Tag Archives: Vaccines

Happy National Immunization Awareness Month: Spotlight on the Chickenpox Vaccine

August is National Immunization Awareness Month and a time to celebrate all the pain, suffering, and deaths avoided thanks to vaccines. I’m currently on maternity leave and very thankful for all of the people who have been vaccinated and help to protect my daughter until she is old enough to be fully vaccinated. Unfortunately, the Bay Area has dangerously low immunization rates in many places (you can find out the immunization rate at the kindergartens in CA here), which compromises herd immunity. This month is a great time to discuss how vaccinations can protect your children from painful and often deadly diseases. In a previous post I discussed how serious a case of the measles can be, especially for babies where there is a 1-2 in 1000 chance they will die. Today I’d like to talk about the importance of the Varicella or Chickenpox Vaccine.

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Babies like my daughter rely on herd immunity to stay safe from vaccine preventable diseases

Some people think that children are given too many vaccines and often point to the chickenpox vaccine as one that is unnecessary. There is extensive evidence that the vaccine schedule suggested by the CDC and endorsed by every reputable medical organization is safe and effective so I won’t spend time on that here (see the Children’s Hospital of Philadelphia’s Vaccine Education Center or the CDC for more information). What I would like to discuss is why it is important for your child to get the chickenpox (varicella) vaccine.

Chickenpox is an unpleasant and sometimes fatal disease

If you are my age you have likely had chickenpox and probably remember the itchy bumps. Chickenpox is extremely contagious and most of us had it along with our siblings. For most children chickenpox is a mild disease, though definitely unpleasant and disruptive to school attendance and parent work schedules.  About 1 in 1000 children will get severe pneumonia, though, and before the widespread use of the chickenpox vaccine about 70 children died every year. Chickenpox is especially dangerous for babies under 1 yr old and anyone over 15. There are heartbreaking stories of babies too young to be vaccinated and adults that never got chickenpox dying from a ‘simple’ case of chickenpox. If there is a chance my baby can die from a disease I definitely want her to be vaccinated.

The virus that causes chickenpox can lead to a painful case of shingles later in life

Following a case of the chickenpox, the virus remains dormant in your body and can reappear later in life as a painful disorder, shingles. Shingles causes a painful, blistering skin rash that persists for 2-4 weeks. A common side effect of shingles is post-herpetic neuralgia (PHN) where the pain from shingles lingers for months or years. Some people also experience vision loss from shingles.  About 1 in 3 Americans will get shingles in their life and there are ~1 million shingles cases in America per year. The incidence of shingles increases with age and about half of shingles cases occur in people over 60. The chickenpox vaccine uses a live but weakened strain of the virus that can still cause shingles, but at a much lower rate than the live virus. In about 40 years once the first generation vaccinated for chickenpox ages we will know the level of shingles reduction that can be gained by widespread chickenpox vaccination. For now, there is a shingles vaccine that is recommended for people over 60.

The chickenpox vaccine is very safe and side effects are usually mild

The most common side effects from the chickenpox vaccine are pain at the injection site, a low grade fever, and a rash near the injection site (rash occurs in ~4 in 100 people). The chickenpox vaccine is very safe and helps prevent your children from getting an uncomfortable and potentially deadly disease. Seeing a child get shots is often hard on parents, but you can find some evidence based tips for how to keep your child as happy as possible during routine vaccinations at the Science of Mom blog.

Want to learn more about vaccines? 

The internet contains a lot of misinformation about vaccines and it is important to get your information from trusted sources. The Children’s Hospital of Philadelphia has a great Vaccine Education website with easy to understand information about every vaccine recommended for your child, including the dangers of your child contracting that disease and the known side effects of each vaccine. This site has been recognized for its accurate information by the World Health Organization (WHO) and is a member of WHO ‘s Vaccine Safety Net, which aims to provide accurate public health information to the public online. The Centers for Disease Control (CDC) also has a very good Vaccine Safety site.

Action Alert: Help Pass CA SB277 And Remove Personal Belief Exemptions for Vaccines

California SB277, which would eliminate the personal belief exemption for public school children in California, is currently working its way through the state legislature (discussed in a previous post). This week following a very heated public comment period, SB277 passed the Health Committee. On Wednesday April 15th the bill will be discussed in the Education Committee. Please join me in contacting your legislators and the members of the Education Committee to voice your support of the bill. The group Vaccinate California has made it very easy to contact your representative. You can also sign up for their web alerts to keep up to date about the progress of the bill.

Below are the phone numbers of all Education Committee members, please take the time to call and ask for their support. The anti-vaccination side has been quite vocal, so we need to let our legislators know that a clear majority of Californians know that vaccines are safe and effective and support this bill.

