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Study: Almost 1 in 5 parents are ‘vaccine hesitant’

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Nearly one in five American parents described themselves as “hesitant about childhood shots” in 2019, a new U.S. government study finds.

That was fewer than the one in four who expressed hesitancy about vaccines in 2018.

The new research found real consequences from vaccine hesitancy. Rates of flu vaccination were 26 percentage points lower in children of “vaccine-hesitant” parents in both years studied.

“This is a very large percentage point difference,” said study leader Tammy Santibanez, an epidemiologist with the U.S. Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, in Atlanta.

Vaccine hesitancy has contributed to large outbreaks of preventable diseases in several countries, including the United States, the study authors said.

“Reducing vaccine hesitancy and increasing confidence in vaccinations could help improve vaccination coverage and thus protect children from disease,” Santibanez said. She suggested parents talk with their health care provider about the benefits of vaccination for individuals and communities.

The need for that conversation is urgent: A lack of trust could have significant consequences if a vaccine for COVID-19 becomes available and a large percentage of parents don’t vaccinate their kids.

Findings from the study were published online Nov. 9 in the journal Pediatrics.

The researchers defined vaccine hesitancy as the “mental state of holding back in doubt or indecision regarding vaccination.”

In the spring of 2018, the researchers surveyed more than 36,000 U.S. parents about vaccine hesitancy. They repeated the survey with almost 40,000 parents in spring of 2019.

The parents were asked whether their kids get vaccinated according to the standard schedule and whether they hesitate to vaccinate. They were also asked about concerns regarding the number of vaccines a child gets at one time and whether their child’s doctor is their most trusted source of vaccine information.

The study found:

  • In 2018, 7.5% of parents were very hesitant and 18% were somewhat hesitant about vaccines.
  • In 2019, almost 6% of parents said they were very hesitant and nearly 14% were somewhat hesitant about vaccines.
  • Just 6% of parents said they used a nonstandard schedule for their child’s vaccines.
  • Almost 23% of parents in 2018 and 19% in 2019 said they were concerned about the number of vaccines a child gets at one time.
  • About 27% of parents in 2018 and 22% in 2019 expressed concern about long-term side effects.
  • Fewer than 15% of parents said they personally knew someone who had a long-term problem related to a vaccine.
  • More than eight out of 10 parents said their child’s doctor was their most trusted source of information on vaccines.

Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, reviewed the study findings.

Offit said while it’s good to see a decline in vaccine hesitancy, it’s important to see if this difference is sustained for more than one year.

Asked about vaccine-hesitant parents possibly skipping flu vaccines for their children, Offit said, “Flu is hard — it’s a yearly vaccine, and because the flu mutates every year, it’s not as effective a vaccine — it’s only around 50% effective.”

But the vaccine is most effective in kids. And, he said, it’s important to remember that flu sends hundreds of thousands of people to the hospital every year and kills tens of thousands.

Dr. Michael Grosso, chief medical officer and chairman of pediatrics at Northwell Health’s Huntington Hospital in New York, said lack of confidence rather than lack of access appears to be “the major driver of under-immunization in the U.S.” He said pediatricians encounter it almost daily.

Grosso cited several contributing factors.

“One is lack of familiarity with vaccine-preventable conditions like measles and whooping cough. In this regard, it has been said that the international vaccine program is the victim of its own success,” he explained.

Other factors include opposition to public health mandates in general, feeling as if the decision is one parents should make, and for some, an anti-science sentiment.

“Needless to say, these issues are exacerbated by social media that amplify the worries of like-minded parents, making it hard for many to discern what is real and what is myth,” Grosso said.

More information

Learn more about how vaccines work from the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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Pandemic has taken a toll on childrens’ mental health

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Since last April, hospital emergency rooms across the United States have seen a sustained surge in visits related to the mental health of school-aged kids, a new report reveals.

The findings suggest the COVID-19 pandemic is taking a toll on children because of disruptions to their everyday life, anxiety about illness and social isolation.

That conclusion comes from a U.S. Centers for Disease Control and Prevention review of data on hospitals in 47 states. Those hospitals account for nearly three-quarters of emergency department visits nationwide.

