Parents PACK Newsletter

October 2008

Parents Pack Newsletter

Possessing, Accessing and Communicating Knowledge About Vaccines

In this issue:

• Feature Article: Perspective of a Polio Survivor 
• Spotlight: Support for Polio Survivors 
• Did You Know? . . . Immunization Rates for Adolescents 
• Ask the VEC - Immunity to Measles, Mumps, and Rubella After Immunization  

Feature Article: Perspective of a Polio Survivor

This month we welcome Mrs. Jan Nichols as a guest author. Mrs. Nichols is a polio survivor who has written a book about how her family was affected by polio in the 1950s. Today, Mrs. Nichols travels to speak to groups about polio and today's vaccine safety concerns.

Let me introduce myself: I'm a middle-aged woman, a wife, a mother, a future grandmother, and... a polio survivor. I can recall my mother commenting that she was fortunate to have had her children before the age of "pregnancy scares" that peppered the media in the '70s and early '80s. My generation endured a fair share of frightening reports: One week, we'd be advised that it was perfectly OK to consume two cups of coffee each day. Seven days later, a report would be released that predicted dire consequences if we dared ingest a "nano-sip" of coffee.

Fast forward to today: As young parents, you cannot get through a day without hearing news reports on everything from toxic lead levels in toys to autism scares linked to anything and everything, including vaccines. I find myself repeating my mother's lament with a new twist: I'm glad that my greatest worries surrounded things like coffee consumption!

It's so difficult to be a parent these days, to somehow sift through the myriad of conflicting information and parenting strategies. It's for this very reason that I feel compelled to tell you a little story.

Let's take a trip back in time

In the early 1950s, the U.S. was challenged each summer by a virus five thousand times smaller than the width of a human hair. The organism caused a disease called infantile paralysis (a.k.a. polio). The early symptoms of polio resembled the flu: fatigue, fever, aches and pains, vomiting, and stiff neck. But, those symptoms could quickly change to an inability to breathe without mechanical assistance, to paralysis of limbs, to life-long deformities of limbs, to death- within a matter of hours.

Since 1916, the United States had endured yearly polio epidemics that left thousands dead and thousands more disabled. That first horrific epidemic, whose epicenter was traced to an immigrant section of Brooklyn called "Pigtown," infected 27,363 children across 26 states. Six thousand children, most under 5 years old, died that terrible summer and early fall.

More alarming still, was the fact that:

• Each year the epidemics were getting worse. Public health officials were baffled by the mercurial properties of polio. One year, a community would experience many cases. The next year, few cases would be reported.
• No one could explain the unpredictable nature of polio. Pregnant women were found to be especially susceptible to the virus. Boys were more apt to be paralyzed than girls.
• The age of polio's victims was also getting older. By the 1940s, the average age of victims was between 5 and 9 years.

In 1952, our country experienced its worst polio year with 57,879 reported cases. An estimated 600,000 cases were reported worldwide that same year. 

Parents lived in fear of warm weather-polio weather. They adhered to all public health recommendations and warnings: avoid large public gatherings, never allow children to swim in public swimming pools, and insist upon frequent hand washing. One of my peers remembers that her mother forbad her to eat peaches in the summer for fear that the virus could flourish in the "peach fuzz." Another friend was forbidden to attend church each Sunday during the summer months. As children born soon after the end of WWII, we were too young to appreciate our parents' terror. For us, "polio weather" was a terrible annoyance. Every time we turned around, our parents were curtailing our activities.

Enter DeWitt, NY (a suburb of Syracuse) in 1953

Frankie and Janice Flood (fraternal twins born one minute apart) were in first grade at Moses DeWitt Elementary School. They were busy picking out Halloween costumes and dreaming of the mountains of candy that would soon overflow their "Trick or Treat" bags. Frankie had a little head cold, so he stayed home from school in the hopes that a chest cold could be averted. Janice wished for a similar fate, hoping for additional playtime with her birth partner and favorite pal.

But, on October 30, 1953, Frankie began to have trouble breathing. He was rushed to City Hospital in Syracuse where a diagnosis was made, via spinal tap, of bulbar polio. He was immediately placed in an iron lung, a cylindrical machine that was designed to do the work of paralyzed muscles that affected breathing and swallowing. Only Frankie's head protruded from the yellow, five hundred pound, seven foot long mechanical "caregiver."

Janice was rushed to the hospital on Halloween morning to receive multiple doses of gamma globulin. Her parents had been told that, most likely, their other twin was already infected with the virus. Gamma globulin (a mixture of antibodies derived from human blood that sometimes prevented polio or lessened its severity in an infected individual) was the best that physicians could offer. The polio vaccine trial would not take place until late spring 1954 (six months away).  

Sixty-one hours after being admitted to the hospital, Frankie Flood succumbed to polio. His father had cradled him as best he could as he was whisked to the operating suite for an emergency tracheostomy. A New York State Certificate of Death recorded his death on November 1, 1953, at 10:25 p.m. On the night of his burial, Janice was admitted to the same hospital with a diagnosis of paralytic polio. Later on in the week, the twins' mother suffered a miscarriage. How quickly life had changed for this young family!

Ultimately, eight children in Frankie and Janice's classroom of 24 contracted polio. Although hospital records from that year are missing, some parents recall that over three dozen DeWitt residents were diagnosed with polio within a span of a few weeks, parents were frantic. Two of the twins' classmates died from complications of polio several years after the epidemic. The children were sisters, leaving the devastated parents childless.

