Why are Vaccines Mandated?

26 05 2011

Why does the government mandate that millions of children and adolescents receive certain immunizations for school entry?

The more people in a community who are vaccinated, the healthier that community is.  Here is how Dr. Samuel Katz, a renowned vaccine expert and a member of PKIDs’ Medical Advisory Board, explained it before Congress in 1999.

“We know too well that the level of [immunization] protection that we have now established in our children and our communities is a fragile one that depends on what we refer to as community or ‘herd’ immunity.  From the standpoint of effectiveness, modern childhood vaccines are approximately 90 to 95 percent effective.  What that means is that for every 20 children who are vaccinated one or two may not develop a sufficient immune response [or antibodies to fight an infection].

“It cannot be assured that these children will be protected from the virus or bacteria should they encounter it at school, at a playground, at a shopping mall, or at their church daycare.  However, if sufficient numbers of children in a community are immunized, the vaccinated ones protect the unprotected by effectively stopping the chain of transmission in its tracks and drastically lowering the probability that the susceptible child will encounter the bacteria or virus,” said Katz.

Community immunity also helps protect children and adults whose immune systems are compromised or weakened because of another illness or old age.

“As long as the great majority of children receive their vaccines, we will be able to maintain our current level of disease control,” Katz explained.  “However, should the level of community protection drop to the point where the viruses and bacteria travel unimpeded from person-to-person, from school-to-school, and from community-to-community, we instantly return to a past era when epidemics were an accepted part of life.”

America experienced such an outbreak in 1989-91 with the resurgence of measles.  There were 55,622 reported cases mainly in children less than 5 years of age, more than 11,000 hospitalizations and 125 deaths.  States do allow personal exemptions, so parents can choose not to vaccinate their children, but those exemptions carry risk to the child and the public’s health, emphasizing the importance of community immunity.

An article in the Journal of the American Medical Association found that, on average, those children who were exempted from immunizations ran a 35-fold greater risk of contracting measles compared to those who were nonexemptors.

Not only are these children at greater risk of disease, their infections can be the spark that ignites a disease outbreak in a community.

According to Dr. Katz, in the late 1960s and early 1970s, despite the availability of a safe and effective measles vaccine, the United States continued to experience regular epidemics of measles.  Left to individual choice (as opposed to government mandates), only 60 to 70 percent of the community was immunized.

That coverage failed to provide adequate community immunity to prevent an outbreak.

“States without school immunization requirements had incidence rates for measles significantly higher than states with these requirements,” noted Dr. Katz.  “Recognizing these data, other states (not the federal government), quickly adopted similar requirements.  These requirements are supported by the American Academy of Pediatrics.

“The results are striking,” he added.  “Before we had a measles vaccine, an estimated 500,000 cases of measles were reported each year.  In 1998, there were 89 cases of measles in the United States with no measles-associated deaths.  Most counties in the United States were free of measles.  However, we have learned that nearly all of the cases of measles that did occur in the United States were imported from other countries.  This would not have been possible without the “school exclusion” statutes that now exist in every state.  While we hear dramatic stories of exotic diseases that are just a plane ride away, the importation of vaccine preventable diseases into a susceptible population is much more frightening.  Should we allow our community immunity to wane, we will negate all the progress we have made and allow our communities to be at risk from threats that are easily prevented.”

Compulsory vaccination laws in the United States have repeatedly been upheld as a reasonable exercise of the state’s compelling interest even in the absence of an epidemic or a single case.  As the U.S. Supreme Court held in 1905 in the case Jacobson vs. Massachusetts:

“ …in every well-ordered society charged with the duty of conserving the safety of its members, the rights of the individuals in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations as the safety of the general public may demand.”

The Supreme Court makes clear that “the liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint.  There are manifold restraints to which every person is necessarily subject for the common good.   [Liberty] is only freedom from restraint under conditions essential to the equal enjoyment of the same right by others.”

