Dr. Paula Watts-White
Special to The Enterprise

It is time to get ready to go back to school, which for many families means it is time to visit their physician’s office to have a routine physical and to get caught up on immunizations.

August is a particularly good time to get the community focused on the value of immunization. Immunizations are recommended because they protect against getting a serious disease and immunizations can make a disease less severe if your child does happen to get sick. Many parents have multiple questions and concerns about immunizations, and the stories one hears in the media can sometimes be confusing. The best way to address concerns about immunizations is to discuss your questions with your physician at the time of the routine well-child visits.

We continue to see outbreaks of many common types of childhood diseases. Measles can be a serious disease in a child, with rash and high fever. One out of four people who gets measles end up in the hospital, and one to three out of every 1,000 people who catch measles die. After a recent record number of kids reported to have measles in 2011, 222 cases, the number of measles cases were down to just 54 cases in 2012, but the number is going up again, with 122 cases reported so far in 2013. In New York State, to date, there have been 56 cases of measles involving adults and children up to 32 months old who were not vaccinated because of refusal or delays in vaccination. The New York outbreak shows not only that vaccinations prevent diseases, but that epidemics can and do take hold in under-immunized communities. Every family that decides not to have their child immunized contributes to making our community vulnerable to having an outbreak of measles.

Pertussis or whooping cough is a respiratory disease spread by coughing. Kids and adults can have severe coughing attacks that last for months and infants can have a life-threatening illness. In 2012, 18 pertussis related deaths were reported in the United States. Compared to 2011, there was an increase in the number of cases reported in 2012, the majority in the states of Wisconsin, Vermont and Minnesota. The primary goal of pertussis control efforts is to decrease severity of complications and death among infants; a secondary goal is to decrease complications among all ages. We are fortunate that two years ago California required kids entering seventh grade to be immunized against pertussis. Unfortunately, California has seen an increase in the number of reported pertussis cases in 2013 to 813, with most of the cases in the San Francisco Bay Area occurring in infants below 6 months age and in children aged 7-16, most in the non-Hispanic white ethnic group. The Bay Area outbreaks are highest in Marin and Santa Clara counties. This pattern shows that diseases like Pertussis can and do take hold in communities in the setting of under-immunization.

Maintaining high immunization rates protects the entire community by interrupting the transmission of disease-causing bacteria or viruses through the community. This reduces the risk that the few unimmunized people will be exposed to disease-causing agents. This type of protection is known as community or “herd” immunity, and embodies the concept that protecting the majority with safe, effective vaccines also protects those who cannot
be immunized for medical reasons. However, if too many children forgo getting immunized, the entire community is at risk for experiencing an epidemic.

The American Academy of Pediatrics has schedules of immunizations for children and adolescents and they have “catch-up” recommendations. For further information, see the web site: www2.aap.org/cisp/IZSchedule.html.
Upon entering kindergarten, a series of immunizations are recommended, including but not limited to MMR, varicella, dTap and polio. Adolescents age 11 to 12 are now recommended to receive Tdap, menactra (to prevent
Meningococcal meningitis), and HPV. At 16, near entrance to college, a menactra booster is required. The best way to stay informed and to discuss immunizations is to maintain your physical exam with your doctor when entering kindergarten, junior high and college.

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Dr. Paula Watts-White, a Davis pediatrician, administers a vaccination to one of her young patients, Ari Asera. As the new school year approaches, parents are reminded to get their children immunized. Wayne Tilcock/Enterprise file photo

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