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Mark Probert
August 1st 03, 07:02 PM
CDC Focuses on Late-Vaccinated Toddlers
Fri Aug 1, 9:12 AM ET

By LAURAN NEERGAARD, AP Medical Writer

WASHINGTON - Mary-Clayton Enderlein worried when a baby brought to her
son's play date had a very distinctive cough — a high-pitched "whoop"
while gasping for air. It might indeed be whooping cough, the baby's
mother agreed, explaining that the family didn't believe in vaccines
against that or any other disease.


A week later, a now-coughing Enderlein gave birth to her second son —
and the newborn promptly sickened, too. Little Colin spent 10 days in
intensive care in a Seattle hospital, turning blue as 50 coughs in a row
would wrack his body. It took months for Enderlein, Colin and the
playmate who infected them to all recover.

About 75 percent of the nation's toddlers get vaccinated on time,
protecting them from getting — and spreading — nine different diseases.

But coverage varies widely among states and major cities, with pockets
of the country where far too few youngsters are up-to-date on their
shots, federal health officials warned Thursday as they urged
communities to eliminate those disparities.

As Enderlein's scare shows, getting shots late or not at all doesn't
just endanger the unvaccinated child. He or she in turn can spread
disease to people with weakened immune systems like elderly
grandparents, friends with cancer, pregnant neighbors or younger
children — a reason that so-called community immunity is vital to public
health.

Last year, Colorado had the most immunization laggards, with just 62.7
percent of toddlers getting all their shots, the Centers for Disease
Control and Prevention (news - web sites) said.

Nine other states have fewer than 70 percent on-time toddler
vaccinations: Arizona, Idaho, Kansas, Louisiana, Montana, New Mexico,
Oklahoma, Texas and Washington.

Massachusetts was doing the best job, immunizing 86 percent of toddlers
on time. Also raising the national average were the five other New
England states as well as North Carolina, Georgia, Michigan, Wisconsin
and South Dakota — states that immunize more than 80 percent of toddlers
on time.

There was even more variation when CDC checked records of some large
cities. In Newark, N.J., for example, just 57.5 percent of toddlers had
up-to-date shots.

The government's goal is that by 2010, 80 percent of all toddlers get
on-time vaccinations against diphtheria, whooping cough, tetanus,
meningitis-causing Haemophilus influenza or Hib, hepatitis B, polio
(news - web sites), measles, mumps and rubella.

Nationally, vaccination rates for those diseases have remained about the
same for the last few years, as doctors struggled to keep toddlers up to
date amid shortages of some key shots. So far this year, supplies seem
adequate.

In addition to the nine most-measured vaccines, toddlers are supposed to
get shots against chickenpox and the pneumococcal vaccine that protects
against certain types of meningitis and ear infections. Last year, a
record 81 percent of toddlers received the chickenpox inoculation, up
from 76 percent in 2001, the CDC said. And 41 percent of youngsters
received the pneumococcal immunization, the first time the CDC ever
counted this vaccine, which hit the market in 2000.

It's not clear why some states have a harder time vaccinating, said CDC
immunization chief Dr. Walter Orenstein.

Vaccine-phobic parents like the mother Enderlein encountered are a
minority — well over 90 percent of infants get vaccinated. Instead,
Orenstein said, simply remembering to keep up with the roughly 20 doses
required by age 2 is hard for parents and doctors alike.

CDC's advice:

_States should identify communities where vaccination rates are
significantly below the national average and eliminate the disparities.
Poorer children are most likely to be missed.

_Parents should get their child's immunization records and ask if the
child is up to date every time they see the pediatrician.



_Doctors should check vaccine records even if the child is just in for,
say, an ear exam. Any visit is an opportunity to give a missed vaccine.

_States should invest in computerized vaccination registries, which can
automatically send parents reminders about overdue shots and help keep
physician records up to date.

"If we let down our guard ... vaccine-preventable diseases will return,"
Orenstein warned.

JG
August 1st 03, 09:06 PM
The M-C anecdote as told by Reuters (www.reutershealth.com, Health
eLine, 8/1/03):


Doubters trouble U.S. immunization professionals

Last Updated: 2003-08-01 10:40:30 -0400 (Reuters Health)

By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) - Mary-Clayton Enderlein was worried when a friend
came by with a wheezing, coughing infant.

"I said, 'I think your child has whooping cough,"' said Enderlein, a
nurse. She was surprised, as whooping cough, which can kill babies, is
one of the first vaccines a child is supposed to receive, by the age of
2 months.

"She said she didn't believe in immunizations," Enderlein said.

