Saturday, May 27, 2017

Why Nurses Need to Advocate for Patients to Recieve Chickenpox Vaccine

Nurses, do you have unpleasant memories of getting the chickenpox when you were young? Some of us may remember having an uncomfortable rash, staying home from school for a week, and trying not to scratch the scabs. Some may even remember the oatmeal baths that did not work as promised.

Many nurses were told that "It is a rite of passage" because all of their friends got it—It was just "part of growing up." With chickenpox being as contagious as it it, it was no wonder so many caught it. One child can spread it to another from 1 to 2 days before they get the rash until all their chickenpox blisters have formed scabs (usually 5-7 days).

But, now, our patients don’t have to suffer the way we did, because there’s a vaccine to protect them against chickenpox.


Before the chickenpox vaccine became available in 1995, nearly 11,000 people were hospitalized every year and about 50 children died. The disease can cause serious complications, even in healthy children. These complications include skin infections, lung infections (pneumonia), swelling of the brain, bleeding problems, blood stream infections (sepsis), and dehydration. In Pakistan, 2017 has brought at least 17 deaths from chickenpox, and the year is only half way. Earlier this year, a 6 year old girl died enroute to a London hospital from complications associated with varicella. 

“The most important thing to remember is that we cannot predict which child will get a serious case or have complications from the chickenpox,” explained Dr. Stephanie Bialek at the CDC. “The chickenpox vaccine is very safe, and about 90% of kids who get both recommended doses of the chickenpox vaccine are protected against the disease. Therefore, we recommend that children get vaccinated.”

CDC recommends pediatric patients receive the first dose of the chickenpox vaccine at age 12 through 15 months old and the second at age 4 through 6 years. Some children do get the disease even after they are vaccinated, but it’s usually milder. Children who get chickenpox after vaccination typically have fewer red spots or blisters and mild or no fever. The chickenpox vaccine prevents almost all cases of severe disease. If a patient has only received one dose in the past, check to see if they can qualify for a second dose.

Have an adult patient questioning whether they should get the varicella vaccine? All adults who never received the chickenpox vaccine and never had the chickenpox should receive the vaccine. If they are unsure about their vaccine statues, it's recommended by experts that they receive the vaccine. Adults who are at higher risk of exposure should especially consider vaccination. They include healthcare workers, college students, teachers, and daycare workers. 



Nurses need to be strong advocates in encouraging patients and families to vaccinate for chickenpox. A strong recommendation can go a long way in preventing unnecessary suffering and even death.

If you have questions about the childhood immunization schedule, you can find more information about vaccines here. Looking for more information about chickenpox? Click here.

Saturday, December 17, 2016

An Important Change this Flu Season: The Injectable Vaccine is Better than the Nasal Spray

Each year, the Centers for Disease control recommends that all healthy people ages 6 months and older get their annual influenza vaccines as early into the season as possible.
For this 2016-2017 influenza season, there is one important change: everyone should get the injectable form instead of the live nasal mist vaccine which may not be as effective. 

Source: http://philcoiinetnetau.blogspot.com/2011_03_01_archive.html
Influenza can be deadly for everyone but especially for children, older adults and those who are immunocompromised. The CDC estimates that about 114,000 people are hospitalized each year for influenza.

It’s very challenging to determine the number of deaths which may be attributed to influenza but the CDC estimates CDC estimates that the number of influenza-related deaths can range from as low as 3,000 to as high as 49,000 people each influenza season.

The annual influenza season typically begins around October but varies based on the first reported cases of influenza. During most influenza seasons, flu activity generally peaks between December and March. During some seasons, positive cases of influenza have continued as late as May.
To build immunity before flu season peaks in the winter, the CDC recommends that flu vaccines be offered as early as possible and flu vaccines are generally available in late August or early September.
Some people worry that if they get the flu vaccine too early into the season that it won’t be effective for the duration of the season. For most healthy adults under age 65, getting the vaccine as early as possible helps to ensure your immune system has time to build an adequate response and that your protection lasts throughout the flu season.
For older adults above the age of 65, their immunity to the flu vaccine may start to decrease throughout the season so FLUAD, a higher dose vaccine with an added adjuvant to enhance the immune response, is recommended for this age group.
It’s especially important that healthcare workers and anyone who works closely with young children or young adults get their annual flu vaccines to ensure that we don’t inadvertently contract influenza and spread it to these vulnerable populations.

