Wednesday, January 28, 2015

When A Nursing Student Depends on Others To Protect Her

Nursing student Rachel writes about how being unable to rely on her immune system has made her into a stronger vaccine advocate.

Like every little kid, I always changed my career plans. However, unlike, most kids, they all had one common theme: they were all medical or health care fields. I switched from veterinarian to doctor, from pharmacist to physical therapist, and so on. All throughout my childhood and high school, I immersed myself in medical shows such as Mystery Diagnosis and researched different diseases and medical treatments just because I found them fascinating. Like my mechanical engineer brother whose first word was “car”, my family had a pretty good idea of what field I would be going into.

When I finally graduated high school, I decided to go into nursing. With so many interests, I felt that with a career in nursing, I would have many opportunities to explore new fields.  As I progressed through nursing school, I learned more and more about what I was interested in, but more than that, I fell in love with the field. I knew this is what I wanted to be doing with my life.

One topic I frequently researched in my free time was vaccines, and it developed into a passion of mine. I believe that education is one of the most important things we can do as nurses. The topic of vaccines is especially important to discuss because it is a subject flooded with misinformation. I used the knowledge I have acquired to discuss the topic with patients who refused vaccines for themselves or their children. I was very careful not to sound accusatory or pushy, and discussing the topic with patients allowed them to explore their fears and misconceptions about vaccination, and some of the patients changed their minds about them. This is something I’m very proud of.

Everything was going great, but the summer before my senior year, I noticed something was wrong. Long story short, I was diagnosed with Microscopic Polyangiitis (MPA), which is a rare autoimmune vasculitis of the small and medium-sized vessels in the body. Most patients are either middle-aged or elderly, but I was only 21-years old. In my case, it had affected the vessels in my skin, joints, lungs, eyes, and kidneys, but can also affect the ears and GI tract. The only treatment available for many autoimmune diseases is to suppress your immune system. While my first thought should have been directed towards my health, it was actually, “How can I continue nursing if I’m immunosupressed?” It was a scary time for my family and I.

I was extremely fortunate to have been diagnosed so early and over the summer before school started back up again. Even though my case was considered severe because I experienced an alveolar hemorrhage, there was no noticeable permanent lung damage, the kidney damage was minimal, and there was no permanent damage to anything else. I responded to treatment, Rituxan infusions and high dose prednisone, quite well (even though no one likes to be on prednisone). Most people who are diagnosed are not as fortunate as I have been and have more severe kidney and/or lung damage. After talking to my rheumatologist, he said I can continue nursing school and clinicals, but that I had to be careful and wear a mask around patients with URIs and certain other illnesses for the time being.

Thankfully, my diagnosis hasn’t otherwise affected my performance in nursing school. After completing over 3 years of schooling, I wasn’t going to let my diagnosis stop me. Other students noticed that my face got a bit puffier from the prednisone, but most of them didn’t say anything and thankfully, I’m now off of prednisone and the puffiness is gone. I’ve discussed my diagnosis with a few of the other students when it came up and used it as an opportunity to educate them. After exploring my interests, I ultimately fell in love with pharmacology and the operating room, which is why I’m striving to eventually become a CRNA. I’m now in the last semester of my senior year, and I’m set to graduate with my BSN from Rutgers in May.

I was a huge advocate of vaccines before my diagnosis, but this solidified my beliefs. I had to start treatment before the annual flu vaccine was available, so by the time I received it, my body couldn't create an immune response to it. I have to rely on others to be vaccinated in order to protect myself. With a weakened immune system and no B-cells, I’m vulnerable to many illnesses and catching them could be dangerous for me. Not many people under 60 can claim to have received the pneumococcal vaccine, but I am one of them. And since MPA has a high relapse rate, I will be receiving maintenance infusions of Rituxan every four months for two years.

My diagnosis, while not pleasant, has had many upsides. I learned what it was like to be a patient and how scary it is to be uncertain about your health. I’ve learned what it’s like to be dismissed, like when people just don’t believe you or think you’re making things up when you know something’s wrong. I’ve learned how frustrating it is be NPO for long periods of time, and go through test after test only to find nothing. I learned how important community immunity is for individuals like myself. But maybe most importantly, although MPA may not have left me physically stronger, it has certainly has made me mentally stronger, and it given me a new perspective that will allow me to be the best nurse I can be.

