Vaccinations: Personal Choice or Civic Duty?
Chelsey with healthy Kaliah
By Kennetha Scott 12/15/2011
There is currently an outbreak of Pertussis (Whooping Cough) in Washington State where there have been over 400 cases this year. Sadly, it has also resulted in the death of two infants, and one of them was very dear to me. This should serve as a warning to everyone to vaccinate themselves and their children. While it is our right to exempt ourselves and/or our children from various vaccinations, it is our duty as citizens of our community to be vaccinated. Misconceptions concerning the safety of today’s vaccinations, government conspiracy theories, and religious beliefs have resulted in a fear of vaccinations that is putting our children, and our world, at risk
I have recently experienced a great loss due to what I feel is a lack of understanding of the risks associated with vaccinations. I watched helplessly as my niece's two week old daughter struggled, and finally lost, her battle with an illness I thought had long since been eradicated.
In early August, 2011, I took my 2 grandchildren to their cousin’s birthday party. When I arrived, I learned that my niece and her 2 week old daughter Kaliah, who also lived there, had Pertussis. As soon as I laid eyes on her, I was very saddened to see Kaliah in so much discomfort. While still very beautiful, there was a pain in her eyes that was unmistakable. I was very surprised to see 4 or 5 other small babies in the same room as her when the parents all knew she had whooping cough.
My grandchildren are 5 and 8 years old and they have been vaccinated from birth, so they are protected. I was still frightened they may have been exposed and didn’t want to take any chances with them spreading it to others at school, so I kept them outside playing with the other older children, unaware that anything was amiss.
Later that evening I heard that Kaliah was in the hospital and was being transferred to Seattle Children’s Hospital in order to get better care. She was in great pain and she required constant transfusions with special equipment that was not available in Everett. After nine days of intensive care, with Kaliah getting weaker by the day, there was not much hope; but we held on to hope anyway. During an extensive surgery, the doctors put her on a special machine that would help her breath and pump her heart because she was so exhausted. They didn’t know if she would survive the surgery, but when she made it we were elated, because this was supposed to keep her alive while the antibiotics and constant transfusions were getting rid of the Pertussis. At this point we really believed she would get better, so we all breathed a sigh of relief, and actually let ourselves smile again. Yet, the next day Kaliah died at 27 days old, barely recognizable after all of the pain and agony she endured. The following picture was taken on the last day of her short life, her mother’s pain barely hidden behind her mask. This innocent little girl did not have to die.
Chelsey and Kaliah near the end This unnecessary tragedy caused me to ask questions. The first one was, why did this happen? We are typically vaccinated against these kinds of diseases, just so we don’t encounter these results. My niece had been vaccinated 5 years earlier and had even asked her obstetrician if she could have the vaccination while she was pregnant!
Secondly, why were all those babies in that room with a sick baby? Don’t doctors warn new parents of the dangers to babies? Those parents must have missed an advertisement I happened to see recently warning of pertussis. It was frightening. A mother was holding her baby and the “whooping” cough was heard in the background as she tells parents “while you think the safest place for a baby is in your arms, it is usually where the baby contracts the disease” (March of Dimes ).
Also, why don’t people know that the vaccination wears off after 5-10 years? It is well known that tetanus shots should be given every 10 years, or when you step on a rusty nail; so what about pertussis? There should be a major drive to draw a line in the sand as to how often the vaccine is required and work to edit the requirements.
In order to find answers to these and other questions, I have been in contact with the Health District and other Health Professionals. My grandchildren’s pediatrician, Dr. Beard told me that usually only babies under 6 months old die from this illness. Another unsettling fact is that in about 50% of cases, the disease is spread from the parent to the child. Pertussis is a bacterial infection which spreads very quickly because of the cough associated with it. It has been called the 100 day cough because it lasts that long; or even longer in some cases. The mucus is really thick and the child may cough many times before they can breathe, so a gasping sound is heard when they are finally able to breath. Because the immune system is compromised, other bacteria begin to grow inside the child’s lungs. All of this can lead to suffocation, stroke, seizures, and eventually death; as in Kaliah’s case (Beard).
Kaliah just after diagnosis
Below are links to two short, but disturbing, videos of babies with pertussis from YouTube. Kaliah sounded something like the children in the videos as she struggled to breathe.
