Walking the Capitol Hill Walk for Life-Saving Vaccines

"There is no evidence to support a vaccine-autism link, and irrefutable evidence supports vaccination as one of the best ways to protect the health and lives of children all over the world."  

"In the context of global vaccine efforts, vaccine hesitancy makes no sense and rarely comes up." 

These two statements underscore why I speak out about the critical importance of vaccines. I've lived in a country and gone to school with people affected by polio. Trust me, no one who has the real-world experience of living in fear of vaccine-preventable diseases questions the necessity of vaccines.

So I wince, almost daily, at the harm done by vaccine denialists, in opening the gate for resurgences of preventable diseases like measles. And I wince again when I see anti-vaccine misinformation  spread by tiny but zealous factions within the autism communities, then blithely repeated by media outlets that value page views more than they do public health [shakes fist].

Anti-vaccine misinformation is a double whammy of dangerous ignorance: It makes people fear autistic people like my beloved son Leo, and it endangers the health and lives of children all over the world. So I counter that misinformation with my own double whammy: I speak out against anti-vaccine information and fight for good vaccine information whenever I can, as hard as I can.

Champions on Capitol Hill. Photo: Shot@Life

Which means I was thrilled to be invited to Washington DC by the United Nations Foundation's Shot@Life Campaign: as a UNF Global Issues Fellow to further the vaccine awareness work other bloggers and I did during Blogust, and as a Shot@Life Champion, trained on global vaccine awareness and issues and then unleashed on Capitol Hill with ninety-nine other Shot@Life champions to meet with our Senators and Congressional Representatives, in order to urge them to continue their support of life-saving global initiatives.

It was an life-changing experience, walking the halls of the Capitol Hill office buildings in the company of people who gave such incredible damns. Realizing, that, as a constituent, I have the same right any other constituent to have my say, directly to my members of Congress (or their staff). Which we did! We talked with staffers for both Dianne Feinstein and Barbara Boxer.

With James Hamos, Legislative Fellow, and
Megan Thompson, Legislative Assistant
Office of Senator Dianne Feinstein

And here is what we told the Senators' and Representatives' Congressional teams: Thank you for supporting global vaccine initiatives (because, thankfully, California and Silicon Valley were already on board). Let us know how we can support you -- and if you get blowback from your other constituents about diverting money internationally when we have so many domestic needs, we're here to provide you with information to address most any concern (and I also offered my services as a pro-vaccine autism parent). We need to keep funding international immunization programs for these reasons:

• Humanitarian: A child dies every 20 seconds because they don't have access to life-saving vaccines, and 1 in 5 children lacks access to vaccines. Plus, immunizations save the lives of 2.5 million children, each year.
• Public Safety: Measles infects 95% of the unvaccinated people who encounter a carrier; polio is only a plane ride away from returning to the United States. And babies can't be vaccinated in against measles in their first year of life. To keep ourselves safe, we must help eradicate vaccine-preventable disease in the rest of the world.
• Cost-savings: The costs of eradicating smallpox are more than recouped by an annual savings of the one billion dollars that would have been needed for treatment, etc. And we're so close to eliminating polio! The current goal for a polio-free world is 2018, and it's reachable.

With Stacy Mintzer Herlihy, co-author of Your Baby's Best Shot
and Melody Butler of Nurses Who Vax

If the thought of meeting with a Congressional Representative scares you, don't let it. It's not that hard, as long as you're prepared. And were we ever prepared! Because when Shot@Life brought together 100 Champions from around the U.S. -- doctors, public health officials, nurses, parents, students -- they gave us a two-day crash course on global vaccines issues  (Storified for you to absorb in smaller bites), led by agencies supporting global vaccines initiatives. We had the privilege of hearing directly from representatives of the UN Foundation, Shot@Life, the World Health Organization (WHO), and GAVI Alliance reps, as well as polio survivor Dennis Ogbe. My favorite quote from the training was by pediatrician Dr. Margaret Fisher, who reminded everyone:

"When you choose not to immunize your child, you're playing Russian Roulette with your child."

And before the Champion Summit, Shot@Life invited a group of bloggers to participate in the UN Foundation Global Issues Fellowship, which was like our own mini TED conference on Conversations About Global Agencies, Public Health, Vaccines, and Communication: Challenges, Goals, Myths, and Next Steps. I felt so grateful and lucky to participate, and to spend time with the group pictured below. So grateful, in fact, that I've put together Storified versions of most of the talks below (just click on the "they talked about" links), so you, too, can share what we learned.

