A Shot of Urgency In Md.'s Vaccine Debate

A study by public health researchers from Johns Hopkins, published in the Journal of the American Medical Association in October, found that states that permitted personal belief exemptions had significantly higher rates of pertussis infection than those that did not allow them.

Several years ago when Maryland began requiring the chickenpox vaccine for entry into kindergarten and elementary school, some parents were misinformed that the shot contained tissue from aborted fetuses, recalled Donna Mazyck, a school health services specialist for the state. (The District requires chickenpox and hepatitis B shots for all students, while Virginia requires hepatitis B shots for all and chickenpox vaccinations for those born after Dec. 31, 1996.)

This time, Mazyck said, the reason for spotty compliance has a much more prosaic cause: Parents have said they had too little time and too much else to do.

"I think this is one of the many things on the plates of parents and guardians," she added.

Mazyck and Reed emphasize that the required vaccines are safe and highly effective and that side effects tend to be mild and temporary. The most common is soreness at the injection site that lasts a few days and occurs in about 20 percent of children who receive the chickenpox vaccine, according to Wexler.

"The risks are very small," she said, adding that the same is true of the hepatitis B vaccine, which has been administered to about 100 million Americans since 1991.

The risks are far greater for the those who aren't immunized, she said.

Chickenpox, she noted, is a highly contagious disease that is spread through the air. Those who have had the disease, which includes the vast majority of older teenagers and adults, do not need the vaccine, which has been administered to newborns since 1995.

The hepatitis B vaccine is especially important for teenagers, according to health officials.

The virus is spread by exposure to blood or body fluids from an infected person through drug use, sex, tattooing or during childbirth or contact sports.

The disease is common in developing countries. It typically causes an illness that can last several weeks and produces symptoms including fever, nausea and yellowing of the skin or eyes.

In about 10 percent of cases, sufferers develop a chronic lifelong infection that can remain dormant for years. These patients can spread the disease and are at greater risk for permanent liver damage, including the development of liver cancer, which is fatal.

When it is unclear whether a child has been properly immunized against hepatitis B or has had a physician-documented case of chickenpox, Reed said, officials are recommending revaccination. "That's the most expedient course," he said. "We want to ensure they are protected." ·

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