Pertussis Cough Video(firesnakepodcast)
A Suitable Case for Treatment Video (Applemask) Chelsey with her healthy baby girl Kaliah Chelsey Charles was interviewed by King 5 News on August 19th, just 3 days after her 27 day old baby girl Kaliah died. She appeared to be in shock and when she said, “She was healthy, and then 9 days later she wasn’t healthy anymore; she was gone. We went back in the room and they put her in my arms and they took her off the machine, and within minutes she was gone. It hurts, it feels like it’s my fault, but I don’t know where I got it (Pertussis).” In the same interview, Dr. Gary Goldbaum, the Director of Snohomish County Health District told the reporter, “The death of an infant reminds us there are vulnerable people in our community and the only way to protect them is if everybody gets vaccinated.” (JAVIER)
Chelsey now says this about her experience:
Personally, I think that getting vaccinated should be a civic duty. We shouldn't have a choice if it’s to protect us from such a dangerous sickness. To all the people who think they shouldn't have to be vaccinated, I would like to ask them how they would feel if it were their little girl that had been taken from them, knowing it could have been prevented. When I was pregnant I was supposed to get the booster shot at school, so my mom and I both asked the doctor for it, but they said they don't like to give it to pregnant women, so to wait until after I delivered. I don't think people know even the slightest thing about Pertussis; nobody realizes that it’s back and how dangerous it is to newborn babies. I had never heard about it except for the commercial with the mother and the baby; and that commercial barely explains anything. I Googled everything, and that's how I found out Kaliah and I had it (Pertussis). That’s also where I read how dangerous it was. I wondered why nobody had warned me about it before. I believe that I was given Kaliah to make a difference and to bring awareness and change peoples’ minds on vaccination. She was just too beautiful and amazing to not let her story be told and save other babies lives. So, to all those people who don't want to be vaccinated, I would ask you to please think again of my baby girl (Charles, Mother).
Surprisingly, Washington’s vaccination exemption rates are the highest* in the country and they have more than doubled over the last 10 years! 6.2 percent of kindergarteners have a parent-signed exemption form for one or more vaccines (Washington State Department of Health). *Edited 2/25/12
Usually, vaccinations cause only a sore arm or mild fever. Today, the risk of death from vaccines is extraordinarily low. Still, many people refuse to vaccinate their children or receive booster shots for themselves. One of the main reasons people have for not choosing to have their children vaccinated is safety. Some vaccines have certainly done their share of damage, and the same is true of the Pertussis vaccine. The second vaccine for Pertussis, DTaP, which was given prior to Tdap was very controversial as it was associated with many cases of high fever, collapse/shock, convulsions, brain inflammation and even permanent brain damage (Fisher).
Since 1996, the newer vaccines have been used to safeguard us from three diseases at once; Diphtheria, Tetanus, and Pertussis. An outbreak Diphtheria causes 1 death in 20, Tetanus causes 2 deaths in 10, and Pertussis causes 1 death in 1500. On the other hand, the vaccine Tdap, which was released in 2005 has caused only instances of continuous crying, convulsions or shock, then a full recovery; in the fifteen years since it DTaP was replaced, there have been no deaths or permanent damage.
Health care providers say that one of the causes of recent outbreaks is the increasing amount of people claiming exemptions from immunization requirements. Of concern was the ease with which one used to be able to claim their child exempt from vaccinations in Washington State. All a parent needed to do was check a box and their child would not have to be vaccinated in order to attend a public school. They did not need to provide any additional information as to why they were not vaccinating their child; just check a box. Health officials say that a lot of people checked that box out of convenience. Often, when unable to locate the immunization records at the time they needed to register their child at school, the parent found it easier to check the box than to locate the records. (Pate)
There are three types of exemptions currently listed on the Washington State immunization exemption form from which a parent may choose. Those exemptions are: Temporary/Permanent Medical, Personal/Philosophical, and finally, Religious.
Temporary Medical, Permanent Medical exemption laws were changed as of May 10, 2011. Regulations for school and child care immunization exemptions now require a licensed health care provider to sign the exemption form. The signature verifies that the provider gave the parent or guardian information about the benefits and risks of immunization. This doesn’t apply to “those who demonstrate membership in a church or religious group that does not allow a health care provider to provide medical treatment to a child.” Changing the law to require that a healthcare provider be required to sign off on the form will guarantee that a medical professional is consulted before a decision is made concerning immunization. An informed decision should be made for something this critical. This change in the laws should also help ensure that people do not check the exemption box out of convenience (Immunization & Child Profile Office).
In 2009 Personal/Philosophical exemptions made up more than 95% of all immunization exemptions in Washington State. No medical consultation or specific reasons were required at that time. Now that people are required to get a signature from a health care provider, it will be interesting to see which route they take after becoming educated (Washington State Chapter of American Academy of Pediatrics).
The Religious exemption is difficult to argue against with the guaranteed freedom of religion which was given to all citizens by our constitution. Sample forms are available to use for the Catholic Church at one website, specifically citing the objections the church has against certain vaccines; primarily citing vaccines said to use aborted fetuses in their making There are no aborted fetuses in the Tdap vaccine. (Children of God For Life).
There are several common myths associated with vaccinations according to the Centers for Disease Control and Prevention or CDC. One myth is that it is not vaccines that are causing diseases to disappear, but “better hygiene and sanitation”. While better living and health conditions have helped, this is not the only reason the disease nearly disappeared. There were around 750,000 cases in the United States around 1957 but that dropped to around 400,000 within 6 years, due to vaccine use (Centers for Disease Control and Prevention).
