Wednesday, January 31, 2024

Rethinking vaccinations

      "Back in the 50's the Polio vaccine was developed. Polio was the biggest worry back then and when the vaccine came out, it was a godsend."
                Comment to this blog by Peter C.

I am in the generation that thought of vaccinations as good. 

It is more complicated now.

I have a dim memory of being five years old in 1955, amid a large gathering of kids a few days before starting first grade. The county health officer, Erin Merkel, M.D., was administering shots to everyone starting school. I have a clear memory of being in a long line in front of Hedrick Junior High a few years later. Families entered the building, approached tables with lines of sugar cubes on them, and we each took and ate one. Now we were safe from polio.

Yesterday's post described two hotspots of vaccine resistance in southern Oregon. Oregon parents can opt out of having their school children vaccinated for measles, chicken pox, mumps, and the other communicable diseases.

Yesterday's post contained an error. I misread the categorization of The Siskiyou School in Ashland as an Ashland public school. It isn't. It is a private Waldorf school, with about 189 students, according to the Oregon Health Authority site that shows schools, their attendance, their status as private, public charter, or public traditional, and their vaccination rates. The Siskiyou School has among the state's lowest vaccination rates, with only 27.7% of students vaccinated for measles.

Private, religious, specialty, and charter schools lead the OCA's list of 3,179 schools, ranked by the percentage of unvaccinated students.  But what about traditional neighborhood elementary schools and district high schools? Parents might enroll students there with no particular awareness of the vaccination status of the school. 

Ashland High School Mission Statement

Five public schools stand out in the OCA list, and they are here in southern Oregon.

Applegate Elementary, in rural Applegate Valley west of Medford. Only 68.1% vaccinated for measles; only 70.2% fully vaccinated.

Walker Elementary, Ashland. Only 77.5% vaccinated for measles; only 72.9% fully vaccinated.

Ashland High School, Ashland. Only 78.1% vaccinated for measles; only 74.6% fully vaccinated.

Ruch Elementary, another rural school in the Applegate Valley. Only 78.1% vaccinated for measles; only 75% fully vaccinated.

Bellview Elementary, Ashland. Only 81.0% vaccinated for measles; only 83.5% fully vaccinated.

Grants Pass area elementary and high schools settle into a range with about 90% of students fully vaccinated. Medford schools fall into a slightly higher range, with little difference among the schools even though the catchment areas of elementary schools have very different demographics. Hoover, Howard, Kennedy, Roosevelt, and Griffin Creek, all report about 93% vaccination rates.

The Oregon Health Authority considers a 95% rate to be the minimum safe rate for adequate herd immunity.

Early in 2020 people were asked to wear masks and keep social distance to protect both oneself and others from a new and unknown Covid infection. Masks protected us, we thought, by filtering micro-particles. Masks were both self protection and good citizenship. I remember disapproving of people in stores who refused to wear a mask. I thought them scofflaws at best and dangerous at worst. Vaccinations weren't yet available. 


But later, evidence suggested most masks did little to protect oneself and that vaccinations gave oneself good protection against hospitalization and death but did not stop one from getting infected and spreading the disease. There was a general shift in public attitude toward self-protection and away from one's obligation to others. 

In Oregon, a Democratic governor, sensitive to the wishes of Oregon teachers, agreed to prioritize their health. It made some sense. Schools might be the worst vectors of Covid spread. Oregon schools went to remote learning early and stuck with it. Education suffered. An idea found traction in Oregon and nationally that public health was primarily about politics, not health. Trump praised vaccines, then backed away from them. Vaccines were for wimps, or part of a conspiracy by Anthony Fauci, Bill Gates, and Nancy Pelosi. Finally, the idea grew in GOP circles that Covid was mostly a minor disease blown up into a vehicle to kill the economy, hurt Trump, and elect Democrats. Infectious diseases are no big deal.

Now, as Americans mentally digest the meaning of Covid and vaccinations, an idea floats in the zeitgeist that vaccinations aren't about protecting the community from something terrible. Vaccinations --or even getting the diseases -- are a personal choice. Parents in Ashland schools who don't vaccinate their children need not consider themselves careless people creating a public health hazard. Being unvaccinated is not the equivalent of littering, or driving drunk, or firing a celebratory gunshot into the air. Ashland High students, even unvaccinated ones, are "responsible citizens," as written in the mission statement. Being unvaccinated is a personal choice, both for you and others. Parents who are worried about their children getting sick from childhood diseases should vaccinate their children.

I grew up the child of the World War II generation. That generation joined together against an outside threat. Children today are growing up the grandchildren of the "Me Generation" and the children of Millennials who saw pensions end in favor of individual retirement accounts. In the economy and as a citizen, we are on our own. 

I list the potential hotspot schools not to shame them, even though I think the number of unvaccinated students in them is unfortunate. The schools and politicians are responding to public sentiment, which is what public schools must do. Parents  nervous about disease outbreaks in local schools need to  vaccinate their children before enrolling them. It's on you. It is a new world, a new generation. I don't like it, but it is the nature of public health in 2024.



Note: The immunity figures for Bellview School in Ashland are taken directly from the Oregon Health Authority report. It does not make sense that there are more. people with full vaccination than are vaccinated for a subset of that whole (measles) but that is how the OHA reported it.)



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12 comments:

Anonymous said...