Nurses Who Vaccinate member Rachel Herman is in the last semester at Rutgers Camden for her BSN. Most of her interests are ridiculously nerdy, but she also loves animals, music, and traveling. She is by no means a writer, and hopes to pursue a career as a nurse anesthetist.

Do you have a story you would like to share with Nurses Who Vaccinate? Email us here-

Tuesday, January 6, 2015

Online Forum For NWV Members

Nurses Who Vaccinate has created an online forum on Facebook for our members! Designed to be a interactive community, the purpose is to discuss vaccine news and Nurses Who Vaccinate events, educational & advocacy opportunities. The group is open to all Nurses Who Vaccinate members.

Before requesting to join, make sure you're a member of Nurses Who Vaccinate. You can check your status and sign up here- Membership Link.

Once you're a member, you can request to join the group, by clicking this link here- Forum Link

All requests will be processed by the NWV group administrators. Any questions or concerns, please email us at Looking forward to seeing you all there!

Thursday, December 4, 2014

CDC's Emergency Flu Health Advisory

The CDC has released an emergency advisory about influenza

The CDC advisory states that so far this season, influenza A (H3N2) viruses have been reported most frequently and have been detected in almost all states. This announcement comes along during a season that has already presented a few "Flu Season Surprises."

Why does this matter? During past seasons when influenza A (H3N2) viruses have predominated, higher overall and age-specific hospitalization rates and more mortality have been observed. Unfortunately 52% of the influenza A (H3N2) viruses collected and analyzed were antigenically different from the vaccine.

What that means is that the vaccine is not as close of a match for these circulating strains as scientists had hoped.  All things considered, clinicians should encourage all patients 6 months and older who have not yet received an influenza vaccine this season to be vaccinated against influenza. As nurses, it is important to share this update and stress to patients that the influenza vaccines still do protect against certain strains of the flu. While not 100% (and no vaccine is), being vaccinated to protect against the flu reduces the risk of influenza complications even among the strains that have mutated.

The CDC also stresses the usage of antiviral medications when needed and deemed appropriate. Roche's Tamiflu and GlaxoSmithKline's Relenza can shorten flu symptoms by around half a day however the CDC states that the benefit of these drugs is greatest when treatment is started early in the course of the infection.

You may see notorious websites using this information as a reason to refuse or avoid the influenza vaccine. Remember--Just because the vaccine is not a “perfect match” to  influenza A (H3N2) does not mean ones should refuse getting vaccinated. There are still other strains circulating and the vaccines still provide protection. If in the event you see websites or news sources advising against vaccination, contact them with the correct information, or direct them to the CDC for clarification. Voices for Vaccines recently wrote a blog post about the effectiveness of the influenza vaccine, and though not impervious, the influenza vaccine can make the difference of a child recovering from the flu at home on the couch or being treated in Pediatric Intensive Care Unit on a ventilator.

What else can we as nurses do to reduce the transmission of the influenza virus? 

Along with the flu prevention tips in the graphic above, the CDC urges you to "Take 3 Actions" to protect yourself and others from influenza (the flu).

  • 1-Take time to get a flu vaccine.
  • 2-Take everyday preventive actions to stop the spread of germs.
  • 3-Take flu antiviral drugs if your doctor prescribes them.

Skeptical Raptor provides a tl;dr version- The flu vaccine is incredibly safe. It’s fairly effective, though that can vary from year to year as flu variants mutate, like this year. This year’s vaccine may not be able to prevent a new variant of H3N2 flu, but it may lessen the symptoms of the variant.

The flu season has only just begun, and we've already had five flu-related pediatric deaths. It is imperative that nurses to educate patients, colleagues and their communities about the need to vaccinate against the flu. Protection is still protection, which is better than no protection at all. 

Tuesday, December 2, 2014

Nurses Need to Lead the Way When It Comes to Flu Shots

In recognition of National Influenza Vaccination Week (NIVW) Nurses Who Vaccinate is participating in a blog relay as part of a countdown to the first day of NIVW. 

