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:

#FluShotSelfie

#VaxSelfie
#VaxWithMe
#VaccinesWork
#TeamVax
#NursesWhoVax

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. 



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). !

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/ 

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.

http://carrington.edu/blog/medical/vaccines/childhood-vaccine-checklist-infographic/

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.

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. 

Welcome to Flu Season 2016-17

Flu Season is upon us as such I felt it important to discuss the flu vaccine when talking about adult vaccination.

Influenza is an acute febrile respiratory disease. In an average year influenza can account for 3,300 – 48,000 deaths per year in the US alone (yes, deaths), 100,000-800,000 hospital admissions, 25 million physician visits, and 50-50 million infections and illnesses. The majority of the deaths occur in people aged 65 and over. Individuals most vulnerable to complications of influenza are children age 2 and under, adults age 65 and over, people with suppressed immune systems (patient’s on chemo, on immunosuppressive drugs, HIV), and people with other underlying conditions (asthma, COPD, chronic renal failure, diabetes, etc). Last year's flu season resulted in 85 pediatric deaths, a vast majority of them unvaccinated or too young to vaccinate.

An inactivated influenza vaccine has been in use since the 1960’s to help prevent influenza infection. The current recommendation in the US is that every individual age 6 months and older get the flu vaccine yet many people do not get it. Why?




Common Reasons Nurses Hear from Patients Who Are Hesitant to Get Their Influenza Vaccines
"I never get the flu” or “I had it and it wasn’t that bad” – That’s great that you haven’t gotten the flu – yet. If you thought you had the flu but felt it wasn’t that bad – it wasn’t the flu, it was probably a bad cold or other influenza like illness. Flu hits hard and fast. Your whole body aches, and your head wants to explode. A large percentage of people who get it, report not being able to get out of bed, and it is serious (see above numbers from the CDC’s Mortality and Morbidity Weekly Report). Even after the flu has run its course, most people report fatigue that lasts for several weeks afterward. Becoming infected with the flu may be as simple as being in the same room with someone who coughs. The incubation period for influenza is 1-4 days. An infected person can shed virus to others from 1 day before, to 5 days after becoming symptomatic. So it is possible to not even know if you are around people who are sick (can you say plane ride?) No amount of “immune boosting” concoctions will prevent the influenza virus from protecting you if you are exposed. (that is all I will say about that. It is a topic for another post). I have seen healthy, athletic, well-nourished young people come down with it and have to be hospitalized.

“The flu shot makes me sick” – This one may be my favorite. The current injected flu vaccine is an inactivated vaccine. It is a dead virus. (insert Monty Python Dead Parrot Sketch here). IT CANNOT GIVE YOU THE FLU! Keep in mind though, it takes the body up to two full weeks to develop an immune response to the vaccine that will protect you from getting sick from the flu. If you did get sick after the flu shot, it was for one of two reasons. Either you were exposed to it before you got the shot or before your body developed immunity via the vaccine OR you got one of the other 99 or so recognized rhinoviruses in existence, and you would have gotten sick whether you were vaccinated or not. As an aside, there is a live virus vaccine called Flumist, but I will discuss that in another point. The shot does not make people sick. Period.

“The flu shot is not very effective, the virus mutates so they never know if it will work or not.” There is some truth to this though not enough to avoid getting the shot. The formula for the flu shot varies from year to year based on surveillance systems from various agencies (Centers for Disease Control-CDC, World Health Organization-WHO, National respiratory and Enteric Virus Surveillance System -NREVSS and about 5 more that I won’t mention unless someone asks as I have been told I am verbose enough). The vaccine takes about a year to develop. Researchers and scientists all over the world use data from previous years and mountains of epidemiological data to predict which 3 or 4 strains will be most prevalent and formulate the vaccine accordingly. It was all over the news during the 2014-2015 flu season how low the effectiveness of the vaccine was that year (about 23%). Last year’s vaccine was better at about 59%. Does this mean the shot is no good? I don’t know about you but I’ll take a 23-59% reduction in the chance of getting flu over 0% reduction. Also in the news was the lack of effectiveness of the quadrivalent nasal Flumist, and the CDC’s recommendation against using it this year. Is this a failing on the part of vaccine research and development? Actually no, it is good medicine at work. It is proof that those who make it their life’s work to develop these vaccines want to make sure they are effective. Interesting enough a Canadian study of the intranasal flu vaccine is reporting different results with effectiveness on par with the shot. This again is demonstrates how no one study can be used to make health care recommendations. All evidence must be compiled and a consensus is then reached. Will this change the CDC’s recommendation? Not likely for this year, but it may have an impact on the recommended use of the intranasal vaccine in the future.

