Enterprise Story: Vaccines By Caterina De Gaetano

When Megan Weigel was pregnant, her husband was opposed to vaccinating their daughter, but when Weigel moved and signed up for classes at New Paltz, she knew she had to vaccinate 14 and a half month Zoey in order to place her in childcare. I knew that I was going back to school and going to put Zoey into daycare, she said. New York State requires your child to have certain vaccinations before they are allowed to be registered in a licensed daycare, so I guess that kind of pushed me to do it more than anything as well. Vaccines, which are either live attenuated or partial cultures of a virus or bacteria provide an immune response within the body that protects an individual from disease, Donna Demeter, nursing supervisor at the Ulster County Health Department said. It is crucial for everyone to get vaccines in order to prevent infection and outbreak of vaccine preventable diseases (VPD) such as the measles and chicken pox, she said. If everyone gets their vaccines, they develop their immunity to microorganism viruses, thus preventing VPDs and putting people who cant get the vaccine at risk. We can eradicate the diseases, she said. Over a decade, the total amount of children from birth to 12th grade in Ulster County completely vaccinated fluctuated between a few percent marks, but from 2002 to 2012, it has risen three percent, the New York State (NYS) School Immunization Survey said. Currently, 97 percent of NYS are vaccinated and 93 percent are vaccinated in Ulster County. Vaccines offered for children less than 19 months and in Pre-Kindergarten are DTAP which includes Tetanus and Pertussis (Whooping cough), Polio, Measles, Rubella (German measles), Mumps, Hepatitis B, Pneumococcal and Varicella (Chicken Pox). For those over the age of four, the second Measles dose is included to this list. Percentages between Pre-K and Kindergarten age children increased throughout the 10 year span, according to the survey. In 2002 for example, 87 percent of individuals under age five were fully vaccinated and increased five percent the following year when that age group entered school. This same trend appeared between these same groups for the Varicella vaccine. In 2007, 89 percent of Pre-K children had their chicken pox shots, and 97 percent of the Kindergarteners were immunized against the virus. When the Pre-K group entered Kindergarten in 2008, 96 percent had the vaccine. Chicken Pox is a childhood disease, according to Linda Ricci, RN and Infection Prevention Specialist. She said that most Americans contract the disease, and that it runs

rampant in the classroom, which is a major reason more children in the county were vaccinated at the time of entering school where they can be exposed to the Varicella virus more often. The chicken pox vaccination is given to children beginning at age one or even right before school starts, Ricci said. It is not required to enter public schools however, so more parents might be hesitant to have their children immunized against chicken pox right away. Those who do get vaccinated are preventing mass outbreaks and contraction of the disease from the smaller percentage of children who are not protected and may catch the virus and become contagious. Eighteen years ago, hospitals saw many cases of it and had to report it to the Department of Health, but today it has calmed down because of the vaccine, she said. Measles, mumps and rubella are entirely a different case, Ricci said. Documentation proving immunity to MMR (measles, mumps and rubella) is required for school entry of those born after January 1, 1957, according to the New York State Department of Health (NYDS). MMR vaccines are given to a child between 12 and 15 months and receive the second course of the shots at four to six years old, Ricci said. In 2012 when a measles case was reported in New Paltz, 96 percent of Ulster County children were immunized against measles, an increase of four percent in 10 years, the survey said. That same year, 2.20 percent of the population claimed religious exemption. Ulster was among the top 10 counties with high rates of religious exemption and about two percent higher than the NYS average religious exemption. According to the NYDS, a student can be exempt from required vaccinations if the guardian has genuine and sincere religious beliefs opposing immunization and submits a written and signed statement. The student does not have to be part of an organized religious group. In the case of an outbreak however, those not immunized will be protected from exposure which may include being excluded from class and the school. Rubella and measles can be very dangerous, especially to those with compromised immune systems and pregnant women, Ricci said. People at schools and who work in hospitals should be immune to these diseases either by having had the infection or the through vaccines, she said. These are all preventable illnesses, Ricci said. If someone doesnt want to get their kid a Rubella shot, they can get [the disease], give it to a pregnant woman and put others at risk who cant be vaccinated like the unborn and newly born babies, people with compromised immune systems or people who cant be vaccinated. Some parents feel that vaccines can cause more harm to their children than it can be beneficial. Ashley Lowden, 21, mother of three-year-old Sophia said that after her daughter

received the RSV (a virus common in premature babies) vaccine in the NICU, Sophia developed a fever of 105 degrees at home and was placed back in the hospital. Her daughter received certain shots after that, but Lowden believes the risks out way the benefits. I always consult other parents and doctors and do my own research before I get her shots done, she said. Although there are some side effects to vaccinations, Ricci said the good will out do any harm. People may experience pain at the injection site, headache, fever, nausea, vomiting, noncontagious rashes from the Varicella shot and very rarely, seizures. The seizures are normally reactions to high fevers, she said. One in a million may suffer from encephalitis or brain swelling and get a severe anaphylactic reaction to an injection, she said. People are just really afraid of it, Ricci said. They think of Autism. Gina Mercato, mother of three, said that all children react differently from vaccines and from what she has heard and experienced, she thinks vaccines are very harmful and cause autism and other cognitive disabilities in children. Even though all three children are immunized, she said she spread the shots out, especially with her youngest. I was concerned with them bringing out autism or other disabilities, Mercato said. Physicians want to give multiple vaccines in one visit. And I wonder if it was the cause of my 10 year old who was such a content, pleasant infant, who now is diagnosed with ADHD and is struggling with other learning disorders ongoing has been caused by vaccines. Whether it is a parents fear or skepticism of vaccinating a child in his or her early years, the numbers increased dramatically every year in the 12th grade group, and those children who did not get vaccinated suddenly were. The survey showed that each year from 2002 to 2012, vaccinated seniors in high school had consistent percentages above 90, with the exception of one outlier. In 2005, 99 percent of 12th graders were completely immunized, meaning they met all the state required shots. Religious exemption dropped from 2009 to 2012 between freshman year and senior year of high school as well. In 2011, 1.21 percent of juniors were religiously exempt and a year later when the group were seniors, exemption decreased to 1.05 percent. A major reason for this trend is the approaching college entry because students cant get in without certain vaccines, Demeter said. According to the SUNY New Paltz Health Center, students must show proof of immunity to the two MMR vaccines, and as of August 2003, state law says that students must be offered a meningococcal vaccine which prevents the life threatening bacterial strain that can cause cerebral swelling and fluid pressure. If students decline, they must sign and submit a waiver form. The school also recommends that college age students receive DTAP, Polio, Hepatitis B and A, Influenza and the Varicella vaccines.

Demeter said that between June and August, graduated seniors rush to health clinics to get all required shots they missed in their younger years. She said health officials want to work with the older age group to get them vaccinated before the last minute. When children are younger, parents follow schedules and keep up with medical appointments and vaccines, she said, but between ages 10 and 12 it is very difficult to get parents to bring their kids in for follow ups and even second courses of a vaccine. Theres no system, which should be follow ups, calling back, she said. Charts get pushed aside, routine kids are coming, the mom is young and making sure they get there. Teenagers dont have time, nobody looks. Weigel is getting a head start with vaccinating Zoey, who currently has her DTAP, Flu, Polio and IPV shot and will continue to get more vaccinations as she gets older. I think that it is important to vaccinate her. You never know if other people are going to vaccinate their children, so I would rather know that she is protected against these diseases that are out there, she said.