Monday, March 28, 2011

Mom to Mom: Karen Ernst

Editor's Note: From time to time, we'll feature a blog post by a parent who vaccinates. If you're a parent who vaccinates or who was afraid of vaccines but now vaccinates and would like to write a guest post for us, please contact us. We'd love to hear from you!

If your children are vaccinated, why do you care whether or not I vaccinate mine?

Most of the parenting decisions I have made are none of your business.  Did I breastfeed or bottle feed my children?  Did I Ferberize them or sleep next to them in my bed?  Did I stay home with them or maintain my career and send them to day care?  I'm not telling you because these are personal decisions which will have no effect on your life or the lives of your children.

The decision to vaccinate my children, however, is not personal.  It is a matter of public health.  And I have the right to know that my neighbors, and that you, are vaccinating.  The answer about why I do care hinges on the concept of herd immunity.

Do not be fooled by herd immunity naysayers.  Doctors noticed the benefits of having a large population immune to certain diseases during the smallpox outbreaks in the nineteenth century.  150 years ago, doctors noted that in communties where a large percentage of the population had either been innoculated or had contracted smallpox, the virus could not make inroads and did not effect the susceptible remainders of the community. (See Fine P (1993). "Herd immunity: history, theory, practice". Epidemiol Rev 15 (2): 265–302.)  In the mid-twentieth century, public health officials used herd immunity to eradicate smallpox from the planet.

Herd immunity functions properly when enough of us are vaccinated to hinder the introduction of certain diseases into our communities.  For example, polio has been absent from the United States since 1994 simply because enough of us have received the polio vaccination.  The virus has trouble finding  bodies to grow in, and therefore it isn't in circulation.  But when too few of us are vaccinated, we find ourselves in the midst of an outbreak, like the measles outbreak Minnesotans are living through right now.

But my children are vaccinated, so why should I worry about the measles outbreak or the unvaccinated lot who are allowing the measles virus to circulate throughout our community?

Vaccines are not a guarantee.  They can't always provide complete immunity for every person every time.  The MMR vaccine produces immunity in 95% of those who receive the first dose.  Doctors intend for the second dose to catch those who did not build immunity after the first dose.  Nonetheless,  some who are vaccinated are still not immune.  

Not everyone can be vaccinated.  Some people are too immuno-compromised to receive the vaccine,  others have allergies to some of the components, and some are too young to receive the vaccine.  Many of those who died in this year's pertussis outbreak in California were too young to have completed the immunization against it.  

And some people in our world have such weakened immune systems that their survival depends on the health of the community.   The mother who has terminal cancer deserves to spend as many days as possible with her children without her life being cut short by a vaccine-preventable disease.  Grandchildren do not want to lose their grandparents early due to a bout of influenza.

I care whether or not you vaccinate because I care not only about my children and their health, but I care about others in my community.  I care about the people I see every day who have asthma or rheumatoid arthitis, and so I get my kids their shots, and I want you to do the same.

Karen Ernst is outnumbered by the four main men in her life, ages thirty-something, seventeen, seven, and two.  She is currently a stay-at-home mom, but has also worked as a high school English teacher, where, among other things, she taught her students to examine the credibility of what they read and the reliability of their own assumptions.  She carries this passion into her armchair advocacy for vaccines.

Friday, March 25, 2011

Source for New Parents with Questions About Vaccines

Please visit Just the Vax's blog and question forum with any questions or concerns you may have about vaccines, vaccine safety, schedules, claims you may have heard from parents who don't vaccinate out of fear, and more. Here you will find science-based information from Science Mom and Catherina relayed in a calm, clear, nonjudgmental manner.

If you have heard from a fellow parent that vaccines are dangerous. I urge you to visit this valuable blog. We know you're going to do your homework when it comes to your kids. Here's one of your most important assignments ;-)

P.S. and then pass the link along to other new or expecting parents who have questions.

