Download The CDC says that there is not a limit on how many vaccines the

What are the benefits of vaccinations? Infectious disease is one of the more
powerful forces on the planet. Deaths from wars has not been nearly so
devastating as deaths from disease when you compare them in history. With
the exception of surviving a disease, vaccination is the only way to become
immune to a disease. It has been man’s greatest conquest. If we did not have
vaccines many people would die daily of infectious disease. We don’t have to
look back too far in history to see that many people died from diseases such as
small pox, influenza, measles and polio before we had vaccines against them.
Small pox was the first disease eradicated completely from the planet using
vaccinations. It is hoped that Polio will be eradicated in the near future.
Are there some that are harmful? There are risks to everything (even driving to
the store). Vaccinations have risks. A very small percentage of persons can
have allergic reactions to vaccination. This is very rare but possible. Some
vaccinations have potential side effects. The Centers for Disease Control on
Prevention (CDC) monitors vaccinations before and after they are licensed and
evaluates their safety. They will discontinue or change a vaccine if it seems
unsafe. The greater the threat of a disease, the higher the benefit of vaccination
even if there might be a risk from the vaccine. All healthcare providers weigh
the health versus benefit value of vaccinating.
An example of this is the Polio. The disease reached its peak in the United
States in 1952 with more than 21,000 paralytic cases. An oral polio vaccine
licensed in 1955 dramatically decreased polio cases in the United States. By
1960 only 2,525 cases were reported in the United States and 65 in 1965. The
last case of wild polio in the US was in 1979. The US used an oral polio vaccine
for many years. There was a slight risk that people can develop a condition
called vaccine associated paralytic polio (VAPP) and evidence showed that
about one in every 2-3 million people would develop this condition. When it
became obvious that the risk of wild polio in the US had become very low, the
CDC examined the risk vs benefit of the live polio vaccine and decided to
discontinue the oral polio vaccine in 2000. An inactivated polio vaccine is now
used.
How can you educate yourself to better know what the vaccination is? The CDC
website is amazing: http://www.cdc.gov/vaccines/ I also like the Immunization
Action coalition website http://www.immunize.org/
What immunizations are required before entering CSU? The state of Colorado
requires all students studying on a campus that has on-campus housing show
proof of immunity to Measles, Mumps and Rubella (MMR). The state requires
proof of two MMR vaccines or positive blood titers on each of the diseases for
everyone born after January 1, 1957. This is similar to the K-12
recommendation in Colorado (except K-12 has many more requirements) and
every other state in the US so most students don’t have any problems getting
those records. The state does allow for exemptions: medical, religious and
personal. If someone has an exemption and we have an outbreak of one of
those diseases they will not be allowed on campus until the outbreak is declared
over. This happened in about 1990 with measles. Fortunately, most of our
students don’t sign exemptions-we discourage it. CSU itself does not have any
immunization requirements except for the vet school requiring Rabies vaccines
for their students.
What immunizations would you personally recommend getting? A current
Tetanus-a new Tetanus vaccine was licensed in 2006 that has pertussis
(whooping cough) for adults (it’s called Tdap). I would love to see everyone on
campus have this because pertussis has been sporadically seen in Ft. Collins
and we’ve had a few cases at CSU. It is spread by a cough. Hepatitis B (which
K-12 began requiring in 2003), meningitis, HPV for women. I have a whole
bunch of vaccines that I recommend for people when they travel.
Can you get too many vaccinations at one time? The CDC says that there is not
a limit on how many vaccines the body can tolerate at one time and it is better to
vaccinate with many then risk that a person won’t return to get vaccinations.
There are rules about the timing of vaccines, especially live vaccines. What
amount is safe? I mostly try to limit the number of vaccines to a person’s
tolerance. I don’t want to make the experience so traumatic that they never get
vaccinated again.
How many shots can children get in one appointment? Many, see above. Many
vaccines now are combinations of many antigens (different diseases) so that
hopefully children aren’t getting too many pokes at one time.
Does it affect children differently than adults? How? In the first year of life a
child may have immunity from its mother and we don’t give live vaccines until
after they turn one for that reason (but we do given the inactivated vaccines then
because they are not affected my maternal antibodies).
Children usually have healthy immune systems and a better immunity formed
after a shot. As we age our ability to produce immunity from a vaccination can
wane. The CDC is evaluating a double strength flu shot for those over 60 (or
65) because of this reason.
Are some vaccinations only appropriate or effective with certain age groups?
When vaccines are researched and then proposed to the FDA they have looked
at certain age groups. Many times this is related to the age at risk such as the
new HPV vaccine being licensed for girls and women from 9-26 because it is
aimed at preventing HPV before their first sexual encounter. Vaccines are
tested for safety and efficacy in the target age groups before they are licensed.
What are the requirements for traveling out of country; why? The only vaccine
that is required in some countries is Yellow Fever. This is required in some
countries in S. America and Africa and people must carry a stamped card
showing proof of this vaccine. There are no other requirements but certainly
recommendations. I use the website cdc.gov/travel to see what is
recommended in each country.
How did you handle the meningitis scare? Communication about how it is
transmitted was very important. People get scared and we have two jobs when
it happens-to identify who might really have been exposed (in the case of
meningitis oral to oral contact) and to educate the public about the disease and
how it can be avoided (don’t share saliva). We also heavily promoted the
vaccine. The first young girl who died had been vaccinated in 2006 and we (the
CDC included) learned that the vaccine is only good for 3-5 years (it had only
been licensed 5 years so this was brand new to everyone) so we had to educate
people and then provide the vaccine.
How has that affected the health center? Since I have been involved in infection
control I have worked on several meningitis cases (not to mention many other
issues)-this one was probably the most obvious and painful because of the
student death. I have always tried to educate the CSU community about
meningitis and with the events of the past year the message is being heard
more than ever.
...the general student body? I hope that there is not anyone left on campus that
hasn’t heard about the risk of meningitis and the vaccine. I am already working
on how I’m going to educate the incoming freshman so my job is never done.
...the nurses individually in their work settings? I am exhausted. So is my staff.
Do you remember how many mengitis vaccinations were given out? We did
about 10,000 at the two clinics in November (I’ve heard the first one, where we
did over 7000 was the biggest vaccine clinic ever in the US), in addition CSU
Health Network has given another 2000. We still are offering the vaccine for
free until the end of this semester.
What is the Health Center’s view on vaccinations/prescriptions and the student
body? I believe that everyone has the right to choose how they live their life and
whether they want to get vaccinations or prescriptions. I think that a health care
practitioner’s job is to help educate people to the risk vs benefits of certain
medical interventions whether they are immunizations or prescriptions. I have
no problem with people listening to my suggestions and they declining if I feel
that they truly understand the risks. I hate to see people not get vaccines or
treatment based on unfounded fear and inaccurate information.
That being said, however, public health only works when we all do what we can
to protect each other. While anyone can refuse to get a measles shot and risk
getting the disease themselves, they can also spread measles, if they get it, to
unvaccinated babies, people who can’t be vaccinated due to
immunosuppression, etc. If almost everyone on campus is vaccinated for
meningitis then those few who aren’t are less likely to become infected. This is
called herd immunity and it is very important in public health.