Some pretty damn amazing people. Recognize anyone?
Photo: Migdalia Rivera

Here are some of the write ups from the other Shot@Life/Global Issues Fellows (I'll add more as they come in):

• Dresden Shumaker at Creating Motherhood: Revolutionary Optimists: Watch an Inspiring Clip
• Caryn Payzant at The MidLife Guru: What Is a Blogger Anyway (And Why Do They Matter?)
• Ellen Seidman at Parents.com: Scary Vaccine Realities You Can't Argue With
and at Love That Max: Because We Fight for Kids Who Can't Fight for Themselves

• Sili Recio at My Mamihood: He Deserved a Shot
• Dresden Shumaker at Creating Motherhood: Almost Five
• Chloe Jeffreys at Chloe of the Mountain: Chloe Goes to Washington

Here are the wonderful people we ever-so-fortunate Global Issues Fellows got to hear from:

Ambassador Jimmy Kolker, former US Ambassador to Uganda and Burkina Faso, current Assistant Secretary for Global Affairs, US Dept of Health and Human Services, along with Peter Yeo, Vice President for Public Policy at the United Nations Foundation, spoke about health challenges around the globe -- include violence, and violence against women.

"Simple solutions to global violence against woman include having
a female police officer at the hospitals, as Namibia does."

Marie Claudet, a news producer for the Canadian Broadcasting Corporation, and Noam Levey, a National Health Reporter for the LA Times, spoke about the challenges and ethics of, and strategies for, reporting on global health issues like vaccines.

 

"Life expectancies in parts of US, like the Mississsippi Delta,
are dismal by global standards, due to lack of health care."

Dr. Asad Majeed Khan, Deputy Chief of Mission, Embassy of Pakistan graciously talked about the Pakistani government's unwavering commitment to eradicating polio within its borders, and the challenges it faces in doing so.

"When public confidence in vaccines is eroded,
trust restoration takes time."
Photo: Migdalia Rivera

Teddy Ruge is co-founder of Project Diaspora and Hive Colab, and the Lead Social Media Strategist for the World Bank. He talked about our obligation to "Create the Right Buzz" while supporting, not displacing, local development efforts.

"The merits of your campaign should be: real, local, current issues,
not making non-locals feel good."
Photo: Flickr/Mashable (cropped)

Sarah Craven is Washington DC representation office Director of the United Nations Population Fund, the "Agency that Makes Sex Boring." She talked about current crises in global women's and reproductive health -- and if her facts and stories don't outrage you, read them again.

"Half the girls in Ethiopia are married before their 15th birthday,
often by well-intentioned parents."
Photo: Chloe Jeffreys

Will Davis is the Director of the United Nations Development Programme, Washington Representation Office. He spoke about the United Nations' role in today's world, including why "Global goals should not be about rich countries preaching to poor countries."

"Peacekeeping is an attempt to get a country back on its feet after a crisis,
including jobs, and access to justice."
Photo: Chloe Jeffreys

Devi Ramachandran Thomas, Director of the United Nations Foundation's Shot@Life program, spoke about prioritizing global children's health, including reducing child mortality through vaccinations and also by combating malnutrition, diarrhea, and malaria.

"In Mozambique, many parents will not name their child until after they've been vaccinated."
Me, Devi (center), Lucrecer Braxton

The incredibly engaging Aaron Sherinian is the United Nations Foundation's Vice President of Communications and Public Relations. He spoke about translating online efforts into real world global engagement that can actually make a difference.

"At the end of the day, social media trends remind us that humans have a lot in common."
Photo: UN Foundation

Now, hopefully, you're wondering "How can I help? Tell me tell me!" And of course, the answers are "get involved!" (Shot@Life's site has an excellent advocacy toolkit) and "donate!" Donate your time, donate funds, donate your voice in spreading the messages above, especially about global vaccine issues. You can always donate to Shot@Life directly, but you can also manage your advocacy and outreach with the Shot@Life app, or even donate photos -- each worth $1 towards global vaccines -- through the Donate a Photo app.

If there is a single message you should be taking away from the onslaught of information above, it is this: You have so many options for helping to get life-saving vaccines to the children who need them. Pick an option, and get going!

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Again, my sincere thanks to the UN Foundation and Shot@Life, and everyone who made this incredible experience possible -- including my companions in the Shot@Life Champions Summit and Global Issues Fellowship. Disclosure: The UN Foundation provided my travel & lodgings for the two events.