Wednesday, March 23, 2011

Measles Herd Immunity in Minnesota is Gone

Yesterday, Minnesota Public Radio reported that public health authorities are saying that 85% of two-year-olds in Minnesota have been vaccinated against measles, mumps, and rubella.

It's official: herd immunity is gone.

Herd immunity dies when vaccination rates dip below about 95%. If your child is unvaccinated, or has not received his or her booster, this is a potentially dangerous situation.

What Should I Do if I Live in Minnesota and...

My child is too young to be vaccinated: the outbreak is currently taking place in Hennepin County, most likely Minneapolis. While about half of the infected children are from the Somali community, the other half are from the community at large. We suggest staying away from public places where young children congregate, within reason. Skip that trip to the Children's Museum for now. Take a raincheck on playdates if you can't be sure everyone there has been vaccinated. If you must take your child to the pediatrician, try to stay in the "newborn" section (most pediatric practices have this) and cover your child's car seat with a blanket.

My child has not been vaccinated, but is old enough for the MMR: Get your child vaccinated. Today. Hennepin County has been holding free immunization clinics in Minneapolis that have been poorly attended. The details are below:

Sunday, March 27, 1-4pm, Children's Hospitals & Clinics, Minneapolis Speciality Center, 2530 Chicago Avenue South, third floor. 

Families with or without health insurance may attend these clinics; those with insurance should bring their insurance cards, those without insurance will not be charged for their vaccinations.

MMR shots also are available to the public at all regularly scheduled Hennepin County Immunization Services walk-in clinics.  MMR shots also are generally available, by appointment, from most family practice and pediatrician medical offices.

My child has been vaccinated, but is age four or under: Hennepin County is advising all parents of children who have received the MMR vaccine to schedule his or her booster--typically due at the four-year physical--now. For example, one of our children is turning four next month. He'll be going in to get his booster next week. One of us has an eighteen-month-old who received her MMR at her 12-month appointment; she will also be getting her booster next week.

Opposed to Vaccination? Let's Make that Sting

We're a little late in posting the op/ed on vaccination in yesterday's Strib, which was written by one of the Moms Who Vax, Ashley Shelby. The Star Tribune editor told Ashley that it was the most-read Opinion piece that day, at least online. And, of course, it stirred up quite a response.

The op/ed focused on creating trade-offs for parents who choose not to vaccinate--higher health insurance premiums, restrictions on attending private preschools and daycares, instituting sincerity testing, and closing the conscientious opt-out loophole in Minnesota's immunization statute. That being said, the Moms Who Vax initiative comes to the vaccine issue assuming that we have already lost the parents who are currently not vaccinating due to misinformation about vaccine safety. They are hardened in their beliefs, can find other parents who support to those beliefs, however devoid of science and common sense they are. Proof of this could be found in the one or two e-mails Ashley received from defensive anti-vaxxers. (It was heartening to learn that she hadn't received much hate e-mail).

We will not try to convert. It is a waste of our precious time and resources.

We will try to help new parents understand vaccine safety and why vaccination is so crucial for their children's health and well-being, but also for the community's health and well-being. One of the more selfish elements of the anti-vax movement has to do with nonvaccinating parents' reliance on herd immunity. If the majority--overwhelming majority, actually--95%--of the population vaccinates, their unvaccinated children should be safe. The problem is that herd immunity is fading fast.

In the case of measles in Minnesota, herd immunity is gone. 85% of parents vaccinate against measles, mumps, and rubella. Let that sink in for a minute.

Let's also make one thing clear about the Moms Who Vax. It should go without saying, but here it is: we have no--absolutely zero--connection to the pharmaceutical companies that make vaccines. In fact, Ashley Shelby has written very critically in the past about pharmaceutical companies on her blog Science for Sale. So yeah, we're not "pawns" of Big Pharma. We're moms who live in Hopkins, Minnesota, Upper Montclair, New Jersey, St. Paul, Minnesota, San Rafael, California, and beyond.

