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Editorial to the Cheyenne Tribune Eagle

Dear Editor:

The Cheyenne Tribune Eagle article called "Avoiding the sting: State officials worry too few vaccinated" states that one young mother "said she doesn't worry about the outbreak of a disease because she doesn't think the vaccines provide any protection." This statement, when read by the typical person, may be interpreted as evidence that the people who choose not to vaccinate are terribly misinformed.

In an article called "Shoot First, Don't Ask Questions Later", Sandy Mintz discussed the question of whether or not vaccines are effective in the prevention of the diseases for which they were manufactured. She does a great job of showing that while they are sometimes effective in prevention of a disease, such as measles, they are not necessarily causing a decline in death rates and in subclinical and mild cases. She feels that the consequences of such mild cases are not treated with the careful study that they deserve. She is "right on the mark" when she says, "The question, in my opinion, that should be asked is: 'What has been the cost of any declining disease incidence brought about by the introduction of vaccines?' To repeat: Since there have never been any long-term studies comparing the vaccinated to the never vaccinated, we simply do not know the answer to that question." This was taken from the Scandals column on Sandy Mintz's web site from September 12, 2003.

Please read Sandy's entire article at, for more insight into this complex question.

Susan Pearce
Wyoming Vaccine Information Network
Banner, WY

Avoiding the sting
State officials worry too few vaccinated

By Allison Fashek
Published in the Wyoming Tribune-Eagle

CHEYENNE - On a recent Wednesday afternoon, Rocio Rodriguez brought her 4-year-old daughter, Alexandra Ferman, to the City-County Health Department for a checkup.

Smiling shyly, the little girl with the bouncing pigtails had been told she wasn't going to get a shot during the visit. But a check of her medical records showed that she needed her second round of measles, mumps and rubella vaccinations and a polio shot before she could attend preschool.

A moment later, the needles appeared, Ferman's sleeves were rolled up and her smile turned to, well, you can guess the rest. It's a scenario that occurs thousands of times a day in clinics and doctors' offices around the world.

But John Jones, Immunization Program Manager for the Wyoming Department of Health, is concerned about statistics that show, lately, it isn't happening as frequently in Wyoming.

In 2002, Wyoming's rate of vaccinating children 19-35 months old at age-appropriate levels dropped to 73 percent, its lowest point since the late 1990s and slightly below the national average, according to statistics compiled by the Centers for Disease Control and Prevention's National Immunization Program.

The statistics were based on the standard 4:3:1:3:3 vaccination, or 4 diphtheria, tetanus, pertussis, 3 poliovirus vaccine, 1 measles-containing vaccine, 3 hemophilus influenzae type b and 3 hepatitis b.

The drop in the immunization rate could have been caused by a number of factors.

A dip in the economy could be preventing parents from taking their children to the doctors' offices and keeping up with their shots. The Wyoming Immunization Program is examining whether minority communities are getting information about vaccination clinics. And the number of children who've asked to be exempt from vaccinations, though still small, has tripled in the state during the past five years.

Whatever the reasons, Jones is concerned.

"Wyoming made big surges in 1999, and now we're below the national average," he said in a recent interview in his office.

"This is a wake-up call for Wyoming."

Since 1900, vaccines have been developed or licensed against 25 diseases. Eleven of them have been recommended for use in all U.S. children.

The Wyoming Immunization Program spends about $4 million of its $5 million federally funded budget on buying and providing about 80 percent of the state's vaccines to both public and private providers, free of charge.

The aim of the program is to increase immunization levels to 90 percent or higher. While Wyoming's vaccine-preventable diseases have followed national trends and decreased over time, in the past 10 years there have been a handful of cases of measles, mumps and pertussis, or whooping cough.

Currently, program statistics show that at any given time, 1,921 children 19-35 months old are inadequately protected against a vaccine-preventable disease. Among about 14,500 preschool children attending Head Start programs and licensed day-care facilities, 6.4 percent, or 928, are susceptible. And among 83,000 school students in grades K-12, 10 percent of 8,300 students are inadequately protected.

Jones believes there is room for improvement.

Minority outreach
The Wyoming Immunization Program has begun working with the state's Minority Health Program to get an accurate picture of the minority immunization level.

"We don't want to assume they're responsible," Jones said. "But there are lots of cultural barriers in terms of access to services and language."

Jones said he's applied for about $200,000 in grant funding that will in part be used to survey minorities and see if the pockets do exist.