"I don’t get the flu shot because it’s full of toxins and heavy metals”. Ok, so I lied. This one is my favorite. First let me start out by saying that the people who screech about that, typically have no understanding of basic chemistry and the fact that everything is a chemical. The air we breathe, the water we drink, every molecule in our body is a chemical. Also, the poison is in the dose. Anything can be toxic at the right dose – water, oxygen, anything. The properties of any element on the periodic table are dependent upon the other elements to which they are bound. Sodium is a metal that is volatile if it comes in contact with water, but when bound to the element chloride it becomes table salt. Not only safe, but fairly essential for life. I’ll start with the big gun in vaccines. Mercury. Not all mercury is created equal. There is elemental mercury, the stuff in thermometers. That stuff is really bad for you, can do a lot of damage if ingested, inhaled, whatever. There is methyl mercury - a dangerous compound often found in polluted water. Then there is thimerosal a vaccine preservative, used only in multidose flu vaccine vials, that breaks down into ethyl mercury. Ethyl mercury does not bio-accumulate. The body excretes it, unlike methyl mercury which can build up in the body and cause harm. Think of ethyl alcohol (wine) vs. methyl alcohol (rubbing alcohol). Drinking 8 oz of ethyl may give you a buzz. Drinking 8 oz of methyl alcohol can kill you. Aluminum is another popular culprit. But the catch here is that the aluminum in a vaccine is not ground up bits of aluminum foil. It is a compound in the form of aluminum salt. The aluminum salt acts as an adjuvant enhancing the immune response of the active ingredient in the vaccine. Aluminum salts are found in many things, particularly oral antacids like Mylanta and Maalox. There is more aluminum in a feeding of breastmilk for a baby than there is in a vaccine. Formaldehyde is another scary sounding chemical in a vaccine. The formaldehyde is used to kill or inactivate the virus used in a vaccine. The human body manufactures its own formaldehyde, and there is more naturally occurring formaldehyde in an organic pear than in a vaccine. There is not enough formaldehyde in a vaccine to even register a change in serum levels in the blood. So, scary chemicals, not so scary after all. By the way have you ever looked at the chemical composition of a strawberry? That shit’ll kill you. 

Ingredients of an All-Natural Strawberry

In closing, everyone 6 months and older is recommended for annual flu vaccination with rare exception. For the 2016-2017 season, CDC recommends use of injectable flu vaccines--inactivated influenza vaccine (or IIV) or the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influena vaccine or LAIV) should not be used during 2016-2017. 



You can use this widget Flu Vaccine Finder, to locate flu vaccine clinics near you. Simply enter your zip code or city and state to find mapped locations of flu vaccine clinics.

You can also visit http://vaccine.healthmap.org/ to find out what other vaccines are available in your area. Talk to your doctor or nurse if you have any questions regarding which flu vaccine is best for you and your family.

And when you get your vaccine... send us your selfie! Like past flu seasons, we'll be collecting and sharing your #Vaxselfie. Send it to us on our Facebook page, email it to us (NursesWhoVaccinate@gmail.com), or tag us on Instagram and Twitter at @NursesWhoVax. We look forward to sharing everyone's efforts to protect themselves and others from influenza. Be safe this season!

Lori B. has been in nursing for 20 years. She began advocating for vaccine awareness and working toward dispelling myths and misinformation about vaccines in 2013 as she was finishing her advance practice degree. Since then she has become a member of Nurses Who Vaccinate, Voices For Vaccines and the New Jersey Immunization Network.