Some people feel that these diseases have been virtually eliminated from the United States so there is no need to keep vaccinating. While it is true that most vaccine-preventable diseases have been nearly eliminated here in the United States some, such as Pertussis, are seeing resurgence. Also, unvaccinated American travelers visiting areas outside the US are susceptible to many diseases they haven’t had to worry about for a long time; such as current outbreaks of Rabies in Bali, Indonesia, Cholera in the Dominican Republic, and Dengue in the Marshall Islands, just to name a few (Center For Disease Control).
There has been controversy surrounding the topic of giving a child multiple vaccinations, simultaneously. It is believed it that in addition to the increased risk of harmful side effects, it can be too much for the child’s immune system. The Advisory Committee on Immunization Practices and American Academy of Pediatrics recommend getting more than one vaccine at a time, when appropriate. Studies have shown that the “recommended vaccines are as effective in combination as they are individually, and that such combinations carry no greater risk for adverse side effects” (Centers for Disease Control and Prevention).
Opponents such as the American Liberties Union, (ALCU), watch for government intrusion into personal choice and individual rights. They also understand vaccinations are sometimes necessary. In a blog from the ALCU concerning the H1N1 flu virus vaccine, Tania Simoncelli states “it is imperative that the nation engage now in conversation about appropriate responses to the current outbreak (H1N1) so that civil liberties concerns are considered part of and not contrary to a public health mitigation effort. It is possible to safeguard privacy and liberty while still protecting public health, and now is the perfect time to set standards for things like vaccination and treatment programs that will keep us and the Constitution healthy” (Simoncelli).
On the other side of the argument, fighting for mandatory vaccinations with no exceptions besides medical, is the CDC. The organization says this of immunization “A successful vaccination program, like a successful society, depends on the cooperation of every individual to ensure the good for all. We would think it irresponsible of a driver to ignore all traffic regulations on the presumption that other drivers will watch out for him or her. In the same way, we shouldn't rely on people around us to stop the spread of disease if we ourselves can be vaccinated. We must all do what we can.” (Centers for Disease Control and Prevention)
Many people feel they have valid reasons not to vaccinate. They do have that right to choose, however, it is difficult to put much weight to even the most valid of those reasons when a baby has died, and with each additional exemption claimed, more are susceptible to the virus. Yes, there have been instances when vaccinations have harmed and even killed children. Historically, the DTP shot even gave people reason for their distrust. But, as previously stated, the newer vaccine, Tdap, has never been proven to have caused any deaths.
When small babies are cared for in a daycare or preschool setting, it is assumed that the state and county child services would be vigilant in ensuring their safety. When it comes to vaccinations there seems to be a void in their vigilance. There is currently no requirement for caretakers to get the Tdap booster shot at all. How can a parent be assured their child will not be infected with the disease and bring it home to their new baby sister or brother? Vaccinated children and adolescents that learn or play around unvaccinated children and adolescents may still carry the disease, possibly infecting the rest of their family. If a facility allows unvaccinated children and they infect a child that has a small baby in the family, that baby could die. The disease could also be spread to the babies under 2 months old in the facility that are unable to have the vaccine yet and it could kill them. (Immunization & Child Profile Office)
According to Dr. Goldbaum there is not enough data to recommend boosters for adults.
He says: The Tdap was originally licensed to be administered at least 5 years following Td. In 2006, the recommendation changed: “An interval as short as 2 years from the last Td is suggested; shorter intervals can be used.” In 2010, the recommendations again changed: “use of Tdap regardless of interval since the last tetanus- or diphtheria-toxoid containing vaccine”. So we cannot yet recommend boosters for adults, but we can recommend getting the Tdap even if someone had the Td recently.
Of course, the most important change to the recommendations is the one that might have saved Kaliah. In October 2011 (too late for Kaliah), CDC issued this statement: “ACIP recommends that women's health-care personnel implement a Tdap vaccination program for pregnant women who previously have not received Tdap. Health-care personnel should administer Tdap during pregnancy, preferably during the third or late second trimester (after 20 weeks' gestation). If not administered during pregnancy, Tdap should be administered immediately postpartum.” In my mind, this recommendation will always be associated with Kaliah. I have and will continue to vigorously urge health care providers to assure that their pregnant patients are vaccinated before delivery, if at all possible. (Goldbaum).
Dr. Goldbaum also has suggestions about how to help people make good decisions about vaccination: “there is so much new information out there, and so much unnecessary resistance to vaccinations, that it is hard for the medical community and public health community to really influence people. Quite frankly a tragic experience such as this; someone who has had a personal experience with the consequences of failure to vaccinate, can really be a powerful, powerful spokesperson.” He elaborates by explaining that a medical professional can tell patients that vaccinations are very effective and that they save lives, and that they are safe; but that is “only statistics and numbers.” Doctors can talk until “blue in the face” but if someone making the decision hears of a real person, a real consequence of not getting vaccinated, they are more inclined to listen. “When someone comes back and says aren’t these vaccines harmful, or why do we really need them? People who have had these experiences can say, “I experienced something that was devastating, a real tragedy; and it didn’t have to happen. It doesn’t have to happen to you or anybody else.” Dr. Goldbaum was very clear that a personal tragedy is “a powerful tool to influence people and to make a difference” (Goldbaum, Director of Snohomish County Health District).
