Immunity for the Community

Alexis Barker
NLJ News Editor
 
Local health officials are stressing the need for parents to visit with their health care providers before the start of school to make sure their children are up-to-date on all required vaccinations.
When fully vaccinated, people are protected from 16 potentially harmful diseases, including diphtheria, tetanus, pertussis, hepatitis B, H. influenza, poliovirus, measles, mumps, rubella, pneumonia, meningitis, bacteremia, sepsis, rotavirus, varicella-zoster virus, according to the Wyoming Department of Health. 
The department of health requires that any child attending a public or private school, including religious-based schools, as well as children participating in school-sanctioned activities, be vaccinated with the DTaP/Tdap (diphtheria, tetanus, pertussis), HepB (hepatitis B), HIB (Haemophilus influenzae type b), IPV (polio), MMR (measles, mumps and rubella), PCV-13 (pneumococcal), RV1/RV5 (rotavirus) and VAR (varicella) to attend schools within Wyoming, unless the individual meets certain requirements. 
According to Weston County public health nurse Lori Bickford, vaccines are required for school-age students because children of this age are more susceptible to the diseases prevented through vaccination. The risk of getting the diseases is higher in unvaccinated children who are in a group setting, such as a school, she said. 
Bickford said that the vaccines prevent diseases that can make people very ill and, in some cases, cause death. 
“The more folks that are vaccinated in a community, the less chance we have of outbreaks of the disease,” Bickford said. “It is the herd community concept. The more people who are vaccinated, the healthier our community and the safer it is for children and the unvaccinated.” 
Kim Scharf, a registered nurse at Regional Health Medical Clinic in Newcastle, is also in charge of vaccinations and immunizations, explained that herd immunity involves everyone doing their part to protect those who cannot receive the vaccination. 
“You are helping those that cannot get vaccinated, whether that is babies that are too young or people who are sick,” Scharf said. 
Bickford and Scharf said that exceptions to the state rules are allowed by Wyoming statute. But unless children meet those requirements, they are required to have the age-appropriate vaccines within 30 days of starting school, they said. 
According to Scharf, the most important “school shots” are those children receive for kindergarten. Children are then due for another round of shots in seventh grade. 
Although not required for school, Scharf said, the HPV shot for girls protects against six different types of cancer. “HPV vaccination is recommended through age 26 for women, and through age 21 for men, if they did not get vaccinated when they were younger,” according to the Centers for Disease Control and Prevention.
“Wyoming does allow for parents to apply for a waiver to the mandatory immunizations based on genuine religious objections or a medical contradiction,” the Department of Health says. “Please note that Wyoming statute does not allow for a waiver based on philosophical or personal beliefs.”  
Scharf noted that children with previous adverse reactions to an immunization will no longer receive that specific vaccination. These children and immune-compromised students are the main reasons for not receiving immunization, she said. 
“However, we do see some religious exemptions, specifically because stem cells from an aborted fetus were used to create the vaccine,” Scharf said. “We went to a conference that explained that those vaccines were created from only one aborted fetus’ lung tissue, one time, those cells were saved, originally being used to study cancer, and were found to be useful in vaccines. That is one misconception around vaccines. Babies were not aborted to create the vaccines, that is simply not the case.”
Bickford said that a doctor’s letter is required for anyone requesting an exemption, whether for religious or medical reasons. She said that it is important for the schools to be aware of who is not immunized in cases of outbreaks. 
“Those unvaccinated children will have to stay home until said outbreak is over. People really need to think it through about the reasons why they don’t want their children vaccinated,” Bickford said.  “Understand that children that are not vaccinated are more at risk of actually getting the diseases and there is that component of not being able to get to school in outbreak situations. You have to stop and think about the weight of the outbreaks. This is usually not just three or four days out of school. There is a domino effect, and it can take some time to get an outbreak under control.” 
Reactions to vaccines are “very rare,” Bickford said. The CDC estimates that less than one in one million doses would cause an adverse reaction, she said, and those reactions would occur minutes to a few hours after administering the vaccine and that “with any medication” there is a remote chance that it may cause serious injury or death. 
“A study that was recently published in the ‘Journal of Allergy and Clinical Immunology’ determined that the odds that a vaccine will trigger a serious or potentially fatal allergic reaction is very slim,” Bickford said. “In fact, it’s about one in a million (or 1.31 in a million to be exact).” 
American Academy of Allergy Asthma and Immunology researchers at the CDC searched the Vaccine Safety Datalink databases, according to Bickford, and identified potential anaphylaxis cases following vaccines in the United States.
“After reviewing 25 million vaccines administered between the years of 2009 to 2011, they found that just 33 people had a serious or potentially life-threatening allergic reaction known as anaphylaxis,” she said. 
After reviewing the cases from more than 17 million visits, the same researchers identified 380 cases of anaphylaxis, possible anaphylaxis or allergy of which only 135 involved children 5 years and younger, she said. 
The same research determined that there have been no cases of vaccine-induced anaphylaxis in children younger than four and that no one who had ever had anaphylaxis from a vaccine died, and that only one was hospitalized, Bickford said. 
The research also determined that asthma or past anaphylaxis were a factor in as many as 85% of the cases and that epinephrine, a first-line treatment for anaphylaxis, was only given in 15% of cases, Bickford said. 
While allergic reaction to vaccines is quite rare, the CDC recommends that caregivers be prepared to treat any symptoms and that parents should be aware of possible signs of allergic reaction. 
Bickford and Scharf both said that is important not only for children but also for adults to know their status when it comes to vaccinations and that acting earlier is better. 
“The biggest thing is to come in before school starts and check with the doctors to see if you are up-to-date on vaccinations,” Bickford said. “It is so important to find the status of your child and yourself to determine which vaccines you have and which ones are needed before school starts. This makes for less of a rush right before school.” 
She said that all students are required to be up-to-date on vaccines within 30 days of starting school in Wyoming. Weston County Public Health and the clinic in Newcastle can help check the status of vaccines and administer them. 
“You can also check with the school nurse. Every vaccination goes into the Wyoming Immunization Registry, and we have that tool to use,” Bickford said. 
Scharf said that living in a small community does not necessarily mean there is less risk of an outbreak.
“We are equally as vulnerable here as in a bigger community, especially because we travel more outside of the community to bigger areas before returning home,” Scharf said.