Officials Caution 2019-2020 Flu Season May Be Severe

After the flu claimed the life of a 4-year-old in California, health officials are warning that the upcoming flu season could be severe.

Health officials are warning that the upcoming 2019-2020 flu season could be severe, as reported by U.S. News & World Report.

The warning comes on the heels of the first reported flu-related death, which claimed the life of a 4-year-old in California earlier this month.

“A death so early in the flu season suggests this year may be worse than usual,” cautioned Dr. Cameron Kaiser, a health official from Riverside County, where the child was from, in a press release.

The Centers for Disease Control and Prevention recently reported that the previous flu season, which ran from October 2018 to May of 2019, was of “moderate severity.” It should also be noted that the 2018-2019 flu season, which lasted 21 weeks, was the longest flu season in a decade, and that, according to the CDC, there were around 600,000 flu-related hospitalizations and between 36,400 and 61,200 flu-related deaths reported.

For the 2019-2020 flu season, officials have recommended flu shots be administered before the end of October, and caution against vaccinating too early, such as in July or August, as reduced protection against the flu may occur. The CDC states that “all persons aged 6 months and older are recommended for annual vaccination, with rare exception.”

Flu vaccines are updated to better combat the strains that are expected to be circulating in the United States. This year:

  • The A(H1N1)pdm09 vaccine component was updated from an A/Michigan/45/2015 (H1N1)pdm09-like virus to an A/Brisbane/02/2018 (H1N1)pdm09-like virus.
  • The A(H3N2) vaccine component was updated from an A/Singapore/INFIMH-16-0019/2016 A(H3N2)-like virus to an A/Kansas/14/2017 (H3N2)-like virus.
  • Both B/Victoria and B/Yamagata virus components from the 2018-2019 flu vaccine remain the same for the 2019-2020 flu vaccine.
  • All regular-dose flu shots will be quadrivalent.

For more in-depth information about the 2019-2020 flu season, the CDC offers a FAQ resource center, which can be accessed at

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

How to Talk to Patients Who Oppose Vaccines

Measles disappeared from the U.S. in 2000. Now, it’s back, with 1,172 cases across 30 states. Here’s how to talk to patients about the importance of vaccines.

As of August 1, 2019, the CDC reported 1,172 cases of measles across 30 states, the greatest number of cases reported in the U.S. since measles was eliminated from the country in the year 2000.

It is commonly known among healthcare professionals that the best way to protect against measles and many other preventable diseases is to vaccinate. However, since 2001, the number of people who did not receive vaccines for preventable diseases has quadrupled, thanks in part to what is commonly known as the “anti-vax” movement. The movement, which has been around for more than a hundred years, has found its foothold in pseudoscience and misinformation disguised as advocacy. At the very least, anti-vaxxers have made it harder for medical professionals to do their jobs and, in what is arguably the worst-case scenario, they and their message have put lives in jeopardy.

But not everyone who does not vaccinate is staunchly anti-vaccines—some are hesitant, others are misinformed. Still, speaking to them about vaccines may be challenging for even the most seasoned provider. Here are some tips that might make the conversation go a bit more smoothly.

Listen to Their Concerns

No one wants to feel like they are being strong-armed or railroaded. Though their concerns may be medically invalid, they are still personally valid to them. Be sure to listen to what they have to say, with empathy and without interrupting, so you know their concerns and, in turn, how to respond to them.

Counter with Facts

They may bring up misinformation as part of their concerns, such as claims that certain vaccines are “linked to” autism or SIDS. As you likely know, there is a barrage of evidence against these unfounded claims. It is your job as a medical professional to provide them with science-based facts to alleviate these concerns.

Stand Firm, but Know You May Not Win

It may take more than one conversation to quell all of their concerns and allow you to administer vaccinations. Be prepared to have the conversation the next time they come to see you, and be sure to explain the risks involved in their decision to not vaccinate in the meantime, as well as precautions they can take to keep themselves, their child, and/or the public as safe as possible while unvaccinated.