As a Registered Nurse, I provide care for many adults whose immune systems are compromised due to current infections or diseases such as COPD, diabetes and cardiac dysfunction. I got my flu vaccine at work early September, and of course, I took my third annual FluShotSelfie since I’ve become a nurse. I always encourage my coworkers to get their flu vaccines as early as possible and encourage them to post their vaccine selfies as well.
I offer the flu vaccine to each and every one of my eligible patients and offer education to them when they are feeling hesitant or unsure about whether they actually need the vaccine. “Are you alive?” I jokingly ask my patients. When they reply, “yes,” I always smile and tell them that the flu vaccine is definitely for them, then!
Whether you’re working with patients or not, getting a flu vaccine each year is a fantastic way to protect yourselves, your families and your communities!
If you do choose to get your flu shot, be sure to share it with us or post a picture to your social media accounts and use the following hashtags:

Friday, December 9, 2016

Silly Rabbit, Flu Shots Aren't Just For Kids!


Growing up, I used to hide the Trix cereal from my parents. In my defense, I was only following the directions from the advertisements I saw on television. You know the ones. The Trix commercials featured a rabbit, whose name is 'coincidentally' Tricks, and in every commercial he continually attempted to trick children into giving him a bowl of cereal. He was discovered every time; and the kids who would reclaim the cereal would say, "Silly rabbit, Trix are for kids!"
So of course, I'd hide the cereal and when my parents would find it, behind the couch, in the closet, under the table... I'd tell them, "Silly dad, Trix are for kids, not dads!"


Flash forward several years later, I'm chatting with a friend who is the parent of young children. She mentions that her children had just received their flu shots and were most upset that the doctor's office was out of stickers than the actual administration of the vaccine itself. I asked her when she was planning on getting hers, and she looked me, like I was being silly and said, "Flu shots are just for kids, I don't need one, right?"


With that, I went into nurse-mode and responded, "You don't need one if you don't mind chancing a risk of contracting the flu virus, getting sick and possibly transmitting to your family, and yes even those who have been vaccinated, are still at risk. People of every age, including people in good health, are at risk of flu." She was shocked, because like others, she thought the influenza vaccine was just recommended for children and immunocompromised patients. I gave her a bit more information about influenza. Like how the CDC recommends that everyone 6 months and older should get a flu vaccine every year by the end of October, if possible. I told her, getting vaccinated later is OK.  It's not too late to vaccinate throughout the flu season, even in January or later. I also shared that although a majority of hospitalizations and deaths occur in people 65 years and older, even healthy young children and younger adults can have severe disease or even die from influenza.


Which brings us to this year's National Influenza Vaccination Week's 2016 key message- It's not too late to get a flu shot and everyone should get one.


With the holiday season among us, we're spending time with loved ones, participating in community events and ultimately taking part in activities that allow for an easy transmission of the flu virus. Flu activity is usually highest between December and February, though activity can last as late as May. As long as flu activity is ongoing, it’s not too late to get vaccinated, even in January or later.


As a nurse, I frequently tell my patients and my friends that not only does a flu vaccine protect you, it also protects your loved ones from the flu. Getting vaccinated protests those around you, including
those who are more vulnerable to serious flu illness, like babies and young children, older people, and
people with certain chronic health conditions.

The flu virus is spread mostly by direct contact and droplets. When a sick person coughs or sneezes, virus droplets can travel six feet or more. If you're in close quarters, like most families, one sick family member will very easily transmit the virus to other family members.

According to the Centers for Disease Control and Prevention (CDC), “most healthy adults are able to infect other people beginning day before symptoms develop and up to 5 to 7 days after becoming sick.”


As per the CDC, community immunity is “When a critical portion of a community is immunized against a contagious disease, most members of the community are protected against that disease because there is little opportunity for an outbreak. Even those who are not eligible for certain vaccines — such as very young infants or immunocompromised individuals — get some protection because the spread of contagious disease is contained.”