What we have in the US is a bunch of whiny, self-centered, spoiled brats who don't know much about history or science. They take "the good life" that their ancestors struggled tirelessly to achieve for granted.

Ed Cooper said...

Perhaps when children in local schools start dying of Measles, when Rubella infected babies start being born with crippling deformities, people will wake up and start getting the vaccinations against those crippling diseases, too late for too many kids, but what the Hell, those kids parents were celebrating their freedom, Right ? And shame on the Oregon Government for letting political considerations override Public Health policies.

Mike Steely said...

Immunizations are required by state law for children and students in attendance at public and private schools, preschools, childcare facilities and Head Start programs in Oregon. Children must have all required immunizations, or a medical or non-medical exemption to stay enrolled.

https://www.oregon.gov/oha/ph/preventionwellness/vaccinesimmunization/gettingimmunized/pages/school.aspx

Unfortunately, the state has made it so easy to obtain nonmedical exemptions that the law has become an unenforceable request.

John F said...

I am acutely aware of polio as my father died from it in 1947. Once the vaccine was available my brother and I were first in line at our local doctor's office to get the shot. Currently, polio is eradicated in the US but still contracted by travelers to regions where infection is possible. On average the US records one case per year.

Oregon had an outbreak of measles last year, accounting for a few of the 58 cases reported nationally. Again, their infections were the result of a person traveling outside the US bringing the disease home to Oregon. Measles is considered to be a highly contagious airborne infection, being in the room or terminal with an infected person results in infection if you’re unvaccinated
90 percent of the time.

Vaccinations remind me of share tires, you don’t think about them until you have a flat or in the case of an inadvertent communicable disease exposure, been vaccinated against it.

Do feel lucky or enjoy gambling with your child’s health?

M2inFLA said...

I am pro vaccine.

I've received at least 5 shots of the Moderna vaccine as has my wife. We travel extensively within the US and also to Europe and Asia. We've been to British Isles, Iceland, France, and Germany during the pandemic. Nary a sniffle, though traveling companions did come down with COVID.

We've never had COVID, though we have tested quite regularly.

A few misconceptions ib the post today:

1. Masks don't filter airborne contagions. You can easily investigate this yourself. The COVID virus and many other airborne viruses and contagions are particles, but are much smaller than common smoke particles. Put on your best mask, and see if you can smell odors or smoke. Likely, you will smell smoke regardless of the type of mask most people wear.

Masks do filter contagions like fluid and mucus that may be expelled when someone sneezes or coughs. That is why we steer quite clear of people hacking away whether they are wearing a mask or covering their sneeze/cough/hack with a tissue.

Rather silly seeing people in their cars wearing a mask as they drive around, unless they are merely assuring they don't forget their mask and are frequently coughing and/or sneezing.

2. Last time I checked during the 2016 campaign, it was Trump who advocated the development of vaccines while he was president, and it was certain Democratic candidates who were anti-vax in those early days. You can easily find videos and news media that quote some of those candidates.

3. You want to attend public schools, enter public building, or enter the country legally, or visit other countries, then you follow the rules in place for vaccinations and masking.

Alas, unfortunately, some rules and vaccines that were useful were improperly used to wage political battles. That is quite unfortunate for all of us.

As for those vaccinations, I am proud of my Governor DeSantis who worked hard to make vaccines available for everyone here in Florida. Very early for 65+ peole like me, and for everyone as soon as it was feasible. I helped many people lacking computer skills to get vaccinated here.

Anonymous said...

At Republican headquarters on Main Street in Medford, they have cards you can take, which list "vaccines that contain aborted fetal DNA." Listed vaccines are: chickenpox; "Hep A" (Havrix, Avaxim, Epaxal, Vaqta); polio; rabies; shingles; smallpox; "MMR" (MMR II, Priorix...). The cards originate from circleofmamas.com and icandecide.org.

Mike Steely said...

Just to clear up a misconception:
Face masks or respirators (N95/KN95s) effectively filter virus-sized particles in laboratory settings. In addition to being up to date with recommended COVID-19 vaccinations, consistently wearing a comfortable, well-fitting face mask or respirator in indoor public settings protects against acquisition of SARS-CoV-2 infection; a respirator (N95) offers the best protection.

https://www.cdc.gov/mmwr/volumes/71/wr/mm7106e1.htm

M2inFLA said...

Re: CDC comment about facemasks and respirators

In a laboratory setting which is a controlled (contrived?) Setting, perhaps, and certainly not 100% effective.

Few if any of us use a respirator mask.

Yes, N95/KN95 is better than most other masks, but as I suggested,

Try one on and tell me if you smell smoke. You will if your nose is working.

The COVID-19 virus is smaller, and odor free.

It does however travel mostly on the spittle/mucus from a hack,cough, or cold.

Airborne transmission of COVID-19 is helped by attaching to something.

Mc said...

Religion is for people who don't understand science.

Mc said...

Oregon needs to eliminate the religious/personal belief exemption. I think California has.

Mc said...

" ... evidence suggested most masks did little to protect oneself ... "

Masks have no downside in terms of public health. None.

Conservatives want freedumb to display their ugly faces while they control women's bodies.

Mike Steely said...

It isn't just the CDC, but all reputable medical sources such as the Mayo Clinic that confirm masks do help prevent the spread of respiratory diseases in general and COVID-19 in particular. N95s are the best, but any of them are better than none. Believe me, they are far more reliable than anonymous posts on a blog.