Saturday July 21, 2018

Parents More Worried About the Vaccines Rather Than the Disease

“Collectively, this factor is driving vaccine refusal and delay,” said Professor Tony Yang, one of the principal authors of the study.

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“I had measles. I had mumps. I had German measles (rubella). I had the chickenpox so I know what those diseases felt like, and it was miserable,” he said
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Dr. Paul Offit is an infectious disease specialist and an expert in vaccines. He’s been at Children’s Hospital of Philadelphia since 1992. Since then he says not a year has gone by when he has not seen a child die from a vaccine-preventable disease. It’s largely, he says, because the parents chose not to vaccinate their child.

Far from Philadelphia, along the rugged border between Pakistan and Afghanistan, health workers are desperately trying to vaccinate every child against polio so no child will ever again suffer the crippling effects of this disease. If they can complete this task, polio will be a disease of the past.

Offit says the difference between parents in this mountainous border region of southcentral Asia and those in the U.S. is that in Pakistan and Afghanistan, people know the devastating consequences of polio. He says previous generations in the U.S. did, too.

Offit says parents in his generation were also quick to vaccinate their children.

“I had measles. I had mumps. I had German measles (rubella). I had the chickenpox so I know what those diseases felt like, and it was miserable,” he said

Dr. Paul Offit is an infectious disease specialist and an expert in vaccines. He’s been at Children’s Hospital of Philadelphia since 1992.
Children’s Hospital of Philadelphia, wikimedia commons

23 viruses, two cancers

Vaccines can prevent 23 viruses and two types of cancer, and more vaccines are in the works, including one for HIV, the virus that causes AIDS. Offit is the co-inventor of a life-saving rotavirus vaccine.

But some parents are not getting their children vaccinated. Last year there were more than 14,000 cases of measles in Europe, mostly in Romania. Nearly 40 children died. It exasperates health officials like Miljana Grbic, head of the World Health Assembly in Romania.

“We cannot fight this disease if we do not increase vaccination coverage,” she said. “… But we also have to understand why vaccination coverage is going down.”

For some parents, it’s the inconvenience of the trip to the doctor’s office. Others think good hygiene and nutrition are all children need to stay healthy. Still others believe vaccines can give their children autism, diabetes and other diseases.

Offit says persuading these parents to vaccinate their children is hard.

“It’s hard to compel people to vaccinate against something that they don’t fear,” he said. “And when they don’t fear that, what they’ll do is, they’ll fear the vaccines, and I think that’s where we’re at.”

Vaccine refusal spreads

A study published in BMJ suggests that in the U.S., vaccine refusal is contagious. It spreads from communities with a high number of parents who oppose vaccines to other communities nearby when parents who oppose vaccines talk to their friends and parents of their children’s schoolmates.

“Collectively, this factor is driving vaccine refusal and delay,” said Professor Tony Yang, one of the principal authors of the study.

If they can complete this task, polio will be a disease of the past.
A health worker gives a polio vaccine to a baby girl in Lahore, Pakistan, Monday, April 9, 2018. A Pakistani official says authorities have launched a new polio vaccination drive, aiming to reach 38.7 million children under the age of 5, VOA

Yang, from George Mason University, and his co-authors looked at the number of non-medical exemptions for vaccines from 2000 to 2013. They found these exemptions increased in geographical clusters.

Some governments are now making it harder for parents not to immunize their children. After a measles outbreak, California passed more restrictive laws. Yang says parents trust their pediatricians, so health care providers need to be more pro-active in getting children vaccinated.

Australia HPV work

Despite hesitancy in some parts of the world, some countries are leading the way in promoting vaccines. Australia has provided the HPV vaccine to school-aged girls since 2007.

Also Read: Sitting in Cars or Planes For Long Duration Can Cause Blood Clots, says Study 

The Human Papilloma Virus (HPV) causes cervical cancer, the second most common type of cancer in women worldwide. It also causes head and neck cancers and genital warts.

By 2013, a study showed a significant reduction in the number of young women with abnormal cells of the cervix and a 90 percent decline in genital warts in young women.

Cervical cancer takes 20 to 30 years to develop. By 2035, Australia expects to see up to a 45 percent decline in deaths from cervical cancer all because of a vaccine and the government’s policy. (IANS)

 

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Will Polio Workers Step Out of Their Comfort Zones to End Virus?