When the overwhelming majority of people are vaccinated, our communities are kept safe. Do your part, protect your family by getting your yearly influenza vaccine. Take it from Nurses Who Vaccinate members, who know that unlike breakfast cereal, Flu Shots aren't just for kids!



"As a nurse, I take my role as a patient advocate seriously. Advocating for my patients also means protecting them, which is why I always get my annual flu shot. Getting vaccinated against the flu keeps me safe and helps prevent the spread of infection to the vulnerable people that I'm caring for during my shifts. The flu can be deadly for anyone of any age, and getting vaccinated is a great way to keep the entire community safe!" -Angela Daly, RN, Cardiac Float Nurse

"I'm a single mother of one. My fully vaccinated daughter learned the value of vaccines when she had the flu at age 6 in 1992. When she was well enough, I explained how she could prevent becoming so ill. Not only does she stay up-to-date on vaccines including an annual flu shot as an adult, she chose to participate in HPV trials while away at college." -Joan E, DrPH, RN, School Nurse

"As a rural nurse in Mexico I saw firsthand pain and sorrow of mothers who lost a child to a vaccine preventable disease. Later, as an educator and mother of three, I was the first one to get vaccinate annually against the flu and I made sure the my children understood the importance of being fully vaccinate to protect them from deadly diseases when they were younger. They learn that having their annual flu shots will protect them from flu and for spreading infections to others. Educating the mothers about the importance of vaccines is a must and a responsibility to keep our families healthy and our communities free of diseases." -Felisa Hilbert, RN, Global Health advocate.

"As a former Oncology nurse, turned NICU nurse, I have cared for many patients who are immunocompromised, and cannot receive vaccines. I vaccinate my family because vaccination not only protect them against diseases, it helps build herd immunity to protect those who truly are unable to be vaccinated, because they are either too young or too immunocompromised." -Ashley Balestriere, BSN, RN, Neonatal Intensive Care Nurse


"My family of four, plus one furry friend, is fully protected against vaccine-preventable disease. Whooping cough is currently circulating in our community, and I'm relieved to know that we have done everything we can to insure that our family will be healthy, and that we've done our bit to stop its spread." - Leah Russin, mom, lawyer, community member. 



It's not too late to get a flu shot!
CDC kicked off their NIVW Blog-a-thon on Monday, December 5. Checkout other participating blogs here. Share your own post on social media using the hashtag #NIVW2016 and #fightflu, and download your own CDC Flu Blog-a-thon badge, here (http://www.cdc.gov/flu/nivw/webtools.htm). !

Saturday, November 26, 2016

Ashley McCormick’s Flu Story


On December 27, 2013, I lost my only daughter, Ashley, to the flu.

She was only 23 years old.

A few days before Christmas 2013, Ashley came home from work not feeling well, she had a sore throat, a fever and just felt achy. She was taken to an urgent care, but her diagnosis of Type A flu came too late for antivirals to be given. When I heard, she was diagnosed with the Flu, I was relieved, I thought, everyone gets the flu, it’s no big deal, you feel horrible for a few days, you get over it, and that’s it.

Boy was I wrong.

I had never gotten a flu shot before, and neither had either of my kids. I wasn’t against it, I just thought it was for people who were sick, and for older people, but it wasn't. I had never heard of anyone dying or having any complication from the flu before.

Late Christmas Night, Ashley was taken to the Emergency Room, her fever was 103.8F and she was having trouble breathing. She was taken to the I.C.U., and hooked up to machines and a special breathing mask within minutes of walking into the triage unit. They said her pulse ox was 88, and she was hypoxic, I didn’t exactly know what that meant, but I knew it was something very serious.

I wasn’t prepared for what was about to happen over the course of the next 24 hours, but throughout the next day, as test results started to come back, doctors began to give us a picture of what was going on, It was not a pretty picture, it was a nightmare.  They said she had the H1N1 Flu, and it had attacked her lungs.

