The Debate Regarding Childhood Vaccinations: What It Means for Your Center
By Carolyn R. Tomlin

Childhood immunizations are becoming an increasing controversial subject matter and a difficult decision for many parents (Murphy, 1993). The debate over whether to have children vaccinated against diseases common to children has become a battle between lawmakers and parents. Many parents feel a number of "standard" childhood vaccinations are not necessary and/or may even be harmful, while others argue that disease prevention is worthwhile. There are pediatricians, policy makers and others on each side of the debate, which means this "hot button" issue appears to be one that care providers will most likely come up against during their career.

In the early 20th century, whooping cough, or pertussis, claimed the lives of 5,000 to 10,000 people in the United States each year. In 1948 a vaccination was created and administered, making whooping cough a bacterial relic of the past. Since that time the pertussis vaccine reduced the numbers of deaths to less than 30 per year (KidsHealth).

However, the number of cases has started to resurge. In 2004, the United States reported 25,827 cases of whooping cough (Klote, 2006). Several reasons exist for this increase in numbers. First, 48 states in the U. S., with the exception of Mississippi and West Virginia, have lax immunization requirements, for both religious and personal reasons. According to the Center for Disease Control, all states allow children with a weak immune system to be exempted from school requirements for medical reasons (Kipperman, 2006).

Another factor in the rise of childhood disease is the fact that a growing number of parents choose to home-school. This means that proof of immunization is not required—as their children do not attend public or private schools. As a result, we have seen a rise in measles, mumps, polio, and Rubella (German measles) in addition to whooping cough.

An additional cause of recent disease outbreaks is that vaccinations are losing their potency, which would require children to have booster shots to reestablish their protection from disease (Klote, 2006). There are cases where teen and adult workers in child care centers have contracted the illness, and, in turn, infected babies and young children who had not been immunized.

Adopted children from foreign countries where vaccines are not required may bring the bacteria into a child care center. Anyone who travels internationally should be aware of the risk of these diseases and keep vaccines current.

Characteristics and Symptoms of Childhood Diseases
Vaccines are available for the diseases described below. Some are relatively mild while others are more serious, especially if secondary infections occur.

· Whooping Cough (pertussis) is an infection of the respiratory system caused by the bacterium Bordetells pertussis. Recognized as a highly contagious disease among children and infants, the disease is spread through droplets released in the air that find their way into the lung of a child. Characterized by severe coughing, the child makes a desperate breath during a break in the coughs making a “whooping” sound. Babies under one year of age are most vulnerable. Infants may appear to gasp for breath, develop a reddened face and actually stop breathing for a few seconds during a spell. Whooping cough can be deadly for babies.

· Rubella (German measles) is usually a mild illness for children, but for pregnant women, the disease affects the unborn child. Miscarriage, stillbirth, deafness, cataracts, heart defects, liver and spleen damage and mental retardation may occur.

· Red measles is characterized by a red skin rash, runny nose, high fever (as high as 104º F.) and can lead to convulsions. It is relatively benign unless infection occurs.

· Polio is a disease that affects the muscles and can cause paralysis of different parts of the body. The vaccine carries no side effects. Any tiny risk factors far outweigh the chance of developing polio.

· Mumps is a contagious disease that may cause discomfort, low-grade fever and swelling of the lymph nodes. Earaches and ear infections may also occur. Usually, mumps is relatively mild.

· Chickenpox is a highly infectious disease caused by a member of the herpes virus family called varicella. It is characterized by itching and discomfort. Chickenpox is relatively mild, unless secondary infections occur.

· A TDaP vaccine helps protect children from tetanus, diphtheria, and pertussis. Vaccination begins at about 2 months of age and a booster shot is required at age five.

Handling Issues in Your Center
Safeguarding the health of children in your child care center is a top priority. Use these guidelines to keep your center healthy:

1. Insist that all employees wash hands frequently.

2. Request a doctor’s statement that employees meet health and wellness guidelines.

3. Know and enforce the immunization guidelines of your state. Check with your local Health Department for information on identifying these diseases.

4. Plan professional development courses led by medical personnel that train employees on identifying the symptoms and characteristics of childhood diseases.

5. Realize that childhood diseases are highly contagious for children not vaccinated.

6. Keep children isolated from others who come to your center showing any sign of a communicable disease. Contact parents or guardians for pick-up.

7. With both parents working, some centers have a sick room where an employee can care for the child who still may be contagious to others

but is not running a high fever.

8. Check with your health department regarding administering a booster shot called Boostrix to the adults in your center. Several areas reported that adults who had previously been immunized as children had contracted a mild form of whooping cough as adults and had passed the disease on to babies. Immunity can weaken in some people.

9. Encourage parents to keep up-to-date records of children’s immunizations.

Emergency Care
Child care workers must realize that whooping cough and some other childhood diseases can be very serious and even fatal. If a child has any of the following symptoms, seek emergency care or call 911. (Health Encyclopedia).

· Bluish skin color, which indicates a lack of oxygen

· Periods of stopped breathing (apnea)

· Seizures or convulsions

· High fever

· Persistent vomiting

· Dehydration

Conclusion
Vaccine-preventable diseases kill and disable millions of children throughout the world. When children are sick, working parents must take sick-leave. And if a pregnant woman is exposed to German measles, her baby is at risk for numerous health problems. These vaccines have been a benefit to the wellness of children. Child care centers have a responsibility to educate parents as a way of keeping children healthy.

Helpful Resources
George Kassianos in his book, Immunizations, provides a reference for current immunizations schedules, advice on vaccines, infections, and childhood travel health. Another source is The Immunization Guide by Diane Rozario, (2000). This book answers questions about childhood immunizations.

References
Kipperman, D. (Oct. 18, 2006) Virginia a leader in whooping cough Vaccinations, The Daily News Record, Harrisonburg, VA.

KidsHealth, Whooping Cough (Pertussis)

Klote, D. (Oct. 18, 2006) Can whooping cough’s comeback be prevented? California Democrat.

Murphy, J., (1993) What Every Parent Should Know. Earth Healing Products.

Web site:
http://www.turnto10.com/encyclopedia/6862191/detail.html

Carolyn Ross Tomlin, M.Ed., has taught kindergarten and university courses in early childhood education courses at Union University, Jackson, TN. She contributes to numerous education publications.