There is a movement in the U. S. for parents to opt out of having their young children vaccinated.

Twenty states currently allow “personal belief exemptions” when it comes to having a child vaccinated: Arkansas, Arizona, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, New Mexico, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Utah, Vermont, Washington and Wisconsin.

 U.S. Centers for Disease Control and Prevention (CDC) recently issued findings that with more kids not being vaccinated, the United States is now experiencing its largest measles outbreak in 15 years. Experts have also blamed a recent resurgence in cases of whooping cough (pertussis), especially in California, on fewer children being vaccinated.

A new study finds that at some schools in California, where parents can opt out of having their children vaccinated, one out of every five kindergarten students is not vaccinated.  This puts those not vaccinated at risk of preventable infectious diseases, as well as other children at the school.

These are schools “where we might be concerned that ‘herd immunity’ has been compromised,” warned lead study author Alison Buttenheim, an assistant professor in family and community health at the University of Pennsylvania School of Nursing.

“Herd immunity is the protection offered to unimmunized people when most people are immunized or otherwise unsusceptible,” she explained. “For example, our herd immunity against measles protects infants, up to age 1, who are too young to receive the MMR [measles, mumps, rubella] shot.”

Dr. Buttenheim added that “schools are an important site of exposure for children. All of our measures point to increasing exposure to intentionally  not vaccinated children among California kindergarteners, a worrisome trend.”

The researchers deemed as “hot spots” schools where more than 20 of 100 children claimed personal belief exemptions.

The researchers found that in 2010, for every 100 children in a California kindergarten, 2.3 had not been vaccinated due to one or more personal belief exemptions. These exempted children tended to cluster in certain schools, typically attending schools where an average of almost 16 of every 100 of their peers also claimed exemptions.

In some schools, more than one in five kindergartners had parental exemptions for not being vaccinated, the study found.

“This looks like an important study, one that’s consistent with what we’ve been learning about philosophical and personal exemptions,” said Dr. Lance Rodewald, director of the immunization services division at the CDC. “Studies done in the past show that the easier it is to get an exemption, the more likely a child will get one. Other studies show that the easier it is to get an exemption, the lower the coverage levels.”

Rodewald said climbing exemption rates can have far-reaching consequences — even for children who get vaccinated.”It does matter for non-exempted children. While with measles vaccination, one dose gives 95 percent protection, the pertussis [whooping cough] vaccine is very good but not perfect. Pertussis wears off over time. [So] even if a child was vaccinated, it’s still possible to get pertussis,” Rodewald explained. “With a lot of exempters, you can attract an outbreak. We’re seeing a lot of pertussis right now.”

Dr. Buttenheim agreed. “Making sure your children are up to date on the recommended immunization schedule is an easy, safe and effective way to protect your child’s health,” she said. “However, no vaccine is 100 percent effective. Your vaccinated child still has a very small — but not zero — probability of contracting a vaccine-preventable disease if exposed.”

Why are parents opting out of having their children vaccinated?

According to Dr. Buttenheim “Parents choose not to have their children vaccinated for many reasons. To generalize across this diverse group, they perceive the risks associated with vaccines to be greater than the risks associated with vaccine-preventable diseases. While there is a very strong scientific consensus that this calculation is not correct, we cannot simply ignore or dismiss parental vaccine hesitancy.

One big fear that many parents have but now has been proven false,  is the fear that having their child vaccinated for measles-mumps-rubella might raise the autism risk for their child. In 1998, a small but widely publicized study appeared to link childhood MMR vaccination to nine cases of autism. The study appeared in the medical journal The Lancet, which retracted the study in 2010. In January of this year, an investigation by another leading British journal, BMJ, denounced the findings as deliberately fraudulent. But the damage was done.”

“In general, parents do value vaccines but exemptions do happen,” said Dr. Rodewald, a pediatrician with the CDC and director of their immunization services division,  “Parents have a lot of questions and they want to make sure that vaccines are effective and safe. It’s important that health professionals like pediatricians, nurse practitioners and school nurses be able to answer questions for parents so they can make informed decisions; decisions of knowledge and strength.”

For a detailed illustration of  Herd Immunity, go to http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx

SOURCES: Alison M. Buttenheim, Ph.D., assistant professor, nursing, department of family and community health, University of Pennsylvania School of Nursing, Philadelphia; Lance Rodewald, M.D., pediatrician and director, immunization services division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention.

Most of us are not sure what the Affordable Health Care Act means for women and families.

The following is a summary  about what this law means for us. It is from HealthCare.gov.

• Insurance Companies Can’t Deny Coverage to Women. Before the Affordable Care Act became law, insurance companies selling individual policies could deny coverage to women due to pre-existing conditions, such as cancer and having been pregnant. Under the law, insurance companies are already banned from denying coverage to children because of a pre-existing condition. In 2014, it will be illegal for insurance companies to discriminate against anyone with a pre-existing condition.

• Women Have a Choice of Doctor. Thanks to the Affordable Care Act, all Americans joining new insurance plans have the freedom to choose from any primary care provider, OB-GYN, or pediatrician in their health plan’s network, or emergency care outside of the plan’s network, without a referral.