We started having Drs wanting to try different things, which we agreed to try anything. It came to a point where she had to be put on a respirator, but her lungs were so severely damaged they would not accept the air being given. Finally, all these ideas that the drs were having weren’t working. We were told her only option was to be put on an ECMO machine, a heart lung bypass machine, to give her lungs a chance to heal. They said she would be airlifted to a larger hospital about an hour away, the hospital she was in didn’t have a machine.

We signed paper work, expected this to happen fairly quickly, but it didn’t. The flu was very bad all over the state, and there were people just as sick as Ashley, so the bigger hospital didn’t have an ECMO machine available for her. We sat there for eight hours, while the hospital frantically searched for a machine for her. We sat by and watched as Ashley coded twice, and there was a line of drs, nurses, and techs, taking turns with an airbag, squeezing it every few seconds to keep her organs from failing. I couldn’t believe how hard she was fighting and everyone in that room was fighting to keep her alive, it was truly amazing.

Finally, they found a machine for her, but Ashley was so much sicker now, so getting her to the hospital with the available machine, was an almost impossible task. We were told she had a 95% chance she wouldn’t make the trip. She did make it, she was taken directly into surgery, and we were met with a nurse to have us sign a bunch of papers, once again we said do anything, and signed all the paperwork. We were again given the odds, a 95% percent chance she would die being hooked up to the ECMO machine during surgery, and if she made it through that a 90% chance she would have a serious complication while being on the machine.

We didn’t care, a 5% chance is better than a 0% chance.

 About an hour, after being given updates every 15 minutes or so, we were taken into a room, expecting to be told what the next step was.

But instead, the dr. came in and said, “I’m sorry, we did everything we could but she died.”

My husband fell to his knees and cried, my son, who was only 17 at the time looked at me like he didn’t understand what was happening, I will never forget the look on his face, it was like this isn’t real, this can’t be real. I honestly, don’t remember what I did. I know I just stood there in shock, I guess. I do remember thinking, she just had the flu, how could she die from just the flu? It just didn’t make sense.

I learned a hard lesson, you can’t take any illness for granted. I don’t know why this happened to Ashley, she was a healthy 23-year-old. I live everyday with guilt, now knowing that if she had gotten a flu shot, she more than likely would still be alive today.

There is nothing I can do to bring her back, but I can tell her story and raise awareness.

A few weeks after Ashley died, we were contacted by many reporters and had news crews showing up at our door wanting to do an interview. Ashley was the 3rd young 20 something-year-old who died from the flu in our county. I really wish the media would have done a story on number 1 or Number 2, I would have seen it, and knew flu shots were so important. I then started to think that if I didn’t know this could happen, I bet the majority of people didn’t know either.

So, on February 2nd, The Ashley McCormick Flu Foundation was born. We go all over to tell Ashley’s story, talk of the importance of getting a flu shot every year, and when we have funds or can get grants provide flu shots. I was right, the majority of people do not realize the flu and be deadly.

We work closely with the State and county health departments, and focus on the college age kids. They are the lowest demographic of people who get flu shots, over all.

The State has created a poster, with Ashley’s picture, and story and is posted in all health departments, colleges, some school districts, doctors’ offices, and just recently in Our County Walgreens stores.


The health dept. tells me that Ashley’s poster really is making a difference in rising the Flu shot rates in every age group.

It's flu season. Get your flu shot.

My name is Patti McCormick. I work full time as the director of The Ashley McCormick Flu Foundation. I devote my life to raising awareness about all vaccine preventable diseases, but especially the Flu. I also run another foundation that honors Ashley's kindness, and her passions, it is called Ashley's Bridge.   For more information, please see:  http://www.theashleymccormickflufoundation.com/ 

Monday, November 7, 2016

Mapping the Course for Your Child's Vaccination Schedule


Mapping the Course for Your Child's Vaccination Schedule


 



Childhood vaccines are extremely important in protecting children from 16 dangerous and deadly diseases. These infections, ranging from influenza and whooping cough to rubella and mumps, can have severe health consequences for a young child. However, vaccines help to dramatically reduce the risk of and even prevent these once devastating childhood illnesses. Thanks to a comprehensive vaccination schedule, the impact of diseases like chicken pox has been limited, and some, such as polio, have become virtual unheard of in the United States. Moreover, the risk of vaccinating your child is extremely low. While parents sometimes worry about side effects -- particularly when their child receives multiple shots at a single doctor's visit -- most children experience nothing more than minor symptoms like low-grade fever.



