Welcome to StarNet's live chat today with Arizona Daily Star reporters Stephanie Innes and Rob O'Dell. We'll be talking about their special report published on Sunday about vaccination rates in Arizona.You may ask questions at any time or share your experiences with vaccinations. Questions will not appear immediately, but will show as the questions are being answered. We'll be getting under way in just a few minutes.
Thanks for joining us in this chat. Just to recap our story from Sunday: the Star found one in three kindergarten classes in Arizona last year had an unsafe level of children vaccinated. That means there was no so-called "herd immunity" to protect children in those classes from vaccine-preventable diseases like whooping cough, measles and mumps.
The federal data is available on the CDC website, in the CDC vaccination pink book. The state data is available through the Arizona Department of Health Services. It is not on their website, but they will provide it on request.
Thanks so much for chatting with us about our series on vaccinations in schools.
We first requested vaccination data for kindergarten classes on Jan 4 from the Arizona Department of Health Services. We felt the school data was a better look at vaccines than zip codes, which is often how vaccination rates are broken down.
We obtained data from the state for the 2009-10 and 2010-11 school years. It was given to use by county, so we had to combine the data, clean it to remove erroneous data and then determine which schools fell below safe levels that we determined by talking to health experts.
The state withheld data for schools with kindergarten classes under 20 students because they claimed unvaccinated children could be identified. They stuck to this even though we threatened to sue them. They finally gave us the data for schools under 20 kindergarten students, but with the names redacted. To get the final vaccination rates by county and statewide, we had to combine the schools both under and over 20 students. It showed that one in three Arizona schools fell below safe vaccination levels, and in some counties, it was much worse.
Many people have concerns about the number of shots/doses that are both recommended by the CDC and mandated by the state. This is understandable - there are a lot! Both doctors and the state allow some leeway on the schedule, so parents may space out the timing. Also, the instances of adverse effects from vaccines are very, very rare and the data shows that the advantages of vaccinating outweigh risks.
As for vaccines in schools, no it's no longer done, likely for liability and cost reasons.
We found that the schools with a commitment to vaccinate were the ones with the highest rates. A school nurse helps, but high vaccinates rates can be accomplished as long as someone at the school is committed to keeping the rates high. That can be a nurse, front office manager, administrator or principal. However, enforcement of the law by the state would obviously help because most of the unvaccinated students are at schools that are not following the law.
We initially included parents with concerns about vaccinations, and the autism/vaccine debate in our story but it turned into a bigger story, and one that will come out in the newspaper in June.
A little more on that: In the upcoming story we will talk about the federal government's vaccine injury compensation fund, and also talk to parents who have very real and understandable concerns about immunizing their children.
Yes, children who aren't vaccinated might not get sick themselves, but they put others at risk, particularly newborn infants who are too young to be immunized. Also, there are many children with compromised immune systems who are in school - children who have received organ transplants, who have cancer, or who are on intense medication like steroids. As medicine improves and keeps more children alive and in school, we also have more immuno-compromised kids who are susceptible to disease.
I don't know what parents say to themselves, but it likely stems from a belief that vaccinations either don't work, or will do more harm to their children than good. Many people don't remember how bad some of these diseases were. Others believe that vaccines cause harm. Our next story will focus more on this.
As for the middle and high school numbers, we don't have them now but are requesting them. That will be another installment of our series that will run around the start of the school year.
We've heard parents who feel vaccinations are a way for the pharmaceutical industry to make money, and doctors, too. Doctors are actually not reimbursed very well for immunizations, and as you know they take a Hippocratic oath: first, do no harm. So most doctors have their patients' best interest when they recommend vaccinations.
I will give two answers to this question. About immigrants, this answer is roughly what we found. Although there are a few low-income schools (likely with many immigrants) that have lower rates, they are often brought up to high levels very quickly.
The data showed that charter schools and private schools do not improve as much or bring their rates to high levels.
As for the second answer, several of these comments are indicative of the divide between people who do and don't vaccine. Arguments on either side will not convince people to think about or change their position. And they often have not very nice things to say about the other side.
This will again be part of our next story.