• Women Can Receive Preventive Care Without Copays. Thanks to the Affordable Care Act, all Americans joining a new health care plan can receive recommended preventive services, like mammograms, new baby care and well-child visits, with no out-of-pocket costs. See a list of preventive services for women. (Preventive services benefits apply if you’re in a new health plan that you joined after March 23, 2010.) Learn about new women’s preventive care guidelines issued August 1, 2011.

• Women Pay Lower Health Care Costs. Before the law, women could be charged more for individual insurance policies simply because of their gender. A 22-year-old woman could be charged 150% the premium that a 22-year-old man paid. In 2014, insurers will not be able to charge women higher premiums than they charge men. The law takes strong action to control health care costs, including helping states crack down on excessive premium increases and making sure most of your premium dollars go for your health care.

The following is a summary  about what this law means for your family and extended family. This summary also comes from HealthCare.gov.

• Delivering New Coverage Options for Americans with Pre-existing Conditions. Health plans that cover children can no longer exclude, limit or deny coverage to your child (under age 19) based on a pre-existing condition. In addition, the law created a new program called the Pre-Existing Condition Insurance Plan (PCIP) to help provide coverage for uninsured people with pre-existing conditions until new insurance market rules that prohibit discriminating against anyone with a pre-existing condition go into effect in 2014.

• Providing Consumers with New Rights and Protections: The Patient’s Bill of Rights. The Affordable Care Act frees Americans from worrying about losing their insurance, or having it capped unexpectedly if someone is in an accident or becomes sick, giving you greater control over your health insurance and care. It also places tough restrictions on health insurance companies to make them more accountable to you.

• Requiring Plans to Cover Preventive Services Without Out-of-Pocket Costs. The law requires new health plans to cover recommended preventive services, including vaccinations, cost-free. Regular well-baby and well-child visits are also covered from birth through age 21. These services do not require a copay or co-insurance when offered by providers in your insurer’s network. See a list of preventive services for women and children. (Preventive services benefits apply if you’re in a new health plan that was created after March 23, 2010.)

• Allowing Children Under 26 to Stay on Their Parents’ Plan. If your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 (except, in some cases, when your child’s employer offers health coverage). It doesn’t matter whether your child is married, living with you, in school, or financially dependent on you.

• Help for Family Members on Medicare. If your parents or other loved ones are on Medicare, it’s good to know the Affordable Care Act protects current benefits, strengthens Medicare for the future, and offers new benefits that will help cut costs. The gap in drug coverage known as the “donut hole” is being closed, reducing seniors’ out-of-pocket costs. In addition, people on Medicare may receive recommended preventive care like mammograms and colonoscopies for free.

September is food safety education month, a good time to take a look at what we know about storing and preparing food safely.

The Partnership for Food Safety Education suggests we take a look at some food safety myths.

Myth #1 Freezing Kills Harmful Bacteria That Can Cause Food Poisoning.

FACT: Bacteria can survive freezing temperatures. Freezing is not a method for making foods safe to eat. When food is thawed, bacteria can still be present and may begin to multiply. Cooking food to the proper internal temperature is the best way to kill
harmful bacteria. Use a thermometer to measure the temperature of cooked foods.

Myth #2 If You Eat a Vegan Diet, You Don’t Have to Worry About Food Poisoning.

FACT: Fruits and vegetables are an important part of a healthy diet, but like other foods they may carry a risk of foodborne illness. Always rinse produce under running tap water including fruits and vegetables with skins and rinds that are not eaten. Never use detergent or bleach to wash fresh fruits or vegetables as these products are not intended for consumption. Packaged fruits and vegetables labeled “ready-to-eat” or “washed” do not need to be re-washed.

Myth #3 Plastic or Glass Cutting Boards Don’t Hold Harmful Bacteria on Their Surfaces Like Wooden Cutting Boards Do.

FACT: Any type of cutting board can hold harmful bacteria on its surface. Regardless of the type of cutting board you use, it should be washed and sanitized after each use. Solid plastic, tempered glass, sealed granite, and hardwood cutting boards are dishwasher safe. However, wood laminates don’t hold up well in the dishwasher. Once cutting boards of any type become excessively worn or develop hard-to clean grooves, they should be discarded.

Myth #4 Locally Grown Organic Foods Will Not Cause Food Poisoning.

FACT: Any food, whether organic or conventional, could become unsafe with illness-causing foodborne bacteria at any point during the chain from the farm to the table. Consumers in their homes can take action to keep their families safe. That is why
it is important to reduce your risk of foodborne illness by practicing the four steps:Clean, Separate, Cook, and Chill.

Hi, I’m Diane Hopkins. Not only do I play the role of a nurse on “Can Do” Street, I am a nurse!

In the interactive program, Germs, I  speak to the “Can Do” Kids about what germs are and how to avoid them so they don’t get sick. When your child plays the program he or she gets to make decisions for the “Can Do” Kids, helping them avoid germs and practice good personal hygiene such as hand washing and covering their mouth and nose when they cough or sneeze.

In Food is Fuel I speak about food being the fuel that runs our bodies and gives us the energy to do well in school and  in recreational and sports activities. Your child will have the opportunity, while playing the program, to make decisions about what foods are good meal foods and snack foods.

Both programs reinforce what your child is learning at home and in school.