Measles, Immunization Registries

I have to admit that it’s difficult to keep up with the blog when I get hit by a combination of visits to clients, snow days, a sick kid, and school vacation. Woo hoo. I often find myself sitting up in bed (or the mental equivalent, it’s cold here) thinking, “Oh my gosh, I have to blog about that!” Some really good ones go flying past me, but I have enough stuff in the closet to keep going for a while.

Here are two immunization pieces as I pack up and head to the in-laws this weekend.

Article one is the CDC summary of the measles outbreak in San Diego, CA. It’s a quick, easy read. This is the line that gets me:

Among these latter four patients, three were infants aged <12 months. One of the three infants was hospitalized for 2 days for dehydration…

The “latter four” patients were those who picked up the measles because they were in the pediatric office the morning the “index patient” visited. Can you imagine that? You bring your newborn son into a pediatric office for a well visit and you end up in the hospital for two days (scaring the bejeezus out of you) because of someone else’s Personal Belief Exemption. I wonder if the original parents are reimbursing families for the work lost, the trauma to their kids?

On PedTalk, I am often torn about what I would do if presented with a family who didn’t want to immunize. Usually, I find myself agreeing with those who say, “I’d rather take care of them than have them go to some chiropractor.” However, here is a cut-and-dried example of how the decision to not immunize endangered someone else’s life. Imagine if one of those kids had died!

Sigh.

Meanwhile, Igor-ette found this interesting excerpt from Pediatric Emergency Care about the accuracy of state immunization registries. PCC knows more about registries than just about anyone (we interface with 20, soon to be 23) and the stories we could tell…it’s crazy. Here’s the important conclusion:

Conclusions: Although most children can be found in the state immunization registry, it seems to be similar in accuracy to parental recall of immunization status when each is compared with the medical record. This may have been due to either underreporting of immunizations from the community or a delay in updating the state database. At this time, neither parental recall nor the database would accurately determine a child’s immunization status during an ED visit.

Emphasis mine.

My reaction? I am not at all surprised. Not one bit.

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