Vaccines that have been well researched and considered to be safe by the majority of health care professionals and scientists should be mandatory in the United States unless a medical exemption is required. A mandate should be made to remove the right to exempt a child from this vaccination if they attend a public school or daycare, unless unable to do so for medical reasons. If a parent chooses not to vaccinate their children, the child should then be educated and/or cared for in a separate facility from those who have had their vaccinations. Thresholds of affectivity for each vaccine should be researched, and recommendations made, as to the frequency of vaccinations required to keep outbreaks in the community to a minimum.
Even before that happens, laws need to be in place to ensure all Child care and Health care providers are immunized to the fullest extent of current recommendations; if it is every 5 to 10 years, they must get it every 5 years, if they wish to be employed in that industry. In the case of Pertussis, because the real danger of death is so great to small babies under 18 months who cannot yet receive the vaccine, it is imperative to view this as a civic duty, not a personal choice.
I asked Dr. Goldbaum how one person could make a difference. He explained, “Take an interest; learn a lot more, become an articulate spokesperson on behalf of vaccinations. If you influence even a handful of people who otherwise were reluctant to vaccinate themselves or their children; if you are able to convince them, you may well save a life” (Goldbaum, Director of Snohomish County Health District).
So, now when I see an expectant mother, or a mother with a small baby, I always ask if she and her family have been vaccinated for Whooping cough recently and share the story of Kaliah. Who knows, maybe I have already saved a life? There are many reasons people give for choosing not to be vaccinated. I hope they will reconsider now and do so; for the sake of everyone in the community, and in memory of our sweet Kaliah Dailynn Holly Jeffery.
(Chelsey Charles and Tanner Jeffery with their daughter Kaliah; gone too soon)
Works Cited
A Suitable Case for Treatment. 27 May 2011. 2 December 2011 <www.youtube.com>.
Beard, Christopher. Doctor of Pediatrics Everett Clinic Personal Interview. 8 August 2011.
Center For Disease Control. Travelers' Health - CDC. 1 December 2011. 1 December 2011 <www.nc.cdc.gov>.
Centers for Disease Control and Prevention. Vaccines and Immunizations Basics and Common Questions. 18 February 2011. 12 October 2011 <www.cdc.gov>.
Charles, Chelsey. Baby Kaliah just after diagnosis. Personal Photos. Everett, 2011.
Charles, Chelsey. Chelsey and Tanner with their daughter Kaliah; gone too soon. Personal Photos. Seattle, 2011.
Charles, Chelsey. Chelsey Charles with daughter Kaliah Dailynn Holly Jeffery near the end . Personal Photos. Seattle, 2011.
Charles, Chelsey. Chelsey Charles with healthy Kaliah. Personal Photos. Woodinville, 2011.
Charles, Chelsey. Healthy Kaliah. Personal Photo Album. Woodinville, 2011.
Charles, Chelsey. Mother Personal Interview. 6 December 2011.
Charles, Chelsey. Tanner Jeffery with daughter Kaliah. Personal Photos. Everett, 2011.
Children of God For Life. "Sample Letter for Catholics." 14 July 2011. Children of God For Life. 3 December 2011 <www.cogforlife.org/sampleletter>.
firesnakepodcast. Pertussis Cough Video. 6 January 2010. 3 December 2011 <www.youtube.com>.
Fisher, Barbara Loe. "NVIC-Vaccine-News Whooping Cough Outbreaks & Vaccine Failures." 8 July 2010. NVIC- National Vaccine Information Center. 2 December 2011 <www.nvic.org>.
Goldbaum, Dr. Gary. Everett, Email. 15 December 2011.
Goldbaum, Dr. Gary. Director of Snohomish County Health District Personal Interview. 12 October 2011.
Immunization & Child Profile Office. "Immunization & Child Profile Office." 25 August 2011. Changes to School and Child Care Immunization Exemptions. 7 November 2011 <www.doh.wa.gov>.
JAVIER, LIZA. "Newborn dies from whooping cough." 19 August 2011. King 5 News. 7 November 2011 <www.king5.com>.
March of Dimes . Adstorical Pertussis, or whooping cough. 1 December 2011. 6 December 2011 <www.adstorical.com>.
Pate, Suzanne. Public Information Officer for Snohomish County Health District Personal Interview. 12 October 2011.
Simoncelli, Tania. ALCU Keeping Us — and the Constitution — Healthy. 10 December 2009. 1 December 2011 <www.aclu.org>.
Washington State Chapter of American Academy of Pediatrics. "WCAAP 2011 Immunization Exemption Position Paper." 5 November 2009. WCAAP. 2 December 2011 <www.wcaap.org>.
Washington State Department of Health. Washington’s kids among least protected in the nation. 11 June 2011. 12 October 2011 <www.doh.wa.gov>.