This is one in a series of excerpts from PKIDs’ Infectious Disease Workshop. We hope you find the materials useful – the instructor’s text and activities are all free downloads.

Photo credit: lawtonjm

Safer Sex

23 05 2011

Warning: This article contains explicit sexual information.  It is intended for the sexually active and those intending to become sexually active. The only way to make sure you won’t get an STD is to not be sexually active.

More than 65 million people—about one in five Americans—are believed to be infected with an incurable sexually transmitted disease.

Safer sex practices allow partners to reduce (but not eliminate) their chance of an infection from sexual activity.  The basic rule for safer sex is to prevent contact with genital sores and prevent the exchange of body fluids, such as semen, blood and vaginal secretions.

The best way to prevent body fluids from reaching someone during intercourse is to use a condom.  A condom is a sheath that fits over the penis.  It can be made of latex (the safest condom available), plastic or animal tissue.

Experts consistently recommend latex because some animal tissue, such as lambskin, has pores small enough for the hepatitis B virus, HIV and other sexually transmitted viruses or bacteria to pass through.  Polyurethane condoms break more often than latex.

The birth control pill, IUDs, Norplant, Depo-Provera, vasectomies and tubal sterilizations offer great protection against pregnancy, but no protection against hepatitis viruses and STDs.  Many people use latex condoms along with these birth control methods for the best protection against both pregnancy and sexually transmitted infections.

Oral sex may not get one pregnant, but it can still transmit disease.

A condom just might save a life, and should be treated like the valuable tool it is.  Store condoms in a cool, dry place.  Long exposure to air, heat or light makes them more breakable.  Do not store them continually in a back pocket, wallet, purse or glove compartment.

Check the expiration date to make sure the condom is fresh and safe.  If there are any doubts about a condom, buy a new one.

To ensure maximum protection, never use a condom twice and always put a new condom on an erect penis before there’s any genital, anal or oral contact.

A condom is like a sock, with a right and wrong side.  First, unroll it about half an inch to see in which direction it is unrolling.  Then put it on.  If a male has not been circumcised, pull the foreskin back first.  It should unroll easily down the penis.  If it starts off on the wrong side, try again with a new condom.

Hold the tip of the condom gently between the fingers as it rolls down.  This keeps out air bubbles or pockets that can increase the chance of a condom breaking.  It also leaves space at the end for semen.

If using a lubricant, make sure it’s water-based because oil breaks latex.  Don’t use vaseline, hand creams or lotions as a lubricant.

After ejaculation, hold the condom at the bottom of the penis so it doesn’t slip off.  Try to pull out while still erect or hard.  The condom comes off only after the penis is completely out of the partner.

Use a condom only once.  Never use the same condom for vaginal and anal intercourse.

It may be embarrassing to talk to a partner about contraception and condoms, but it’s essential, and should be done before a sexual situation begins.  Don’t wait until the heat of passion takes over.  It can overwhelm good intentions.

Be honest about feelings and needs.  Silence is not a virtue in this situation.  Talking about condoms will make it easier for both partners.

Embarrassment should not become a health risk and increase chances of infection.  It’s important for partners to be open and share health concerns and sexual health history.

This is one in a series of excerpts from PKIDs’ Infectious Disease Workshop. We hope you find the materials useful – the instructor’s text and activities are all free downloads.

Photo credit: music2work2

Bacteria and Viruses-How They Work

19 05 2011

There are thousands of types of bacteria and most are harmless or even beneficial.  However, even “good” bacteria, if they find their way to the wrong place, can cause harm.  For example, bacteria that live in our mouth can cause illness if they find their way to the middle ear and cause an ear infection.  Also, some bacteria that ordinarily do not cause disease in persons with a working immune system, may do so in people with a weakened immune defense system.

Most bacterial diseases occur when bacteria multiply rapidly in tissue, damaging or killing it.  Boils result from the multiplication of bacteria in the skin.  Other bacteria cause disease by producing toxins or poisons.  Tetanus is a disease that begins after bacteria that normally live in soil enter the body through a wound.  The bacteria produce a poison that affects muscles and nerves far away from the wound.