A week later Enderlein, then nine months pregnant, came down with a
violent cough just before she gave birth to a healthy son, Colin.

"When I kissed him, I passed on pertussis (whooping cough) to him,"
Enderlein told a news conference. Both infants ended up in intensive
care and Colin nearly died.

Enderlein was angry at first but now wants to educate parents who oppose
getting their children vaccinated.

"I live in Seattle--we have a lot of that going on," she said in an
interview. "People are skeptical of the government, they are skeptical
about side effects. They are living an alternative lifestyle."

Before immunizations became widespread, an average of 147,000 people in
the United States developed whooping cough every year and 9,000 died.

The U.S. Centers for Disease Control and Prevention says 62 U.S.
children died of whooping cough between 1997 and 2000.

Overall, 75 percent of U.S. children have received the full schedule of
shots to protect against polio, mumps, measles, rubella (German
measles), Haemophilus influenzae B, hepatitis B, diphtheria, whooping
cough and tetanus.

PARENTS OPTING OUT

Although children cannot enroll in school or day-care without the shots,
states often allow parents whose religions forbid vaccination to send
their children to school.

Texas and Arkansas this year also passed laws allowing "conscientious or
philosophical" exemptions.

Parents need to be able to make such choices for themselves, argues
Kathi Williams of the Vienna, Virginia-based National Vaccine
Information Center.

"Our group was formed because our kids were injured by vaccines,"
Williams said in a telephone interview. "We are not anti-vaccine. But I
think parents have legitimate concerns about the number of vaccines
their children are given and the vaccine schedule."

Williams, who believes her son suffered brain damage after receiving the
combined diphtheria, pertussis (whooping cough) and tetanus vaccine 20
years ago, said many parents feel backed against a wall by "all or
nothing" vaccine requirements.

But vaccine advocates worry that parents do not understand the risks.
"We can respect some choices, such as smoking," said Lynn Frank, chief
of public health services in Montgomery County, Maryland. "But I cannot
really respect choices that will lead to the death of a child."

Enderlein also believes in choices. "However, a choice not to immunize
is a choice that affects the whole community," she said.

Measles kills 1.1 million children around the world every year, about
half of them in Africa. In the Netherlands, 3,000 cases of measles and
three deaths were reported in 2000 after a small group of children at
one school were not vaccinated for religious reasons and many became
infected.

"We need to do a better job educating parents," said Dr. David Neumann,
head of the National Partnership for Immunization.

Roger Schlafly
August 1st 03, 09:25 PM
"JG" > wrote
> > The government's goal is that by 2010, 80 percent of all toddlers get
> > on-time vaccinations against diphtheria, whooping cough, tetanus,
> > meningitis-causing Haemophilus influenza or Hib, hepatitis B, polio
> > (news - web sites), measles, mumps and rubella.
> Someone call WHO(!); I read a couple of days ago that "they" think
> eradicating polio by 2005 is "doable" (given MORE money, natch!).

And polio was already eradicated from N.America many years
ago. The polio vaccine is a sacred cow. The pro-vaccine folks
might still be urging polio vaccines in 2010, even if polio is eradicated
worldwide in 2005.

> > "If we let down our guard ... vaccine-preventable diseases will
> > return," Orenstein warned.
> *Yawn*

See the other story about vaccination rates at an all-time high?

As I write this, Dr. Dean Edell is reciting the M-C nurse story on
his radio program. He says that parents making choices about
vaccines is about like drivers making choices about how fast
they go. It seems like a wacky analogy from someone whose
main political cause is legalized marijuana.

JG
August 1st 03, 10:09 PM
"Roger Schlafly" > wrote in message
t...
> "JG" > wrote

> See the other story about vaccination rates at an all-time high?

Yes; it looks like the federal public health poohbahs could use someone
more adept at timing press releases! <g>

> As I write this, Dr. Dean Edell is reciting the M-C nurse story on
> his radio program. He says that parents making choices about
> vaccines is about like drivers making choices about how fast
> they go. It seems like a wacky analogy from someone whose
> main political cause is legalized marijuana.

Hehehe. An ophthalmologist dispensing advice about
vaccinations...sheesh. Anyone call in to point out the (timing) flaws
in M-C's "A week later..." story?

JG

Roger Schlafly
August 1st 03, 10:29 PM
"JG" > wrote
> Hehehe. An ophthalmologist dispensing advice about
> vaccinations...sheesh. Anyone call in to point out the (timing) flaws
> in M-C's "A week later..." story?

No, Dean Edell doesn't take contrary calls. If he did, he'd surely
get a lot on circumcision and recreational drug use, where he often
states controversial opinions.