There is currently an outbreak of Pertussis (Whooping Cough) in Washington State where there have been over 400 cases this year. Sadly, it has also resulted in the death of two infants, and one of them was very dear to me. This should serve as a warning to everyone to vaccinate themselves and their children. While it is our right to exempt ourselves and/or our children from various vaccinations, it is our duty as citizens of our community to be vaccinated. Misconceptions concerning the safety of today’s vaccinations, government conspiracy theories, and religious beliefs have resulted in a fear of vaccinations that is putting our children, and our world, at risk
I have recently experienced a great loss due to what I feel is a lack of understanding of the risks associated with vaccinations. I watched helplessly as my niece's two week old daughter struggled, and finally lost, her battle with an illness I thought had long since been eradicated.
In early August, 2011, I took my 2 grandchildren to their cousin’s birthday party. When I arrived, I learned that my niece and her 2 week old daughter Kaliah, who also lived there, had Pertussis. As soon as I laid eyes on her, I was very saddened to see Kaliah in so much discomfort. While still very beautiful, there was a pain in her eyes that was unmistakable. I was very surprised to see 4 or 5 other small babies in the same room as her when the parents all knew she had whooping cough.
My grandchildren are 5 and 8 years old and they have been vaccinated from birth, so they are protected. I was still frightened they may have been exposed and didn’t want to take any chances with them spreading it to others at school, so I kept them outside playing with the other older children, unaware that anything was amiss.
Later that evening I heard that Kaliah was in the hospital and was being transferred to Seattle Children’s Hospital in order to get better care. She was in great pain and she required constant transfusions with special equipment that was not available in Everett. After nine days of intensive care, with Kaliah getting weaker by the day, there was not much hope; but we held on to hope anyway. During an extensive surgery, the doctors put her on a special machine that would help her breath and pump her heart because she was so exhausted. They didn’t know if she would survive the surgery, but when she made it we were elated, because this was supposed to keep her alive while the antibiotics and constant transfusions were getting rid of the Pertussis. At this point we really believed she would get better, so we all breathed a sigh of relief, and actually let ourselves smile again. Yet, the next day Kaliah died at 27 days old, barely recognizable after all of the pain and agony she endured. The following picture was taken on the last day of her short life, her mother’s pain barely hidden behind her mask. This innocent little girl did not have to die.
Chelsey and Kaliah near the end This unnecessary tragedy caused me to ask questions. The first one was, why did this happen? We are typically vaccinated against these kinds of diseases, just so we don’t encounter these results. My niece had been vaccinated 5 years earlier and had even asked her obstetrician if she could have the vaccination while she was pregnant!
Secondly, why were all those babies in that room with a sick baby? Don’t doctors warn new parents of the dangers to babies? Those parents must have missed an advertisement I happened to see recently warning of pertussis. It was frightening. A mother was holding her baby and the “whooping” cough was heard in the background as she tells parents “while you think the safest place for a baby is in your arms, it is usually where the baby contracts the disease” (March of Dimes ).
Also, why don’t people know that the vaccination wears off after 5-10 years? It is well known that tetanus shots should be given every 10 years, or when you step on a rusty nail; so what about pertussis? There should be a major drive to draw a line in the sand as to how often the vaccine is required and work to edit the requirements.
In order to find answers to these and other questions, I have been in contact with the Health District and other Health Professionals. My grandchildren’s pediatrician, Dr. Beard told me that usually only babies under 6 months old die from this illness. Another unsettling fact is that in about 50% of cases, the disease is spread from the parent to the child. Pertussis is a bacterial infection which spreads very quickly because of the cough associated with it. It has been called the 100 day cough because it lasts that long; or even longer in some cases. The mucus is really thick and the child may cough many times before they can breathe, so a gasping sound is heard when they are finally able to breath. Because the immune system is compromised, other bacteria begin to grow inside the child’s lungs. All of this can lead to suffocation, stroke, seizures, and eventually death; as in Kaliah’s case (Beard).
Kaliah just after diagnosis
Below are links to two short, but disturbing, videos of babies with pertussis from YouTube. Kaliah sounded something like the children in the videos as she struggled to breathe.
