In recent years we have seen an increase in vaccine refusal both regionally and nationally. Oregon’s rate of patients choosing to opt out of vaccines is one of the highest in the country. As experts predicted, the lower immunization rates have brought with them the return of vaccine-preventable diseases, especially measles and pertussis (“whooping cough”). These two diseases along with varicella (“chicken pox”) are the most contagious of the vaccine-preventable diseases that we immunize children against. Measles and varicella are airborne and spread very easily in public places, while pertussis has a very long infectious period and is hard to recognize and diagnose in older children and adults, making it easily spread throughout a community. All three of these diseases can be especially devastating for children and youth with special health care needs.
There is overwhelming evidence that vaccines are our most effective way to protect children against these diseases and the others that we are lucky enough to have vaccines for. There is also overwhelming evidence that these vaccines are safe for routine use in children and adults. Routine childhood vaccines are covered by insurance as part of preventive care, and supplied by the federal Vaccines for Children program for children on Medicaid (OHP) or without insurance, and we carry and administer all routine childhood vaccines. For children who are otherwise up-to-date on their preventive care, vaccines are available at our office on a walk-in basis. Patients in our practice have one of the higher vaccine rates in the state and one of the lowest vaccine refusal rates (about seven percent); our families clearly consider it the community norm to vaccinate. We care for the highest percentage of children with special health care needs in our community and are especially concerned about the need to protect those children from acquiring a vaccine-preventable disease while at our office.
In June of this year the physician partners of CHAOS voted to begin requiring the following immunizations for patients who wish to remain in the practice: one dose each of MMR and varicella by age 24 months, and three doses of DTap by age 24 months. While the other childhood vaccines also protect against potentially devastating diseases and are equally important, the consequences of not vaccinating against those disease are usually limited to the unvaccinated patient. We remain firm advocates of the AAP/ACIP vaccine schedule as offering the very best protection for all children.
If your child is currently not fully vaccinated either by parental choice or by oversight, now is the time period to get those vaccines up to date. Please ask us about your child’s vaccines at any office visit. You can also call us, send us a portal message, or stop by the office if you need help getting your child’s vaccines up to date. Parents of children who have not yet received the vaccines mentioned above (MMR, varicella, three doses of DTap) and who have reached the age of 24 months will begin to receive letters this fall. We have decided on a compliance date of January 4th, 2016 for unvaccinated children 24 months or older to receive their MMR and varicella as well as their first dose of DTap; there will then be a six-month grace period in which to obtain the second two doses of DTap.
There are a very few medical conditions that make it unsafe to vaccinate a child; these include a known serious allergy to a vaccine or a vaccine component, or a medical condition known to cause a severely impaired immune system. Children with a history of fever with vaccines, those with a family history of an allergic reaction, medically fragile children without specific immune system problems, and children with developmental disorders such as autism should all be vaccinated. If you have questions about vaccines and your child’s specific health condition then please speak with your child’s PCP.
Parents who do not choose to have their children vaccinated according to the minimum schedule will be asked to seek care at another primary care office. We do not maintain lists of healthcare providers who encourage parents not to vaccinate, nor would we recommend that they provide your child’s healthcare.
Please contact our office with any specific questions about the roll-out of this policy or to get up-to-date information on your child’s vaccine status. Your children’s safety is of the utmost concern to us, both the safety of the vaccines that they receive and their safety while visiting our clinic.