Your Vaccine Recommendation is a Critical Factor in Protecting Patient Health

 Patients trust you to give them the best counsel on how to protect their health. You know that immunization is an important preventive measure – but it’s unlikely that getting vaccinated is on the radar for your adult patients. Your strong recommendation is critical in ensuring that they get the vaccines they need to help them stay healthy.

 

Adults are not getting the vaccines they need. The latest data from the Centers for Disease Control and Prevention (CDC) shows that vaccination rates for adults are extremely low (National Health Interview Survey, 2014). For example, rates for Tdap and zoster vaccination are 28 percent or less for adults who are recommended to get them. Even high risk groups are not getting the vaccines they need – only 20 percent of adults 64 years or younger who are at increased risk for complications from pneumococcal disease are vaccinated. This means that each year tens of thousands of adults needlessly suffer, are hospitalized, and even die as a result of diseases that could be prevented by vaccines.

 

Your patients are likely to get the vaccines you recommend to them. Clinicians are a valued and trusted source of health information for adults. Your patients rely on you to let them know which vaccines are necessary and right for them.

 

“Since many adults are not up to date on their vaccines, we need ALL health care professionals to use every patient encounter as an opportunity to assess whether any vaccines are needed,” Dr. Carolyn Bridges, Associate Director for Adult Immunization at CDC.

 

If the patient is due for a vaccine, make a strong recommendation that you advise getting the vaccine because it can help protect them against a disease that could be serious. For some patients, this may be sufficient information to accept the vaccine. Others may want to learn more about the vaccine and why it is right for them. For these patients, sharing the following can help them make an informed decision. 

• Share the tailored reasons why the recommended vaccine is right for the patient, given his or her age, health status, lifestyle, job, or other risk factors. 
• Highlight positive experiences with vaccines (personal or in your practice) to reinforce the benefits and strengthen confidence in vaccination. NIAM Toolkit: Adults 23 
• Address patient questions and any concerns about the vaccine, including side effects safety, and vaccine effectiveness in plain and understandable language. 
• Remind patients that vaccines protect them and their loved ones from many common and serious diseases. 
• Explain the potential costs of getting vaccine-preventable diseases, including serious health effects, time lost (missing work or family obligations), and financial costs.

 

Some patients may need additional time to consider information about vaccines or want more details than can be provided during a single office visit. There are a number of things you can do to help these patients stay on track with recommended vaccinations. 

 

• Provide educational materials or trusted websites for them to review. 
• Send reminders about needed vaccines. 
• Document the conversation and continue the discussion at the next visit.

 

To download free patient education materials or find resources on addressing patient questions and concerns about adult vaccines, visit: www.cdc.gov/vaccines/hcp/adults.


August is National Immunization Awareness Month – a reminder of the importance of immunization in keeping our communities healthy. Your strong recommendation can make a difference.

Every Child’s Life is Precious

During World Immunization Week (April 24-30) organizations around the world raise their voices to educate, promote and increase the rates of immunization against vaccine-preventable diseases.

Why? Because every child’s life is precious!  Yet in developing countries around the world, a child dies every 20 seconds of diseases that can be easily prevented with a vaccine.  When you think that every 20 seconds a child dies (which equals 3 children per minute), 180 will die in an hour and 4320 children will die in a day.  Can you imagine 1440 children dying during your shift of 8 hours at work? I know for many of us here in United States this seems astonishing and incredible, but this is a reality for many mothers and children in developing countries.




As a former nurse, an avid educator and as an advocate for children’s health, I know the impact vaccines have in improving children’s chances to grow healthy and to get an education.  I personally witnessed firsthand the pain and sorrow of mothers when their children were suffering.  I remember their stoic faces as others held back tears while holding their dead children in their arms.  I witnessed how diarrhea took the lives of little children because their mothers did not realize they could die from it.  The sad part is that all of these childhood diseases could have been prevented with a simple vaccine.

