By BECKY GILLETTE
A recent outbreak of chickpox at the Asheville Waldoff School in North Carolina sickened 36 children and put renewed attention on allowing parents to claim exemptions to keep their child from being vaccinated.
Mississippi doesn’t have nearly as many exemptions to vaccinations required to attend public school. As a result of that and a robust effort to make sure cost-free vaccinations are available, the state has the highest rate of compliance with childhood vaccinations in the country, said Thomas Dobbs, MD, MPH, interim State Health Officer, Mississippi Department of Health.
“The most important component of that is we have a strong science-based immunization law in Mississippi that insures kids are protected from vaccine preventable diseases when they go to school,” Dobbs said. “
Immunizations are covered by all insurances, Medicaid, the Children’s Health Insurance Program, and the Vaccines for Children program sponsored by Centers for Disease Control and Prevention (CDC).
Chickenpox can range from mild to severe. It can also re-emerge later in life causing shingles, a viral infection that can cause a painful rash. Dobbs said with more people living longer, there is a large pool of people with weakened immune systems who could be susceptible to shingles.
There have also been outbreaks of another vaccine-preventable disease, measles, in Europe and in New Jersey in an under immunized population.
“In Europe, there have been 31,000 cases of measles and 47 deaths,” Dobbs said. “It is felt a large portion of that is due to unfounded vaccine fears. Measles is extremely contagious. Every case of measles on average spreads to 18 other people in an unimmunized community.”
Some “antivaxers”, as they are known, express concerns that vaccines can cause autism. Dobbs said that has been thoroughly refuted.
“There is no evidence immunization causes autism, but there is a mountain of misinformation and fear mongering,” he said. “I understand people become scared and it becomes emotional. But if you look at the science and the data, the claims that are circulated are thoroughly discredited. You have to let reason decide. You shouldn’t let emotions and frightening YouTube videos influence policy.”
University of Southern Mississippi Public Health Professor Susan Dobson said one of the reasons we might be seeing some resistance to vaccines for things like chickenpox is a lot of parents who are raising children today either didn’t get chickenpox as a child or don’t remember it.
“They don’t realize how bad chickenpox was,” Dobson said. “I think a lot of times when we can’t visualize what an illness might look like in real life, we might not realize it could be severe for our children. Chickenpox can be a dangerous illness. So, we want to prevent it and we have public health tools to prevent it.”
Dobson said one thing health educators know is that people are generally open to taking action when they believe whatever they are preventing is severe and that they are susceptible. Is this thing bad? What are my chances of getting it? If those two things register high concerns, people are motivated to take actions.
“Many things we vaccinate for most adults have not seen in their life,” Dobson said. “I’ve never seen anyone who has suffered from polio for example, so maybe I can’t appreciate how bad that it. My children didn’t get chickenpox and my friend’s children didn’t get chickenpox. That can prevent people from taking action. They are perceiving it not to be serious and they are perceiving a small chance of catching it. Those perceptions are not true.”
With Mississippi’s current high coverage for vaccines, the likelihood of children getting vaccine-preventable illness is lower. But if we start to see people refusing vaccinations, the risk of catching an illness increases.
“It doesn’t matter what is true,” Dobson said. “It only matters what people believe to be true. The two are not always the same. Our challenge in public health is to correct their perception and then for people to take the correct action to protect the health of their children and others. In North Carolina, there was a community that had pushed back against recommendations for vaccination. We saw an outbreak there and we have a tool to prevent it. Our job as public health professionals is to educate the public so they understand the consequences. We want to lower the number of people who are pushing back against vaccination.”
Dobson said in public health, one of the ways they measure the impact a disease has on an area or community is look at the cost associated with that. Obviously, you have direct medical costs if the child gets sick, and if the child is receiving any state or federal benefits, the expense may be passed on to taxpayers. When you look at it in an economic development way, when children miss schools, parents miss work, which can reduce productivity at their place of employment.
The flu shot also can be controversial. The CDC recommends the flu shot annually for anyone more than six months of age. Employers mandate it for most healthcare workers. But fewer than half of Americans have gotten the flu shot this season.
Dobbs said the flu shot is not perfect.
“We acknowledge that,” he said. “In a good year, it is 62 percent effective in preventing all symptoms. And even when get it the flu anyhow, the duration is less, you are less contagious, and there are fewer deaths.”
Dobbs said it is important for people in a healthcare setting to get the flu shot as they are taking care of ill people. But it also makes sense in other types of businesses.
“As far as businesses go, flu is a killer for productivity,”Dobbs said. “People in the workforce who have had the flu shot are less likely to spread it around. You are doing your best to wall off the domino effect in the workforce.”
Dobbs said one of the myths is that the flu shot can give you the flu. He said that is absolutely not true. The flu shot does not contain the flu, but protein segments that stimulate the immune system to recognize the flu. As your immune system learns to generate a response to those proteins, people can feel a little achy.
“The problem we see people is when people get the flu shot and then get a cold around the same time or they get the flu before the flu shot has time to take effect,” Dodds said. “It takes two weeks for the flu shot immunity to kick in. People make these temporal associations that are not linked to the vaccine. And it is not too late to get the flu shot. If you haven’t gotten it, or your kids or parents haven’t gotten it, it is not too late.”
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