Each day, a different Flu Vaccination Digital Ambassador will post about the importance of flu vaccination as it relates to their readers. You can follow the NIVW conversation on Twitter using hashtag #NIVW2014 and stay tuned as each Digital Ambassador shares who will be posting next.

-NIVW Blog Relay Schedule-

Monday, December 1  –     A Place for Mom – adults 65 years and older
Tuesday, December 2 –      Nurses Who Vaccinate – health care professionals
Wednesday, December 3  - Voices for Vaccines – parents and caregivers of young children
Thursday, December 4  –   Shot of Prevention – pregnant women and parents
Friday, December 5  –       Healtheo360 – people with a chronic illness, like heart disease or diabetes
Saturday, December 6 –    HealthCentral – people with asthma 
Sunday, December 7 – Cold & Flu – people at any age or stage of life

Nurses Who Vaccinate are proud to be partnering with our fellow Digital Ambassadors in sharing the importance of influenza vaccines in the week preceding National Influenza Vaccination Week (NIVW). Initiated by the CDC in 2005 to highlight the importance of continuing flu vaccination through the holiday season and beyond, this year's NIVW is scheduled for December 7-13, 2014.

Nurses are the leading teachers of health care.

Nurses are the main health care workers responsible for educating patients and communities. Like many public health initiatives, the best way to educate our patients about vaccines is to lead by example.

We can only expect our patients to follow our medical advice when we implement it ourselves. We need to walk the walk if we're going to talk the talk. A nurses' role is not limited to administering vaccinations.  It is a nurses' responsibility to be vaccinated and, importantly, do so publicly.

Many nurses and doctors have taken to social media to share that they've received their influenza vaccines. Many of our Nurses Who Vaccinate members have done just that!

Another way to demonstrate the evidence-based side of nursing is by taking the CDC Flu Vaccination Pledge for the 2014-2015 Season. Nurses are also encouraged to participate the  CDC-hosted Twitter chat on Tuesday, December 9 from 1­2pm EST. Nurses can follow this event on Twitter at  @CDCFlu, and with the hashtag #NIVW2014.
The chat will:
o Emphasize that getting vaccinated in December, January and beyond may still provide protective
benefit against influenza.
o Remind parents and providers of the need for certain children to receive a second dose of flu vaccine for optimal protection.
o Provide an opportunity for people to ask questions about the flu and flu vaccination.

The influenza vaccine is safe and effective.

Vaccinating nurses and health care workers has been proven to be effective in protecting patients from influenza. Several studies have shown that vaccination of health care workers protect elderly patients in long-term care. One analysis predicted that if all health care workers in a facility were vaccinated, then approximately 60% of patient influenza infections could be prevented.

Yet, the final numbers for last flu season reported that health care worker influenza vaccination coverage was only 75.2% , similar to coverage of 72.0% in the 2012-13 season. We need to do better.

According to the American Public Health Association, "Influenza vaccination of health care workers is the single most important measure for preventing occupation-acquired and nosocomial influenza from both known and unexpected sources. Other measures, such as hand hygiene and barrier precautions, are additional protective steps, not alternatives. Masks or respirators, whether worn by people with influenza-like illness (ILI) symptoms or those who are in proximity to them, are not as protective as preexposure immunization, especially given the high proportion of asymptomatic infectious people."

You can join the growing number of nurses who are getting their influenza vaccine. Be one of the main pro-science nurses proudly saying, "I won't spread the flu to my patients or my family this year!"

If you've already received your yearly influenza vaccine for this flu season-- kudos and THANK YOU! You're setting a positive example among your co-workers and patients.

