Ky. recognized for high immunization rate; up 17% since 2007

For having childhood vaccination rates considerably higher than the national average, Kentucky's Department for Public Health was recognized by the Centers for Disease Control and Prevention this week.

Kentucky's childhood vaccination series coverage rate was about 80.6 percent in the last two quarters of 2010 and the first two quarters of 2011. Nationwide, the rate was 73.1 percent. Kentucky was also acknowledged for improving its childhood coverage from 63.3 percent in 2007. The data were collected from the annual National Immunization Survey.

Starting July 1, 2011, immunization requirements started being imposed for infants, toddlers and school-age children that were more in line with CDC recommendations and national pediatric standards.

"We have been working to increase immunization rates among Kentucky's children for several years now, including a campaign to make the public aware of the changes to the immunization schedule that took effect last July," said acting Health Commissioner Dr. Steve Davis. "The improvement in vaccine coverage helps improve the health and well-being of our fellow Kentuckians, and particularly our children." (Read more)

Avoiding immunizations on religious grounds is risky: Bill Moyers

The movie "Contagion" has veteran journalist and commentator Bill Moyers thinking about how fast a deadly disease outbreak can spread, something that can be further propagated by children whose parents have declined to get them immunized on religious grounds.

All states require children to receive some vaccinations, but almost all, including Kentucky, grant religious exemptions. "Now seven states are considering legislation to make it even easier for mothers and fathers to spare their children from vaccinations, especially on religious grounds," Moyers writes.

In some places, that is affecting vaccination rates. In Oregon, the number of children in kindergarten with religious exemptions is up from 3.7 percent to 5.6 percent in the past four years. When the number of people who are not vaccinated increases, that can affect the whole population, since "a certain number of any population group needs to have been vaccinated to maintain the ability of the whole population — 'the herd' — to resist the spread of a disease," Moyers explains. In a class of 25 students, it just takes five who are unvaccinated "for the herd immunity to break down," he writes.

Recently, several outbreaks have been linked to children who have not received their vaccinations. Reuters reported 13 cases of measles in central Indiana, including two whop attended the Super Bowl in Indianapolis. "Patriot and Giants fans back East have been alerted," writes the New York-based Moyers. "So far, no news is good news."

Moyers calls the vaccination gaps "serious business," and reminds readers about serious disease outbreaks of the past, including measles, flu, small pox, polio, and whooping cough. While it's easy to be unconcerned, he says "our human herd moves on a conveyor belt of constant mobility, so that a virus can travel as swiftly as a voice from one cell phone to another. When and if a contagion strikes, we can't count on divine intervention to spare us. That's when you want a darn good scientist in a research lab." (Read more)

"The comments from vaccination skeptics on Bill's column show there are science-deniers on the left just as there are on the right," said Al Cross, director of the Institute for Rural Journalism and Community Issues.

Rural women are less likely to complete vaccinations for cervical-cancer virus; study finds vaccine does not increase sexual activity

Women living in rural areas of the U.S. were far less likely to return for their follow-up doses after they get the initial injection of the human papillomavirus vaccine, a study in the Journal of Rural Health has found. (Photo by Pete Rodman, Bowling Green Daily News)

The study contrasted the rates of vaccination follow-up by young women recruited from two rural locations and one urban location. "Despite being free, the researchers concluded that uptake of booster doses by rural women was problematic," states an article in the Rural Center for AIDS/STD Prevention's "RAP Time" publication. "This barrier might be resolved by providing the HPV doses at easy-to-access locations in rural communities, such as large grocery stores and area events."

The HPV vaccine requires three doses. The women who went to the rural clinic were seven times less likely to return for at least one follow-up dose.

The vaccine, which has proven to prevent most cervical cancers, has been approved for use in women ages 9 to 26 years, as well as boys. The vaccine is generally given at the age of 11 or 12 and is effective only if administered before a person becomes sexually active. As many as 80 percent of men and women become infected with HPV during their lives, but most do not develop symptoms or illness.

The vaccine has been met with reluctance by parents, some of whom fear it encourages sexual activity, but a study published in the American Journal of Preventive Medicine found girls or women who received the vaccine "were no more likely to be sexually active or have more partners than those not vaccinated."

Last year, just 49 percent of adolescent girls nationwide had received at least the first dose of the vaccine, and only a third had gotten all three. In Kentucky, just 25 percent of adolescent females had gotten the first dose and fewer than 11 percent had received all three doses.

