Out of tragedy, a campaign to increase vaccine uptake in Michigan

I’ve written before about how our vaccination rate here in Michigan are…suboptimal. Indeed, a couple of years ago, health officials were so alarmed at the increases in personal belief exemptions to school vaccine mandates that a new regulation was instituted that require parents seeking nonmedical exemptions to school vaccine mandates to travel to an office of the state health department in order to receive instruction about vaccines. They can still get their personal belief exemption, but not without first undergoing instruction. So far, it’s been working reasonably well, with decreases in the number of personal belief exemptions. Unfortunately (and predictably), antivaxers did not like this new regulation, not at all, and tried to get it eliminated by having the legislature pass a law (in the name of “parental rights,” of course, an argument that our highly conservative legislature finds compelling, including, alas, my very own state senator). Fortunately, they failed.

Unfortunately, thanks to a combination of factors and also aided by our own homegrown antivaccine movement, Michigan has not been immune to pertussis outbreaks, such as this one that occurred in 2012. We even have our own variety of clueless naturopaths who inflict horrific suffering on children by trying to treat pertussis “naturally.” Even though there have been improvements, Michigan’s vaccination rates remain too low.

And, this week, someone with an enormous stake—the biggest—launched an initiative to do something about it:

Baby Francesca was just 12 weeks old when she came down with a cough. Nine days later, she died of pertussis, better known as whooping cough.

Now, her mother, Veronica McNally, has made it her life’s work to teach others why she believes vaccination is so important. She started the Franny Strong Foundation in her daughter’s honor. And as of today, she’s begun a new campaign called “I Vaccinate.”

McNally and Dr. Eden Wells, chief medical executive for the Michigan Department of Health and Human Services, joined Stateside to talk about why vaccination is so important.

Currently, Michigan ranks 43rd in the nation when it comes to immunization coverage for preschoolers. Just 54% of preschoolers are up-to-date on their vaccines (while 29% of teenagers are up-to-date).

It turns out that Francesca died during the 2012 pertussis outbreak. The story of how she became ill and ultimately died is heartrending:

When Francesca was a month old, she had RSV infection, a virus that causes cold-like symptoms. Because of that, she did not receive the pertussis vaccination recommended at 2 months.

However, McNally said, “One shot would not have protected her. It takes a series of shots. You’re not immune until 15 or 18 months.”

When Francesca became sick in May, her parents sought medical treatment for her several times – through their doctor and at an emergency room. Their doctor diagnosed Francesca with pertussis on the morning of May 14.

That evening, with her condition growing worse, the McNallys brought her to the emergency department at C.S. Mott Children’s Hospital at the University of Michigan.

“She was admitted immediately to the pediatric intensive care unit,” McNally said.

The next morning, she was placed on a respirator. Although her daughter did not have the characteristic “whooping” cough, McNally said she “coughed incessantly by the time she was getting intubated.”

Francesca died two days later.

I Vaccinate has a very simple message:

  • Vaccines are safe
  • Vaccines are effective
  • Vaccines protect everyone

It’s then explained why, with a very useful section entitled Answering Your Questions.

And the message is needed, now, more than ever. Remember how I discussed the pertussis outbreak of 2012? Well, things are still bad in 2017. I just came across a story that tells us that cases of whooping cough in Michigan are on the rise in Michigan:

Pertussis, or whooping cough, is on the rise in Michigan. The number of cases this year has surpassed 100 and continues to climb, according to preliminary data from the Michigan Department of Health and Human Services and the Oakland County Health Department. In 2016, there were about 448 cases of whooping cough in the state.

In Oakland County last month, there were 31 confirmed and probable cases of the vaccine-preventable disease, compared with four cases in January 2016.

“These are the highest numbers we have seen since 2014, ” said Dr. Pamela Hackert, chief of medical services in Oakland County. The county had 108 case of pertussis last year, 44 in 2015 and 161 in 2014.

Health officials in Michigan are not blaming this latest outbreak solely on antivaxers, although certainly they contribute to the problem. Dr. Wells points out that there are multiple reasons why vaccination rates in our state are so low, leading experts and stakeholders to meet last year to try to determine why so many children are not up-to-date on their vaccinations. They concluded that poor access to health care was part of the answer, but it’s more than that. There are far too many children who start their vaccines but never finish the whole series. While vaccination with one dose of MMR can generally be expected to result in >90% immunity, the whole series of pertussis vaccine is required to be assured of reasonable immunity.

Pertussis is a tricky disease as well, because immunity wanes, leaving adolescents potentially susceptible. This is a known issue, but, contrary to what antivaxers claim, letting children suffer from pertussis will not alleviate it, although there are several strategies that might possible accomplish this end. The point of course is that these recent epidemics, while they point to problems with the current vaccination schedule, do not by any means demonstrate that the vaccine doesn’t work or that it’s failed, contrary to what antivaxers try to claim.

Sometimes, tragedy is the most powerful motivator to action. The McNallys suffered a tragedy far beyond what I can imagine having to endure personally. They lost a child to pertussis. I’m not forgetting that child, either, who suffered the worst fate of all at such an incredibly young age. I can only hope that, out of this loss, the Franny Strong Foundation and “I Vaccinate” become a force that reverse our rather dismal vaccination rates here in Michigan.