Sunday, April 12, 2015

Public Health is Everybody's Responsibility

On Wednesday April 8th, 2015, NBC aired an episode of Law & Order: Special Victims Unit entitled “Granting Immunity” which took the anti-vaccine movement head on. A Jenny McCarthy-look-alike fictional mother “Trudy” falsified immunization records for her son Gabriel with her pediatrician stating, “The risks of vaccination outweigh the benefits. When Gabriel was born, I tried to get a medical or a religious exemption, but I couldn’t get either one.” Trudy’s son Gabriel is dubbed “Patient Zero” by the Centers for Disease Control (CDC) investigators in a string of over 50 cases of measles which resulted around NYC as a result of his lack of immunity to measles during a recent trip to the Philippines. When Trudy is charged with reckless endangerment, she states on the stand that she watched her nephew slowly change after each dose of the MMR vaccine and this is why she chose not to vaccine her own son Gabriel.


On April 28, 2009 Law & Order: Special Victims Unit also aired an episode about measles entitled "Selfish." Guest star Hilary Duff plays young mother Ashlee Walker and she hides the dead body of her two year old daughter Sierra when she thinks she killed her but the medical examiner determines that the cause of death was actually due to measles which Sierra contracted from an unvaccinated child at the playground. Monica Stewart, the mother who stated the measles outbreak by forgoing the necessary vaccine schedule for her children is brought up on charges for young Sierra's death but is found not guilty since she had a religious belief against vaccines. It was determined that she really had a philosophical belief against vaccines but was hiding behind the religious exemption loophole.


These episodes raise an important issue through the characters of Trudy and Monica: the issue that parents still believe that autism is the result of the MMR vaccine. Despite the mountains of evidence in support of this important childhood vaccine series, parents still reference one "study." The fact is that the only “study” which has ever been rumored to have "suggested" such a link (right in that very study it states that no link was found between autism and MMR) was retracted in 2000, yet parents still buy into the belief that vaccines do anything except ensure the sanctity of public health and keep people safe.


In 1998, a study was published in the British medical journal The Lancet which was rumored and presented by the media as having "proved" a link between autism and the MMR vaccine. The study, led by Andrew Wakefield, is widely cited by the anti-vaccine movement as "evidence" of how "the risks far outweigh the benefits of vaccines," as fictional mom Trudy says in the episode. There are many problems with this "study," most notably the fact that it states right within the study that no link was found between autism and the MMR vaccine. Herlihy and Hagood also note some major problems with using this small "study" to justify forgoing important medical treatment including the fact that the study included a small sample size of 12 subjects and the fact that the subjects never had blood tests to verify that they had even received the MMR vaccine in the first place. The many problems with this study led to eleven of the original coauthors rescinding their involvement with the study and the remaining two coauthors losing their medical licenses. Including Andrew Wakefield. Andrew Wakefield has no medical license and continues to use his flawed study to encourage parents to forgo the recommended vaccine schedule. And parents are listening.


Public health is everyone's concern and following the recommended vaccine schedule is the most important thing we can do to keep our population safe. There has never been a single study proving any link between the MMR vaccine and autism. In fact, here is a list of 75 studies which have demonstrated that vaccines are safe, effective and save lives.


The development of vaccines is the single most important human innovation, even more important than industry, than cars, than the Internet. Vaccines are so important because they are the only protection against preventable illness, such as measles, pertussis and smallpox, which have been responsible for massive public health outbreaks and wiping out entire families. Until vaccines, families lived in constant fear that their children would succumb to illness. As Herlihy and Hagood note in their book, “Your Baby’s Best Shot: Why Vaccines are Safe and Save Lives,” prior to the mass availability of vaccines, losing a child to illnesses such as diphtheria, measles and smallpox was so common that the phrase “a real mother” was coined to describe the battles, profound fears and constant child death which mothers faced in the midst of these public health outbreaks. Today, the chance of losing your child to a preventable illness should be slim to none when herd immunity is maintained, but the conscious choice on the part of parents across this country to forgo the necessary vaccine schedule with no good reason at all is violating that herd immunity for all.


Whether you are a nurse, work in health care, a parent or just a human being, public health affects you and keeps you safe. It is our duty as members of this society to fight for public health every chance we can and to celebrate that we no longer fear the wipeout of entire neighborhoods due to illness thanks to vaccines. Encourage every parent you know to vaccinate their children. Get your flu shot annually. And most importantly, never forget that public health is everybody's responsibility.