Pertussis Cough Video(firesnakepodcast)
A Suitable Case for Treatment Video (Applemask) Chelsey with her healthy baby girl Kaliah Chelsey Charles was interviewed by King 5 News on August 19th, just 3 days after her 27 day old baby girl Kaliah died. She appeared to be in shock and when she said, “She was healthy, and then 9 days later she wasn’t healthy anymore; she was gone. We went back in the room and they put her in my arms and they took her off the machine, and within minutes she was gone. It hurts, it feels like it’s my fault, but I don’t know where I got it (Pertussis).” In the same interview, Dr. Gary Goldbaum, the Director of Snohomish County Health District told the reporter, “The death of an infant reminds us there are vulnerable people in our community and the only way to protect them is if everybody gets vaccinated.” (JAVIER)
Chelsey now says this about her experience:
Personally, I think that getting vaccinated should be a civic duty. We shouldn't have a choice if it’s to protect us from such a dangerous sickness. To all the people who think they shouldn't have to be vaccinated, I would like to ask them how they would feel if it were their little girl that had been taken from them, knowing it could have been prevented. When I was pregnant I was supposed to get the booster shot at school, so my mom and I both asked the doctor for it, but they said they don't like to give it to pregnant women, so to wait until after I delivered. I don't think people know even the slightest thing about Pertussis; nobody realizes that it’s back and how dangerous it is to newborn babies. I had never heard about it except for the commercial with the mother and the baby; and that commercial barely explains anything. I Googled everything, and that's how I found out Kaliah and I had it (Pertussis). That’s also where I read how dangerous it was. I wondered why nobody had warned me about it before. I believe that I was given Kaliah to make a difference and to bring awareness and change peoples’ minds on vaccination. She was just too beautiful and amazing to not let her story be told and save other babies lives. So, to all those people who don't want to be vaccinated, I would ask you to please think again of my baby girl (Charles, Mother).
Surprisingly, Washington’s vaccination exemption rates are the highest* in the country and they have more than doubled over the last 10 years! 6.2 percent of kindergarteners have a parent-signed exemption form for one or more vaccines (Washington State Department of Health). *Edited 2/25/12
Usually, vaccinations cause only a sore arm or mild fever. Today, the risk of death from vaccines is extraordinarily low. Still, many people refuse to vaccinate their children or receive booster shots for themselves. One of the main reasons people have for not choosing to have their children vaccinated is safety. Some vaccines have certainly done their share of damage, and the same is true of the Pertussis vaccine. The second vaccine for Pertussis, DTaP, which was given prior to Tdap was very controversial as it was associated with many cases of high fever, collapse/shock, convulsions, brain inflammation and even permanent brain damage (Fisher).
Since 1996, the newer vaccines have been used to safeguard us from three diseases at once; Diphtheria, Tetanus, and Pertussis. An outbreak Diphtheria causes 1 death in 20, Tetanus causes 2 deaths in 10, and Pertussis causes 1 death in 1500. On the other hand, the vaccine Tdap, which was released in 2005 has caused only instances of continuous crying, convulsions or shock, then a full recovery; in the fifteen years since it DTaP was replaced, there have been no deaths or permanent damage.
Health care providers say that one of the causes of recent outbreaks is the increasing amount of people claiming exemptions from immunization requirements. Of concern was the ease with which one used to be able to claim their child exempt from vaccinations in Washington State. All a parent needed to do was check a box and their child would not have to be vaccinated in order to attend a public school. They did not need to provide any additional information as to why they were not vaccinating their child; just check a box. Health officials say that a lot of people checked that box out of convenience. Often, when unable to locate the immunization records at the time they needed to register their child at school, the parent found it easier to check the box than to locate the records. (Pate)
There are three types of exemptions currently listed on the Washington State immunization exemption form from which a parent may choose. Those exemptions are: Temporary/Permanent Medical, Personal/Philosophical, and finally, Religious.
Temporary Medical, Permanent Medical exemption laws were changed as of May 10, 2011. Regulations for school and child care immunization exemptions now require a licensed health care provider to sign the exemption form. The signature verifies that the provider gave the parent or guardian information about the benefits and risks of immunization. This doesn’t apply to “those who demonstrate membership in a church or religious group that does not allow a health care provider to provide medical treatment to a child.” Changing the law to require that a healthcare provider be required to sign off on the form will guarantee that a medical professional is consulted before a decision is made concerning immunization. An informed decision should be made for something this critical. This change in the laws should also help ensure that people do not check the exemption box out of convenience (Immunization & Child Profile Office).
In 2009 Personal/Philosophical exemptions made up more than 95% of all immunization exemptions in Washington State. No medical consultation or specific reasons were required at that time. Now that people are required to get a signature from a health care provider, it will be interesting to see which route they take after becoming educated (Washington State Chapter of American Academy of Pediatrics).
The Religious exemption is difficult to argue against with the guaranteed freedom of religion which was given to all citizens by our constitution. Sample forms are available to use for the Catholic Church at one website, specifically citing the objections the church has against certain vaccines; primarily citing vaccines said to use aborted fetuses in their making There are no aborted fetuses in the Tdap vaccine. (Children of God For Life).
There are several common myths associated with vaccinations according to the Centers for Disease Control and Prevention or CDC. One myth is that it is not vaccines that are causing diseases to disappear, but “better hygiene and sanitation”. While better living and health conditions have helped, this is not the only reason the disease nearly disappeared. There were around 750,000 cases in the United States around 1957 but that dropped to around 400,000 within 6 years, due to vaccine use (Centers for Disease Control and Prevention).