Are you encountering questions and concerns from others who are flu vaccine hesitant? Seeing a large number of flu-refusing, mask-wearing co-workers? The CDC has complied common questions and misconceptions about influenza vaccines and answered them on this page. Feel free to print it out for educational handout material and even post it in the break room! Looking for more influenza information to help encourage colleagues to get their flu shots? Check out the CDC Flu campaign for healthcare workers. If you're uncomfortable answering questions personally, send them our way via email-

Remember: CDC says an annual flu vaccination is the best protection against flu. Nurses get your flu vaccine and encourage other healthcare workers to do the same by sharing your flu vaccine selfies (#vaxselfies) on social media using the #VaxWithMe tag! Be sure to stop by the other NIVW relay participants’ blogs to learn about flu vaccination for everyone – tomorrow’s post will be hosted by our friends over at Voices for Vaccines.

Nurses Who Vaccinate are nurses and health care workers who care about themselves, patients and communities. Are you a pro-science nurse? Supporter of evidence-based nurses? Become a member- 

Friday, November 21, 2014

Americans Finally Have Access to Technology to Prevent Deaths from Meningococcal Disease Serogroup B

Americans finally have access to technology to prevent deaths from Meningococcal disease Serogroup B, but will they use it?

My 17-year-old daughter Kimberly died from meningococcal disease serogroup B in 2012.  She had been vaccinated with the current U.S. vaccine, which protects against serogroups A, C, W and Y.  Until now, there had not been a meningococcal B vaccine in the U.S.  Trumenba, a vaccine which will potentially protect against meningococcal disease, serogroup B, was approved by the FDA on October 29, 2014.

"We have been working around the clock since Trumenba was approved by the U.S. Food and Drug
Administration on Oct. 29 to supply Trumenba in the U.S., as the most frequent question we have been asked following approval is when the vaccine would be available here," stated Susan Silbermann, president and general manager of Pfizer Vaccines. "As of Nov. 18, Trumenba is available for order by health care providers, retail pharmacies, hospitals and college health centers who may be interested in stocking and administering the vaccine."

According to the Centers for Disease Control and Prevention, about 500 total cases of   meningococcal disease were reported in the United States in 2012; of those cases, 160 were caused by serogroup B.  My daughter was 1 of 160 of those cases in 2012.  160 cases may seem like a low number but serogroup B accounts for 30% of meningococcal disease in the U.S.

My healthy child was robbed of her young life and declared brain dead after nine days of fighting for her life against meningococcemia.  She died during her last week of high school.  She was registered to begin nursing school in the fall of 2012.  She wanted to follow in my footsteps as a nurse.  Her dream was to be a pediatric nurse.

Meningococcal disease is a life-threatening illness caused by bacteria that infect the bloodstream and the lining that surrounds the brain and spinal cord.  N. meningitidis is a leading cause of bacterial meningitis. The bacteria are transmitted from person to person through respiratory or throat secretions (e.g., by coughing, kissing, or sharing eating utensils).

The symptoms of meningococcal disease are fever, joint pain, extreme headache, sensitivity to light, vomiting and in the case of meningococcemia – a purplish rash.  A person does not have to exhibit all of these symptoms.  In fact, my daughter’s symptoms were a temperature of 101 and joint pain.  Typical symptoms of the flu.  It wasn’t until the following morning that she developed petechiae and I rushed her to the Emergency Room.  In spite of being diagnosed and treated immediately, she did not survive. This disease acts very quickly and a healthy person can die from meningococcal disease within 24 hours.

We are waiting for the February meeting of the Advisory Committee on Immunization Practices (ACIP) to announce their recommendations on when to use this vaccine in early 2015 and be covered under medical insurance.  It is my hope that it will be on added to the current immunization schedule as soon as possible. With a vaccine available for the B serogroup, we will have the broadest protection available to protect against all five of the most common strains in the U.S. It would be a tragedy if Americans didn't taken advantage of this life-saving vaccine, to prevent a deadly disease from taking away more children from their parents.