-Angela Quinn, BSN, RN- Nurses Who Vaccinate Advocacy Director, Social Media & Educational Outreach Coordinator 

Sunday, March 15, 2015

Nurses Are Standing Up for Children Everywhere



Earlier this month, Shot@Life Champions gathered in our nation's capitol, Washington, D.C., to advocate for global childhood immunization programs. Over one hundred volunteers were there to help more children celebrate their 5th birthday by protecting them against vaccine preventable diseases. Nurses Who Vaccinate members were there among American Academy of Pediatrics (AAP), American Association of Nurse Practitioners (AANP), General Federation of Women's Clubs (GWFC), parents, and professional nannies. Together, we met with legislators, attended educational sessions and worked to plan ways to mobilize our communities to take an active participation in helping the United Nations and partners to eliminate childhood deaths from vaccine-preventable diseases.

We had the honor of meeting and hearing from inspirational speakers about UNICEF, the United Nations Foundation, the CDC, even the Ambassador of the United Republic of Tarzania to the United States.

We worked and listened to Paralympian Dennis Ogbe, who contracted polio at age 3 in his native Nigeria. He eventually regained full mobility in one leg and went on to compete in track and field
You can read more about Ogbe and his life story here in an article on CNN.

Paralympian Dennis Ogbe

We met Shot@Life Global Advocate Jo Frost, well known for her role on Supernanny and Extreme Parental Guidance. She advocates for several children and family issues, including food allergies and joined the Shot@Life team as a Global Advocate last year. She personally with Congressman about how in developing countries, parents have many burdens ans obstacles standing in the way of their children accessing vaccines.


NWV Patti .W, Jo Frost, NWV Melody B., NWV Andrea Riley

We had the opportunity to discuss the global issue of access to vaccines with congressmen, congresswomen and their staff. It was an easy conversation to be had- we weren't talking about vaccine choice. We were talking about ways to help parents willing to walk 15 miles to vaccinate their children. It was about preventing 400 daily deaths from measles. We discussed how pneumonia is one of the leading causes of death in children worldwide. We were advocating for continued support for Gavi, the Vaccine Alliance- that would support funding of more than 100,000 pneumococcal vaccines ad 136,00 rotavirus vaccines. We discussed the need for the Measles & Rubella Initative and it's mission to reduce global deaths from measles by at least 95% by the end of 2015 (as compared with 2000 levels). As nurses, we spoke about how close the Global Polio Eradication Initiative is to ending polio worldwide. (How close? #ThisClose).

As constituents it was vital that our members of congress not only knew we supported these global health initiatives, but we were willing to donate our time to help educate the communities and public about how we can give children everywhere a shot a living a healthy life.

Below are the photos from the New York group who led a very busy day with 5 meetings. We weren't alone though- There were approximately 140 meetings with policymakers on Capitol Hill. An additional 1,100 letters voicing support for global vaccines were sent to Congress while we were on the Capitol Hill, further amplifying our message.



Office of Congressman Elliot Engel, Heidi Ross, Senior Leg Assist.
Office of Senator Chuck Schumer, Morgan Brand, Legislative Assist.
        
Office of Kirsten Gillibrand, Denzel Singletary
Congressman Chris Gibson
Office of Congressman Steve Israel, Kyle Hill, Leg. Assist.


NY Shot@Life Champions
NWV Melody B, Kelly P, NWV Patti W, Dr. Barbara B, Holly F.


Throughout the summit, Nurses Who Vaccinate members did what we do best- educate! Some of us discussed the science behind vaccines, our involvement with Shot@Life, and establishing relationships with members of congress. A few of us had the opportunity to present our unique perspectives and share knowledge to help fellow Shot@life champions advocate within their communities on behalf of global childhood immunization programs.



2015 Shot@Life Champion Summit- Washington, D.C.
What we accomplished at the 2015 Shot@Life Champion Summit in Washington, D.C. strengthened our ability to continue our work at home to give every child a shot at healthy life.

But there's plenty you can do right now. It is a perfect time to inform your community and members of congress of the critical value and importance of global childhood vaccines. You'll have an opportunity to join a nationwide event in April called Advocate2Vaccinate.  Advocate2Vaccinate 2015 will take place during World Immunization Week, April 24–April 30. As nurses, you can unite with global vaccine champions across the country to reach three collective goals in three areas: building relationships with your representatives, leveraging the media for advocacy and building community support.

Advocate2Vaccinate 2015
You can learn more about Advocate2Vaccinate next week. Mark your calendars to participate and register for the introductory webinar on Thursday, March 26 at 8 p.m. EST at bit.ly/Advocate2Vaccinate!

Together, we can all stand up for children everywhere.