A Critical Flu Season Q&A

December 4 - 10 is National Influenza Vaccination Week. I was asked to participate in a conference call hosted by Every Child by Two (www.ecbt.org) and Families Fighting Flu (www.familiesfightingflu.org), to help spread the word about correct and helpful flu vaccine information. The call featured:

• Dr. William Schaffner, a renowned flu expert and Chairman of the Department of Preventive Medicine from Vanderbilt University School of Medicine and current president of the National Foundation for Infectious Diseases; and 
• Jennifer Lastinger, a mother of four who lost her young daughter to the flu and who as a results is now a founding member of Families Fighting Flu and a passionate advocate for flu vaccination.

Both Ms. Lastinger and Dr. Schaffner spoke at length -- Dr. Scaffner about the most current information and recommendations for flu vaccines, and Ms. Lastinger courageously shared the story of losing her perfectly healthy daughter to influenza. I will be reporting on that section of the call at BlogHer. But the call also featured a lengthy Q&A, in which I and several other participants were able to query Ms. Lastinger and Dr. Schaffner directly, and that is what follows -- absolutely critical reading for anyone concerned about keeping their children and themselves healthy.

A thread that ran through the Q&A was how to counter the harm caused by vaccine opponents and misinformation. Jennifer Lastinger's response was impassioned:

I get very frustrated with a lot of the arguments [against vaccination]. The bottom argument is, do you want your your children alive? YES!

I fully believe vaccination would have kept my daughter here with me, so that's as simple as I can get.

Here is the remainder of the Q&A:

Shannon Rosa: Who cannot receive the flu vaccine?

Dr. Shaffner: There are some people who cannot be vaccinated or who respond poorly to vaccines, but really the only group in which flu vaccines are medically contraindicated is those with a genuine allergy to eggs. But even that group has been narrowed down to only those who really cannot eat eggs at all. Beyond that, as we get older -- here's the paradox -- senior citizens are the ones who tend to get the most complications, but because their immune systems aren't as robust as they used to be, and they also tend to not respond to immunizations as well as younger people. So they clearly should be vaccinated -- but all of us who have contact with them should also be vaccinated.

And then of course there younger persons who for reasons of immunodeficiency or because they're taking immune-suppressing medication do not respond to the vaccines as strongly either -- and therefore everyone who has contact with them needs to get immunized for influenza, that important "cocoon" of protection.

Trish Parnell from www.PKids.org: There were some recent official concerns regarding the intradermal flu vaccine injection, can you tell us what happened?

Dr. Schaffner: The FDA discovered that some pharmacies were using the intradermal "jet" injector with the regular flu vaccine -- and that combination is not licensed, it hasn't been tested. So in the interests of being overly cautious, they recommended that people get re-immunized. But after more thought they realized that re-immunization wasn't necessary.

Vincent Iannelli, Pediatrics.About.Com: In my area of Texas, half the pulmonologists say it's OK to use the FluMist [nasal spray] vaccine in kids with stable asthma, and the other half say it's not OK.

Dr. Schaffner: The FDA and the CDC recommend that it not be used in children with asthma because in rare occasions it can provoke a broncho-spastic response. I do know that very astute pediatric pulmonologists will use the FluMist vaccine in children whose conditions are very stable.

So then the question is, why would these doctors be more interested in using the FluMist version of the influenza vaccine in children? The answer is that for the A strains of influenza, the nasal spray provides more immunity than the injectable vaccines, and it's also a little bit broader, more likely to provide protection against those mutant variations of the flu. Though that's not a big issue so far this year.

Dr. Iannelli: We're also seeing some parents who are skeptical of the FluMist vaccine because they say it's a live virus vaccine -- though my kids all got FluMist because they don't like shots.

Dr. Schaffner: The pediatricians in our area are definitely moving to FluMist because it's quicker and easier to administer in a busy office practice, and also because the kids seem to like it better than the inoculation.

The live virus in FluMist is a live attenuated strain. So it's been tamed in the lab to be what's called "cold sensitive." What that means is that if we take the temperature of any of us at the back of our nasopharynx, it's a degree and a half cooler than it is in our lungs -- unsurprising as our nose and throat are exposed to air. The virus can only multiply at that cooler temperature; it cannot multiply in our lungs or cause any mischief there. It may cause, just for a day or two, a little bit of a scratchy throat, and in some people a little bit of nasal discharge. But that's it. It cannot cause influenza.