In order to properly safeguard children, the CDC recommends a complex schedule of 13 vaccinations spaced out over the first 18 years of life, with many vaccines administered through multiple doses months or even years apart. This timetable is designed to prevent children from contracting serious illnesses at the times that they are most vulnerable to infection. Carrington.edu has created a guide to help parents visualize and plan their children's vaccination schedule.




Wednesday, October 12, 2016

The Longest 7 Weeks

The coughing was mild at first. Not a nagging cough, not a juicy or wet cough, just a mild cough. I stared at my 16 year old son across the table from dinner and asked him if he was feeling well, he shrugged and said yes, he was fine. That night the cough continued, I contributed it to end of summer weather, allergies perhaps, maybe mold? I gave my son cough syrup for nighttime. I took his temperature which was normal (hint #1) and both of us went to sleep. I did hear him cough occasionally through the night and this marked the beginning of the longest months of our lives.

My son is a healthy 16-year-old, middle linebacker for his varsity football team, he jet skis, is a avid boater, plays Lacrosse off season. My son is into working out, eating healthy and exercising. He had a milk protein allergy as an infant, a bout with apnea as an infant, and other than childhood colds, only one ear ache his entire sixteen years, a fractured clavicle and nasal bone, he was never sick.

The mild cough continued for a week, no sputum, it was dry and still occasional. He stayed afebrile, ate normally, was taking fluids, and had no complaints. I myself developed a cough, I do have a history of asthma and thought I was coming down with my yearly bronchitis. I was thinking maybe my son was also developing a case. I went to urgent care, and got myself a Medrol dose pack and a antibiotic, when I came home, I decided that I wasn't going to take the antibiotic that was prescribed, (doxycycline) and I opted to take a Z-Pak that I had filled 8 months before but didn't take. I didn't realize it then, but it was a good call on my part. In this time my sons cough remained mild, but in the days that followed I noticed it was worsening. He was coughing all through the night, and it was making him very short of breath. I dropped him off at school and a couple of hours later he called me and asked me to pick him up. I took him right over to urgent care, where they diagnosed him with bronchitis, gave him amoxicillin, put him on prednisone 20 mg daily x 5 days and gave him an inhaler, as I gave him a few puffs off of my inhaler the night before to which his breathing improved.

That night was the real beginning of this nightmare, he coughed so violently became short of breath, and was gasping and choking. He began vomiting (hint #2) phlegm and whatever he ate that remained undigested. And this type of coughing, gagging, shortness of breath and vomiting continued for the next day and night. He was exhausted. I was exhausted. I felt helpless. I am a nurse and part of me was telling him not to be so dramatic, as vomiting with him was always a big production, ( I liken my son to the Seinfeld episode where Jerry proudly states he hasn't vomited in 13 years, only to toss his cookies later) and the other part of me was getting very very nervous.

I took him to the local Emergency Department. I was happy to see the pediatric Physican that was on call was a doctor that I loved and respected. They gave him a albuterol neb and a chest X-ray. She came back to tell me that his chest x-ray was crystal clear (hint #3) and that they would discharge him, but I was not happy with that. The vomiting had me very concerned, she stated it was probably a gag reflex. But she did decide to keep him for a while after seeing my face. The gave him a bolus of normal saline for dehydration , and did bloodwork and urine. All of his blood work came back fine except for his neutrophils, and his monocytes. They were only slightly elevated (hint #4). The mycoplasm, wasn't resulted but she didn't think it would show anything. She then decided she was going to treat him as an atypical pneumonia. Thank God for that. She discontinued the amoxicillin. And put him on Zithromax 500 mg daily x five days. She said to continue the prednisone until finished. We left.

