‘We are all in this together’
It’s early morning when a fleet of vans rolls out from Tarrant County Public Health (TCPH), ready to immunize children and keep them safe from the dangerous, sometimes deadly effects of infectious diseases like measles, polio, chickenpox and others.
Across town, the UNT Health Science Center Pediatric Mobile Clinic hits the streets on a similar mission, and the Pediatric Clinic on the UNTHSC campus opens for another day of service to local families.
A lot has changed over the last 30 years, from a time when children as near as Dallas County were dying from a measles outbreak that threatened the entire U.S.
More community resources are available today than ever before to protect the health of children, often at low or no cost and provided at convenient locations all around the community.
Hard lessons have been learned from the country’s battles over the last century against polio, influenza, smallpox, tuberculosis, whooping cough, pertussis, mumps, Rubella, scarlet fever and other causes of childhood deaths or harm.
Given current science, the developed world should suffer less from infectious disease, yet news reports shout headlines every day about the growing anti-vaccination sentiment in Texas and across the country, and measles made another comeback this year as a major public health concern.
“There is an incredible amount of misinformation to be found on social media and internet sites,” said Terri Andrews, President of the Immunization Collaboration of Tarrant County (ICTC), a non-profit that partners with organizations like UNTHSC, TCPH, health care providers and concerned citizens to educate, advocate, support and inform efforts on behalf of healthy children.
As a grandmother who remembers receiving her own vaccinations at school back in the days when they were required for all children almost without exception, Andrews attributes today’s growing vaccine hesitancy to a number of reasons, including some very vocal opposition groups, such as the locally based Texans for Vaccine Choice.
“Take a stand for liberty,” “preserve our rights” and “parents call the shots” are the types of messages found on these websites. What’s missing is the science and a public health perspective on why children’s vaccinations are so critical to the health of communities.
The benefits of vaccinations are twofold.
First, they provide long-term, sometimes lifelong protection against a particular disease.
They also keep other people safe in a very interesting way.
“It’s called ‘herd immunity,’ in that vaccines protect not just the individuals who receive them, but others around them as well,” said Anita Colbert, LVN, TCPH Immunization Outreach Supervisor. “When enough people in a community are vaccinated, it’s harder for a disease to spread and it’s safer for all.”
Since 1990, in the days when she was first hired by TCPH and loaded up the trunk of her own car to take immunizations to schools, churches, community centers, neighborhood events and anywhere kids could be found, Colbert has engaged with parents to provide information and the scientifically based facts they need to make sound decisions.
“There is now a whole new generation of parents who have never known polio, never seen people die from measles,” she said. “As a child, I remember throwing an absolute fit over my own polio immunizations, until my mom took me to see children in iron lungs. The experience is still with me today, and I do believe this led to my interest in public health and working to keep kids safe.”
Erika Thompson, PhD, UNTHSC School of Public Health Assistant Professor of Maternal and Child Health, who works with Colbert and Andrews on ICTC efforts and conducts research on the HPV vaccine for adolescents and young adults, says vaccine hesitancy can come from fear of chemicals or harmful ingredients, concerns over side effects and opposition to so-called government “interference” in personal choices. It also stems from conspiracy theories, distrust in pharmaceutical companies, and uninformed influences from friends, family and peer groups.
There are even disinformation campaigns from sources like Twitter bots and Russian trolls. For example, recently published research in the American Journal of Public Health found internet trolling from Russian sources relied on propaganda to spread false information about vaccines on the social media of Americans.
“Additionally, many states, Texas included, have made it easy for families to opt out of the school-required children’s immunization schedule,” Dr. Thompson said. “All it takes is going online to complete a simple form with your contact information and the names of your children.”
In recent years, anti-vaxxer groups have been known to go to great lengths to convince parents to opt out, even showing up at back-to-school health fairs and community immunization events to tell families how “easy and timesaving” it is to file the form and get a vaccine exemption for their kids.
The number of opt outs is rising nationwide, experts say, and is of great concern in many communities, including Tarrant County, which is now considered a “hot spot” because of its alarming increase.
Nationwide, there is a movement among physician groups, such as the American Academy of Pediatrics, to opt out of serving families who refuse to vaccinate.
The Academy’s stand is that families who do not vaccinate their children are jeopardizing the health of the overall community by creating unnecessary risks for the children of other families, persons with weakened immunity systems and pregnant women.
As someone who was among the first age group eligible for the HPV vaccine when it was introduced in 2006, Dr. Thompson said she wishes more people recognized credible sources of information endorsing vaccines, rather than the misinformation online.
Her research focuses on the HPV vaccine, and it was her experience as an “early adopter” to get protected herself while in college that helped lead her to graduate studies and a career in public health.
UNT Health Pediatric Clinic Medical Director Sarah Matches, DO, also is seeing a significant rise in parents with vaccine hesitancy. During the last 25 years she has been with UNTHSC, she says, the last five have been the most concerning.
“Word of mouth and the internet do seem to be doing the most harm, and there are even campaigns that try to discredit reliable information sources like the CDC,” Dr. Matches said. “There are those who don’t trust organizations like the CDC because they are government sources.”
Still, she says, most patients do want to vaccinate and understand the importance, as evidenced by the more than 10,000 immunizations administered through the UNTHSC Pediatric Clinic annually. Add to that the tens of thousands of doses of vaccines given each year through the public health department, partners like ICTC and other organizations and health care providers, and there is hope that the majority of children will be protected.
“The important thing to know is that vaccines are very safe in all but a few rare cases,” said Christina Robinson, MD, UNTHSC Assistant Professor, Pediatrics, and Pediatric Mobile Clinic Medical Director. “For parents with questions, concerns or anxieties, the best place to start is by having a conversation with your health care provider. We are all in partnership together, all looking for the best outcome for your child, and we are here to provide the answers you need to feel more comfortable.”
Finding reliable answers
Dr. Robinson also recommends the American Academy of Pediatrics’ website as a good resource for credible vaccine information.
“The facts are presented in easy-to-follow layman’s terms, like a grandmother’s good, solid advice,” she said.
Other resources Drs. Robinson and Matches suggest include the national Immunization Action Coalition, the Centers for Disease Control, World Health Organization, and Tarrant County’s own Public Health department and ICTC website.
These organizations are also active on Facebook, Twitter and other social media, so parents can connect that way as well.
Guarding children’s health really does take a village, and Tarrant County is fortunate to have so many resources available to families.
“We can all count on the fact that vaccines have a long history of saving lives and still remain as one of the best and safest ways to protect your kids,” Andrews said. “We are all in this together.”