There is a lot of information on the Internet both for and against vaccines. When we talked to Dr. Arturo Gonzalez, an Arizona pediatrician who is president of the Arizona chapter of the American Academy of Pediatrics, he advised against using "Dr. Google" for the answer. Rather, talk to your pediatrician. The CDC's pink book on vaccinations also provides good statistical information, including pre-and post-vaccine morbidity statistics.
But as Rob said: A lot of these pro and anti vaccine issues will be addressed in our next story.
This story was to identify rates in schools.
That's right. Doctors are not reimbursed very well for vaccines. I'm sorry if that wasn't clear in my previous post.
This is a question I need to ask for those who believe there is no evidence that vaccines work. What about smallpox? It was one of the largest killers in history. Wiped out millions of people.
We don't have to get vaccinated for smallpox anymore because it has been eradicated from the world. Vaccinations eliminated it from the world as a disease. How do you address this?
Yes, I will add to what Rob said: look at haemophilus influenzae, now preventable in babies with the Hib vaccine. Before the vaccine, haemophilus influenzae killed nearly half of the babies who contracted it, and those who survived often had lasting damage.
There are a lot of groups who believe they are giving the best information. A group with excellent unbiased information in Arizona is The Arizona Partnership for Immunization.
One of the doctors we spoke to mentioned "birds of a feather" - so the worst thing to do is just rely on word-of-mouth from fellow parents. Best to go directly to a trusted medical source.
This is the main point of our story. Science has shown that the concept of herd immunity protects the weak, unvaccinated, those whose vaccines didn't work and babies who are too young to be vaccinated.
The unvaccinated do serve as vectors for the vaccine preventable disease, which is why unvaccinated children are excluded from schools when there is an outbreak.
This is what is happening with measles. The US declared that measles was eradicated in the US in 2000. But there are still outbreaks of the disease because those infected with measles come to the US and inflect a population that is increasingly not vaccinated against measles.
Measles cases hit a 15 year high in 2011. Highest since 1996
There are low-cost back to school clinics offered through Pima County this summer. Also, medical students at the University of Arizona College of Medicine are offering free shot clinics at the Community Food Bank this summer.
Parents are not forced to immunize their children. They can sign a personal belief waiver if they have personal or religious objection.
They can also get a medical waiver, but that must be signed by a doctor.
Although the personal belief and medical waivers are allowed, children who are unvaccinated can be set home from school if there is a disease outbreak.
Some experts suggest it may also help to speak with people who remember vaccine-preventable disease outbreaks before the vaccines were developed. Thousands of children were paralyzed from polio in the 20th century, and nearly 17,000 in the U.S. died.
This will become a bigger issue if vaccination rates continue to trend at the levels they are.
Schools and others could face civil liability for an outbreak that kills or severely injures people. This could be especially true if schools are not following the state law. It's hard to quantify exactly what could happen because I haven't seen any cases like that yet. If someone knows of one, please let us know.
Our investigation was looking at the state law on immunizations and how well it was being enforced in schools. We found many schools weren't enforcing it, and possibly not even giving parents a chance to explore their options.
We only have time for a few more questions. Please feel free to contact us at firstname.lastname@example.org or email@example.com. We want to hear from you, whatever your beliefs on vaccinations are. We are putting together our story on autism and other objections to vaccines and want to hear people's voices. The story should run in June.
The other issue that has come up is school nurses - the schools with school nurses, or someone else dedicated to enforcing the law had a much better rate of complying with the law.
A lot of comments in the chat and in emails to us since the story ran have talked about vaccines and how they are cultured. We will address this in our next story, so please contact us.
The right to be protected from the unvaccinated could be a bigger issue in the coming years. Two more questions.
There are some comparisons, but since states don't collect data in the same ways it's difficult to say it's apples to apples. We do know there are pockets or clusters in the country that have large numbers of unvaccinated children.
Again, to this I have to come back to the example of smallpox. It was eliminated by vaccinations.
Bubonic plague is still around. It just isn't a big factor now because world conditions are much more sanitary. It is spread from the fleas of rats. The more sanitary the conditions, the less this is a factor. It's still around however.
Thanks so much for chatting with us. Please contact us at firstname.lastname@example.org or email@example.com. We'd love to hear from you.
The March of Dimes has been a big player in trying to improve vaccination rates in Arizona, too.
Thanks for chatting with us!