Ashley Shelby with the Moms Who Vax blog momswhovax.blogspot.com: I've been hearing from parents who have had nurses or physician's assistants wait until the pediatrician leaves the room, and then discourage them from getting the flu vaccine. Have you heard about this, are there safeguards in place, and what can parents do about it?

Dr. Schaffner: I'm not shocked, because within medical centers all around the country -- as we try to persuade everyone who works in such places to be vaccinated -- it paradoxically turns out that our nurses are the group most wary of immunization. Also the myth that you can get flu from the flu vaccine is most common among nurses. And their opinion is often extremely persuasive. So we're working hard not just to persuade them to get immunized but to become immunization advocates.

If you encounter nurses who have misinformation about vaccines, I would say to parents: be adamant! Insist on vaccination. If you have trouble, ask for the doctor.

Lara Zibner, pediatric emergency specialist, Author of If Your Kid Eats This Book, Everything Will Still Be Okay, writer for Parenting Magazine: Are there currently any reimbursement issues with the flu vaccine?

Dr. Schaffner: There aren't any problems with insurance and flu vaccines in the U.S. When it comes to influenza vaccines, it's difficult to find a child who isn't covered either by their private insurance, or by Vaccines for Children, which provides no-cost immunizations for children whose families are not able to pay for them. Also pharmacies like Walgreens often have programs that offer free vaccines to people in underserved communities.

Melody from Nurses Who Vaccinate (www.facebook.com/NursesWhoVaccinate): What is the best point in pregnancy for expectant mothers to receive the influenza vaccine, to allow for optimal results for both the mother and the unborn child, and create the most prolonged protection?

Dr. Schaffner: At any time during pregnancy. Initially when the AICP -- the Advisory Committee on Immunization Practices -- recommended second and third trimester only, but then a few years later along with their colleagues in ACOG, the American College of Obstetricians and Gynecologists, they reevaluated it and said that when you're pregnant and in the doctor's office is the time to do it.

Natasha Burgert: Private Pediatrician in Kansas City, blogger at kckidsdoc.com: I have a very Internet-savvy patient population who keep bringing to my attention a recent Lancet article from late October with the claim that the influenza vaccine may not be as protective as we thought it was. That was not my interpretation after reading the paper myself, but I'm wondering if you're familiar with the paper and what your comments would be.

Dr. Schaffner: What they did in a very rigorous way is summarize what we already knew. The influenza vaccine has limitations. I like to say that it's a good vaccine, it's not a great vaccine -- in the sense that if the influenza virus changes, we haven't matched it up exactly. Also, there are individuals in our society who don't respond optimally to influenza vaccines. We need a new one, a better one. The lights are definitely on in the research labs at night as people are trying to provide a better vaccine. Some of the innovations -- the intradermal vaccine, the high-dose vaccine that's now available for people age 65 and older -- are products of that research, as is the nasal spray variant.

There are adjuvanted vaccines that are licensed in Europe but not the U.S., and there are many people working on the Holy Grail of vaccines -- the universal flu vaccine that would allow us to get our flu shots like we do our tetanus shots -- once every ten years. The director of the NIH hopes there will be one ready for testing in 2014.

Until that happens, we need to use our "good" vaccine to its best advantage. It will protect many people against illness, it will protect against complications of pneumonia and hospitalization, and it will protect against  deaths. It can't protect against all of them, but protecting against some of those things is the current good, while we hope and wait for perfection down the road.

Shannon (again): I keep up on anti-vaccine literature, and one myth I keep seeing is that of "virus shedding," of people who get vaccinated for the flu then infecting other people.

Dr. Schaffner: If you get any of the injectable vaccines, not only is it a killed vaccine but it is broken up into tiny little pieces and can't reassemble, so it can't become a new virus in your body and you can't shed it. The nasal spray vaccine is a live attenuated vaccine, but it just goes in your nose and the studies show that it is not spread to any people roundabout, so you don't have to worry about that either.

Christine Vara, Shot of Prevention: The universal influenza vaccination recommendations have been in effect for two years, what has the uptake been like?

Dr. Schaffner: We now have a universal recommendation that everyone who comes to a clinic, hospital, pharmacy; everyone should be vaccinated -- not just to keep themselves healthy, but so they don't transmit the virus to others. The more people we get vaccinated, the more likely it is that we will reduce transmission in and protect our communities.

Amy Pisani from Every Child by Two: We hear a lot about the safety of influenza and people questioning that because it's new every year. I wonder if you could talk a little bit about how the basic strain of the vaccine has already been tested and has such a long profile, and how they achieve such a quick turnaround time each year.

