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Sunday, September 25, 2011

Why We Require Childhood Vaccinations

Roanoke Times Editorial by Dr. W. Austin Spruill | Spruill writes on behalf of Physicians to Children in Roanoke.

We, the providers of Physicians to Children, believe it is important to communicate to the public clearly and feel that the message and intent of our new vaccination policy has been poorly conveyed thus far. We recognize and respect the right of all citizens to possess certain views and make personal choices, and we realize we will not always agree.

With more than 150years of collective pediatric experience, we possess the unified view that childhood vaccinations have been and continue to be one of the most powerful public health measures ever instituted, and they have saved countless lives by preventing communicable diseases rarely seen today.

This view is based on the results of decades of scientific study and data gathering on millions of children worldwide. It is important to note that when outbreaks of these diseases do occur, they generally do so in communities where children are either unimmunized or underimmunized.

We also believe it is our responsibility to strongly advocate for the health of all of our patients. As it relates to vaccinations, we spend countless hours educating and reassuring parents about the effectiveness of vaccines and promoting their adoption consistent with our unified view and in keeping with our stated responsibility.

We understand that some do not share our view and will make the choice to decline vaccinations. This is where it gets difficult for us to fulfill our responsibility of advocacy for all of our patients.

We cannot possibly claim this degree of advocacy if we knowingly allow patients who are not immunized by parental choice to put the health of our most vulnerable patients at risk.

It is not our fully immunized patients that we are most concerned for as they are mostly protected, but rather the youngest infants and the immuno-compromised patients with cancer, transplanted organs and other debilitating diseases. For healthy children and adults, pertussis, or whooping cough, can be a mild to moderate illness; however, it can be fatal for the most vulnerable patients.

As a result of our belief in the benefits of vaccinations and our responsibility to be advocates for the health of all of our patients, we cannot reconcile the practice of placing our most vulnerable patients at risk through no choice of their own.

Therefore, after months of thoughtful deliberation we, like a growing number of practices nationwide, have come to the decision to ask families that have made the choice to decline vaccinations to seek care with a practice or provider who may accommodate their views.

As always we sincerely wish for them the best of health, and we will assist these families in any way possible during their transition

For our patients who have been considering vaccinations and are wondering how this policy change will affect them, we encourage them to discuss this with their primary provider.

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Effective 01/01/2012 Physicians to Children will be participating with the following new HMO's in the Roanoke Area: Amerigroup, CareNet, MajestaCare, Optima Family Care, and Va Premier Health Plan, Inc..

All people age six months and older are now recommended receiving annual influenza vaccination.

To protect your family the CDC recommends a yearly flu vaccine as the first and most important step in protecting against this serious disease. While there are many different flu viruses, the flu vaccine protects against the three main flu strains that research indicates will cause the most illness during the flu season.
Flu seasons are unpredictable in a number of ways. Although epidemics of flu happen every year, the timing, severity, and length of the epidemic depends on many factors, including what influenza viruses are spreading and whether they match the viruses in the vaccine. Last flu season (2009-2010) saw the emergence of the 2009 H1N1 influenza virus (previously called "novel H1N1" or "swine flu"). This virus caused the first influenza pandemic (global outbreak of disease caused by a new flu virus) in more than 40 years. While not certain, it is likely that 2009 H1N1 viruses will continue to spread along with seasonal viruses in the U.S. during the 2010-2011 flu season.

The timing of flu is very unpredictable and can vary from season to season. Flu activity most commonly peaks in the U.S. in January or February. However, seasonal flu activity can occur as late as May.

CDC recommends a yearly flu vaccine for everyone as the first and most important step in protecting against this serious disease. While there are many different flu viruses, the flu vaccine is designed to protect against the three main flu strains that research indicates will cause the most illness during the flu season. The 2010-2011 flu vaccine will protect against three different flu viruses: an H3N2 virus, an influenza B virus and the H1N1 virus that caused so much illness last season. Getting the flu vaccine soon after it becomes available each year is always a good idea, and the protection you get from vaccination will last throughout the flu season.

The effectiveness of the vaccine can vary and depends in part on the match between the viruses in the vaccine and flu viruses that are circulating in the community. If these are closely matched, vaccine effectiveness (VE) is higher. If they are not closely matched, VE can be reduced. During well-matched years, clinical trials have shown VE between 70% and 90% among healthy adults.
It’s not possible to predict with certainty which flu viruses will predominate during a given season. Flu viruses are constantly changing (called drift) – they can change from one season to the next or they can even change within the course of one flu season. Experts must pick which viruses to include in the vaccine many months in advance in order for vaccine to be produced and delivered on time.
The vaccine provides protection even if the vaccine is not a good match. Antibodies made in response to vaccination with one strain of flu viruses can provide protection against different, but related strains. A less than ideal match may result in reduced vaccine effectiveness against the variant viruses, but it can still provide some protection against influenza illness. In addition, it's important to remember that the flu vaccine contains three virus strains so that even when there is a less than ideal match or lower effectiveness against one strain, the vaccine may protect against the other two viruses. For these reasons, even during seasons when there is a less than ideal match, CDC continues to recommend flu vaccination. This is particularly important for people at high risk for serious flu complications, and their close contacts.
In addition, you can take everyday preventive steps like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading influenza to others.

Center for Disease Control and Prevention: