Ohio AAP’s Dr. Bob Frenck Urges Adult Mumps Shot in The Columbus Dispatch

The Columbus Dispatch :: April 24, 2014

If you’re a child of the 1960s, ’70s or ’80s, there’s a decent chance you aren’t fully immunized against mumps, and unless your mom and dad kept meticulous records, it probably makes sense to think about a shot, health officials say.

The central Ohio mumps outbreak is persisting, with 263 people sickened as of yesterday.

As the case count climbs, more adults are worrying over often-foggy vaccine histories. A look at the age breakdown for cases not connected to Ohio State University shows that much of the illness has been in working-age adults.

Those who know or suspect they didn’t get two MMR (measles, mumps and rubella) shots should strongly consider getting the vaccine, said Dr. Julie Mangino, an infectious-disease expert at Ohio State University’s Wexner Medical Center.

Today, children are supposed to get two rounds, the first when they’re a year old and the next between 4 and 6 years old.

But the second dose wasn’t recommended until 1989, after a measles outbreak highlighted the need, said Dr. Robert Frenck, a professor of pediatrics and infectious-disease expert at Cincinnati Children’s Hospital.

About 5 percent of people vaccinated with one round of the MMR vaccine get no benefit from it; the second shot is designed to catch those people and boost immunity for others, said Frenck, who is the medical director for the immunization program for the Ohio chapter of the American Academy of Pediatrics.

There is a blood test that determines whether a person has immunity against mumps (either through natural exposure or a vaccine), but Mangino said it makes sense to just go ahead and get a second dose if you know you didn’t have the second shot.

The vaccine contains a live virus and shouldn’t be given to people with compromised immune systems, including those with cancer or HIV, or to those who are being treated with steroids, she said. It’s also not recommended for women who are looking to become pregnant in the next few months and for those who are breast-feeding.

“It’s not just like getting a flu shot,” Mangino said.

Public-health concerns about MMR under-vaccination go beyond the current mumps outbreak. Several measles outbreaks are underway elsewhere, and that disease more commonly leads to serious complications, including pneumonia, which can be deadly.

In some cases, shots might make sense for older adults who never contracted mumps as children (if you had mumps, you don’t need the vaccine).

In general, it is assumed that those born before 1957 were exposed because mumps was so common, but there are exceptions.

Mabel Freeman, 69, had her first shot recently and will be back for a second next month in light of concerns about mumps at Columbus State Community College, where she is interim vice president for student affairs.

“This is a personal choice on my part,” she said, adding that she wants to make sure she doesn’t carry the illness to family members, including her grandchildren.

“I know I had the measles and the German measles (rubella), but I never had the mumps,” Freeman said. “You don’t forget that you’ve had them.”

Many doctors who care for adults won’t have the MMR vaccine in their office, but it is available at health departments and currently is free at Columbus Public Health. Minute Clinics charge $129.99, according to their website, though most routine vaccinations are covered by insurance.

Some parents are asking about speeding up the vaccine schedule so that their children who are younger than 4 can have a second dose. Pediatricians aren’t encouraging this in general, but in some cases they’re vaccinating early.

Sara Ijams-Dashner’s twin girls, Keira and Ella, will be 4 on May 19. When the Blacklick woman learned that a child in her daughters’ preschool had mumps, she asked their pediatrician about early vaccines.

He didn’t want to do it at first, but he agreed after researching outbreak-specific guidance from the Centers for Disease Control and Prevention, Ijams-Dashner said.

“The preschool is full of half-vaccinated kids,” she said. “I was scared. The mumps can pose very serious health risks.”

She also has been frustrated by some parents’ decisions to forgo vaccines.

“There’s no evidence that vaccines are more harmful than the diseases they prevent,” Ijams-Dashner said. “The fact is those kids aren’t vaccinated and they expose our kids to the disease.”

mcrane@dispatch.com

Letter to the Editor: Mumps Outbreak

Research, record family’s vaccinations

Published in The Columbus Dispatch on Thursday, April 10, 2014

The Dispatch has reported that the lack of vaccinations among students in local schools has helped spread the mumps cases in our community (“Lack of vaccination helps spread mumps,” last Thursday).

With more than 150 cases now reported, there are evidenced-based actions that can be taken to prevent another outbreak.

Pediatricians statewide support parental education about vaccines to help parents make informed decisions and to help them understand the importance of keeping vaccinations up to date through routine well-child visits.

We support mandating vaccinations for entry into child-care settings at all levels, from birth to college. One simply needs to look at how one case of mumps at Ohio State University now is linked to at least 100 cases to understand how important it is for children who are in group care or close living settings to receive these critical vaccinations.

Additionally, attempts by special-interest groups to fracture the medical home in our state can lead to missed vaccinations and lack of parental education about important health topics. That’s why we work hard to ensure that any efforts to improve access to health care for Ohio children maintain the high quality and consistency of care available through a licensed pediatrician.

This is not the time to panic over the spread of preventable diseases like mumps, but it is the time to look at our public policies and utilize evidence-based medical practices that can prevent and eliminate these diseases in our local community.

More information about vaccinations for children of all ages can be found at ohioaap.org.

MELISSA WERVEY ARNOLD

Executive director

Ohio Chapter

American Academy of Pediatrics

Westerville

 

Ohio AAP Concussion Victory

Ohio AAP Successfully Removes Provision to Allow Chiropractors to Assess Concussions… Again

The Ohio Chapter, American Academy of Pediatrics successfully removed an amendment from House Bill 483 that would have allowed chiropractors to clear young athletes to return to play following a concussion and would have required 6 hours of CME annually for physicians and chiropractors who want to return youth to play.

Advocacy PillarThe amendment was removed from HB 483 on Wednesday, April 9 as part of the mid-biennium review (MBR).

James Duffee, MD, voiced his concerns before the House Finance Committee on Tuesday, calling it “unnecessary and potentially harmful to Ohio’s youth athletes.”

Ohio AAP secured a line-item veto in 2013 striking down a similar amendment in the annual budget.

An Advocacy Call is scheduled for Tuesday, April 15 from 5:30pm-6:30pm if you would like more information on today’s victory and the potential for this amendment to return in the senate. Email Melanie Farkas if you would like to take part. (#1-800-466-8543, code: 462132)

For those of you who would like to express your gratitude to Representative Ryan Smith for removing the amendment, click here for his email address. Please thank him for removing his amendment to allow us more time for dialogue with those who were supportive of allowing chiropractors to assess concussions and why we think this could be very harmful to children.

You may also view Ohio AAP’s Concussion Guidelines for Physicians by clicking here.

 

Ohio AAP Promotes Vaccinations Amid Mumps Outbreak

April 8, 2014 — With now more than 160 cases of mumps reported in the Columbus area, the Ohio Chapter of the American Academy of Pediatrics is urging physicians and parents to be vigilant in keeping their children’s vaccines up-to-date.

Mumps is a systemic viral illness characterized by swelling of the salivary glands. In males, the virus also can cause orchitis and possibly sterility, although the latter is unusual.

There are reports that many of the cases of the current outbreak, which began on a university campus, are in those who were vaccinated. Outbreaks of mumps are typically found to be associated with the initial case occurring in a person who is unimmunized or under-immunized. The more people who are not fully immunized, the more risk of a large outbreak.

Children should receive an initial dose of MMR (measles-mumps-rubella) vaccine at 12-15 months of age and a second dose at 4-6 years of age.

“The second dose is important to boost immunity as well as provide immunity to people who did not respond to the first dose of the vaccine — about 5% of people. A single dose of MMR is not sufficient to provide lasting immunity and is why the second dose is recommended,” said Robert W. Frenck, Jr., MD, professor in the Division of Infectious Diseases at Cincinnati Children’s Hospital Medical Center.

To best prevent outbreaks, it is important to check the immunization status of people before they enter school and also before entering college. Those who are not fully immunized should receive the required number of vaccinations to bring the person up to date.

