NIIW 2013 – Resources for Vax Educators

23 04 2013

It’s National Infant Immunization Week!

We put out the call for infant vaccination resources that groups were prepared to share, and this is what we received. If you have any tools or resources you can share with others, either hard copies or downloadables, just add them to the comments section.

Vaccinate Your Baby has a nice section on their website of video FAQs, featuring Dr. Paul Offit, Dr. Mark Sawyer, Alison Singer, and Dr. Mary Beth Koslap-Petraco. The videos are very short, and they each ask and answer a question about vaccines. Plus, they have the full transcripts available for download. Nice way to hear how other healthcare professionals answer questions, and something you can show patients.

AAP has a multitude of resources, as you would imagine.

Here’s the Childhood Immunization Support Program Best Practices Summary. Clinicians answer several questions, and their answers are compared to best practices for each question. Sample question: “How does your practice ensure that, whenever possible, immunization appointments are scheduled along with other appointments, to prevent missed opportunities?” Good opportunity to find out how others are overcoming issues related to best practices.

AAP also has a nice page with several provider resources listed for those wanting to communicate with parents of infants, or children of any age.

The Alliance for Immunization in Michigan has a toolkit available for download that addresses infant immunization, as well as immunization in other age groups.

The Illinois Maternal & Child Health Coalition has a Community Immunization Education Guide Toolkit available in English and Spanish. It provides background information that the trainee can use as they train fellow community workers and/or educate the public about immunizations. Key topics include: What is a vaccine preventable disease, what are the five key immunization messages, what do vaccine preventable diseases look like, how to give an excellent presentation.

The Hepatitis B Foundation has a downloadable flyer promoting hep B vaccination.

CDC has an entire infant/toddler immunization section on its website.

Stanford’s Asian Liver Center has a flyer available in multiple languages that addresses HBV and Moms-to-be

CHOP’s Vaccine Education Center has several resources available:

Print materials: – Vaccines and Your Baby booklet; Q and A sheets about related vaccines: rotavirus, hep A, chickenpox, influenza, pertussis; Vaccine safety q and a sheets – facts about childhood vaccines, aluminum, recommended immunization schedule, thimerosal, too many vaccines, vaccine ingredients, vaccines and autism; Clings of the immunization schedule.

Videos: – Vaccines and your baby (for new or expectant parents), Vaccines: Separating Fact from Fear (for parents concerned about vaccine safety)

Parents PACK program – website and monthly e-newsletter (sample)

IAC has several resources for those working with infants:

FOR PARENTS:

Immunizations for Babies  (also available in 8 translations)

Vaccinations for Infants and Children, Age 0–10 Years

Clear Answers & Smart Advice About Your Baby’s Shots by Dr. Ari Brown, MD, FAAP

Cocooning Protects Babies

Personal belief exemptions for vaccination put people at risk. Examine the evidence for yourself.

Questions Parents Ask about Baby Shots   (also available in 8 translations)

Reliable Sources of Immunization Information: Where to go to find answers!

What if you don’t immunize your child?

FOR PROVIDERS:

Vaccine Administration Record for Children and Teens

Summary of Recommendations for Child/Teen Immunization

Recommendations for Pneumococcal Vaccine Use in Children and Teens

Meningococcal Vaccination Recommendations by Age and/or Risk Factor

Screening Checklist for Contraindications to Vaccines for Children and Teens   (also available in 9 translations)

Decision to Not Vaccinate My Child (declination form)

Standing orders for all routine childhood vaccines

PKIDs has several infant-specific resources that anyone may use. There’s a nice section on pertussis with video and audio PSAs, , and other materials for use by providers and parents. For the Make On-Time Vaccination Easy program, there are radio PSAs available for download . There are also videos covering a variety of vaccine-preventable diseases that may be used by anyone as PSAs, or there are longer versions for showing in waiting rooms .





Sports and Infectious Diseases – Part 2 of 3

10 04 2013

bloodborneWhat risk does an athlete with a bloodborne pathogen pose?

The American Academy of Pediatrics tackled this difficult issue in December, 1999, with a policy statement on HIV and Other Bloodborne Viral Pathogens in the Athletic Setting.  In it, the Academy made clear, “Because of the low probability of transmission of their infection to other athletes, athletes infected with HIV, hepatitis B or hepatitis C should be allowed to participate in all sports.”

That participation, however, assumes all athletes and coaches will follow standard precautions to prevent and minimize exposure to bloodborne viruses.  The Academy tackled each infectious disease individually:

HIV: The risk of HIV infection via skin or mucous membrane exposure to blood or other infectious bodily fluids during sports participation is very low . . . such transmission appears to require, in addition to a portal of entry, prolonged exposure to large quantities of blood.  Transmission through intact skin has not been documented: no HIV infections occurred after 2,712 such exposures in 1 large prospective study.  Transmission of HIV in sports has not been documented.  One unsubstantiated report describes possible transmission during a collision between professional soccer players.

Hepatitis B: HBV [hepatitis B virus] is more easily transmitted via exposure to infected blood than is HIV . . . the risk of infection [is] greater if the blood [is] positive for HBV e antigen . . . transmission of infection by contamination of mucous membranes or broken skin with infected blood has been documented, but the magnitude of risk has not been quantified.

Although transmission of HBV is apparently rare in sports, 2 reports document such transmission.  An asymptomatic high school sumo wrestler who had a chronic infection transmitted HBV to other members of his team.  An epidemic of HBV infection occurred through unknown means among Swedish athletes participating in track finding (orienteering).  The epidemiologists concluded that the most likely route of infection was the use of water contaminated with infected blood to clean wounds caused by branches and thorns.

