D4 TH E BULLETIN • THURSDAY, FEBRUARY 7, 2013
MEDICINE Vaccinate Continued from 01
Why immunize Presently, the U.S. Centers for Disease Control and Prevention recommends which vaccines children should receive and in what sequence. Vaccines immunize against viruses that cause potentially dangerous illnesses that were once common. For example, measles kills I in 1,000 people who contract it and is very contagious, according to the CDC. Before the measles vaccine came along in the 1960s, nearly all children contracted it by age 15, the agency says. Chunn, a strong advocate of vaccination, said he recalls at times being kept inside to play as a child because of polio. According to the CDC, the disease
Exemption ratesfor Central Oregonschools The percentage ofchildren with at least one religious exemption is above the levels needed tothwart the spread of vaccine-preventable diseases in many Central Oregon schools. Data for schools with at least 50 students and more than10 exemptions are shown.
OLow exemptionrate, 6% or less OHigh,7% to14% 0 Very high, 15% to 50%
School name
: ,2011-12 2010-11
Amity Creek Elementary School
0 29% ' 0 3 4 %
Bear Creek Elementary School
0 5% :
0 6%
Bend High School
05% '
04%
Buckingham Elementary School
0 3% :
0 4%
CascadeMiddleSchool
07% '
05%
Elk Meadow Elementary School
0 8% '
0 7%
0 5% :
0 5%
Ensworth Elementary School High Desert Middle School High Lakes Elementary School
0 10%,' 0 10%
crippledroughly 35,000 people
Highland School (at Kenwoodl
014%:
in the U.S. per year in the late 1940s to early 1950s, and there is no cure. "That was a mother's worst fear, was your child getting polio," he said. Immunization, however, has been very effective. The U.S. has beenconsidered polio-free since 1979, although it still exists in other parts of the world and could be reintroduced here. The reason polio was eradicated here is that widespread vaccination creates herd immunity, sometimes called community immunity. The concept, according to the National Institute of Allergy and Infectious Diseases, is that when a critical percentage of a community is immunized against a communicabledisease,thereisa reduced chance of the disease's spread. This immunity is particularly important for certain groups of people. Some have medical conditions that prevent them from being vaccinated. The herd immunity protects them. Infants who haven't yet been vaccinated are another concern. Forinstance,Chunn said,pertussis can be fatal in infants. Some vaccines also don't provide 100 percent protection from contracting the illness, according to the CDC. Pertussis is one such example. The herd immunity therefore also provides additional protection to those already vaccinated. When looking at herd immunity, a community can be an entity like a school. The Oregon Health A u t hority's Public Health Division every year gathers data from schools acrossthe state on the number of children who are immunized and the number whose p arents exempt them f r om vaccination. According to the state's data for the 2011-12 school year, the immunization rates at several Central Oregon schools weren't high enough to provide herd immunity to the rest of the students and staff (see "Exemption rates CentralOregon schools"). The potential for an outbreak isn't just theoretical. For instance, a CDC report recounts how an unvaccinated 7-yearold boy visiting Europe in 2008 contracted measles. He returned home to San Diego, but didn't show symptoms until eight days later. Another four days went by until he saw his pediatrician. And another week went by until the illness was identified as measles. In that t ime, he exposed approximately 70 children at school and in medical facilities to measles. Twenty-one of them weren't vaccinated and were placed on a three-week home quarantine. E l even o t h ers who hadn't been immunized received the shot during the outbreak. Eleven other children did get sick, including the boy's siblings, five children fr om school and four children from the pediatrician's office. Of the four, three were not yet a year old. One of the three was hospitalized. Just last week, at least one person had come down with measles in the Seattle area. The person was exposed to a traveler with the illness who made a stopover at Sea-Tac Airport, a ccording to Seattle 8 K i n g County Public Health. Heather Kaisner, immunization coordinator for Deschutes County, said the same sort of scenario could happen anywhere. County health departm ents in Oregon, she said, are empowered torequire unvaccinated children to stay at home, potentially for weeks, in the event of an outbreak.
Juniper Elementary School
0 6% .
0 8%
La Pine Elementary School
0 4% :
0 3%
0 3% : 06% '
0 3%
01 4%
School exclusiondayapproaches
Protect theherd
Children who aremissing
Research has shown that
Lava Ridge Elementary School
05%
Marshall High School Mountain View High School
0 5%
0 4%
Pilot Butte Middle School
0 5%
0 6%
Pine Ridge Elementary
0 7%
0 10 %
Ponderosa Elementary
0 4%
0 4%
0 4% :
0 4%
R.E Jewell Elementary School
REALMS (middle school) Rosland Elementary
0 15% 0 2 8 %
Sky View Middle School
0 4% :
Summit High School
0 5%. : 0 5%
Three Rivers Elementary School
0 6% '
Westside Village Magnet School William E. Miller Elementary
0 4% 0 6%
0 32% . 0 3 5 % 0 9% '
0 9%
Cecil Sly Elementary School
0 3% :
0 3%
Crook County High School
0 3%
0 3%
Crook County Middle School
0 2% :
0 2%
I I
I
II
I
Crooked River Elementary School
Ochoco Elementary School Paulina School
records with the school or child care provider prior to Feb. 20.
percentage of individuals in
or child care starting Feb. 20,
acommunit ywhoneedtobe immunized toprovide herd
according to the Oregon lm-
and Rotary International are
munization Program.
sponsoring aShots for Tots and Teens clinic from10 a.m. to 2
immunity. Actual vaccination
rates mayneedto behigher, since not everyonewho
Also, Deschutes County
State law requires that all children in public and private
p.m. Saturday at the La Pine school-based health center
schools, preschools, Head Start and certified child care
is vaccinated will develop
next to La PineHighSchool. No appointment is necessary.