Monday, March 21, 2011

Andrew Wakefield in Twin Cities to Speak to Somali Community

A friend of mine at the Minnesota Department of Health told me that disgraced doctor--and elaborate fraudster--Andrew Wakefield has made his way to the Twin Cities this week to speak to the Somali community about vaccines. He will be speaking at a Somali restaurant. I don't have the address yet, but I will post it when I find out.

Minnesota's measles outbreak has made national news, largely because of the sheer number of infected children (equalling in a single month the total number of measles cases recorded in Minnesota in the last five years) and because the outbreak was started by an unvaccinated child. The story becomes even more layered when you take into account the outbreak is taking place largely in the Somali community at the moment, where vaccination rates are hovering around 30% because of fear of vaccines. This fear has been fanned by people like Wakefield, who was here in December warning parents against vaccines, and Generation Rescue, which sends volunteers into the community as "advocates" but who instead infect worried parents with bogus fears of vaccine danger.

The Minnesota Department of Health may stage a counter-event, but they are very keen to let the leadership within the Somali community lead the way, something Wakefield and Generation Rescue, and other anti-vax folks have not bothered about. There are a number of vocal pediatricians and doctors of Somali descent trying to speak out about this, but I believe this requires a community-wide effort. Very unfortunately, the public health authorities are mistrusted; volunteers from Generation Rescue have told many Somali parents that the Department of Health doesn't care about their children or their concerns. It's time for those of us who vaccinate our kids to step forward and take our place on the front line to combat this, or else more unvaccinated children--including babies too young to be immunized--fall seriously ill, or die.

Sunday, March 20, 2011

Anti-Vaxxers and Somali Immigrants: Biography of a Measles Outbreak

When I told my husband about the measles outbreak in the Minnesota Somali community, he was rendered speechless. As an immigrant himself—he immigrated to this country from Peru with his family when he was eleven—he found the idea of immigrants, especially from developing nations, refusing vaccinations straining his credulity. In Peru, and certainly in other developing nations, preventable diseases run rampant because of a scarcity of vaccines. Measles is widespread in Africa, including Kenya, from where the Somali infant believed to be the source of the current outbreak had just returned after a trip. Polio is still extant in Asia, including India. Seeing these horrors first-hand, and wanting vaccines for their children but being unable to get them, made vaccines a no-brainer when my husband’s family came to the United States.

“Immigrants are the first ones in line at immunization clinics,” my husband said. “I just don’t understand why this immigrant community would be anti-vaxxers.”

I know.

The Somali communities in both Minnesota and Sweden, which are roughly on the same latitude lines (this comes into play later), have been suffering what seems like higher than normal occurrences of autism in their children. Faced with a terrifying illness with no easy answers, Somali immigrants have often been understandably frightened and looking for reasons why their children have changed so dramatically. Autism rates in Somali are so low as to be considered non-existent. There must be something happening in this new country that is causing this dread disease.

Anti-vaxxers saw an in. Typically unconcerned with lower-income immigrant populations, they saw this cluster of fear as an opportunity to advance their misinformation campaign. Generation Rescue, in particular, made it their mission to begin “educating” Minnesota Somalis about the non-existent links between autism and vaccines. Patti Carroll, a mother living in Shoreview, Minnesota, and a Generation Rescue volunteer, took it upon herself to “advocate” for Somali parents who were parents of autistic children and didn’t want to vaccinate their other children because of the fear of vaccines. She attended a community meeting, that was also attended by representatives from the Minnesota Department of Health and, as she writes, “My suspicions were confirmed: the Department of Health was planning to assure the Somali parents that there was no connection between vaccines and autism.” Incidentally, here is a link to her article:

She subsequently was part of an effort to get copies of the film Autism Yesterday—Autism is Reversable, a 26-minute “documentary” that advances claims that autism is reversible and “preventable," subtitled in the Somali language and circulated in other “Somali settlements.”
            In 2009, the New York Times focused on Generation Rescue’s attempt to terrify Somali parents into not vaccinating their children, and to be suspicious of medical authorities, and even their own pediatricians. JB Handley of the organization actually told Somali parents, point-blank, that their children’s autism was caused by vaccines. From the New York Times, 

[Handley] warned them not to trust the state health department and suggested they slow down their children’s shots and get exemptions to school vaccination requirements. He also offered to pay for some to attend an antivaccine conference.