During the next 10 days, as he completed the medications, my son continued to have these bouts of uncontrollable violent coughing, always resulting in vomiting, choking on phlegm and gasping. Still he remained with no temperature, he would eat, but vomit whatever food if the coughing started right after he finished. He was losing weight. He was in and out of school, going in late if he was up all night coughing. One evening he vomited in the basin where I noticed black stringy flecks, of course the nurse in me immediately thought blood, he is assured me he had eaten fried Oreos. OK I thought to myself that makes sense. But the next morning first thing in the morning, he vomited again, this time it was phlegm with blackened red strings (hint #5). I put the vomit in a baggie and I threw him in the car and took him again right back to the emergency room. This time it was the Doctor who I did not know. And I did not care for her as she was dismissive, and told me it wasn't blood, and did not want to hear his story. Well guess what?, it was positive for blood. They gave him three back to back nebulizer treatments, they upped his prednisone to 60 mg a day, repeated the chest x-ray which of course came back clear, told us to do the inhaler every four hours and released him. They did not draw labs. Dismissed.

With the increased prednisone, the cough did slow down a bit, he still was vomiting phlegm and gasping but no more blood. Still not happy, I made a follow up appointment with his physician. I saw the nurse practitioner in the office. She listened to what I had to say. She did a very thorough exam, and it was the nurse practitioner who believed it was pertussis. Pertussis? Really?? Nah. He was vaccinated. I was pro-vaccine, he was up to date. No way was it whooping cough. But my son was so sick and had lost 10 pounds. She was so concerned that she sent right us over to the lab to have blood work drawn. The weekend came and went, he was feeling somewhat better, less coughing, but still coughing nonetheless. On Monday, I followed up with his pediatrician, the labs were still pending, but she cleared him to return to school and football. She assured me he was not contagious as he completed the medication often prescribed for pertussis. Later in the afternoon the Dr. called, his results were in and Bordeltella Pertussis and Mycoplasma were elevated, positive.

Pertussis! Bingo. Wait, what??

 How did my healthy, so healthy never sick kid get whooping cough?? How did three different doctors miss this???? He has a pro-vaccine mom who diligently took him for his appointments. I am a community visiting nurse, I might have seen this in my poorer neighborhoods. I ruled myself out as I've been home on a shoulder injury and a surgery for 5 months. Meanwhile, I waited for the dreaded Department of Health call.



The call came, and the nurse assigned to my sons case was lovely. We went over my sons symptoms and created a timeline. She was convinced it was mid to end of August when he was exposed. Most likely from another child during practice or from the gym. I was safe as I took the z-pak when I had bronchial symptoms. My immediate family also showed no symptoms and remain well. They were not exposed to my son until after he did his course of antibiotics. She explained that they were treating it as a probable, not confirmed case. To get a confirmation you need to do a nasal swab. No swab was taken, just blood. She explained that the pertussis vaccine last approximately 3 to 6 years, as it weakens. My son had a Tdap 5 years prior, so his booster lasted just 5 years.
Dtap is given as a vaccine, Ttap is given as a booster and is offered as the tetanus booster. She also explains how the bacteria goes into what are called "pockets." Pockets are areas where the disease can lays dormant. Anti-vaccine parents create these pockets when they miss vaccinations as they leave their communities vulnerable to outbreaks of vaccine preventable disease. Anti-vaccine parents rely on community immunity, and this is the very reason why you should not rely on community immunity. A unvaccinated child, or an adult who was carrying exposed my son, who fits in the profile of who is at risk. Children that are at risk are my sons age as this is the year where their vaccination would be weakening and wearing off. I never knew this vaccine could wear off just like that.

Pertussis is a highly contagious bacterial respiratory disease. It is spread by contact with respiratory droplets, like cough, sneezing, saliva, handshakes and hugs. It is called "Whooping Cough" because of the sound that is made when they gasp for air after fits of coughing. The cough is mild in the beginning, mimics a cold and there is no fever. If you have a cough and are running a 101° temperature, chances are, you do not have pertussis.