The study tracked emergency visits involving children under age 18 who sought care for a mental health issue between Jan. 1 and Oct. 17, 2020.

“Our study looked at a composite group of mental health concerns that included conditions that are likely to increase during and after a public health emergency, such as stress, anxiety, acute post-traumatic stress disorder and panic,” said lead author Rebecca Leeb, a health scientist at the CDC in Atlanta who is part of its COVID-19 Response Team.

“We found that from March through October, the proportion of mental health-related emergency department visits increased 24% for children aged 5 to 11, and 31% among teenagers aged 12 to 17 years, compared to 2019,” Leeb said.

Pediatric mental health visits actually dropped off dramatically from mid-March to mid-April, when stay-at-home orders were in effect in much of the country. Since then, however, such visits have steadily increased, according to the report.

But Leeb said interpreting the numbers is not straightforward.

On the one hand, she said even the large jumps seen in the report likely underestimate the total number of pediatric mental health emergencies. “Many mental health care encounters occur outside of emergency departments,” Leeb explained.

But additional research indicates emergency department visits as a whole dropped significantly between January and October. And that, Leeb said, might mean that “the relative proportion of emergency department visits for children’s mental health-related concerns may be inflated.”

Regardless, Leeb said the findings show that many kids’ mental health was sufficiently concerning to prompt ER visits at a time when the public was being discouraged from using emergency departments for anything but the most critical care.

As such, the findings “highlight the importance of continuing to monitor children’s mental health during the pandemic to ensure access to mental health services during public health crises,” Leeb said.

The study did not set out to identify specific reasons for emergency visits and Leeb said figuring that out requires more study.

But past research shows that the lost sense of safety and disruption to daily living that often accompanies disasters is a common trigger for stress. And that stress, in turn, can lead to isolation and trigger mental health emergencies, Leeb said.

This is not surprising, according to psychologist Lynn Bufka, senior director for practice, research and policy at the American Psychological Association.

“These are stressful times for many and stress can exacerbate mental health concerns,” Bufka noted. “Previous research indicates that a portion of children do have adverse outcomes from traumatic events, and this pandemic is no different.”

Bufka pointed to the wholesale uprooting of kids’ routines and structure, both in terms of school and socializing.

“Children’s play is one way children explore and understand their world, so not being able to play with friends gives them fewer outlets for fun, but also just fewer general opportunities to cope and explore,” she explained.

Kids may also pick up on parents’ stress, which can magnify their own fears.

“All of this has an impact on children and how they understand their world and interpret the events around them,” Bufka said. Some kids adapt more easily; others will struggle. For youngsters with existing mental health problems, the current stresses will add to them.

But parents and other adults can do a lot to support kids and help those who are struggling.

On that front, Leeb advised parents to foster a supportive environment and learn about behavior that signals kids are under mounting stress. The CDC has a number of helpful resources, she said, including an online primer on talking with your child about the coronavirus.

Leeb and her colleagues published their findings in the Nov. 13 issue of the CDC’s Morbidity and Mortality Weekly Report.

More information

Get tips on talking with your child about coronavirus at the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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Moderna says data show COVID-19 vaccine almost 95% effective

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Nov. 16 (UPI) — The COVID-19 vaccine under development by U.S. biotech firm Moderna is 94.5% effective in preventing infection, according to interim data the company published Monday.

Moderna said early analysis from its late-stage “COVE” clinical trial for its mRNA-1273 vaccine candidate was based on nearly 100 COVID-19 cases.

“This is a pivotal moment in the development of our COVID-19 vaccine candidate,” Moderna CEO Stephane Bancel said in a statement. “Since early January, we have chased this virus with the intent to protect as many people around the world as possible. All along, we have known that each day matters.

“This positive interim analysis from our Phase 3 study has given us the first clinical validation that our vaccine can prevent COVID-19 disease, including severe disease.”

Moderna said its COVE trial has found no serious side effects from the mRNA-1273 vaccine.

Bancel said the company will apply for emergency use authorization from the Food and Drug Administration to distribute the vaccine once it finishes compiling safety data later this month.

