Archive | September, 2011

Loss is Never Easy

15 Sep

I’m spending my days in a hospice unit, waiting for my mother to pass away, yet terrified at the same time of her loss.  She is 87 and has lived a good life.  But these days remind me too much of 26 days that happened 13 years ago, when my 20 year old son died from meningococcal meningitis.  So much is the same — watching numbers on machines, kissing my mother, kissing my son, telling them how much I love them.  One is dying from old age.  One’s death could have been prevented.  Being in a hospice unit is beyond terrible for me, because as I grieve for my mom, I also am reliving the days my son was sick.  In recent days, politicians have misspoken about vaccine safety.  Don’t believe them.  I have confidence in the FDA and the CDC to protect my children.  In the parking lot this morning, I found a few pennies.  I thought to myself, for a few pennies a day, I could have saved my son with a vaccine, if only I had known.

Protecting Girls and Young Women Now for a Healthier Future

14 Sep

The HPV vaccine is a life-saving vaccine with a proven-safety record. It can protect our young girls and women from cervical cancer later in life. The medical and public health communities are working together to reinforce the importance of HPV prevention. The below statement from the American Academy of Pediatrics (AAP) addresses false statements that were recently made about this vaccine.  Please share this statement with others.

http://www.aap.org/advocacy/releases/hpv2011.pdf

For Immediate Release: September 13, 2011 

Contacts          Debbie Linchesky – dlinchesky@aap.org (847-434-7084)

                       Susan Stevens Martin – ssmartin@aap.org (847-434-7131)

American Academy of Pediatrics Statement on HPV Vaccine

By: O Marion Burton, MD, FAAP, president, American Academy of Pediatrics

“The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation. There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.

“The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That’s because this is the age at which the vaccine produces the best immune response in the body, and because it’s important to protect girls well before the onset of sexual activity. In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer.”

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 The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults. For more information, visit www.aap.org.

Creating a Healthy Future

11 Sep

As I look forward to going home after spending many weeks out of town taking care of my seriously ill mother, I am especially excited to see my new grandson, born a few weeks ago.  I am lucky to have three healthy grandchildren, and they bring me so much joy.  I hope their parents  –my son and his wife — will never go through the sadness and heartache of losing a child, especially losing one to a vaccine-preventable disease, as my husband and I did.  My son knows loss, because he lost his brother to bacterial meningitis at the age of 20.  His grief will never end, nor will my grief and my husband’s grief.  I am thankful that there are vaccines available today to protect my grandchildren, that weren’t available when my children grew up.  But, there are still diseases for which there are no vaccines, so we must never be complacent.  I am very excited that there is already a vaccine for infant meningitis, licensed for 9 month olds, and look forward to other vaccines being licensed in the near future.  I hope that parents will be lined up at their health care providers’ offices when these vaccines are licensed.  Let’s have our children and grandchildren grow up and enjoy life, and not suffer from a vaccine-preventable disease.

Back-to-School Vaccine Checklist

6 Sep

By Mary Beth Koslap-Petraco, DNP, CPNP

The lazy summer days are quickly coming to an end and it is time for all parents to start thinking of getting their children prepared to return to school.  Of course we want our children to be healthy and one of the most important things we can do to keep them healthy is to immunize them.  No matter what age our children are when they are either beginning or returning to school, we as parents need to ensure that our children are fully immunized.

Since different vaccines are indicated for different age groups, let’s review what is needed for school for each age group of children.  Let’s start with nursery school.  Nursery school children need the following:

Age 3-4 years old for children who will be starting or returning to nursery school:
4 doses Diphtheria-Tetanus-Acellular Pertussis (whooping cough) vaccine (DTaP)
3 doses Inactivated Polio vaccine (IPV)
3-4 doses Haemophilus Influenzae type b vaccine (Hib)
4 doses Pneumococcal Conjugate vaccine (PCV13)
3 doses Hepatitis B vaccine (Hep B)
2 doses of Hepatitis A vaccine (Hep A)
1 dose Measles-Mumps-Rubella vaccine (MMR)
1 dose Varicella (chickenpox) vaccine (VAR)

These vaccines are very important for young children.  It takes the full series of each vaccine to offer optimal protection.  The United States has experienced a resurgence of whooping cough, most likely due to children who have not completed the vaccine series and older children and adults who were vaccinated as young children, but whose immunity has worn off.

Now let’s talk about children who will be entering kindergarten.