Sen. Bob Huff (916) 651-4029
Sen. Connie Leyva (916) 651-4020
Sen. Carol Liu (916) 651-4025
Sen. Marty Block (916) 651-4039
Sen. Loni Hancock (916) 651-4009
Sen. Tony Mendoza (916) 651-4032
Sen. Andy Vidak (916) 651-4014
Sen. Richard Pan (916) 651-4006 (SB277’s sponsor–you can call to thank his office)

Resources About the Safety and Efficacy of Vaccines

A sample call or email script (including an example of my personalized response in bold):

Dear State Senator/Representative ____,

I am writing/calling to encourage you to support the bill introduced by Senators Pan and Allen that would eliminate the personal belief exemption for vaccination in public school children. The science is clear, vaccines are safe and prevent millions of deaths a year. The efficacy of vaccination rests on herd immunity and California vaccination rates are dangerously low. This has led to recent outbreaks in whooping cough and the measles, which are incredibly dangerous diseases, especially to babies too young to be vaccinated and people with compromised immune systems. Controlling these diseases is also costly to the state and strains our public health resources. [if desired you can add something personalized here like: As a scientist and soon to be mother, this is a very important issue to me. When my baby is born in May, I am worried she will be needlessly exposed to dangerous diseases due to the high concentration of people who have chosen not to vaccinate in the Bay Area. I have a PhD in Biomedical Sciences and am trained to read and understand medical literature. I can assure you that the research supporting the safety of vaccines is sound. I would be happy to discuss this further with your office, provide you with easy to understand information about how vaccines work and the evidence that they are safe, or provide any other assistance you may need in making your decision.] Please help prevent needless outbreaks and deaths by supporting this bill and eliminating the personal belief exemption for vaccination in public school children.

Thank you for your consideration of this issue,

 

Action Alert: Contact CA State Legislators in Support of Bill to Eliminate Personal Belief Vaccination Exemption

California state Senators Richard Pan (D-Sacramento) and Ben Allen (D-Santa Monica) introduced legislation to eliminate the personal belief exemption for vaccination in public school children. Currently parents can claim an exemption from the state-mandated vaccination requirements for their personal beliefs. A 2012 law mandates that parents choosing this personal belief exemption must consult a licensed health care provider about their decision, which decreased the number of personal belief exemptions claimed by ~20% in 2013. Even with this decrease, 2.5% of children are entering CA public schools with personal belief exemptions, with this number rising in some communities to over 10% of children. California vaccination rates are ~91% of the population, which compromises herd immunity as we are seeing quite clearly with the current measles outbreak. Vaccines are safe and save literally millions of lives a year (1 or 2 in 1,000 kids who contract the measles will die). Those families who opt out of vaccines put the rest of us at risk, especially those most vulnerable including children too young to be vaccinated or those with compromised immune systems. (For more information on the safety and efficacy of vaccines see an earlier post). Controlling an outbreak of a previously vanquished disease like the measles is also incredibly costly and strains public health resources. Join me in contacting your state legislators to show your support for this bill which would make CA the 33rd state to eliminate personal belief exemptions for all children entering public schools.

How to Contact Your State Legislators

As the saying goes, the squeaky wheel gets the grease. Opinion polls consistently show the majority of Americans are in favor of vaccination and research overwhelmingly supports the safety and efficacy of vaccination. There is a very vocal minority opposed to vaccination, though, and you can bet they will be contacting their legislators. Let your state legislators know that you are in favor of this bill by contacting their offices through email or phone. You can find your state senator and representative here. You will be directed to you to your representative’s official website where you can find contact information for their offices and a web contact form. Below I have a sample email or phone script that I would encourage you to use and customize.

Dear State Senator/Representative ____,

I am writing/calling to encourage you to support the bill introduced by Senators Pan and Allen that would eliminate the personal belief exemption for vaccination in public school children. The science is clear, vaccines are safe and prevent millions of deaths a year. The efficacy of vaccination rests on herd immunity and California vaccination rates are dangerously low. This has led to recent outbreaks in whooping cough and the measles, which are incredibly dangerous diseases, especially to babies too young to be vaccinated and people with compromised immune systems. Controlling these diseases is also costly to the state and strains our public health resources. [if desired you can add something personalized here like: As a scientist and soon to be mother, this is a very important issue to me. When my baby is born in May, I am worried she will be needlessly exposed to dangerous diseases due to the high concentration of people who have chosen not to vaccinate in the Bay Area. I have a PhD in Biomedical Sciences and am trained to read and understand medical literature. I can assure you that the research supporting the safety of vaccines is sound. I would be happy to discuss this further with your office, provide you with easy to understand information about how vaccines work and the evidence that they are safe, or provide any other assistance you may need in making your decision.] Please help prevent needless outbreaks and deaths by supporting this bill and eliminating the personal belief exemption for vaccination in public school children.