What other methods have you found to be effective in speaking to patients about vaccines? Leave them in the comments below.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Nurse’s Post about Vaccines Goes Viral

If you buck vaccinations and Big Pharma, should you be allowed go to the doctor or the hospital when you get sick? This nurse says no in her viral post.

Days before an article was published by the Los Angeles Times stating, “Health authorities in California have more power to insist that a dog is vaccinated against rabies than to ensure that a child enrolled in public school is vaccinated against measles,” a California nurse took to Facebook and made a post about that very topic. In her post, Meggy Doodle, as she’s known on the site, told parents that they may have the “freedom” not to vaccinate their children, but that it comes with a caveat—”The caveat to that is this: then they should NOT be allowed go to the doctor or the hospital when they get sick, looking for treatment,” if they think Big Pharma is “just trying to turn a profit or poison us all.”

Doodle went on to urge those against vaccinations to, “stop being so naïve,” and rattled off a list of live-saving measures which are also compliments of Big Pharma—antibiotics for sepsis, steroids and epinephrine for anaphylaxis, an inhaler for asthma.

“Having a heart attack? Better break out your essential oils and get your affairs in order, because the only thing we have to offer you is medicine and procedures brought to you by the very same people who are responsible for those vaccines you insist are evil,” Doodle continued.

She then said that she personally takes offense to anyone who, “implies that medical professionals, like myself, would ever administer anything to anyone, especially a child, that would intentionally harm them. I take even more offense to anyone that would imply that a college educated professional, like myself, is incapable of “doing the research.””

She signed the post as “a nurse, a mother, a college graduate (with a science based degree), NOT BIG PHARMA.”

The post quickly went viral, amassing more than 12,000 shares and upwards of 13,000 reactions in mere days, with many who shared the post echoing Doodle’s sentiment. “You tell them girl. I agree with you,” said one woman who shared the post. “With flu season approaching… I’ll just leave this here,” said another. “Something to think about,” read comments accompanying quite a few other shares.

As a nurse, do you agree with Doodle’s sentiment? Read her post in full below, then tell us in the comments.

Can’t see the post above? Click here to view it directly on Facebook.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Another Way For Anti-Vaxxers To Skip Shots For Schoolkids: A Doctor’s Note

Families who oppose mandated immunization for schoolchildren may be seeking medical exemptions to get around a new California law, according to a study published Tuesday.

By Ana B. Ibarra and Barbara Feder Ostrov

Dr. Tara Zandvliet was inundated with calls and emails from parents last year, after California passed a law nixing personal beliefs as an exemption from school vaccinations. Suddenly, many parents sought exemptions for medical reasons.

Someone even faked two medical exemption forms purportedly written by the San Diego pediatrician, copying a legitimate document she’d provided for a patient and writing in the names of students she’d never treated, she said. She learned of the forgeries only when the school called for verification.

Only 1 in 10 families contacting her for such exemptions could cite a legitimate reason, such as a severe allergic reaction to a previous vaccine, Zandvliet said. Of those kids with valid health problems, she estimates, only about a third merited the exemption.

Families who oppose mandated immunization for schoolchildren may be seeking medical exemptions to get around the new state law, which requires kindergartners entering public and private schools to be fully vaccinated regardless of families’ personal beliefs, according to a study published Tuesday in JAMA, the Journal of the American Medical Association.

Before the 2016-17 school year, parents who opposed vaccination, or anti-vaxxers as they are often called, could enroll their unvaccinated children in school citing the personal belief exemption, based on religious or philosophical convictions, for example.

After a rampant measles outbreak originating at Disneyland in 2014 that resulted in 147 cases reported across seven states, California scrapped the personal belief exemption. The law, which was hotly contested by some parents, left in place waivers for medical reasons.

Such a stringent policy is fairly unusual. Eighteen states have personal belief exemptions and 47 allow parents to opt out of vaccinations for their children based on religious beliefs, according to the National Conference of State Legislatures. Besides California, Mississippi and West Virgina allow exemptions based on medical concerns alone.

Michigan also recently tackled this issue and required families seeking an exemption to meet personally with local public health departments. After instituting the new rules, state officials reported that the number of waivers fell 35 percent.

The increase in California medical waivers suggests that anti-vaccine parents may be finding doctors willing to exempt their kids from the mandate, according to the researchers.