Tuesday, February 10, 2015

Free Measles Educational Materials for Healthcare Professionals and Patients


During this measles outbreak, Nurses Who Vaccinate would like to encourage our readers to utilize Immunization Actions Coalition’s free educational materials for healthcare professionals and patients; many available in other languages. Please refer to the following information and resources as we all work together to help stop the spread of measles during this multi-state outbreak.
  


Resources about Measles for Healthcare Providers
Resources about Measles for Parents and Patients
Vaccine Hesitancy Resources



Monday, February 9, 2015

Measles- What Nurses Need to Know

Measles was declared eliminated in the US in 2000 but now we are in the midst of a measles outbreak that is pretty near in numbers to an epidemic. So what happened?  There has been a small but growing number of parents who refuse or delay MMR vaccine based on the now discredited study that came out of England some years ago. While the U.S. has an overall high rate of measles immunization, pockets of unvaccinated children in some communities leave everyone vulnerable.  

Measles is the most infectious of all diseases. If you are not immune and walk into a room previously occupied by a person infected with measles 2 hours ago, you WILL most likely get measles. Unvaccinated people can hide in the head in the US because we have so many vaccinated here but once that unvaccinated person goes somewhere where measles is epidemic, that person can bring measles back here and cause a measles outbreak of catastrophic proportions. 

Once measles gets into the community, it is very difficult to eliminate it. 


So what are nurses to do? 


Nurses need to make sure that they are:
  • protected.
  • able recognize signs and symptoms of measles,
  • up-to-date with latest treatments.
  • using a respectful and effective method of education with vaccine-hesitant patients and families.
Protection

When it comes to making sure you are protected that means verifying your vaccination status. You should have been vaccinated yourself unless you are old enough to have had the disease yourself. According to the CDC:
If you were born in 1957 or later and have not had the MMR vaccine, or if you don't have an up-to-date blood test that shows you are immune to measles or mumps (i.e., no serologic evidence of immunity or prior vaccination), get 2 doses of MMR (1 dose now and the 2nd dose at least 28 days later). If you were born in 1957 or later and have not had the MMR vaccine, or if you don't have an up-to-date blood test that shows you are immune to rubella, only 1 dose of MMR is recommended. However, you may end up receiving 2 doses, because the rubella component is in the combination vaccine with measles and mumps. For health care workers born before 1957, see the MMR ACIP vaccine recommendations.

Signs and Symptoms of Measles


It can be quite difficult in the winter season, with cold and influenza patients seeking treatment, to differentiate measles patients from others early in the infection. 
  • 7-14 days after incubation, catarrhal symptoms manifest themselves.  They include: cough, soreness, temperature, sore throat, rhinorrhea (runny nose), and conjuctivitis (red eyes).
  • 2-4 days into the infection, Koplik spots (small white spots) resembling grains of salt, appear on the inside of the mouth.
  • 3-5 days after the initial symptoms, an itchy macular rash (reddish flat) and papules (solid, raised spots) develop on the face.
  • Within 1-2 days, the rash spreads to the trunk, arms and legs, while a rash on the face began to fade. At this point of the disease, the patient's temperature can reach as high as 104.
It is important to remember that the patient is infectious 2-4 days before the rash appears and remains infectious 2-5 days after the onset of the rash.



Treatment

There is no treatment for uncomplicated measles. The interventions below are to provide support and treatment of the symptoms. 
  • Isolation- Patients will need to be on isolation precautions to decrease transmission within the community. Emphasize the need for immediate isolation when early catarrhal symptoms appear 
  • Skin care- Measles causes extreme pruritus. Nursing interventions include keeping the patient's nails short, encourage long pants and sleeves to prevent scratching, keeping skin moist with health care provider recommended lotions, and avoiding sunlight and heat. 
  • Eye care- Treat conjunctivitis with warm saline when removing eye secretions and encourage patient not to rub eyes. Protect the eyes from glare of strong light.
  • Hydration- encourage oral hydration. Medical literature encourages the use of Oral Re-hydration Solution. 
  • Temperature control- Antipyretics should be administered to the patient as ordered for a temperature greater than 100.4 Fahrenheit unless directed elsewise by a healthcare provider. Be sure to remind parents not to administer aspirin due to the risk of Rey's syndrome.
  • Supplements- Vitamin A has been shown to help decrease mortality in children under the age of two years. The American Academy of Pediatrics  provides dosage recommendations here.
Patients should seek emergency medical treatment for the following signs and symptoms-

  • -Intolerance to food and/or unable to drink adequately.
  • -Altered level of consciousness and/or seizures.
  • -Severe respiratory infection.
  • -Severe diarrhea
Patient Education


The best way to treat measles is to prevent it. The best prevention is vaccination. The vaccine used to prevent the measles is the MMR vaccine (measeles, mumps, and rubella). According the the National Center for Immunization and Respiratory Diseases, "Two doses of this vaccine are needed for complete protection. Children should be given the first dose of MMR vaccine at 12 to 15 months of age. The second dose can be given 4 weeks later, but is usually given before the start of kindergarten at 4 to 6 years of age." 