Patti Wukovits, R.N. Secretary of Nurses Who Vaccinate
Patti Wukovits has been a nurse for 8 years. She is a certified oncology nurse and a M.O.M. (Mom on Meningitis) with the National Meningitis Association. Married with 4 children (one son, angel daughter Kim, a stepson and a stepdaughter). Her mission is to spread awareness of meningococcal disease - to be the voice for her daughter Kim. She is the founder of The Kimberly Coffey Foundation. Their mission is "Educating the public and healthcare professionals about bacterial meningitis (meningococcal disease), including the symptoms of the disease and the importance of prevention through vaccination. Our vision is a world without meningococcal disease." The Foundation plans to make nursing scholarships available in Kim's name as well as through the Foundation.
To make a donation, please send to:
The Kimberly Coffey Foundation

P.O. Box 344
Massapequa Park, NY 11762

Thursday, October 30, 2014

Demand More Than a Paper Mask

My Facebook newsfeed is inundated with Ebola panic.  I am a nurse, so many of my Facebook friends are also nurses, or have various healthcare roles.  I have never before seen this many nurses be this upset about an infectious disease.  So I would like to ask everyone who is panicking about Ebola a few questions.

-If there was a thoroughly tested Ebola vaccine, would you get it right now?

-If the hospital you worked for required you to get this Ebola vaccine during this Ebola season, would you refuse?

-If you did in fact refuse, how would you feel if the hospital you worked for required you to wear a paper mask in lieu of the vaccine?

-If you were the coworker (or more importantly the patient) of a nurse refusing the vaccine and choosing to wear the mask, would you feel a simple paper mask was sufficient to prevent the spread of Ebola?

-Would you be upset if they pulled the mask down to cough or sneeze? Would you be upset if they removed the mask while in the break room, or on their way to the cafeteria to grab some lunch?

-Assume you are a patient and your nurse walks into your room wearing a mask.   You ask why they are wearing a mask and they responded that they were required to because they refused the Ebola vaccine.  When you voice some concern, they say "Oh, it's just Ebola."  How would that make you feel?

-Would you be concerned if your unvaccinated nurse previously cared for a patient with Ebola, and then came to work not feeling so well and then cared for you?

How would that make you feel, if you knew nurses refusing a vaccine for a disease that takes anywhere from 3,000 to 48,000 lives a year in this country? But wait a minute.... Ebola doesn't claim thousands of lives in the United States, nor is there a vaccine available for the public.

But influenza has been documented to kill thousands in a season. Yet, while there are vaccines to prevent transmission, people, even nurses, still refuse to get their annual flu shot.

Think about that for a moment.  

Although not gloriously paraded around social media at the moment, influenza can kill up to 50,000 Americans each year.  Be alarmed!  Influenza is more contagious than Ebola.  But guess what?  We can prevent some of those cases and save some of those lives by vaccinating ourselves and our patients.

Ebola has killed one person who traveled to the United States.  It has no vaccine.  It has killed approximately 4,000 worldwide.  If you are upset about Ebola, that's normal and understandable.  But you should also be upset about influenza, measles, and pertussis, amongst others.

Infectious diseases should upset nurses.  Preventable infectious diseases that are being spread due to vaccine refusal should really upset nurses.  Seeing colleagues willingly refuse their influenza vaccines based on misinformation should really really upset pro-science nurses.

Protect your patients.  Demand preparation.  Demand those you work with to join you in protecting the patients, each other and your community.  Get your flu vaccine!

"Ebola is very scary. But people in the United States are frightened of Ebola for statistically very little good reason. It's fear disproportionate to the risk. Influenza has far too little fear based on the risk. It's fascinating to me to see social media panic and listen to people worried about Ebola who have never had an influenza vaccine, where statistically the thing you will get this year is influenza. You'll probably do yourself and those around you the most good by getting a flu shot." - David Cennimo, infectious disease physician/assistant professor of medicine and pediatrics at Rutgers New Jersey Medical School.

Nurses Who Vaccinate member Margaret Smith is a Registered Nurse from Sacramento, California.  She is currently working in Gastroenterology and Quality Management, but her primary background is in Emergency nursing.  Margaret holds a Bachelors of Science from Grove City College, and studied nursing in Pittsburgh, Pennsylvania.  She is currently pursuing her BSN and MSN.  Margaret became passionate about vaccine promotion after having her first child, when she became aware of the anti-vaccine movement and local parents choosing not to vaccinate.  She has a husband, two daughters, a dog, and two cats, all fully vaccinated.  ;)  Her one wish is that nurses and healthcare professionals everywhere would understand and accept evidenced based practice and educate their patients accordingly.