You may find out more about Maximizing Office Based Immunization, Ohio AAP’s free statewide provider immunization education and training program developed for health care workers, by clicking here.

 

 

Ohio House Bill 394

Advocacy PillarThe Ohio Chapter, American Academy of Pediatrics is expressing concern over a bill that would allow pharmacists and pharmacy interns in Ohio to administer immunizations in certain circumstances. Lawmakers voted to approve House Bill 394 on Wednesday, April 2, 2014.

Ohio AAP Executive Director Melissa Wervey Arnold sent a letter to the members of the House of Representatives expressing concern on behalf of the members of the Ohio AAP.

Wervey Arnold said Ohio and other states have been promoting the patient-centered medical home (PCMH) model, which addresses a patient’s health and wellness needs through a collaborative, team-based approach.

“House Bill 394 contradicts this trend and could lead to fewer Ohio children receiving much needed comprehensive primary care services,” wrote Wervey Arnold.

“In the medical home model, immunizations are coupled with screenings and other services that are delivered by a pediatrician; allowing pharmacists to administer vaccines outside of the medical home creates seams in a system we are striving to make seamless. Outcomes are improved when primary care is delivered in a coordinated, physician-led environment.”

Wervey Arnold pointed out Ohio’s immunization rates among children seven years of age and older are on the rise thanks in part to evidence-based strategies and recent policy changes requiring certain vaccines be administered.

“Any discussion on increasing Ohio’s vaccine rates should start by focusing strategies on kids who are eligible for Medicaid or the Vaccines for Children program,” she wrote. “Without any safeguards, pharmacists will be able to target only those kids with private insurance, many of whom already have a primary care physician. HB 394 threatens the progress we’ve made on Ohio vaccine rates and could lead to those rates actually declining.”

House Bill 394 now heads to the Ohio Senate for hearings.

To read Ohio AAP Executive Director Melissa Wervey Arnold’s letter to the members of the Ohio House of representatives, click here.

 

 

ICD-10 Delay

President Barack Obama has signed a measure to delay the transition to the ICD-10 medical coding system for one year.

The provision was included in a bill the president signed Tuesday evening that delays the implementation date until October 1, 2015.

The Ohio Chapter, American Academy of Pediatrics can help you prepare for the implementation of ICD-10. Richard Tuck, MD, FAAP, will present “ICD-1O Update and Top 10 Coding Opportunities” at our Practice Administrator Workshop at Annual Meeting this September.

Practice Administrator Workshop Information

Annual Meeting Information

TIES Regional Trainings

tieslogo smallRegional Seminars

The Ohio Chapter, American Academy of Pediatrics and Ohio Department of Health present four regional seminars to educate physicians, nurses and other vaccinators in Ohio on adolescent vaccines. National and local experts will speak about various issues relating to adolescent vaccination, including parental refusal, sexual misconceptions, HPV-caused cancers and reminder/recall strategies.

Columbus

Cincinnati

  • b529715c-4270-42d3-aa82-3ac317d16807Thursday, June 12, 2014
  • 9am-1pm
  • Location: Cincinnati Children’s Hospital Medical Center MERC Building, (map)
  • Keynote Speaker: Robert W. Frenck, MD, Medical Director of Division of Infectious Diseases at Cincinnati Children’s Hospital Medical Center
  • Lunch provided by the American Academy of Pediatrics
  • click here to register

Cleveland

  • Thursday, July 17, 2014
  • 9am-1pm
  • Location: Cleveland Metroparks Zoo Auditorium (map)
  • Lunch provided by the American Academy of Pediatrics
  • click here to register

Athens

  • Thursday, August 21, 2014
  • 9am-1pm
  • Location: Athens Community Center (map)
  • Lunch provided by the American Academy of Pediatrics
  • click here to register

An application is pending for the regional trainings to provide 3.00 prescribed credits of CME by the American Academy of Family Physicians. Nurses will be provided the same certificate of participation as physicians by your trainer. Keep your certificate on file, as the Ohio Nurses Association will accept CME toward CNE credit.