Some people feel that these diseases have been virtually eliminated from the United States so there is no need to keep vaccinating. While it is true that most vaccine-preventable diseases have been nearly eliminated here in the United States some, such as Pertussis, are seeing resurgence. Also, unvaccinated American travelers visiting areas outside the US are susceptible to many diseases they haven’t had to worry about for a long time; such as current outbreaks of Rabies in Bali, Indonesia, Cholera in the Dominican Republic, and Dengue in the Marshall Islands, just to name a few (Center For Disease Control).
There has been controversy surrounding the topic of giving a child multiple vaccinations, simultaneously. It is believed it that in addition to the increased risk of harmful side effects, it can be too much for the child’s immune system. The Advisory Committee on Immunization Practices and American Academy of Pediatrics recommend getting more than one vaccine at a time, when appropriate. Studies have shown that the “recommended vaccines are as effective in combination as they are individually, and that such combinations carry no greater risk for adverse side effects” (Centers for Disease Control and Prevention).
Opponents such as the American Liberties Union, (ALCU), watch for government intrusion into personal choice and individual rights. They also understand vaccinations are sometimes necessary. In a blog from the ALCU concerning the H1N1 flu virus vaccine, Tania Simoncelli states “it is imperative that the nation engage now in conversation about appropriate responses to the current outbreak (H1N1) so that civil liberties concerns are considered part of and not contrary to a public health mitigation effort. It is possible to safeguard privacy and liberty while still protecting public health, and now is the perfect time to set standards for things like vaccination and treatment programs that will keep us and the Constitution healthy” (Simoncelli).
On the other side of the argument, fighting for mandatory vaccinations with no exceptions besides medical, is the CDC. The organization says this of immunization “A successful vaccination program, like a successful society, depends on the cooperation of every individual to ensure the good for all. We would think it irresponsible of a driver to ignore all traffic regulations on the presumption that other drivers will watch out for him or her. In the same way, we shouldn't rely on people around us to stop the spread of disease if we ourselves can be vaccinated. We must all do what we can.” (Centers for Disease Control and Prevention)
Many people feel they have valid reasons not to vaccinate. They do have that right to choose, however, it is difficult to put much weight to even the most valid of those reasons when a baby has died, and with each additional exemption claimed, more are susceptible to the virus. Yes, there have been instances when vaccinations have harmed and even killed children. Historically, the DTP shot even gave people reason for their distrust. But, as previously stated, the newer vaccine, Tdap, has never been proven to have caused any deaths.
When small babies are cared for in a daycare or preschool setting, it is assumed that the state and county child services would be vigilant in ensuring their safety. When it comes to vaccinations there seems to be a void in their vigilance. There is currently no requirement for caretakers to get the Tdap booster shot at all. How can a parent be assured their child will not be infected with the disease and bring it home to their new baby sister or brother? Vaccinated children and adolescents that learn or play around unvaccinated children and adolescents may still carry the disease, possibly infecting the rest of their family. If a facility allows unvaccinated children and they infect a child that has a small baby in the family, that baby could die. The disease could also be spread to the babies under 2 months old in the facility that are unable to have the vaccine yet and it could kill them. (Immunization & Child Profile Office)
According to Dr. Goldbaum there is not enough data to recommend boosters for adults.
He says: The Tdap was originally licensed to be administered at least 5 years following Td. In 2006, the recommendation changed: “An interval as short as 2 years from the last Td is suggested; shorter intervals can be used.” In 2010, the recommendations again changed: “use of Tdap regardless of interval since the last tetanus- or diphtheria-toxoid containing vaccine”. So we cannot yet recommend boosters for adults, but we can recommend getting the Tdap even if someone had the Td recently.
Of course, the most important change to the recommendations is the one that might have saved Kaliah. In October 2011 (too late for Kaliah), CDC issued this statement: “ACIP recommends that women's health-care personnel implement a Tdap vaccination program for pregnant women who previously have not received Tdap. Health-care personnel should administer Tdap during pregnancy, preferably during the third or late second trimester (after 20 weeks' gestation). If not administered during pregnancy, Tdap should be administered immediately postpartum.” In my mind, this recommendation will always be associated with Kaliah. I have and will continue to vigorously urge health care providers to assure that their pregnant patients are vaccinated before delivery, if at all possible. (Goldbaum).
Dr. Goldbaum also has suggestions about how to help people make good decisions about vaccination: “there is so much new information out there, and so much unnecessary resistance to vaccinations, that it is hard for the medical community and public health community to really influence people. Quite frankly a tragic experience such as this; someone who has had a personal experience with the consequences of failure to vaccinate, can really be a powerful, powerful spokesperson.” He elaborates by explaining that a medical professional can tell patients that vaccinations are very effective and that they save lives, and that they are safe; but that is “only statistics and numbers.” Doctors can talk until “blue in the face” but if someone making the decision hears of a real person, a real consequence of not getting vaccinated, they are more inclined to listen. “When someone comes back and says aren’t these vaccines harmful, or why do we really need them? People who have had these experiences can say, “I experienced something that was devastating, a real tragedy; and it didn’t have to happen. It doesn’t have to happen to you or anybody else.” Dr. Goldbaum was very clear that a personal tragedy is “a powerful tool to influence people and to make a difference” (Goldbaum, Director of Snohomish County Health District).