Patients and parents will often have questions and concerns about the MMR vaccine used to prevent the illness due to the large amount of misinformation circulating the internet. Be sure to provide up-to-date handouts and patient education materials when the opportunity presents itself. The CDC provides patient education in a range of different languages, such as Spanish. If you're looking for studies that debunk the vaccines/autism myth- here is a list of 107 peer-reviewed, evidence-based research studies that show there is NO LINK between autism and vaccines. We also suggest providing them with this powerful letter written by famous children's author Roald Dahl about his personal (heartbreaking) experience with measles. 

The most important part of addressing and educating vaccine-hesitant patients is listening to the concerns expressed by patients and others who question vaccines. The following is a guided walk-though that allows nurses to effectively respond to frequently asked questions about vaccine safety.

  • Express your understanding of their reservations.
  • Explain to them that you have educated yourself about the dangers of measles disease because you want or be able to help them make healthy decisions for themselves and their children.
  • Tell them stories about measles disease in friends or family if you know any.
  • Then explain the science behind the safety of MMR vaccine and as a scientist yourself you trust the science.
  • Then tell them you are vaccinated yourself and you want to offer the same protection to them or their child and you want to vaccinate them today.
If this framework of conversation sounds familiar, it's based on the CASE method, a framework of conversation many of us at Nurses Who Vaccinate use for communicating with patients and families.  
Try it.

Nurses are the most trusted of all professions. Let's use that trust to help our patients and prevent them from the ravages of the measles. You can save a life doing this. And no one does it better than nurses!


Check Out Additional Educational Resources

Thursday, February 5, 2015

Guest Blog: Patients Should Speak Up, and Speak Out, About Anti-Vaccine Nurses


Vaccines are safe and save lives.


That is the determination of decades of research into and development of vaccines. Vaccines are considered by the vast majority of people to be one of the, if not THE, most important medical breakthrough during the last century. Billions of cases of disease have been prevented, millions of lives have been saved, and incalculable misery has been avoided, all because of vaccines. Say it aloud- Vaccines are one of the most successful public health initiatives EVER.

"Vaccines save tens of thousands of children every year. Vaccination has eliminated or reduced a wide range of once-common diseases in the U.S. [and everywhere else]. Without current vaccines, approximately 42,000 of the 4.1 million children born in the U.S. in 2009 would die early deaths. For that same group of kids, researchers estimate that vaccines have prevented and will prevent 20 million cases of disease." - Kevin Loria, Business Insider

That’s why when I see a nurse or other health care worker spouting anti-vaccine propaganda and lies, I question their ability to adequately care for me or for other patients. And I question why they are working in a science-related field at all.

Recently, I’ve seen a small but extremely vocal movement of nurses and other health care workers who are openly rejecting science and research by advocating against vaccines. These so-called professionals are taking pride in making statements that are the antithesis of hundreds of thousands of studies, conducted by experts, monitoring the efficacy, effectiveness, and safety of vaccines. It’s troubling to me that health care workers would dismiss science in favor of unproven nonsense.

Many of these health care workers repeat and spread misinformation regarding vaccines, such as the lie “vaccines didn’t reduce disease” (yes, they did) or “vaccines are more dangerous than diseases” (no, they are not).  Most troubling of all, it’s not uncommon for anti-vaccine and anti-science health care workers to reject even germ theory, claiming that germs do not cause disease. How can someone whose job it is to care for people who are physically vulnerable reject the very basis of their field?

These anti-science health care workers place their patients and their communities at risk through their actions and through their beliefs. As a past patient, I would not want such a person caring for me, a loved one, or indeed anyone in a health care setting.  Health care clinics and hospitals should not allow their employees to threaten the physical health of their patients through rejection of proven science. The existence of such employees undermines the trust that patients should have in their health care providers.




Nurses Who Vaccinate member Allison Hagood is the co-author of “Your Baby’s Best Shot: Why Vaccines are Safe and Save Lives."

Click here to join the Nurses Who Vaccinate movement. Speak up.

Nurses Who Vaccinate is a non-profit and relies on donations from people like you to further our cause. No amount is too small.

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- NursesWhoVaccinate@gmail.com


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 NursesWhoVaccinate@gmail.com. Looking forward to seeing you all there!