Every year I volunteer and travel to do humanitarian missions in developing countries.  My personal focus is to educate the rural community leaders and adults about childhood diseases and of the importance of immunizations as a way to prevent these diseases in their children.  Without regard to the distances and sacrifices they bear, these parents are eager to learn and walk 5-10 hours to get to a clinic to ask for help and receive proper care.  Poverty, malnutrition and lack of education keep these little communities isolated and far away from common notice or knowledge.

I traveled to Uganda with the Shot@life team and witnessed their Childhood Immunization Family Health Day hosted by UNICEF in the districts of Mumbende and Fort Portal after mosque and church services.  Mothers with their children lined up and waited patiently to receive medical care, some of them having walked 10-15 miles to get their children immunized.  My favorite part was talking to the mothers and listening to their concerns and worries which were not unlike ours.  I met mothers that had lost as many as five children before their 5th birthday.  Other mothers did not name their children until they were sure they would not die young.  In developing countries, many mothers never see their children live to celebrate their 5th birthday.  Instead of celebrating a birthday, they have to prepare for their child’s burial.

                 

I talked to doctors and country representatives of Fort Portal and they told me that 386 children under the age of five will die in one day and that 141,000 children under five are lost annually.  Uganda is one of 30 countries in the world with the highest number of deaths of children in that age group.
I know these mothers and children seem a world far away from us, but they are no different than we are and each child life is precious.  Children everywhere deserve a shot at a healthy life no matter where they live.

The good news is that the worldwide measles vaccination program has resulted in a 79% drop in measles-related deaths (between 2000 and 2014) - and we, here in the U.S., can have an impact on the lives of children around the globe.  Funding for global vaccine programs is less than 1% of the total U.S. budget, but this funding helps save 2.5 million lives every year.

Vaccines don’t just prevent illness!  They give children the chance to grow up healthy, attend school, and become productive members of society.  They are a “best-buy” in global health with a low cost and a long-term payoff that extends far beyond the health of an individual child.

It is also important to remember that vaccinations are not just a global issue - vaccinations are a local and a national issue. We all are part of the human race and we have a shared responsibility for the less fortunate.  Policymakers, both here and in Washington, should stand up and support US-led global health programs, specifically those programs focused on saving the lives of children in developing countries by providing them with vaccines.

As a mother and a Shot@Life Champion Leader I know that each of us can make a difference this week!

 Join us in supporting global health by; meeting with your legislators and asking for their support in funding global vaccines programs. You can also make a donation to support the work of the UN and vaccine partners around the globe at www.shotatlife.org.

Think about it – in the 6 or 7 minutes it took you to read this article, 18 to 21 children died of vaccine- preventable diseases.  Please, every child life is precious.  Together we can save more children!

Felisa Hilbert is former nurse from Mexico that worked and participated in many rural vaccine campaigns where she saw firsthand the pain and sorrow that many  children suffer due to the lack of vaccines and medical care. She is also a Nurses Who Vaccinate member. 

Mrs. Hilbert humanitarian mom & wife with a heart to help children in or from developing countries. Global health, poverty and  participate in education are some of her favorite passions.

CDC—When a Behemoth Needs Help #NIIW

To obtain a master’s degree in public relations, one of my course requirements was to analyze the public relations perspectives of any topical issue. It coincided with the peak period of the Ebola crisis, so I quickly picked on the Center for Diseases Control and Prevention (CDC), because the Center was in the middle of it all.

Predictably, the summation of my presentation was that the CDC underperformed in managing the crisis, as it was always putting the wrong foot forward at almost all instances. It was either the CDC reacted very late or said the wrong thing, so much so that its credibility was almost called into question. Barely one year after, another deadly disease, Zika is now on the prowl, and I visited the CDC website to see how the Center is responding this time around.

While on the site, I spent more time going through other activities of the CDC and was astounded at the volume of activities the Center deals with on daily basis.

From diseases like cancer to heart disease, sexually transmitted disease, ADHD, diabetes, flu(influenza), the Center is also highly involved in emergency preparedness, workplace safety& health, environmental health and outbreaks, to mention but a few.