In Kentucky, the annual death rate caused by cervical cancer is 2.9 deaths per 100,000. In the United States, it's 2.4 per 100,000. "The U.S. is remaining stable. Kentucky's is actually falling," gynecologist Dr. Mark Yurchisin told Alyssa Harvey of the Bowling Green Daily News.

The decrease is being attributed to an increase in screenings. "In certain counties in Kentucky there is a high incidence, they implemented outreach clinics because they didn't have clinics where they could get Pap screenings done," Yurchisin said. "They can diagnose it at an earlier and treatable stage." (Read more)

Boys should get HPV vaccine to keep from spreading virus

A federal committee has recommended that boys receive the human papilloma virus vaccine, already recommended for girls, to fight the sexually transmitted virus that is known to cause cervical cancer. The vaccine could also protect boys against genital warts and anal cancer.

The Advisory Committee on Immunization Practices released its recommendation Wednesday. It is the first time there has been a public push for boys to receive the vaccine, though it has been licensed for male use for the past two years.

Dr. Baretta Casey, director of Cervical Cancer-Free Kentucky, applauded the move. "To stem the spread of the HPV virus and the many problems it causes is the best thing," she said.

The vaccine is usually given at the age of 11 or 12 and is only effective if it is given before a person becomes sexually active. As many as 80 percent of men and women are infected with HPV during the course of their lives, but most do not develop symptoms or illness, the Centers for Disease Control and Prevention reports.

The vaccine has been met with reluctance by parents, some of whom fear it would encourage sexual activity. Last year, just 49 percent of adolescent girls nationwide had received at least the first of its three doses, and only a third had gotten all three. In Kentucky, only 25 percent of adolescent females had received the first dose, and fewer than 11 percent had received all three doses.

Casey attributed parents' hesitation to a fear that the vaccine is harmful, though research shows otherwise. "It's our hope that people understand that this is a vaccine that has been around for quite a while now," she said. "The effects of the immunization are similar to other vaccines that we currently give our children. And if I can give my child a vaccine that would prevent them from ever developing cancer, I'm for it." On average, 391 Kentucky women develop cervical cancer and 66 die.

The cost of the vaccine — about $110 for each of the three doses — is also believed to be a factor in the low vaccination numbers, though Casey said Medicaid covers it, as do major health insurance providers such as Blue Cross Blue Shield and Anthem. Though the numbers are low, Casey said she is seeing some boys being vaccinated in Kentucky "but it's not a widely done practice." (Read more)

Parents, children should discuss HPV vaccine, study indicates

A study at Ohio State University found that college-aged women who have talked to their mothers about the human papillomavirus are more likely to get the vaccine that prevents it, Brandy Reeves, right, a certified sexuality educator and health education coordinator at the University of Kentucky, writes in the Lexington Herald-Leader.

HPV is known to cause cancer, including cervical cancer, oral cancer, vulvar cancer, anal cancer and penile cancer.

There are two vaccines for HPV approved by the Food and Drug Administration: Gardasil and Cervarix. "Because men can carry HPV and transmit it sexually to their partners, the FDA has approved the use of Gardasil in both genders, from ages 9 to 26," Reeves writes. "Parents who are nervous about bringing up the topic can focus on how the vaccine is safe and effective, and that it prevents cancer." (Read more)

High-dose flu shot, which many doctors recommend for those over 65 due to risk of death, is becoming more available

It's time for flu shots, but the annual reminder has a new angle: Fluzone HighDose, a special vaccine designed for people 65 and older, who make up 90 percent of the 23,000 people who die of the flu and its complications.

"The high-dose vaccine for seniors, introduced last year by drug-maker Sanofi Pasteur, is becoming more widely available in the area, and health workers say it’s in high demand," Laura Ungar reports for The Courier-Journal of Louisville.The Jefferson County Health Department "charges $40 for the high-dose shot and $25 for the regular vaccine that is injected." (C-J photo by Bill Luster: Joe Blincoe of Louisville gets one of the new, high-dose shots)

The high-dose vaccine contains four times as much antibody-creating antigen as a regular shot, and it is recommended by Dr. Nancy Stiles, a geriatrician and associate professor of medicine at the University of Kentucky, but the Centers for Disease Control and Prevention "says problems such as pain and swelling at the injection site and headache or muscle aches were reported more frequently after people got the high-dose vaccine," Ungar writes. "At this point, the CDC is not recommending one type over the other," pending a study. "Whichever type of flu shot seniors get, local doctors are also urging them to make sure they have had a pneumonia shot," which is good for at least five years. (Read more)