The study, which used data from the California Department of Public Health, shows that the number of medical exemptions among kindergartners, though small, tripled to 2,850 in 2016 from the previous year. Meanwhile, the number of exemptions for personal beliefs was about four times lower in 2016 than in the year before. (They did not plunge to zero in part because some pre-kindergartners had exemptions that were grandfathered in under the law.)

The state’s law, however, gives doctors more wiggle room to authorize medical exemptions — for example, for children with a family history of adverse reactions to vaccines.

Paul Delamater, an assistant professor at the University of North Carolina-Chapel Hill and lead author of the JAMA study, said this reason is inconsistent with the recommendation from the American Academy of Pediatrics. The academy states that medical exemptions should be reserved for students who could truly be harmed by vaccination, such as those with a weak immune system because of chemotherapy or a known dangerous reaction to a vaccine ingredient.

Many of the California counties with the biggest increases in medical exemptions since the law took effect are in Northern California, including Shasta, Plumas, Sonoma and Marin. Some with high percentages of personal belief exemptions before the law had among the greater increases in medical waivers afterward, Delamater said.

In one Southern California county, Orange, the number of medical exemptions went from 92 in the 2015-16 school year to 348 in 2016-17, according to state data. Meanwhile the number of personal belief exemptions decreased from 1,270 to 269 in the same period.

“The medical exemption increase is concerning,” said Catherine Flores-Martin, executive director of the California Immunization Coalition, a public-private partnership that promotes vaccinations and co-sponsored the state’s vaccine law.

Flores-Martin said health professionals expected a short-term rise in medical exemptions because parents previously may have obtained the easier-to-get personal belief exemptions for children who actually qualified medically. But the rise in medical exemptions is greater than she had anticipated, and Flores-Martin said some doctors may be inappropriately offering them to parents on a broad basis.

“It would be unusual for a child to be exempted from every vaccine forever, because that’s pretty extreme. You see patterns [of such exemptions] in some of these schools. I don’t think that’s a coincidence.”

Her group is encouraging people to contact the Medical Board of California if they encounter doctors writing medical exemptions for conditions like asthma that aren’t included under the state law.

“It really isn’t up to the parents,” Flores-Martin said. “Some doctors may feel emboldened if they … feel they can do that without scrutiny or consequence. It’s an issue that physicians need to address with their peers, and we’re going to help start that conversation. It’s up to the doctors to behave professionally.”

Many parents who don’t want vaccinations for their children, including some vocal opponents from affluent, well-educated regions of the state, say they are concerned that vaccines are linked to autism, despite overwhelming scientific evidence that this is not the case.

Zandvliet, the San Diego doctor, tries to take a judicious approach. Unlike some other doctors, she doesn’t charge extra for writing exemptions. She does, however, require families asking for an exemption to provide medical documentation of the child’s condition before she’ll write one.

Although she said she has not yet written a permanent medical exemption for all vaccines, she has written “medical exemptions lite,” which spare the students from one or more vaccines for a limited period. Sometimes, she will write these for students with siblings who experienced an adverse reaction to the vaccine, although she acknowledges there are no studies showing that it’s useful to do so.

For families seeking exemptions without a health reason, perhaps because they’re misinformed or philosophically opposed to vaccines, Zandvliet takes the opportunity to educate them. Sometimes, she succeeds in getting reluctant parents to partially vaccinate their children, or to spread out vaccines over a longer period than the U.S. Centers for Disease Control and Prevention recommends.

“If we stop listening as doctors, we’re going to turn people off,” Zandvliet said. “Doctors are saying, ‘If you won’t go by the CDC schedule for vaccinations, get out of my office.’ So they didn’t vaccinate, and they didn’t protect that child.”

Pamela Kahn, president-elect of the California School Nurses Organization, who works in Orange County, said California has a strong record on vaccinations and there is only so much school nurses can do to educate parents who oppose them.

“Overall, the vaccine rates are really high in the state of California after this law went into effect,” Kahn said. “When you compare the amount of kids that were exempt between both pools, we’re still way ahead of the game.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.