I quickly came to the conclusion that the CDC is akin to a healthcare clearing house, a healthcare behemoth and I wondered if its staff strength is able to effectively coordinate these numerous activities.

I left the site with empathy, feeling strongly that the Center needs help. For a Center that works daily to protect Americans from health, safety and security threats, both from abroad and in the U.S, the body sure needs help from health workers, it needs help from health professionals and it needs help from volunteers and most especially it needs help from nonprofit organizations that are scattered all over the place.

Taking into consideration that whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, the CDC fights them and supports communities and citizens to do the same.

It is in the light of this that one commends the initiative of Nurses Who Vaccinate (NWV), a not-for-profit organization made up of nurses and other health professionals who advocate for immunizations to hold a local version of the National Infant Immunization Awareness program in Long Island, New York must be commended.

The National Infant Immunization Week (NIIW), is an annual program of the Center for Disease Control to highlight the positive impact of vaccinations on the lives of infants and children. It is a national program set for April 16-23 in 2016 and is celebrated as part of the World Immunization Week, an initiative of the World Health Organization.

However, Nurses Who Vaccinate, in conjunction with other nurses on Long Island, is leveraging the CDC’s infant immunization week to reach out to the underserved population with information and education to advocate for wellness of children in its communities.

Melody Butler, a pediatric nurse at Good Samaritan Hospital in Long Island, founder of the organization says “their mission is to collaborate with health systems and other organizations to promote general wellness for all through immunization.”

This collaboration becomes very pertinent because as big as CDC might be, it cannot be at every nook and corner of the country and therefore needs foot soldiers to help spread its health and wellness message.


Without a doubt, not many people are aware of the infants’ immunization week, but this young and proactive nonprofit, NWV is holding the event at the Martin Luther King Health Center at Wyandanch, a small community in New York.

According to Melody Butler, the event is to compliment efforts of the CDC in advancing the cause and benefits of immunization.

“At a time, some nurses, saddled with the responsibility to vaccinate are now opposed to it, it becomes incumbent on us, the pro-vaccination nurses to raise the bar by joining hands to promote vaccination,” Butler pointed out.

NWV she indicated, has put in place all that is needed at the community level to bring together parents and guardians and educate them on the virtue of vaccinations.

At the national level, the CDC is using the infants’ immunization awareness week to among others highlight the dangers of vaccine-preventable diseases, especially to infants and young children, educate parents and caregivers about the importance of vaccination in protecting their children from birth against vaccine-preventable diseases and focus attention on its immunization achievements and also, celebrate the accomplishments made possible through successful collaboration.

Findings show that the CDC will also step up efforts to protect children against vaccine-preventable diseases, thereby give them a healthy start in life, encourage better communication between parents and health care professionals and remind parents and caregivers they need to make and keep needed immunization appointments.

It has also created events that attract community support and media interest in order to increase national and local coverage of stories on the importance of childhood immunization, as well as create opportunities for local organizations and agencies to work together as immunization partners, for which the NWV is taking advantage of.

The Center has never pretended it can effectively do this nationwide alone, it therefore supports efforts to provide web-based resources for state and local health departments and local coalitions to develop and implement a communication strategy that will increase awareness of the importance of immunization and improve local vaccine coverage rates.

Not even a million staff members can help send CDC’s wellness message to all the communities, it therefore needs in large number, the partnership of organizations like Nurses Who Vaccinate to serve as messengers of this important lifesaving information.

Since 1994, local and state health departments, national immunization partners, healthcare professionals, community leaders from across the United States and CDC have worked together through NIIW to highlight the positive impact of vaccination on the lives of infants and children, and to call attention to immunization achievements. By so doing, several notable milestones have been accomplished in controlling vaccine-preventable diseases worldwide.

Partnership is the keyword here. Working on the communications aspect for the 2016 NIIW, with Nurses Who Vaccinate in New York, one sees first hand, how the organization takes the immunization message to the grassroots through a one on one mobilization and education of members of the community on the benefits of immunization.