To cause illness in humans, bacteria need to be able to gain access to the human body, reach their unique place within the body and multiply there.  The human body has developed several strategies to make life as difficult as possible for disease-causing or pathogenic bacteria, but bacteria have also learned how to break down our defenses.

An infection by pathogenic bacteria can be seen as a miniature battle between bacteria and host.  Bacteria try to survive and feed and multiply, while the human body’s immune system tries to prevent this.  The resulting infection is a process with three possible outcomes:

  • The immune system wins and the bacteria are removed, possibly with the help of medications.
  • The bacteria win the ultimate battle and kill their host (bacterial infections are a major cause of death, especially for children and elderly people).
  • An equilibrium is reached in which host and bacteria live in relationship together and damage is minimized.

All viruses live to make more viruses, and they usually make more viruses by invading a host’s cell (for instance, one of the cells in our bodies) and using the host cell’s “machinery” to churn out more of themselves.

Once the viruses mature, they leave the host cell and go find many more host cells to set up shop in so that they can start churning out more of themselves.

Sometimes, there is a hitch in the churning process.  During viral replication, mutations can occur.

The mutation can be bad enough to interfere with the virus’s ability to duplicate itself.  Or, it might just create a new strain of the virus.  The influenza virus does this, which is why every year, each new strain of flu virus must be identified in order to make a vaccine that is effective against it.

Humans are able to fight off viruses in several ways:

  • Proteins called interferons help neighboring cells resist infection by the virus.
  • If interferons fail, the immune system kicks in and fights the infection by killing the virus floating around outside the host cells and killing infected host cells.  (HIV is the exception, because HIV infects cells of the immune system that are necessary to kill the infected cells.)
  • There are drugs that help the body fight certain viral infections.  They hinder or stop the replication of the virus and are known as antivirals/retrovirals.

This is one in a series of excerpts from PKIDs’ Infectious Disease Workshop.  We hope you find the materials useful – the instructor’s text and activities are all free downloads. 

Photo credit: measles – sanofi pasteur

Infectious Diseases Start to Spread

16 05 2011

If we could see millennia into the past, before people started forming societies, we would probably see them living isolated from one another—nomadic in nature.  This lifestyle was a natural barrier to the spread of infectious disease.  But, when they started clustering together, planting crops and staying in one place, infectious diseases surfaced and became lethal foes of humanity.

Cities grew, people started traveling for business, soldiers traveled for war, and they were all prime candidates to be carriers of disease.  Just as in the recent past, when the Native American population was decimated by the diseases brought in by the Europeans, so too have populations in the past two thousand years been seriously affected by a disease’s introduction into their society.  Bayer Pharmaceutical’s A Brief History of Infectious Disease illustrates this phenomenon:

430 BC, the plague of Athens resulted from 200,000 inhabitants and villagers fleeing into Athens when threatened by the Spartans.  An unidentified infectious agent, from Ethiopia via Egypt, killed one-third of this population and ended the Golden Age of Athens.

166 AD, the Antonine plague was brought to Rome from Syria by returning Roman troops.  The plague had been introduced to Syria from India by the marauding Huns.  The plague (probably smallpox, bubonic plague, and measles) devastated the Roman Empire, killing 4–7 million people throughout Europe.  The resulting social and political upheaval led to the collapse of the Roman Empire.

Circa 160 AD, bubonic plague (‘Barbarian boils’) carried by invaders from the north, led to the collapse of the Han Empire in China.

1346 to 1350, the bubonic plague pandemic started in China and moved along the trade routes through South Russia to the Crimea, which was besieged at the time.  This bubonic plague killed more than one-third of the population of Europe.

1492, influenza, smallpox, tuberculosis and gonorrhea began when Columbus went to the Caribbean.  The local inhabitants did not have immunity to these endemic European infections, and as a consequence, many of the people on the island of Hispaniola (where Columbus first set foot in the New World) died.  Replacement of the population by African slaves introduced African infectious diseases such as malaria and yellow fever into the Caribbean and Americas, which, in turn, killed many European settlers.