It is no wonder that vaccination rates among Minnesota Somalis have fallen to 30%. Yes. You read that right. 70% of Somali children are unvaccinated. And a large number of these children return regularly to the African continent, where communicable, vaccine-preventable diseases are commonplace. Generation Rescue, and anti-vaxxers caught up in the Somali question, have used these desperate parents as pawns in their despicable misinformation campaign. And it won’ t be long before these Somali families are not only coping with autism, but with children disabled, or killed, by preventable diseases. The anti-vax campaign has been so successful that last December, Andrew Wakefield was invited by the Somali community to speak on autism and vaccines. 

The blame for this will fall squarely on the shoulders of anti-vaccine advocates who gunned for this vulnerable population. Somalis are a vulnerable population because they are new immigrants, many of them don't speak the language, and precious few of us in Minnesota speak theirs, and they are suddenly faced with a strange new disease that seems to be affecting a large number of children in their community. Doctors, correctly, can give them no definitive answers. People from organizations like Generation Rescue tell these parents that they do have definitive answers--vaccines cause autism. And when these unvaccinated children begin developing autism at the same rate as the vaccinated population, I wonder what their answer will be then. We can no longer afford to sit by and watch this unfold. We must step forward as vaccinating parents and make our voices heard.

Incidentally, one of the more interesting theories about the cluster of autism cases in both Minnesota and Sweden has to do with Vitamin D deficiency. Individuals with darker skin require more Vitamin D, and with the sun too far from the earth in both Sweden and Minnesota during the winter months, even pale-skinned folks like me suffer from Vitamin D deficiency. But I’ll get into that in another post.

For now, we must begin try to repair the damage done by the anti-vax campaign in the Somali community. 

Friday, March 18, 2011

The Moms Who Vax Manifesto

In a San Diego pediatrician’s office in 2008, Megan Campbell waited with her ten-month-old son in the waiting room with an unvaccinated seven-year-old boy and his parents. She didn’t know he wasn’t vaccinated. She also didn’t know he had measles. Within days, her ten-month-old was in the hospital, fighting for his life, infected with the measles the unvaccinated child had brought back with him after a trip to Switzerland. The 2008 San Diego measles outbreak was triggered by a pocket of parents who believed the MMR vaccine was worse than the disease it prevents. Eleven people were infected, and forty-eight children too young to be vaccinated had to be quarantined. Megan Campbell’s son, thankfully, recovered, but barely. I wish this were an isolated incident. Measles is in Minnesota.
With news that six area children, including infants, were diagnosed with measles in Hennepin County, several of them unvaccinated because of parental fears, it has become clear that despite heroic efforts, the medical and public health establishment has failed to counteract claims of vaccine danger that have about as much veracity as Sasquatch sightings. It is the very success of the public health system in nearly eradicating what were once terrifying childhood diseases that makes its job so difficult now.
It’s time for the gloves to come off, and for the medical community, the public health authorities, legislators, and—perhaps most important—the overwhelming majority of parents, like me, who choose to vaccinate their children to stop being Minnesota Nice. Despite the fact that science had tried and failed to find any link between vaccines and autism, the percentage of unvaccinated Minnesota children continues to rise. The miniscule amounts of aluminum in vaccines, which some parents cite as a reason for not vaccinating their children, is a fraction of the amount of aluminum we ingest in self-rising flour. A breast-fed infant ingests seven times more aluminum in the first six months of breastfeeding than is present in the entire recommended course of childhood vaccines.
But this isn’t about science. If it were, nearly everyone would be vaccinated. This is about fear, and truth rarely trumps fear. The decision not to vaccinate has been made too easy. Because the risk of debilitating, and potentially disabling, illness, and even death, seems, for many parents, not a compelling enough reason to vaccinate, it may be time to try other tactics. There is currently no real repercussion, no real trade-offs, besides this risk, for parents who choose not to vaccinate out of fear. I am proposing some.

