What Can We Do About Vaccine Misinformation?

“ . . . schools reported immunization rates ranging from 19% to 100%, with an average of 91%. . . . Alarmingly, one school reported that none of its students had been vaccinated.”

This year’s measles and mumps outbreaks are a reminder that many of us still think of vaccination as only a personal health practice. We forget that it is also something we do as a member of a community. When a vaccine-preventable disease starts to circulate, every vaccinated or otherwise immune person is a transmission dead end. It’s as though the virus skids to a stop in front of us, unable to pass through the closed door of our immunity to continue to replicate and spread disease.

In “Countering Vaccine Misinformation” in this month’s AJN, Lindsey Danielson and colleagues discuss vaccines, health literacy, and the ease with which misinformation can proliferate on social media. They emphasize the importance of understanding different kinds of opposition to vaccination:

“Vaccine hesitant describes a person who is hesitant about vaccines but still receptive to scientific evidence, while vaccine denier refers to a person who is against vaccination, denies scientific evidence, and uses rhetorical arguments to give the false appearance of legitimate debate.”

[…]

2019-10-21T07:57:26-04:00October 21st, 2019|infectious diseases, Nursing, nursing roles, Public health|1 Comment
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Measles Outbreaks, and an Unexpected Vulnerability

The second-greatest number of cases since ‘elimination.’

3D graphical representation of spherical-shaped, measles virus particle studded with glycoprotein tubercles. CDC/ Allison M. Maiuri, MPH, CHES

Last month, a state of emergency—which has now been halted by state court—was declared in nearby Rockland County, New York, barring children who hadn’t been vaccinated against measles from public places. The unprecedented step made worldwide news and highlights the public health measures being taken to stem the six currently ongoing measles outbreaks in the United States.

Measles was eliminated in the United States in 2000, but outbreaks have occurred since, increasingly so in recent years. The CDC reported this week that almost 400 cases of measles have been confirmed in 15 states during the first three months of this year alone. This is the second-greatest number of reported cases since eradication of the disease. The most—667 cases—occurred in 2014.

Public health authorities are clear about the cause of these outbreaks: people contract measles abroad and bring it back to the United States, where groups of people who are unvaccinated are particularly susceptible to developing and spreading this highly contagious disease. Up to 90% of unvaccinated […]

2019-04-08T07:55:37-04:00April 8th, 2019|infectious diseases, Nursing, Public health|3 Comments
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Measles 101: The Basics for Nurses

While debates about measles vaccination swirl around the current U.S. measles outbreak, most U.S. nurses have never actually seen the disease itself, and right now we are a lot more likely to encounter a case of measles than of Ebola virus disease. Here, then, is a measles primer.

Symptoms.

Measles is an upper-respiratory infection with initial symptoms of fever, cough, runny nose, red and teary eyes, and (just before the rash appears) “Koplik spots” (tiny blue/white spots) on a reddened buccal mucosa. The maculopapular rash emerges a few days after these first symptoms appear (about 14 days after exposure), beginning at the hairline and slowly working its way down the rest of the body.

Infected people who are severely immunosuppressed may not have any rash at all. “Modified” measles, with a longer incubation period and sparse rash, can occur in infants who are partially protected by maternal antibodies and in people who receive immune globulin after exposure to measles.

Transmission.

The virus spreads via respiratory droplets and aerosols, from the time symptoms begin until three to four days after the rash appears. (People who are immunosuppressed can shed virus and remain contagious for several weeks.) Measles is highly contagious, and more than 90% of exposed, nonimmune people will contract the disease. There is no known asymptomatic carrier state, and […]

2019-01-22T15:31:41-05:00February 11th, 2015|infectious diseases, nursing perspective|3 Comments
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Fear of Infection, Getting Job Done: Not New to Nurses

Quarantine, isolation: medical terms heavy with accreted meanings (psychological, metaphorical). Terms we’ve been hearing a lot lately, as in the case of nurse Kaci Hickox, quarantined in a tent in New Jersey after her return from treating Ebola patients in Sierra Leone, released today after days of public controversy.

These words have vivid histories. Epidemics of polio, influenza, and other illnesses took many lives in the U.S. during the 20th century. And nurses were always there, taking risks, applying the latest knowledge to control or cure. In the April 1940 edition of the American Journal of Nursing, a nurse wrote a short but evocative essay about her own fears of entering an isolation room to treat a child with an unnamed condition, perhaps measles or scarlet fever. Here’s a snippet.

Germs

(One wonders if she had been given the recommended personal protective equipment of the time for such infections . . .)

To read the article, free until December 1, click this link and then click through to the PDF version in the upper-right corner of the landing page.—Jacob Molyneux, senior editor

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2016-11-21T13:03:38-05:00October 27th, 2014|Nursing|3 Comments
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States Easing Up, Pediatricians Buckling Down on Childhood Immunizations

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Two newspaper reports last week showed the dichotomy that exists in attitudes about mandating vaccines for children.

On February 15, the Wall Street Journal reported that more pediatricians are turning away families who refuse to have their children receive immunizations.

The next day, USA Today reported that several states are considering changing laws that currently allow parents to opt out of mandatory vaccines only for religious reasons, and extending the opt-out to include “philosophical reasons.” These reasons invariably come back to parental fears that vaccines put their children at high risk for autism. (See the our November 2011 report on what fueled this controversy.)

Highly publicized resurgences of measles and pertussis seem to have done little to change some parents’ mindsets about the need for immunizations. Has the success of the vaccines campaigns lulled some into a false sense of security—that the “risks” of vaccines, though unproven, are more dangerous than the diseases or their complications?

I shared in an editorial a story of a childhood friend who was left paralyzed in his lower extremities from contracting polio in childhood. And a cousin has a child, now almost 40 years old, who was left blind and speechless from encephalitis following measles contracted when she was five years old.

Cases like these are rarely seen anymore, but will they become more commonplace with more parents refusing to let their children receive vaccines? […]

2016-11-21T13:10:41-05:00February 21st, 2012|Nursing|9 Comments
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