Thank you for your consideration of this issue,

___________

Talk to Your Friends and Family About Science: Vaccines Edition

The number of people who have contracted measles from an outbreak started in Disneyland has topped 50 this week, making it a very good time to talk to your friends and family about the importance of vaccination. Vaccines are one of the most successful public health advances, practically eliminating such awful diseases as polio and smallpox. Since 2000, vaccines have been credited with decreasing the number of worldwide childhood deaths by 3.6 million, even though the population has increased by 1 billion in the same time frame. Sadly, the success of vaccination may be contributing to the current outbreaks of diseases, like the measles, that we thought were a thing of the past. Without the memory of closed public pools and rows of iron lungs in hospital wards it is easier to weigh the perceived risks of vaccination as the scarier option. Below are ways you can answer some common questions about vaccination as well as some resources about the safety and efficacy of vaccination.

 Is a Measles Outbreak Really That Bad?

Short answer: YES! In 1980, before widespread vaccination 2.6 million people died of the measles. In 2012, with 84% of babies vaccinated that number was only 122,000 worldwide. About 1 or 2 in 1,000 babies who contract the measles will die, whereas the worst vaccine side effect, a severe allergic reaction, only occurs in 1 in 1,000,000 babies. The measles are one of the most contagious diseases known. Measles spread through the air and an unvaccinated person can still contract the disease if they enter the room 2 hours after the infected person has left. The Ro, or average number of people one sick person will infect, for measles is 18! For comparison, the Ro for Ebola is 2. This is why it is important to quarantine unvaccinated people potentially exposed to the measles. A measles outbreak is also incredibly costly, with contact tracing and other measures costing ~$33,000 per person infected.

 Shouldn’t It Be My Choice Whether To Vaccinate My Children?

Many of the health decisions that we make, like what foods we eat, are choices that mainly affect us as individuals. The choice to refuse vaccination, though, affects society at large since the success of vaccines rests on herd immunity. Transmission of a disease can be prevented if the majority of people are immune. Herd immunity protects those who cannot be vaccinated because they are too young or have a compromised immune system that prevents them from being vaccinated. Herd immunity also protects the minority of people vaccinated that don’t gain protection (most vaccines are ~80-85% effective, which is pretty darn good, and the measles vaccine is ~95-98% effective.). As long as between 83-94% of the population is vaccinated, it is highly unlikely that a disease will spread. US vaccination rates are now ~91% on average, lower than half the countries in the world, and even lower in certain areas, including Marin County, CA where only 83% of kindergartners were vaccinated in 2010. If only a few families opt out of vaccinations, they still receive protection from herd immunity. Once too many people opt out, the rest of us are placed in danger, just like the 2 babies too young for vaccination that contracted the measles at Disneyland. It is in society’s best interest to start making the cost of refusing to vaccinate higher, especially since the safety of vaccination has been shown repeatedly (serious side effects from vaccines are very rare). For instance, unvaccinated children are barred from entering many daycare facilities and we could make it much harder to receive vaccination exemptions for children in public schools. Similarly some pediatricians are refusing to treat unvaccinated children, which will protect their other patients.

But Don’t Vaccines Cause Autism?

No, vaccines do not cause autism. This idea was started thanks to a fradulent, now retracted paper by Andrew Wakefield (who has since had his medical license revoked). Since the publication of that paper, many studies including over 14.7 MILLION children have found NO LINK between autism and vaccination. Anti-vaxxers will trot out figures showing increasing autism rates as vaccination rates have increased. Don’t fall for this, that is simply correlation, not causation. In fact, there is a similarly good correlation between autism rates and organic foods sales, which I’m sure we can all agree is a highly unlikely cause of autism.

AutismOrganicFood

 

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Some Great Resources About Vaccines

Wonderful cartoon by the Nib explaining how vaccines work, how shady the Wakefield study was, and how important vaccinations are.

Upworthy infographic sponsored by the Bill and Melinda Gates Foundation showing the evidence that vaccines do not cause autism.

Business Insider video explaining herd immunity and why ‘If you don’t vaccinate your kid, please don’t ask me not to judge you.’

Skeptical Raptor’s explanation of the mumps outbreak in the NHL and why vaccinated players can still get the mumps.

Journal article for clinicians refuting 3 common anti-vaxx arguments (behind a paywall).

 * *Updated on 2/8/15 to include risk of death from measles vs risk of severe allergic reaction to MMR vaccine, efficacy rate of MMR vaccine, and clarification that I am in no way suggesting the sale of organic food causes autism.**