Dr. Schaffner: The influenza vaccine is the most used vaccine, it's given in the millions upon millions around the world every year; the CDC monitors its safety like a hawk. It's an extraordinarily safe vaccine. The FDA, although it licenses a new variant of the vaccine every year, has all the safety history of the basic construct of the vaccine in mind. This year in the U.S. we will give more than 120 million doses of the vaccine, the safey profile does not change -- it continues to be extraordinarily safe.

Amy Pisani: To clarify for a prior question: You said that some people don't respond optimally to the flu vacine. You're not talking about a reaction, but rather than they don't realize their body is not building up the antibodies, correct?

Dr. Schaffner: Correct. Some people's bodies are not capable of responding and creating those antibodies that will protect them against influenza. They're too frail, or they are immunodeficient, or they are taking immune suppressant medications that prevents their body from responding optimally, from creating the prevention that the vaccine is designed to produce.

And as lay people we use the word "flu" rather casually, a lot of people mistakenly think a bad cold is the flu. But when you get influenza, and you've had the vaccine, your illness will be milder, and you're less likely to have complications like pneumonia, hospitalization, or death.

Christine Vara: Jen, could you elaborate on Emily's Law?

Jennifer Lastinger: My husband Joe was really passionate about getting the word out [about the real-world consequences of not getting vaccinated for vaccine-preventable disease], especially through schools -- we felt the schools were the key to getting kids vaccinated. We worked with a local senator who helped us pass the law a couple of years ago, and now school websites in Texas have to post information during flu season about the flu, how to prevent it, where to get shots, and how to keep your kids healthy.

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In case you are unfamiliar with how dramatically misinformed vaccine opponents are and why ongoing efforts to communicate helpful, correct vaccine information are so necessary, consider the excerpts from the Up Your Nose post by AoA's Cathy Jameson:

• "...we were recently exposed to some kids who had received the Flumist [sic] vaccine.  Hours and hours and hours of contact, play time, meal time and chit chat occurred before I found out those children opted to have the live flu virus jammed up their nostrils earlier in the day."
• "…when people get live virus vaccinations but then don’t quarantine themselves while the live virus sheds, other people are at risk."
• "...Three days later my five-year old came down with her flu-like symptoms.  She was the third to get pummeled getting hit hard with the aches, chills and a very high fever.  Coming home from school very distraught that day, she told me that a classmate of hers missed the morning portion of school to get his flu shot.  In the throes of her high fever she burst into tears, “Mommy, why’d they go and do that?”  My typical son listened to this sad story and announced through his horrible wheezing and coughing, “I wish the flu shot had never been invented.”"

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Additional Flu information resources:

• Every Child By Two’s Vaccinate Your Baby website (seasonal flu web pages):
  http://www.vaccinateyourbaby.org/about/flu-vaccines/index.cfm
• The Vaccinate Your Baby site lists other Every Child By Two suggested influenza resources:
  http://www.vaccinateyourbaby.org/about/flu-vaccines/more-resources.cfm
• www.flu.gov
• www.flu.gov/individualfamily/vaccination/locator.html
• http://www2c.cdc.gov/ecards/index.asp?category=175
• www.familiesfightingflu.org
• www.preventchildhoodinfluenza.org

The Vaccine Song's Take on Jenny McCarthy

Not quite sure how I missed this one, either.

Although it does oversimplify matters Jenny McCarthy, saying we shouldn't listen to her because she's a former Playboy Bunny. I honestly don't care what her background is -- I would listen to her whether she was actively filming porn, or a Christian homeschooler -- if she was able to discuss vaccines intelligently.

Instead she keeps changing her story about what effects she thinks vaccines had on her son, uses her professional performing skills to milk testimonials while attacking scientists and doctors on camera (and if you haven't seen her in action, I strongly recommend clicking that second link), argues against toxins in vaccines while rhapsodizing about Botox, and has poured her considerable passion and power into compromising public health.

I don't think she's an evil person, but I do think she's a credulous person, a passionately misguided person, and given her influence on other credulous and passionately misguided people, a dangerous person. I think she is a skilled performer rather than a skilled thinker.

She can still redeem herself, if starts learning from her mistakes instead of rewriting them -- her audience will stick with her, may even like her better, as they did with Angelina Jolie when she reinvented herself, and flipped from blood-vial wearing "whore" to UNICEF-ambassador "madonna."

Our society needs to value children's health over celebrity hubris.

Please do forward this video along.