Age 4-5 year old children who will be starting kindergarten need the following:
5 doses Tetanus-Diphtheria-Acellular Pertussis (whooping cough) vaccine (DTaP)
4 doses Inactivated Polio vaccine (IPV)
3-4 doses Haemophilus Influenzae type b vaccine (Hib)
2 doses Hepatitis A vaccine (Hep A)
4 doses Pneumococcal Conjugate vaccine (PCV7 or PCV13 or a combination of both)

–          A single supplemental dose of PCV13 is recommended for all children 14 -59 months who received an age appropriate series of PCV7
–          A single supplemental dose of PCV13 is recommended for all children 60-71 months with underlying medical conditions who received age appropriate series of PCV7

3 doses Hepatitis B vaccine (Hep B)
2 doses Measles-Mumps-Rubella vaccine (MMR)
2 doses Varicella (chickenpox) vaccine (VAR)

Children entering kindergarten will have received most of the vaccines listed above under nursery school vaccines, but as you can see with the vaccines listed for the 4-5 year old children booster or additional doses of some of the vaccines have been added.  Specifically for kindergarten children need DTaP and IPV boosters and the second doses of MMR and Varicella vaccines.

Unimmunized individuals have contributed to a resurgence of measles.  The US has experienced 156 cases of measles since January 2011.  These cases are occurring in unimmunized US residents who have traveled abroad to countries where measles are widespread.  When these individuals return to the US with measles, both the immunized and unimmunized are put at risk.  No vaccine is one hundred percent effective and once the disease is reintroduced into the community, the chances of anyone contracting measles increases.  This scenario is just what the US is experiencing right now.  Please make sure your 4-5 year old receives the recommended DTaP and IPV boosters, and second doses of MMR and Varicella vaccines to keep themselves and the community healthy.

Many think that once children receive vaccines to start kindergarten they no longer need any more vaccines.  This could not be farther from the truth.  The next group of school aged individuals who need immunizations are adolescents aged 11-12 years old.  If children received all of the vaccines they should have in infancy and for kindergarten, then the following immunizations are indicated.  If adolescents did not finish their vaccine series as very young children, then they might also need additional vaccines in addition to those listed below.

Age 11-12 years old adolescents who will be starting middle school:
1 dose Tdap (a version of the DTaP vaccine for adolescents and adults)
1 dose of meningococcal vaccine (MCV4)
2 doses of Hepatitis A vaccine (Hep A if they have not previously received it)
3 doses of Human Papillomavirus vaccine (HPV)

You might ask why we need to give meningococcal vaccine to adolescents when you probably have never heard of anyone who has had meningitis.  Meningitis is a devastating disease and is often fatal.  Those who do survive are usually changed forever.  They may lose their arms, legs, or both or maybe fingers or toes.  Survivors may be deaf following meningitis.  While the disease is rare, do you want to take the chance that your child may develop it?  And what about HPV vaccine which protects against the most common forms of cervical cancer?  Currently there are two HPV vaccines licensed in the US.  One protects against two of the most common forms of cervical cancer and the other protects against the two most common forms of cervical cancer and genital warts.  Boys can also receive the HPV vaccine that prevents genital warts.

As you prepare your child to head off to college you will want to review that immunization record also.  Your college bound child should have received all of the vaccines we have discussed already, but a review by your child’s health care provider is in order to make sure.  Listed below are the vaccines that we want to make sure your college freshman has received.

1 dose MCV4 (if your child received the first dose before age 16 or has never had a dose)
1 dose VAR (if your child did not receive 2 doses previously)
1-2 doses of Hep A vaccine (if your child did not receive 2 doses previously)
1-3 doses of HPV vaccine (if your child did not receive 3 doses previously)
1 dose Tdap (if our child did not receive a dose previously)

Intervals from one to six months between doses are necessary if your child requires a vaccine that has more than one dose in the series.  Please ask your health care provider about any intervals between doses of vaccine.

If you as the parent will be in contact with children less than 2 years of age you should consider Tdap vaccine for yourself.  Very young babies cannot start the DTaP vaccine series until they are about 2 months old and it takes 4 doses to offer the best protection.  Everyone who comes in contact with infants should get a dose of Tdap vaccine not only to protect themselves against pertussis but especially the babies.  This is called cocooning.  We immunize everyone who comes in contact with the baby to provide a protective cocoon.

There is one final vaccine that everyone 6 months through the entire life span should receive and that is influenza vaccine.  Influenza season begins every year in early fall.  Please make sure everyone in your family receives this vaccine every year.  Influenza is a serious disease that can cause pneumonia and even death and we want to make sure everyone is protected.  If you child is 6 months old through 8 years old your child will need 2 doses of influenza vaccine separated by 4 weeks if this is the first year that the child receives influenza vaccine.

Remember that those school bells are not only signaling the start of a new school year, but a reminder that it is time to check to make sure our children and we as parents are up to date on our vaccines.

Mary Beth is the Coordinator of Child Health for the Suffolk County Department of Health Services. She is a clinical Assistant Professor at SUNY Stony Brook School of Nursing.