Vaccines that have been well researched and considered to be safe by the majority of health care professionals and scientists should be mandatory in the United States unless a medical exemption is required. A mandate should be made to remove the right to exempt a child from this vaccination if they attend a public school or daycare, unless unable to do so for medical reasons. If a parent chooses not to vaccinate their children, the child should then be educated and/or cared for in a separate facility from those who have had their vaccinations. Thresholds of affectivity for each vaccine should be researched, and recommendations made, as to the frequency of vaccinations required to keep outbreaks in the community to a minimum.
Even before that happens, laws need to be in place to ensure all Child care and Health care providers are immunized to the fullest extent of current recommendations; if it is every 5 to 10 years, they must get it every 5 years, if they wish to be employed in that industry. In the case of Pertussis, because the real danger of death is so great to small babies under 18 months who cannot yet receive the vaccine, it is imperative to view this as a civic duty, not a personal choice.
I asked Dr. Goldbaum how one person could make a difference. He explained, “Take an interest; learn a lot more, become an articulate spokesperson on behalf of vaccinations. If you influence even a handful of people who otherwise were reluctant to vaccinate themselves or their children; if you are able to convince them, you may well save a life” (Goldbaum, Director of Snohomish County Health District).
So, now when I see an expectant mother, or a mother with a small baby, I always ask if she and her family have been vaccinated for Whooping cough recently and share the story of Kaliah. Who knows, maybe I have already saved a life? There are many reasons people give for choosing not to be vaccinated. I hope they will reconsider now and do so; for the sake of everyone in the community, and in memory of our sweet Kaliah Dailynn Holly Jeffery.
(Chelsey Charles and Tanner Jeffery with their daughter Kaliah; gone too soon)
Works Cited
A Suitable Case for Treatment. 27 May 2011. 2 December 2011 <www.youtube.com>.
Beard, Christopher. Doctor of Pediatrics Everett Clinic Personal Interview. 8 August 2011.
Center For Disease Control. Travelers' Health - CDC. 1 December 2011. 1 December 2011 <www.nc.cdc.gov>.
Centers for Disease Control and Prevention. Vaccines and Immunizations Basics and Common Questions. 18 February 2011. 12 October 2011 <www.cdc.gov>.
Charles, Chelsey. Baby Kaliah just after diagnosis. Personal Photos. Everett, 2011.
Charles, Chelsey. Chelsey and Tanner with their daughter Kaliah; gone too soon. Personal Photos. Seattle, 2011.
Charles, Chelsey. Chelsey Charles with daughter Kaliah Dailynn Holly Jeffery near the end . Personal Photos. Seattle, 2011.
Charles, Chelsey. Chelsey Charles with healthy Kaliah. Personal Photos. Woodinville, 2011.
Charles, Chelsey. Healthy Kaliah. Personal Photo Album. Woodinville, 2011.
Charles, Chelsey. Mother Personal Interview. 6 December 2011.
Charles, Chelsey. Tanner Jeffery with daughter Kaliah. Personal Photos. Everett, 2011.
Children of God For Life. "Sample Letter for Catholics." 14 July 2011. Children of God For Life. 3 December 2011 <www.cogforlife.org/sampleletter>.
firesnakepodcast. Pertussis Cough Video. 6 January 2010. 3 December 2011 <www.youtube.com>.
Fisher, Barbara Loe. "NVIC-Vaccine-News Whooping Cough Outbreaks & Vaccine Failures." 8 July 2010. NVIC- National Vaccine Information Center. 2 December 2011 <www.nvic.org>.
Goldbaum, Dr. Gary. Everett, Email. 15 December 2011.
Goldbaum, Dr. Gary. Director of Snohomish County Health District Personal Interview. 12 October 2011.
Immunization & Child Profile Office. "Immunization & Child Profile Office." 25 August 2011. Changes to School and Child Care Immunization Exemptions. 7 November 2011 <www.doh.wa.gov>.
JAVIER, LIZA. "Newborn dies from whooping cough." 19 August 2011. King 5 News. 7 November 2011 <www.king5.com>.
March of Dimes . Adstorical Pertussis, or whooping cough. 1 December 2011. 6 December 2011 <www.adstorical.com>.
Pate, Suzanne. Public Information Officer for Snohomish County Health District Personal Interview. 12 October 2011.
Simoncelli, Tania. ALCU Keeping Us — and the Constitution — Healthy. 10 December 2009. 1 December 2011 <www.aclu.org>.
Washington State Chapter of American Academy of Pediatrics. "WCAAP 2011 Immunization Exemption Position Paper." 5 November 2009. WCAAP. 2 December 2011 <www.wcaap.org>.
Washington State Department of Health. Washington’s kids among least protected in the nation. 11 June 2011. 12 October 2011 <www.doh.wa.gov>.