Higher insurance premiums for the non-vaccinated

Institute higher health insurance premiums for those who choose not to vaccinate their children for “philosophical reasons.” Parents who choose not to vaccinate are overwhelmingly the middle to upper-middle class individuals most likely to have private insurance. Insurance companies know which of their clients vaccinate. Those who have inadvertently—or purposefully—missed a scheduled vaccine often receive a reminder from the insurance company in the mail. Insurance companies need to see unvaccinated children for what they are—higher-risk clients. Just like a diabetic refusing to take his or her medication, the risk of illness skyrockets when preventive health measures are deliberately not taken, resulting in higher costs for the insurer. A compromise between kicking parents who choose not to vaccinate off their policies and letting it go without consequence would be to institute higher premiums for these families. After all, the cost of a measles outbreak affects the bottom line of not just the insurance carrier associated with the unvaccinated carrier, but also the insurer of individuals too young to have received vaccinations who were infected by that unvaccinated child—like Megan Campbell’s ten-month-old son.

Make it easier for daycares and preschools to refuse admission to the unvaccinated

State law requires that parents produce a vaccination record before enrolling children in school or daycare. But it would be a mistake to take comfort in this law, because all one needs to do to free oneself from our obligation to vaccinate one’s children before they enter a child care setting is walk down to the local notary and sign the “conscientious objection” opt-out line. Right now, because unvaccinated parents have followed Minnesota statute 121A.15 by obtaining the notarization, they are in “compliance” with Minnesota state law and can’t be refused admission to a childcare facility. It’s time to allow these childcare facilities—day care and preschools—to protect their students by making vaccination 100% mandatory if they want to do so. Right now, many of us leave our children in school environments in which other children may or may not be vaccinated, and that is a risk many of us are not willing to take anymore, especially if we have an infant at home.

Institute Sincerity Testing in Minnesota

In New York State, parents who want to opt-out of vaccines for philosophical or religious reasons are required to do a little more leg-work than heading down to the notary. They must undergo sincerity testing before a religious waiver is granted (in New York state, many parents who are fearful of vaccines claim religious exemption). This testing determines that the parents’ claimed religious belief is genuinely religious in nature, rather than secular. These typically consist of questionnaires, affidavits, and occasionally more detailed questions. Instituting sincerity testing may cut down on the more casual non-vaccinators, who have been infected, themselves, by blogs, Jenny McCarthy, and the other usual suspects.

Remove the conscientious objection opt-out from Minnesota state law.

While unlikely to happen, removing this loophole in our immunization statute, 121A.15, would go a long way to ensuring that measles, pertussis, and polio outbreaks caused by unvaccinated children would return to the history books, where they belong.

Here's the deal. We breastfed, too. Some of us co-slept. We feed our kids organic foods. We use BPA-free bottles and we scrutinize labels for phthalates, EDTA, and parabens. But that's because the science is on our side in these crusades. Science is on the side of vaccines. And we're sick of standing on the sidelines, letting Jenny McCarthy speak for "Mommies." (Incidentally--you'll find no "mommies" here, only women who are also mothers. We like "moms.") It is partly our fault that the anti-vaxxers have taken over the dialogue. The majority of us who vax sat idly by, saying nothing, while this very vocal fringe group has wreaked havoc in our public health system, put their own kids, and others, at risk, and created controversy where none exists. In the meantime, children have died. And not just the ones whose parents made the decision on their behalf to skip vaccinations. Infants, like Megan Campbell's son, too young to be vaccinated, have gone through physical agony--their parents through psychological agony-- because of someone else's fear-based decision. Some of them have died. The thought of planning a funeral for an infant who died because someone else decided not to vaccinate their kid is part of what kindles the fire that powers this blog. So yeah, we're done being nice. It's on. 
. The time is now. Join us. And now, here is a cute photo of some vaccinated children....Enjoy!