The grassroots approach at community health centers, WIC offices, pediatric clinics adopted by Nurses Who Vaccinate goes a long way to allay the fears and concerns parents have against immunization and kudos must also be given to the CDC for the avalanche of materials made available in various languages for this awareness drive on infant immunization.

Like the theme of this year’s campaign says, immunization indeed has power to protect!




Williams Ekanem, is a communications specialist based in Long Island, New York can be reached @ kayceewills@yahoo.com

This Is Why it's Important that DeNiro Canceled "VAXXED:" There is no link between vaccines and autism.

In light of Autism Acceptance Month, we at Nurses Who Vaccinate would like to sincerely thank the TriBeCa Film Festival and Mr. Robert DeNiro for making the decision to remove the documentary "Vaxxed" from the lineup.  While Mr. DeNiro originally desired to add more to the conversation on vaccines and autism, we are thrilled to hear that he listened to the advice and wisdom of the medical professionals he met with from the CDC when they assured him that there are no links between vaccines and autism, and that nothing additional would be added to the conversation by showing the film.

It's really important that DeNiro canceled this film, and this is why: vaccines don't have anything to do with autism, and promoting this idea is not only dangerous to public health, but it leads parents to put their children at risk by making the choice to forgo the recommended schedule of vaccines for their children without any good reason to do so.

The film "Vaxxed" discusses the flawed research of Dr. Andrew Wakefield, a British gastroenterologist who lost his medical license for claiming that the MMR vaccine led to autism based upon his "research," which appeared in the British Medical Journal, The Lancet, in 1998. It has been stated that the Wakefield fraud is "likely to go down as one of the most serious frauds in medical history." (Godlee F. The fraud behind the MMR scare. BMJ. 2011;342:d22.)

 In the year 2000, the Lancet retracted Wakefield's study and 10 of the 12 authors also rescinded their involvement.

Since the Wakefield study hit the world in 1998, countless families across the globe have made the choice to stop vaccinating their children for fear of developing autism despite the fact that there are hundreds of large-scale studies  involving thousands of children which demonstrate no link between vaccines and autism. Parents still cling to Wakefield's study, which only included a sample size of 12 children from which he took blood samples at child's birthday party. Research studies typically include thousands of study subjects, and 12 is hardly grounds for proving any link of any kind. Further, no scientist or researcher has ever been able to replicate Dr. Wakefield's results and the CDC alone has funded 9 studies since 2013 which also demonstrate no link between vaccines and autism.

 The global damage from Wakefield's retracted study has been insurmountable. In Britain, MMR vaccinations dropped to only 80% in 2004. There were more cases of measles in the US in 2008 than there were in 1997 before the MMR vaccine was widely utilized. Even after anti-vaxxers funded a study which also demonstrated no link between vaccines and autism, people still believe that there is a link.

Wakefield received more than $670,000 from lawyers to testify on behalf of families who intended to sue the manufacturers of the MMR vaccine, while Wakefield was also working on his own measles vaccine. This was a huge conflict of interest which he failed to report and ultimately led to the rescinding of his medical license in 2004.

It has been 18 years since Andrew Wakefield fueled the fears of parents globally, and he intends to do so further with the creation of the "Vaxxed" documentary.

It was a very big high-five for public health that "Vaxxed" was not played at the TriBeCa film festival and we are very thankful that to TriBeCa and Mr. DeNiro for making the decision to end a conversation which shouldn't have been started in the first place. Here's a great review on the documentary and why it's not worth seeing: https://www.statnews.com/2016/04/01/vaxxed-autism-movie-review/

There never has been, nor will there ever be, a link between vaccines and autism and getting your children vaccinated against measles, mumps and rubella (MMR) is one of the best choices you can make for your family!

Angela Quinn, BSN, RN is a registered nurse on Long Island, NY. She is passionate about nursing and public health and is involved with a number of projects which promote life-saving vaccines. Angela volunteers as an Executive Board Member in Vaccine Advocacy for Nurses Who Vaccinate, is the founder of the blog Correcting the Misconceptions of Anti-Vaccine Resources and is the creator of Future Nurse Abby.