Betty Sones, minority health program coordinator for the state's Maternal and Child Health Program, said she's not sure how big the problem is. But she said she does see people who don't have family records and don't know if their children have had vaccinations.

"Some people will only go to the doctor when they have a sickness," she said. "They may get a shot, and it's never documented. They don't know if they had it or not."

She added that increasing outreach about vaccinations could help promote preventative care and get people into doctors' offices before they land in emergency rooms.

Shirley Torrez, a Spanish interpreter for the City-County Health Department and the state's Women, Infants and Children Program, said she thinks outreach is essential.

"There a big Hispanic community here that needs to be reached about the importance of the medical field," she said. "They don't make it in, and there's not enough people to talk to them."

The rise in exemptions
The Wyoming Vaccine Information Network holds monthly meetings during most of the year in Sheridan and Buffalo discussing vaccination propaganda, whether vaccinations are safe or effective, how to get an exemption for your child and ways to strengthen the immune system without vaccinations.

Susan Pearce co-founded the Wyoming Vaccine Information Network in April 2001, about a month after the Wyoming Supreme Court ruled that anyone applying for a religious exemption must receive it. Prior to the ruling, the state health department required some parents to go through a hearing process to prove their religious sincerity.

Pearce wanted to make sure that parents who wanted exemptions for their children had a place to turn for support.

"Personally, I believe that vaccines harm a person's immune system against the way God or the creator would have you treat it," she said.

Pearce is not alone. Jones estimates that during the past five years, the number of children in the state asking for exemptions from vaccinations has tripled from about 700 to 3,000.

Cyndi Atter, 43, of Sheridan got involved with the group after researching the potential benefits and dangers of vaccines.

"The more I educated myself, the more appalled I was," she said.

Atter said she hasn't read any scientific proof that vaccinations prevent children from catching diseases. Her 7-year-old child, Eddie, has never had a vaccination. He also has never had an illness other than two ear infections.

"I attribute that to not having his immune system compromised by all those drugs," she said.

April Phillips, 24, of Sheridan also has chosen not to have her two young children vaccinated. Phillips said she doesn't worry about the outbreak of a disease because she doesn't think the vaccines provide any protection.

On the other side of the coin, the CDC's Web site states that while no vaccine is 100 percent safe and effective, vaccines have reduced preventable infectious diseases to an all-time low.

Katheryn McKee, a nurse with the vaccination clinic at the City-County Health Department, worries about the growing number of exemptions. In her career, McKee has seen children die of diseases such as chickenpox.

McKee said her department is working harder to educate parents about vaccines by showing videos on the topic during prenatal and parenting classes.

"We can't force anybody to do anything, and I don't think that's the answer," McKee said. "But some people are afraid of vaccines. We'd like parents to realize they're the safest around."

The next steps
One easy way to increase the state's immunization levels for children would be for the state to mandate varicella, or chickenpox, vaccinations prior to school entrance, Jones suggested.

Wyoming is one of 12 states without any varicella childhood mandate, according to information from the Immunization Action Coalition. The state has a 54 percent rate of chickenpox vaccinations for children 19-35 months old, about 11 percent below the national average.

Dr. Barry Wohl, president of the Wyoming Chapter of the American Academy of Pediatrics, recently wrote a letter to Jones in support of pushing for the mandate.

Chris Bartholomew, head nurse for Laramie County School District 1, would like to see the state mandate that students be up-to-date on their vaccinations before school starts each year. Currently, students have 30 calendar days once school begins to play catch-up. Checking each student's status is a huge drain on school nurses' time, Bartholomew said.

Two years ago, she kept track of how many phone calls and letters she sent inquiring about students' vaccinations at Carey Junior High. During one year, she made 700 attempts.

"That's time I could have spent working with students and teachers about different health issues," she said.

State Rep. Larry Meuli, R-Cheyenne, former health officer for the state health department, said he doesn't know of any new legislation involving vaccination requirements in the works.

For the time being, public health officials are excited about a new registry that will track and share information among providers about who has been immunized in the Wyoming Immunization Program.

By the end of the month, about 33 public health facilities will be able to use the computer program, which complies with new federal privacy laws and has an annual $200,000-$300,000 price tag.

Over the next six months, the program will solicit private physicians to see if they would like to get on board. In the coming years, the program will target schools and hospitals to complete the registry.

Jones sees the registry as another tool in his efforts to turn around vaccination rates for children in the state.

"We need to raise immunization levels in Wyoming by whatever method we can," he said.

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