In 1979, wild-virus polio was eradicated in the United States. But as late as 1988, 350,000 people in 125 countries around the world contracted polio each year. That same year, the Global Polio Eradication Initiative was formed. To this day, it remains the world's largest public health endeavor.

Back to present day

Polio is not eradicated worldwide, though the global case count has been drastically reduced. The public health community believes that polio can be eradicated but time is running out. If eradication is not soon realized, it is now estimated that over 10 million more children will be paralyzed by mid-century.

There is no known cure for polio. Vaccination is the only prevention for the killer and crippler that prefers children as its victims. Any infected individual can carry the virus and infect any other unprotected individual anywhere he or she travels. Some public health officials describe polio as "a plane trip away, no passport required." 

I am Janice Flood Nichols, a middle-aged woman, a wife, a mother, a future grandmother, and... a polio survivor who still misses her twin brother, Frankie, and two of her classmates. I fought hard and long to learn to walk again. I fought harder still to navigate the rocky road of grief following Frankie's death.

As a mother, I know all too well your desire to protect your children from any and all harm. Sadly, I know that that is an impossible task. All we can do is our best, with "best" becoming a pretty confusing, sometimes terrifying task these days.

I ask you to address your vaccine concerns to your medical providers and to receive accurate vaccine information from well documented sources. The Centers for Disease Control and Prevention and the American Academy of Pediatrics offer excellent Web-based information for parents.

I continue to pray that polio remains a thing of the past in the United States. As more and more parents question the necessity and safety of vaccinations (primarily because of inaccurate information that has flooded the airwaves and the Internet), I must confess that I am worried.

About the author

Polio survivor Janice Flood Nichols is the author of "Twin Voices: A Memoir of Polio, the Forgotten Killer" (honorable mention recipient of the 2007 London Book Festival award in both nonfiction and biography). Nichols holds a BA in Psychology from Seton Hill University and a MEd in rehabilitation counseling from the University of Pittsburgh; she has been employed as an instructor in the social work graduate school at Syracuse University and in the social service department at Community-General Hospital, Syracuse, NY.

Learn more about polio disease and vaccines:
Centers for Disease Control and Prevention 
Vaccine Education Center at The Children's Hospital of Philadelphia 
Global Polio Eradication Initiative

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Spotlight: Support for Polio Survivors

There are between 12 and 20 million polio survivors throughout the world. Between 400,000 and 600,000 of these people live in the U.S. In addition to living with the long-term effects of polio, such as paralysis or other physical limitations, a significant percentage of these people are also experiencing symptoms consistent with post-polio syndrome. Post-polio syndrome is a condition characterized by fatigue, new muscle weaknesses, pain in muscles and/or joints, and sleeping or breathing problems.

There are groups that offer information and support for survivors and those who want to help:

• Post-Polio Health International (PHI) works to "enhance the lives and independence of polio survivors and home ventilator users through education, advocacy, research and networking."
• International Ventilator Users Network is an affiliate of PHI, that aids families living with someone at home on a ventilator.
• Stand Proud is a group that "helps polio survivors and youth with other disabilities in Africa to walk."
• The Global Polio Eradication group provides several links to groups working to eradicate polio around the world.

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Did You Know? . . . Immunization Rates for Adolescents

A recent telephone survey conducted by the Centers for Disease Control and Prevention (CDC) determined that most 13- to 15-year-olds are up-to-date on their hepatitis B and MMR vaccines, but many are not receiving other vaccines that are recommended for their age.

While the coverage was better than that measured about a year ago, there is still more to be done. Only about one-third of all adolescents have been immunized against meningococcus and even fewer (about one-fourth) girls have had at least one dose of the human papillomavirus (HPV) vaccine. While most adolescents (about three-fourths) have received a booster vaccine for tetanus and diphtheria, many have not had the version that also includes protection against pertussis or whooping cough.

To find out which vaccines an adolescent should have, consult the CDC schedule.

Learn more about individual vaccines recommended for adolescents:
Centers for Disease Control and Prevention
Vaccine Education Center at The Children's Hospital of Philadelphia 

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Ask the VEC - Immunity to Measles, Mumps and Rubella after Immunization

Q.  Is there a test to prove that the MMR vaccine has worked in an individual

A. Yes. A person can find out if he or she has developed an immune response to each of the three diseases that the MMR vaccine prevents (measles, mumps and rubella) by getting a blood sample drawn. A clinical laboratory can then check for the presence of antibodies for each of the diseases.

However, if there is a question about immunity, doctors typically will recommend receipt of the vaccine rather than prescribing the blood test first. This is done for a few reasons. First, a second dose of vaccine will not harm the person and is, in fact, likely to boost any response that developed previously. Second, if the blood work comes back negative, a second needle (and appointment) will be necessary to get the vaccine. Finally, the cost of the vaccine is likely to be similar to that of getting the blood work, so if a vaccine is then necessary, the cost will also be higher when the same could have been accomplished by just administering the vaccine. 

Any questions about individual immunity should be discussed with your healthcare provider, so that individual situations can be handled most appropriately.

Send us your comments

If you have any comments about this newsletter or suggestions about how we can make our Web site more helpful, please send your comments to contactPACK@email.chop.edu.

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