.  And other states with high philosophical exemption rates, including Washington and Oregon, have also seen a revival of pertussis.

According to the Vermont Coalition for Vaccine Choice, an advocacy group of parents, health care providers and others lobbying to stop the bill from passing, many people are naturally immune to communicable diseases without the need for vaccines.

The group also maintains that mass vaccinations will lower the risk of infection among people who decline the vaccinations, a phenomenon known as "herd immunity."

"There is no need to allow the state to strip parents of their rights to make medical decisions for their own kids," the group's website reads.  "Given that vaccines have known risks associated with them, it seems only prudent to continue the philosophical exemption, and to make sure that we are not divided by fear mongering."

Schaffner said it's impossible to know who would have natural immunity, adding that herd immunity works only if the majority of the population is vaccinated, which stresses the importance of getting vaccinated.

In addition, he said, some children have medical conditions that preclude them from receiving vaccinations.

"The way we protect them is for all the rest of us to be protected," Schaffner said. 

Copyright 2012 ABC News Radio







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