Friday, October 24, 2014

Why Are Nurses Celebrating World Polio Day?

While some nurses are busy huffing and puffing about refusing free influenza shots, other nurses are taking action to protect children around the world from vaccine preventable diseases. One of these diseases they’re working to eradicate is the infamous Poliovirus. Today, we’re closer than ever to ridding the world of this devastating disease. However while the vast majority of the world is polio-free, there are still three countries where the wild poliovirus has never been stopped: Afghanistan, Nigeria, and Pakistan… Nearly 80 percent of all polio cases are concentrated in Pakistan. The two other remaining polio-endemic countries continue to show progress. Nigeria has decreased polio cases by 87 percent and Afghanistan has recorded fewer than 10 cases of this devastating disease. The remaining 1 percent of polio cases are the most difficult to prevent, due to factors such as geographical isolation, poor public infrastructure, armed conflict, and cultural barriers.

But what are nurses, so far and removed, in developed countries doing to stop polio?

They are celebrating World Polio Day. 

Every year, World Polio Day provides an opportunity to recognize the importance of polio eradication efforts. World Polio Day was established to commemorate the birth of Jonas Salk, who led the first team to develop a vaccine against poliomyelitis. Use of this inactivated poliovirus vaccine and subsequent widespread use of the oral poliovirus, developed by Albert Sabin, led to the establishment of the Global Polio Eradication Initiative (GPEI) in 1988. Since then, GPEI has reduced polio worldwide by 99%.

World Polio Day represents celebration and awareness: We should celebrate the success of the polio eradication efforts- the millions of lives that have been saved and the fact that the polio vaccine has helped children avoid the devastating complications of polio. However we need to be aware of the need to continue the work that that is necessary to completely eradicate this horrid disease.

Rotary's campaign End Polio Now makes it easy for busy healthcare workers(who aren’t wasting time organizing protests against life-saving vaccines). The vast majority of nurses are pro-science and advocate for usage of medical technology that keeps patients and communities healthy.  If you’re one to recognize the positive impact that vaccines have made on lives everywhere, check out a Rotary chapter in your area. They’ve been playing a major role in the fight against polio. When Rotary began the fight in 1985, polio affected 350,000 people, mostly children, in 125 countries every year. Since then, polio cases have dropped by more than 99 percent. To date, Rotary has contributed $1.3 billion and countless volunteer hours to protect more than two billion children. After nearly 30 years, the Global Polio Eradication Initiative stands on the brink of history by making polio only the second human disease to be stopped forever.

To mark World Polio Day, Rotary will host a live-streamed global status update on the fight to end polio. Invited guests include Global Polio Eradication Initiative partners; celebrity ambassadors, including Ziggy Marley; polio survivors, including inspirational athlete Minda Dentler; and Rotary members. Nurses are encouraged to watch and live-tweet support during the event.
Link -

Nurses are busy working here in the United States to address these global concerns. Many are working towards a solution here in our own back yard, with Shot@Life, a UN Foundation campaign that educates, connects and empowers Americans to champion vaccines as one of the most cost-effective ways to save the lives of children in developing countries. If advocacy is your calling, sign up to become a champion today.

 Nurses Who Vaccinate members are sharing personal stories about polio on blogs and social media. You can also read a post here by Nurses Who Vaccinate member Julie Cali, about how polio has and still continues to affect her family today. She’s working hard to share her story and to educate others about the importance of vaccinating.

And Nurses Who Vaccinate members are celebrating World Polio Day by doing what they do best- throwing a party. If you’re in the New York/Long Island area tonight, you can also stop by our World Polio Day event, Nurses Night Out. Nurses and healthcare workers are some of the most compassionate people, and as we thank them for working hard to keep our communities safe and healthy, we’re going to be educating them on how everyone can play a part in this historical movement.

While it may be too late to host your own World Polio Day event, you can make a difference in many ways. You can donate to causes on the front lines, tweet and blog about polio, and watch the live-streamed events. Together, let us celebrate vaccines and work together to ensure that children everywhere are protected from vaccine preventable diseases and have a shot at life.