“These are obviously very exciting results,” Dr. Anthony Fauci, the nation’s top infectious diseases expert, said Monday. “It’s just as good as it gets — 94.5% is truly outstanding.”

Moderna’s results are similar to those published last week by drugmaker Pfizer, which said its vaccine has shown to be about 90% effective.

Other vaccines are being tested in late-stage trials by Johnson & Johnson, AstraZeneca and Novavax.

Fauci said last week a vaccine could be available to the most at-risk populations before the end of the year.



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Experimental herpes vaccine shows promise in lab trials

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Scientists are reporting early success with an experimental herpes vaccine that uses a genetically modified version of the virus.

The gene edit prevents the virus from performing its normal evasive maneuver: hiding out in nervous system cells in order to elude the immune system.

So far, the vaccine has only been tested in lab animals. But scientists hope the genetic tweak will eventually allow the vaccine to succeed where past ones have failed.

The target is herpes simplex virus, or HSV, which in humans includes HSV-1 and HSV-2. Both can cause genital herpes, though HSV-1 is best known for triggering cold sores.

Globally, a half-billion people aged 15 to 49 have a genital herpes infection, according to the World Health Organization.

Those figures alone show there is a “huge need” for a vaccine, said Gary Pickard, one of the researchers on the new study.

But beyond that, once HSV invades the body, it’s there to stay, said Pickard, a professor of neuroscience at the University of Nebraska-Lincoln School of Veterinary Medicine and Biomedical Sciences.

To evade the immune system, the virus works its way into nerve cells and remains there in a dormant state. It can periodically become active again, traveling to the skin and causing sores and other symptoms.

In addition to those flare-ups, HSV infection can sometimes lead to complications. Pregnant women can, rarely, pass it to their newborns, who can become very sick or die, said Terri Warren, a registered nurse and medical advisor to the American Sexual Health Association.

Genital sores, and active HSV infection, also leave people more vulnerable to contracting HIV.

“In some places,” Warren said, “it accounts for many cases of HIV.”

Genital herpes also exacts a psychological toll, she explained, because it’s a lifelong infection that people can transmit to their partners, even when they are symptom-free.

That’s why researchers have been trying for years to create a preventive vaccine — with no success thus far.

As Pickard explained, one issue is that some candidate vaccines use only a subset of HSV components, or antigens, to try to generate an immune response. And that may not be enough: One vaccine with that design failed to prevent HSV-2 infection in a clinical trial involving thousands of young women.

Some other experimental vaccines have used a live, weakened form of HSV, but have run into similar issues.

“They’ve essentially made the virus so ‘sick’ that it can’t illicit a strong immune response,” Pickard said.

The new approach, recently described in the journal npj Vaccines, might circumvent those problems.

For the study, the researchers tested a vaccine made with a live, weakened form of HSV-1 that has a key genetic edit: It prevents the virus from advancing into the nervous system, while allowing it to replicate outside nerve tissue, to draw an immune response.

In lab experiments with guinea pigs, the tactic showed promise.

Of 12 animals given skin injections of the vaccine, only one developed sores after being exposed to HSV-2. In contrast, sores cropped up in 10 of 12 guinea pigs given no vaccine, and in five of 12 given the vaccine that failed in the earlier, human clinical trial.

In addition, the modified vaccine cut the viral shedding period by more than half, from 29 days to about 13. That’s important, Pickard said, because in humans it’s the viral shedding that can transmit the infection, even when there are no sores present.

“The findings on viral shedding are positive,” agreed Warren, who was not involved in the research.

She said a big question is whether a version of the vaccine that uses HSV-2 — rather than HSV-1 — can be shown effective in animals.

The researchers are working on that. Pickard said they are encouraged by the fact that the current vaccine showed “cross-protection” against HSV-2: If anything, they anticipate that an HSV-2 version will be more effective.

The road to an approved vaccine, however, is a long and very expensive one.

The hope is to have a vaccine ready for initial, phase I human testing within a few years, according to Pickard.

More information

The American Sexual Health Association has more on herpes.

Copyright 2020 HealthDay. All rights reserved.



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