enoughofanimmune reaction to beprotected.
facilities have up-to-date documentation of their immu-
HERD IMMUNITY THRESHOLDSFOR COMMON VACCINEPREVENTABLEDISEASES
medical exemption. Children with incomplete im-
0 Measles 9 0 Pertussis 9
2%- 9 4% 2 % - 94%
0 Mumps 7
5% - 86%
0 Diphtheria 8 5% 0 Rubella 8 3%- 8 5 % 0 Influenza 3
Parents are asked to bring the
nizations or have areligious or
0 % - 75%
Source: Oregon Health Authority Public Health Division
La Pine Middle School
La Pine High School
missing and to update their
required immunizations will not be able to attend school
the more contagious a disease is, thehigherthe
gious exemption. Dr. Jay Rosenbloom, a Lake Oswego pediatrician who cochairs the Oregon Partnership to Immunize Children, said he believesthere are a number of reasons parents choose the nonmedical exemption t h at aren't related to religion. Some do so for convenience, he said. They might have trouble accessing health care, or they just haven't been diligent about getting their child to annual wellness checkups. Perhaps a more pervasive reason, he said, is that they believe immunizations can potentially harm their children. Scientific studies have soundly refuted such claims, but Rosenbloom said h e o f ten t a lks through such concerns with parents in his practice. "People read on the Internet," Rosenbloom said. "In 20 minutes, they say, 'I did my research' and they feel they don't need to vaccinate." "That's the reason for this legislation," he continued. "We want peopleto have accurate
child's immunization records. Contact: www.healthoregon. org/imm, 800-723-3638; or,
munizations will receive aletter
in DeschutesCounty: www.
in the next couple of weeks letting parents know what is
deschutes.org/immunizations or 541-322-7400.
information." The proposed law would allow for nonmedical exemptions in two ways. One requires a primary care doctor'ssignature. The form says the physician has discussed immunizations with the parent. The other way would require parents to complete an online
SusanWickstrom,communications coordinator for the Oregon Immunization Program, said the project is expected to offer a menu of activities to the schools in an effort to educate.
Options range from organizing
panel discussionsto creating an outbreak model for what would be expectedifmeasles were inprogram, called an "educa- troduced into the school. "We're not the state coming tion module" in the bilL Stone said the details on the module in and telling parents what to haven't been ironed out, but do," Wickstrom said. "Our bathat it would likely have an sic concern is to get the parents i nteractive component a n d information." wouldn't be prohibitively long. Kaisner s ai d De s chutes Parents could complete it at County public health staff are home and print a certificate at talking to principals, day-care the end. providers and others about "The whole process would be why immunizations are iminformed by parentsbecause portant. A local group, called they're the audience," Stone said the Deschutes Immunization of the module's design. Coalition, brought in a speaker S imilar l e g islation t h a t in August to discuss with pedipassed in Washington state in atricians and family-care phy2011 worked, she added. The sicians how to talk to parents year following its passage, the about immunizations. stateexperienced a 25 percent Chunn said if he has a pardecrease i n i mm u n ization ent with immunization quesexemptions. tions, he takes the time to make sure they understand. He also Getting the word out talks to groups. Recently, a Meanwhile, other health pro- Bend moms group asked him fessionals are workingtoget the to speak and parents filled the word out about immunizations. house. "They had a lot of good quesThe state presently is finalizing the details of an educational tions," he said. "They were pilot project that will focus on motivated. They really want to targeting schools with high im- know." — Reporter: 541-617-7828, munization exemption rates, including in Central Oregon. hhagemeier@bendbulletin.com
Pioneer Secondary Alternative High Powell Butte Community Charter School
07 % ' .
Culver Elementary School
06% ' '
06%
04% '
03%
Culver High School Culver Middle School Big Muddy Elementary Buff Intermediate School
Jefferson County Middle School Madras High School
01%
Madras Primary School
Metolius Elementary School Warm Springs Elementary School
A1 I
I
I
I
1
I
Elton Gregory Middle School
0 3% . ' 0 3 %
John TuckElementary School
0 3% :
M.A. Lynch Elementary School
What people may think about you...
02%
Obsidian Middle School
0 3% :
Redmond High School
0 3% :
0 2%
RedmondProficiencyAcademy Sage Elementary School Terrebonne Community School
0 5%,'
0 5%
Tom McCall Elementary School
04% '
05%
Tumalo Community School
08%: :
08%
Vern Patrick Elementary School
04% '
05%
010% '
0 8%
Sisters High School
0 6% :
0 4%
Sisters Middle School
07% '
0 9%
Not Interested • Unfriendly Insensitive • Confused
0 5%: : 0 6%
Sisters Elementary School
What they may not know is that you
struggle to hear. •
Cascades Academy
015%
Central Christian School
011% '
Circle of Friends Preschool 8
0 47%; 0 28 %
FREE
Video Ear Exam
0 7%
and
Hearing Screening
Kindergarten, Llc
High Desert Early Intervention
014%:
Morning Star Christian School
011% '
Seven PeaksSchool Trinity Lutheran School
Waldorf School of Bend
To increase immunization rates, doctors and public health officials are trying to address the reasons parents opt not to immunize. State law requires children to have up-to-date immunization records or an exemption from vaccinations signed by a parent. Those without the proper
0 6%
08% '
06%
• 6 4% ' 0 4 8 %
Source: Oregon Health Authority Public Health Division
Changing the law?
0 7% :
t
AndyzeigertiTheBulletin
records on fileare excluded from school, thisyearasofFeb. 20. Some children can't be immunized for medicalreasons and therefore are exempted. Other parents choose not to vaccinate based on personal beliefs, some of those based on their religion. Presently, they can sign what is called a reli-
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