1542, bubonic plague started in Egypt, killed 40 percent of the population of Constantinople, and spread all over Europe.

Early trading period, blackwater fever (malaria), yellow fever, bloody flux (dysentery), and worm infestations made trading with the continent of Africa difficult.  The impact on travelers and soldiers was so severe that Africa was called ‘the white man’s grave.’

16th century, similarly devastating epidemics with European and then African infections – introduced by the Spanish into Central and South America.  After the Spanish invasion, the population of Mexico decreased by 33 percent in 10 years and by 95 percent in 75 years.

As trade journeys lengthened, chronic infections such as tuberculosis and venereal diseases were introduced by European sailors to the Pacific islands, which lost 95 percent of their population as a result.

Present time, even during the past few decades, there has been a resurgence of epidemics such as Lyme disease and Rocky Mountain spotted fever in the United States and AIDS, genital herpes, and chlamydia worldwide.

This is one in a series of excerpts from PKIDs’ Infectious Disease Workshop.  We hope you find the materials useful – the instructor’s text and activities are all free downloads. 

Photo credit: AJC1

Just the Facts, Please

12 05 2011

Usually, the facts are the facts, right? Maybe not. Everything depends on the language we use to frame a given issue. That might sound kind of dry, but take a look at this:

Who would hire THAT babysitter?!

The same thing happens sometimes when people talk about vaccines. Even real facts can look alarming when they’re not presented in an accurate context. Watch how it works.

CBS News: “Ratajczak also looks at a factor that hasn’t been widely discussed: human DNA contained in vaccines. That’s right, human DNA.”

Notice how the reporter repeats “human DNA,” suggesting there’s something shocking about it. Yes, there is human DNA in vaccines that are cultured using human cells. They are a biological product that can’t just be cooked up out of inert materials, and if being exposed to foreign DNA were dangerous, it’d be baaaaad news for anyone who’s ever breathed around an animal.

Also, if it were this easy for one organism’s DNA to hijack the biology of another, kindergarteners could do gene therapy.

Fox News, on how the Court of Federal Claims is dealing with cases in the Omnibus Autism Proceeding now that all of the vaccines-cause-autism theories have been conclusively rejected: “It sounds like they’re making these families jump through almost impossible legal hoops. They want them to go out and somehow drum up their own medical expert, pay for it themselves, come up with a new medical theory…why are they making it so tough?”

Yes, the families who had cases in the Omnibus Autism Proceeding are now being asked to speak up if there’s any reason to believe their child’s case is different from the six test cases the Court heard. And yes, it is almost impossible any of them will prevail. Why? Not because, as the reporter insinuates, there’s some dark conspiracy to suppress information. It’s because the Omnibus Autism Proceeding was exhaustive. If there were any possibility that the vaccines-cause-autism theories held water, the test cases provided every chance in the world to prove it—but they couldn’t.

See how easy it is? Start with something harmless, pour on some spooky music, whip to a frothy doomsday conclusion, and . . . voila! You’ve got yourself a delectable morsel of Pernicious Urban Legend! Unfortunately, many consumers don’t know to beware before digging in.

International Conference on Viral Hepatitis

9 05 2011

The International Conference on Viral Hepatitis was held in mid-April in Baltimore.  The conference description was as follows:

There exist significant challenges to diagnosing and linking to treatment large numbers of hepatitis B virus (HBV)- and hepatitis C virus (HCV)-infected patients who are unaware of their serostatus and thus are not on either anti-HBV or anti-HCV treatment. Additionally, bottlenecks preventing expanded access to HBV and HCV care must be addressed in light of shifting treatment paradigms, which requires an expanded number of clinicians from multiple disciplines to deliver HBV and HCV care.