What's more, the border between Afghanistan and Pakistan stretches for more than 2,000 kilometers. Thousands of people who cross this very porous border can easily transmit the virus in both countries.

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Polio
Widespread unrest in Afghanistan has kept thousands of children from receiving polio vaccines this year. Conflict in northern Nigeria does the same. VOA

The move to end Polio started in 1985 with Rotary International. At that time, polio paralyzed hundreds of thousands of children every year. There is still no cure, but two scientists developed vaccines against the virus in the 1950’s.

Dr. Jonas Salk produced one with an inactivated virus that could protect against polio without spreading the disease. Later, Dr. Albert Sabin developed an oral vaccine with weakened strains of the virus.

In 1988, public and private groups joined the effort in the Global Polio Eradication Program. Members included governments, the World Health Organization, the United Nations Children’s Fund (UNICEF), Rotary International, the U.S. Centers for Disease Control and Prevention (CDC) and the Bill and Melinda Gates Foundation.

Since then, the number of polio cases has dropped by 99.9 percent. Last year, 22 children were crippled by this disease. The wild polio virus exists in only three countries: Pakistan, Afghanistan and Nigeria, but it’s still a global threat.

Dr. John Vertefeuille, from the CDC said, “This last mile is a complicated mile.” It’s not just because of conflict or terrorism. “It’s extreme remoteness. It’s very fragile health systems.” And in these remote conflict prone areas gaining access to children can be a major problem.

If polio exists anywhere, it can once again spread everywhere.

Polio
In many places the vaccinators are women because women can go into the homes, talk to other women and gain access to the children. Wikimedia

Vertefeuille and other experts discussed strategies to realize a polio-free world July 10 at the Center for Strategic and International Studies in Washington.

Widespread unrest in Afghanistan has kept thousands of children from receiving polio vaccines this year. Conflict in northern Nigeria does the same.

What’s more, the border between Afghanistan and Pakistan stretches for more than 2,000 kilometers. Thousands of people who cross this very porous border can easily transmit the virus in both countries.

While the funding and technical support has to come from large, private-public partnerships, immunization teams succeed best if they are local. Approaches have to take culture and customs into consideration.

In many places the vaccinators are women because women can go into the homes, talk to other women and gain access to the children.

Elsewhere, soldiers vaccinate children when they take over an area run by anti-government forces. Vaccination teams have to be prepared to move quickly when there is a lull in the fighting and to deliver multiple doses of vaccine in a short period of time.

Polio
Community volunteers are a great resource. Some get cell phones so they can alert health officials if a child becomes paralyzed. VOA

Surveillance is just as critical. To end polio, you have to know where the outbreaks are. Community volunteers are a great resource. Some get cell phones so they can alert health officials if a child becomes paralyzed.

Another challenge is getting children in migrant groups vaccinated. Vertefeuille says this is where technology helps. The CDC uses satellites to see where people have moved and what areas are abandoned. Clues are where structures have been repaired, where the grass grows on roads, indicating abandoned areas, and where it doesn’t, indicating where people are living.

Dr. Andrew Etsana from the International Federation of Red Cross and Red Crescent Societies said these groups present a particular challenge because “you have people moving with a virus and it is difficult to track them and vaccinate the vulnerable children in this mobile population.”

Another issue is the nature of viruses themselves. Viruses mutate. So far, the polio vaccines have been effective, but if not enough children get vaccinated, the virus can change, and perhaps make the vaccine less effective. That’s why every child needs to be vaccinated.

Outbreaks that can be avoided by vaccinating the whole population so that there are no gaps for the mutated virus to slip through.

International experts are working with local leaders to close this gap.

Another issue is complacency. Etsana said, “People are getting tired. The program has been going on. They thought it would have ended.”

Rotary has pledged to continue its support, other groups as well. International support and funding is critical to ending polio, but after three decades, many people have never seen polio. Etsana says he sees complacency creeping into all areas of the program. “The funders of the program are also getting tired. The fund is drying up and if the fund dries up and the job is not done, we’re going to have a major problem. We may have reinfection.”

Also Read-After Three Years Struggle, WHO Declares Somalia Polio Free

But, if people recognize the program’s value – it has united communities, established vaccine centers, created partnerships never before imagined – the world can not only end polio, but tackle other diseases as well. The polio program is widely credited with stopping the spread of Ebola in Nigeria while the disease ravaged other west African countries. (VOA)