Community immunity: taking care of each other | Guest column

by Iris Graville

Here’s what we islanders do for each other. We make meals when a new baby arrives or when someone goes through chemotherapy.  When a family’s house burns down, we give shelter and help build a new one. Some of us mentor school kids, others drive shuttle buses for seniors, and many serve on the boards of nonprofits.

But we’re missing the boat when it comes to one important way to help our communities – immunizations.

Earlier this year, two health reports singled out San Juan County. The first, a survey by the University of Wisconsin’s Population Health Institute, named ours the healthiest county in Washington state, citing our low rates of adult obesity and smoking.  Around the same time, the “New England Journal of Medicine” reported that San Juan County is the worst in the nation when it comes to vaccinating children, with only 28 percent of kindergarteners and 11 percent of sixth graders meeting school vaccine requirements.

These numbers are troubling in light of Gov. Gregoire’s recent announcement of a statewide pertussis (whooping cough) epidemic. She projects we’re headed for 3,000 cases this year, an alarming jump over the 965 reported in 2011.

Pertussis is a highly contagious bacterial infection that usually starts with mild cold symptoms. For young children, it typically causes uncontrollable coughing spells, followed by gagging or vomiting and a “whoop” sound. Infants are most vulnerable for severe complications and death. Last year, 38 Washington infants were hospitalized with pertussis, and two died (including a baby in nearby Everett).

Our community is at risk. School immunization reports indicate just over half of San Juan County kindergartners were adequately immunized against pertussis for the 2010–2011 school year. A vaccine for adolescents and adults (Tdap – tetanus, diphtheria, pertussis) is available, too, but vaccination rates for this group are even worse than those for young children. And that’s a worry for prevention efforts. Since the disease often is less severe for older youth and adults, they may unknowingly pass it on those around them.

Some people are susceptible to vaccine-preventable diseases like pertussis because they decline immunizations. As a school nurse and former immunization nurse, I’ve answered parents’ doubts that diseases like polio and measles still exist (they do and in some places are on the rise); I’ve heard fears about a study linking measles vaccines and autism (the report was retracted, and the doctor involved lost his license); and I’m aware that some perceive school vaccine requirements as government intrusion.

Others, though, can’t receive this preventive care even if they wanted to. The vaccination isn’t given to babies under two months because their immature immune systems can’t respond. Older children and adults whose immune systems are weak because of illness or aging can’t be vaccinated, either.

Here’s where our helping spirit comes in. When enough of us get our vaccinations, we benefit even those who don’t.  Such “community immunity” cuts the spread of diseases like pertussis to our vulnerable neighbors.

In response to the pertussis epidemic, San Juan County Health and Community Services has scheduled drop-in Tdap immunization clinics (Orcas – May 31, 11-6 p.m). Now it’s time for us to do our part to achieve community immunity.

– Lopezian Iris Graville, RN, MN is the school nurse for Orcas Island Schools.