Pertussis can be life-threatening especially to babies, and can cause serious illness in children, teens and adults. 90% of deaths from pertussis are in infants less than 1 year old.
What I learned:
  • Vaccinated children and adults can become infected with the disease, but it's less serious in vaccinated people.
  • Vaccination and booster shots are the most effective way to prevent pertussis. Dtap for infants, Tdap for children and adults. 
  • Pregnant mothers should get the Pertussis booster vaccine with every pregnancy. The Centers for Disease Control and Prevention (CDC) now recommends that pregnant women receive the whooping cough, vaccine for adolescents and adults (called Tdap vaccine) during the third trimester of each pregnancy ideally in the 27th through 36th week.
  • You are not considered communicable if you complete the course of antibiotic therapy.
  • It is recommended that you complete the course of antibiotic, and still remain contained for at least five days after completion.
  • It is also called the cough of 100 days, as you can have coughing symptoms for up to three months.

Healthcare providers need to be educated that whooping cough or being exposed to whooping cough is prevalent in our communities and our patients are at risk. They need to do nasal swabbing if suspected as this is the true test to confirm. My child had every sign and symptom, he was textbook. Yet all three doctors missed it.. His course could have been shortened if only they knew the signs.

It is been a difficult few weeks, a letter went out to the parents of the school, (of course omitting his name). I had to talk with my teen about who he could have infected with close contact (including kissing), and that they needed to be told. I promised that I would talk to the parents. So far no one else has shown signs, although believe me, I listen to every cough now and know the symptoms.

It's been a long 7 weeks, but we're finally seeing improvement. My son is still coughing a lot, but he's no longer vomiting, he's eating, has returned to school and is returning to football this weekend.

Carolyn M. is a Home Health Community Nurse, member of Nurses Who Vaccinate and mom.

Thursday, October 6, 2016

In this modern world, being immunized is, at its heart, a social issue.

I never know what to say.

I’ve been a nurse for over two decades, I’ve given hundreds of vaccines and never seen a serious side effect or evidence of the development of a chronic disease related to vaccines. I’ve spent years studying the vaccine debate, written a website on the subject, spoken at national conferences, and yet, I am still stumped by the simplest statement made by parents: “I’m not anti-vaccine.”


You’ve just refused a vaccine for your child and then made that statement.

 For the life of me, I don’t know how to respond. You see, I don’t want to have an argument with you, I just want your child to be healthy and safe. I really do. I truly believe you want the very best for your child. I do too.

I don’t think I’m right about everything, but I do know a thing or two about the safety of vaccines and the risks of disease.
I don’t make a penny more or a penny less if you choose to immunize or not.
I understand your fears.
I have children of my own.
I don’t think your decision to not vaccinate your child implies you would intentionally disregard the welfare of those in our community who can’t be vaccinated, or who need protection against preventable diseases.


But actually, it does.

I do think you are an intelligent person who just might have been swayed by misinformation or by well-intentioned peers. I don’t think you are the first; I have been too. But in the end, you are against the receiving of vaccines for your child who is both precious and vulnerable. You’ve refused an amazing medical gift. And, it’s hard for me to understand that.

Would you refuse chemo if your child had cancer?
An antibiotic for a life-threatening infection?
The same science and quest for better health is behind vaccines. So what am I to think?

You might not be “anti-vaccine” but from my perspective you’re not exactly pro-community.
You might not know those in your community who are physically fragile.

Because of my job, I do, and that changes the way I view your decision.

Through immunization it’s possible that you might see the complete eradication of polio in your lifetime. Maybe even measles. Surely, in your child’s. But it takes a universal and monumental effort to keep children from being crippled and disabled.

It’s ok to be fearful.
Just fear the right thing.


You want to make a difference in your community? Vaccinate.
Smallpox didn’t go away by itself and neither will hepatitis B, polio, and Hib.
You want to have some small impact on the life of a child in a developing country? Vaccinate.

It’s a lifetime of giving. In this modern world, being immunized is, at its heart, a social issue.



Eula Biss writes in On Immunity, “Immunity is a shared space… a garden we tend together.”
I like to think we do the same for our community.





Rebekah Sherman RN, BSN, MPH
Author of Ashlandchild.org


Rebekah Sherman BSN, MPH is the primary author of Ashlandchild.org; a website for vaccine hesitant parents. Her real job is working as a clinical RN/RN Educator at La Clinica de Valle where she provides immunization counseling for vaccine hesitant/refusing parents. She lives in Ashland, OR with her family.