Whooping cough rates in the US have been increasing since the 1980’s and reached a 50-year high in 2012. Reasons for the resurgence of pertussis infection in recent years may include: genetic changes in the bacteria that causes pertussis, decreasing vaccine-induced immunity over time, greater awareness of the disease, and general availability of better laboratory tests. Researchers suspect that vaccine refusal, which has risen in recent years in several states, may have also played a role.
Unvaccinated children are at higher risk for getting pertussis than their vaccinated peers. This vulnerable population brings the illness into a community in spite of high immunization rates. A study published in the journal Pediatrics (September 24, 2013) looked at the impact of non-medical vaccine exemptions on the rates of pertussis in children from California during 2010. The researchers identified groups of children living in the same community (called geographic clusters) whose parents filed non-medical vaccination exemption forms prior to kindergarten. This group was compared with geographic areas where there was an increase in pertussis cases. The researchers found that areas with many unvaccinated children were 2.5 times more likely to have a cluster of pertussis cases than areas with few unvaccinated children.
The study can’t prove that clusters of unvaccinated children contributed to pertussis outbreaks, but the findings are consistent with other studies that have found that clusters of unvaccinated children impact outbreaks of pertussis and other illnesses.
The Vaccine Injury Compensation Program (VICP) was established by Congress in 1986 as part of the National Childhood Vaccine Injury Act (NCVIA), driven in part by a scare over the diphtheria–pertussis–tetanus (DPT) vaccine, concerns that were later generally discredited. Most public health officials believed that the claims of side effects were unfounded, but some families in the United States won substantial awards from sympathetic juries who were convinced otherwise. As a result, many companies stopped making the DPT vaccine. Health officials feared the consequences of lower immunization rates, and Congress responded by passing the NCVIA. The NCVIA was a piece of legislation that was meant to clarify rights and obligations for all parties involved, including patients, pediatricians, drug manufacturers and the government. A special section of the U.S. Court of Federal Claims, the so-called “Vaccine Court,” administers VICP awards. The NCVIA also established the Vaccine Adverse Event Reporting System (VAERS).
The Vaccine Court is different from the traditional legal system in that it operates under a “no fault” standard. This standard means that if an injury occurred within a defined period of time following the administration of the vaccine, then the court would assume causality without further evidence. The claimant does not need to prove everything that is required to hold a vaccine maker liable in a product liability lawsuit. In the VICP context, proof of causation does not need to be shown to the extent of what some might call scientific certainty. Rather, it suffices to prove causation according to the civil-law standard of “the preponderance of the evidence,” showing that causation is “more likely than not.” Although proving a mere possibility won’t suffice, proof “beyond a reasonable doubt” is not required.
Injury awards are determined based on the NCVIA Reporting and Compensation Tables (VIT), which lists each covered vaccine, its associated adverse events, and the allowable interval from vaccination to onset of event. The Table lists and explains injuries/conditions that are presumed to be caused by vaccines. If an injury/condition is not on the Table or did not occur within the time period on the Table, the individual must prove that the vaccine caused the injury/condition. Autism has not been added to the National Childhood Vaccine Injury Act Reporting and Compensation Tables (VIT) for any vaccine. Through a special program established in 2002 called the Omnibus Autism Proceeding, the NCIVP has found that the measles-mumps-rubella (MMR) vaccine given alone or with thimerosal-containing vaccines (TCVs) is not a causal factor in autism, nor are TCVs alone a causal factor in autism.
Like any other medicine, some people can react adversely to vaccines. This can happen even with common medicines that are widely considered harmless, such as Tylenol. The VICP establishes a course of action for peopled harmed by vaccines. These people, to some degree, have assumed the risk of adverse event on behalf of the society in which they live. Therefore, many governments have adopted the position that it is fair and reasonable to compensate those who are harmed by properly manufactured vaccines. A decision not to immunize a child also involves risk.
The Vermont Department of Health is proud to announce that Kristin Gilbert, RN has been selected as the 2013 Centers for Disease Control and Prevention (CDC) Childhood Immunization Champion for Vermont. This is an annual awards program to honor immunization champions across the 50 U.S. states during National Infant Immunization Week (April 20-27, 2013).
Kristin Gilbert is a nurse at Barre Pediatrics. She is committed to improving immunization rates, and is passionate about protecting children from vaccine-preventable diseases. Gilbert makes sure that her patients are educated about vaccines, and reaches out to vaccine hesitant parents.
Gilbert helps to keep the staff at Barre Pediatrics informed of the most current vaccine information, and she oversees the proper storage and handling of the vaccine in the practice. She generously volunteered to answer questions asked by parents for the It’s Ok to Ask public education campaign targeting parents with concerns about immunizations. Please join us in honoring Kristin Gilbert.
We all have questions and concerns when it comes to immunizations for our children. But with so many different sources of information out there, it can be tricky to wade through all of it and make an informed decision.
Is there any risk of my child developing autism from vaccines?
What risks does my child face if there are unvaccinated children in the community?
Does it make sense to delay or spread out my child’s immunizations?
What should I look for in choosing a pediatrician?
What might make the topic of immunizations less polarizing?
What are some possible side effects after my child gets immunized?