An effective way of preventing HBV transmission in the athletic setting is through immunization of athletes.  The American Academy of Pediatrics (AAP) recommends that all children and adolescents be immunized.  Clinicians and the staff of athletic programs should aggressively promote immunization.

Hepatitis C: Although the transmission risks of HCV infection are not completely understood, the risk of infection from percutaneous [through the skin] exposure to infected blood is estimated to be 10 times greater than that of HIV but lower than that of HBV.  Transmission via contamination of mucous membranes or broken skin also probably has a risk intermediate between that for blood infected with HIV and HBV.

“There is clearly no basis for excluding any student from sports if they are infected,” said Dr. Steven J. Anderson, who was chair of the Academy’s Committee on Sports Medicine and Fitness when it drafted the Academy’s policy, “and we should also try to protect the confidentiality of each athlete.”

Dr. Anderson, a pediatrics professor at the University of Washington and a team doctor for many high school athletic teams, ballet companies and the U.S. Olympic Diving Team, suggests students should have access to any sport, except boxing, which the Academy opposes for all youths because of its physical risks.

“I personally feel parents have no obligation to disclose the infectious status of their children to anyone,” said Dr. Anderson.  Strict compliance with standard precautions is critical for this open-embrace of all athletes, regardless of their infectious status.  Coaches and teachers must have a plan in place to handle blood spills, said Dr. Anderson, including latex [or non-permeable] gloves, occlusive dressings, appropriate sterilizing solutions, disposal bags and even a printed protocol for coaches, athletes and officials.

The following is an excerpt of a sample school policy, used by numerous public school districts and in compliance with ADA that addresses HIV infection:

“The privilege of participating in physical education classes, programs, competitive sports and recess is not conditional on a person’s HIV status.  School authorities will make reasonable accommodations to allow students living with HIV infection to participate in school-sponsored physical activities.

“All employees must consistently adhere to infection control guidelines in locker rooms and all play and athletic settings.  Rulebooks will reflect these guidelines.  First aid kits and standard precautions equipment must be on hand at every athletic event.

“All physical education teachers and athletic program staff will complete an approved first aid and injury prevention course that includes implementation of infection control guidelines.  Student orientation about safety on the playing field will include guidelines for avoiding HIV infection.”

In addition to the Academy, several sports and other health organizations have also weighed in on this issue.  According to the NCAA, National Football League (NFL) and World Health Organization, athletes with HIV should be permitted to participate in all competitive sports at all levels.

These organizations all endorse immunization against hepatitis B for all athletes.

The National Athletic Trainers’ Association (NATA) echoes Dr. Anderson’s suggestion that coaches, trainers, athletic directors, school officials and others take the lead in educating themselves, their teams, parents and their communities about the importance of effective disease prevention.

Trainers and coaches, they suggest, should provide the following information in age-appropriate terms to all participants before or during any competition :

  • The risk of transmission or infection during competition.
  • The risk of transmission or infection generally.
  • The availability of HIV testing (for teens and adults).
  • The availability of hepatitis B vaccination and testing (for parents, teens and adults).

“Athletic trainers who have educational program responsibility should extend educational efforts to include those, such as the athletes’ families and communities, who are directly or indirectly affected by the presence of bloodborne pathogens in athletic competitions,” the NATA stated in a position paper.

See PKIDs’ Infectious Disease Workshop for more information.

Photo courtesy of Lolie Smith





Obesity in Children Often Overlooked by Parents

19 07 2010

We love our kids, no matter what.  We want them to be happy, healthy people, but in the U.S., our children’s health is increasingly at risk from obesity.

A new study “F as in Fat: How Obesity Threatens America’s Future 2010”  released by the Trust for America’s Health and the Robert Wood Johnson Foundation (RWJF) found that 1/3rd of American children are now overweight or obese and nearly 10% of infants and toddlers are overweight. That is triple (triple!!) the childhood obesity rate of 1980.

Polls reveal that many parents believe that childhood obesity is a big problem, yet fail to recognize the problem within their own household. Obesity in children (defined as a body mass index, or BMI, between the 85th and 96th percentile for their age and gender) is reaching such epidemic proportions that Dr. James Marks, RWJF’s senior vice president says,“We’re in danger of raising the first generation of children who could live sicker and die younger than the generation before them” [emphasis added].

First Lady Michelle Obama is tackling the issue with the Let’s Move! campaign, a national effort to bring healthier food to schools and to low-income areas, and to get kids exercising.

From a health standpoint, there are few things a parent can do for a child that are more important than introducing a healthy lifestyle and eating habits.

According to the American Academy of Pediatrics (AAP), here are some actions parents and families can take to encourage healthier habits in kids:  

  1. Make sure your child eats breakfast daily
  2. Choose family meals together rather than eating out
  3. Limit screen time (less than 2 hours per day is recommended)
  4. Pay attention – relatively speaking your child may look “healthy,” but keep in mind that he/she may be surrounded by other overweight kids
  5. Encourage your child to get at least one hour  of exercise each day

It’s been shown time and again that too much screen time, whether sitting in front of video games, television, phones, or computers, is linked to insufficient exercise and an overall sedentary lifestyle, which in turn can lead to overweight kids. Along with eating foods overly packed with fat and calories (such as fast food) American kids are spending too much time sitting around.

In the words of a Nike commercial, we need to get our kids up off the couch, get them outside, and inspire them (hopefully with our own active healthy example) to“Just Do It!”