Presentations will feature state-of-the-art information on HBV and HCV research, clinical perspectives, and medical treatment, both within the context of HBV and HCV monoinfection, as well as coinfection with HIV. The conference will feature 24 oral abstract presentations, poster sessions, plenary presentations, invited panel discussions, and clinical case study reviews.

A couple of findings from the conference that could interest parents of HCV+ kids include:

Forty percent of HCV+ patients are not adhering to their treatment. The key to this is identifying those patients who are depressed and treating the depression along with the disease. Those who were treated for their depression showed higher rates of adherence and, consequently, higher rates of viral suppression.

SPRINT-2 was a study of previously untreated HCV+ genotype 1 patients looking at boceprevir with peginterferon/ribavirin.  In this study, this combination of drugs increased sustained virologic response  significantly over standard therapy. Another study looked at patients who had been previously treated with standard therapy but either did not respond to treatment or relapsed.  For those patients, boceprevir was added in re-treatment and significantly higher rates of sustained virologic response were achieved.

These studies were not performed on children, but we know that what works in the adult population will eventually find its way to the pediatric population.

Please read the conference PDF for more abstract findings.


Going Mobile

5 05 2011

We’re going mobile with our health info.  We’ll keep the websites and social media accounts we currently have, but once we find the funding (a daily mutterance in nonprofit offices worldwide), we’ll add access and tools for mobile users.

Researchers at the Pew Internet & American Life Project and the California Healthcare Foundation  studied mobile technology and found that 85% of American adults use a cell phone, with 17% of them having used their phones to look up health/medical info.  That figure goes up to 29% when we’re talking specifically about younger adults ages 18-29.

We want to stay connected to our audiences and make it easy for people to retrieve the information they need when they need it.  We believe that, just as the use of social media is embedded in the habits of Americans under the age of 30, so will be the use of mobile technology within a few years.  That’s where Americans are headed.  That’s where the world is headed.

A paragraph in the Mobile Health 2010 report reminds us of how social media usage was once talked about, as whispers of a changing reality, and now that reality is here.

“The ‘mobile difference,’ which Pew Internet first identified in 2009, is the observation that once someone has a wireless device, that person is more likely to use the internet to gather information, share information and create new content. These patterns are beginning to emerge in Americans’ pursuit of health information on mobile devices as well as traditional wired computers.”

These patterns will soon be the norm.  Where do you see your public health education dollars being spent over the next five years?

Photo credit: juhansonin

Be Ready to Fight Those Germs!

2 05 2011

(Thanks to our 11-year-old guest blogger, Paloma, for this timely reminder and her exciting design choices!)

When you sneeze or cough and then you touch something, you’re spreading germs all around.

For example, sneezing then climbing into the school bus, touching the hand rail and the backs and bottoms of the seats.  Everywhere your hand touches, it leaves germs behind.


When a kid sneezes or coughs and doesn’t use a tissue or wash their hands after, they spread a lot of germs around.  That’s how a lot of colds and flu and other diseases jump from kid to kid.

To prevent from getting sick or spreading your sickness around, you can wash your hands, and if you don’t have soap around, you can always carry hand sanitizer in whatever you have, like a satchel or a purse.

Kids should bring hand sanitizer to school because school is probably one of the most likely places where you can get sick because little kids are sneezing and touching things after and probably not using a tissue, but I’m sure they do sometimes.

You don’t always know where the germs are because they are little tiny germs and you can get them by just touching one thing that has someone’s germs on it.

Make sure to always wash your hands when you cough or sneeze, and if you don’t have any soap then sanitize. If you don’t have sanitizer make sure you go pick some up.

Germs hate soap and sanitizer.


Always remember to cover your cough with a tissue and when you sneeze cover it up with a tissue. And when you sneeze into a tissue or cough into one you still have to wash your hands or use hand sanitizer. Soap would be better to use if you had some around.  Always wash your hands before dinner or before you empty the dishwasher etc.


Photo credits: Creative Commons, Mountainside Medical, Discovery School