How good is vaccination coverage in your State (US)?

The CDC released the results from their survey of  National, State, and Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2011

Have a browse for the situation in your State - be glad if you are not in the Virgin Islands, I guess. What strikes me indeed is the great inequality between States and also between demographics. Ironically (because anti-vaccine minded parents seem to be concentrated in this group), a white rich child's chance of having been vaccinated age-appropriately are still higher than the chance for a hispanic, black and/or poor child. I was recently discussing vaccine recommendations/mandates and someone argued that only "high risk" children should be vaccinated. The table is a great reminder of how big the United States are and how unequal access to health care is, even when there are uniform recommendations. 

♭♩ ♫ what a difference 5 weeks make... ♫ ♬

New Merseyside measles numbers were released Friday and there are now 414 laboratory confirmed cases of measles, plus 173 probably cases. Measles are contagious - so to reiterate from yesterday:

Older pupils, students and adults should check their vaccination records to ensure that they really have had two MMRs, children older than 13 and younger than 41 months could get their second MMR early during an outbreak to reduce the risk.

Consider getting your infant (between 6 and 12 months) vaccinated, if s/he is at "higher risk" (daycare) and there is an outbreak in the area - almost a quarter of cases in this outbreak were in the under one-year-olds, who are at particularly high risk of complications.

Anyone who intends to work/volunteer in the medical sector should have had two MMRs. In this, as in nearly every recent outbreak, transmissions within the medical setting and to medical personnel occurred.

Doctors and nurses need to familiarise themselves with the symptoms of measles, so that they can diagnose them early and limit transmission in the medical setting. 

And finally, all parents need to think long and hard before taking their child into A&E or their GP's practice whether their child could be contagious, especially if the child has not had their MMRs and could be carrying a potentially fatal disease. Call ahead, get an "out of hours" appointment or home visit, if at all possible.

Edited to exchange first link to go to original source

oh look - vaccines resurrected on Ask Dr. Sears site

at least somewhat - as promised by Matt Sears to Seth Mnookin, "Vaccines" are back on the Ask Dr. Sears website:



The content is still a bit disappointing, cannot say the info is "updated". It consists of links to old "The Vaccine Book" (dead link) blog posts, mostly sans comments (big shame, since there were some beautiful ones in there by SM and me). This is not really suitable as an info site (yet) especially since posts don't have date stamps or corrections (no, the return of single measles, mumps and rubella vaccines is not planned for 2011, at least not according to Merck). The "purchase the vaccine book" link works (not surprisingly). I would advise against it.

Vaccines dumped from new Ask Dr Sears website?

I just caught a glimpse of the new Ask Dr. Sears Website. It was terrible slow loading when I first saw it, but the the landing page was all re-structured and modern in nice greens and oranges (I like that, very purdy).



Since we have been posting on the vaccine discussion board (justthevax passim), I thought I should take a stroll through the new page and have a look what the vaccine area looks like now. Well, this morning, there was none. While the "all categories" page did not load all too well, both on the left category bar



and on the middle all categories bar, there were no vaccines.



but they certainly had been there on the old page.



UPDATED TO ADD - indeed, no "Vaccines Area" - the search for "vaccines" only leads to Dr. Bob, not to further info (bites tongue):

closeup

I wonder whether this is going to be amended, or, whether in a year of pertussis and measles outbreaks that have cost 10 infants in the Sears' home state of California their lives, and have put many kids in hospital, the Sears have decided to drop this potentially contentious part of their web presence.

In any case - since the Sears' vaccine book discussion board has now disappeared, I hope you do have a good doctor and I can recommend our forum and, if you want a bit of a mixed audience, also the Immunization Discussion forum on Babycenter - see you there!

Policy vs. Evidence: Part 1, personal

I have been planning a small series of posts for a while looking at vaccine policy vs. evidence for vaccine policy (i.e. when which vaccine are recommended for which population). This had originally been triggered by the flu vaccine recommendation for under 2 year olds and criticism thereof and some anecdotes on the handling of vaccine recommendations in my own life and online. I will kick off this series with a personal admission:

I am a vaccine refuser/alternatively vaccinating parent - our older child's school holds a current vaccination "non consent" form.

That is the short story. The long story is a little more complex. In the UK, children get their booster shots in school. They are paid for by the National Health Service. So last year, we got a letter home, asking us for consent to a dT/IPV (Diphtheria, Tetanus, inactivated Polio vaccine) booster. Well, it was 9 years after the dT pre-school booster, so the dT was a very good idea. The IPV however, we did not quite see as critical. Polio has been eradicated in the Western Hemisphere (this was before the Russian polio import from Tajikistan. Both children had had 4 polios. More importantly, however, I wanted the kids to be boosted for pertussis (routine on the German teen schedule). First of all, we know that pertussis immunity wanes, whether you had the shots (see also here) or coughed for it, then we know that the booster works for teens, adolescent and adult vaccination was likely to be cost effective, and finally, I had pertussis as a 15 year old (from babysitting an unvaccinated toddler) and I was not keen on anyone in the family living through a summer of relentless choughing. Pertussis is not nick-named "100 day cough" for nothing.

This was an interesting experience. The nurses from the school immunisation service could not help me with a dTaP (aP = acellular Pertussis) or dTaP/IPV. They were nice, though. The GP referred us to the health visitor, who only does babies and toddlers. The nurse from the travel vaccine section of our GP practise hung up on me after I had explained our wishes, with very little patience for something extraordinary. So finally, we landed in a private practise, one of those places that used to make money by selling the single M(easles), M(umps) and R(ubella) vaccines (call me hypocrite). While the nurse was clueless, she was exquisitely friendly, she did not hang up on me, so I could explain which vaccine we wanted, then explained to their resident GP that while that particularly vaccine was not licensed for kids over 10 years in the UK, it was in a lot of other countries (German pdf; I know because DH and I got the same vaccine in 2005). And eventually, after a reasonable office fee and a surprisingly cheap booster shot (£5 a pop), the whole family was back on track. Phew. So when the school sent out another consent form this year, we responded back with another non-consent (and an explanation why we did not consent).

In the end, the whole procedure was extremely sobering. Our decision to vaccinate our school children against pertussis was totally backed by evidence, biologically relevant and followed European recommendations, just not the UK's. In our opinion, the current UK policy was lagging behind the available evidence, even studies from the UK. It required a fair amount of perseverance and the luxury of some dispensable money to protect our children what we considered adequately.