County public health directors discuss measles, potential changes to childhood vaccine recommendations

DES MOINES — It has been a busy year for public health, with the Trump administration considering changes to the vaccines recommended for infants, measles cases being confirmed in Iowa throughout the year, and the portion of Iowans who have received a flu shot declining.

President Donald Trump earlier this month signed a memorandum instructing the U.S. Department of Health and Human Services and Centers for Disease Control and Prevention to review the federal government’s recommended vaccine schedule for children and more closely align it to other countries that require fewer vaccines.

Denmark’s recommendations were believed to be the model the administration sought to emulate, according to national reports. Politico reported last weekend that HHS backed off on making the new recommendations after the agency’s lawyers warned that the changes would invite a lawsuit that the agency would not win.

Meanwhile, a measles case was confirmed recently in Polk County — earlier this year the state had confirmed at least eight measles cases.

And the share of Iowans who had received a flu shot through Dec. 19 was down 9 percentage points from the same time last year and down 14 points from the same point in 2019, according to state data.

Two local public health leaders — Linn County Public Health Director Dr. Pramod Dwivedi, and Johnson County Public Health Director Danielle Pettit-Majewski — talked to The Gazette earlier this month about these topics and more.

The following is edited for brevity and clarity.

Q: Polk County recently announced a confirmed case of the measles, and in July the state said there had been eight confirmed cases of the measles in Iowa at that point. What is your level of concern with that?

Dwivedi: “We are in a situation, as you know, that in 2000 this country had declared that we had gotten rid of measles. And since then we have seen episodes of measles cases. And earlier this year we saw too many outbreaks in the United States. The thing is that vaccination has been one of the greatest public health achievements. And there are vaccine-preventable diseases. And vaccines go through rigorous years of experimentation and efficacy, and their safety, through scientific methods, have been proven to be effective. I cannot really speculate on what others are trying to do, but I can say that we have a long, long track record of their safety and their efficacy and keeping our children safe.”

Pettit-Majewski: “This individual was not old enough to be vaccinated, and had traveled to an area where there is an ongoing outbreak. And I think there is genuine concern, and there should be genuine concern, because we are seeing these pockets of outbreaks. And as we can continue to see fewer people getting vaccinated, we’re going to see more cases pop up. And I just want to remind folks that the majority of parents do vaccinate their children. However, because measles is so contagious, we need a herd immunity of 95 percent to protect children who are too young to be vaccinated, those who are very, very vulnerable.”

Q: What is your recommendation to people regarding the measles vaccine?

Dwivedi: “Oh, get it. Get it. Because measles is a dangerous disease and it’s highly infectious. People have been hospitalized — people means our kids. So why do we want to experience that kind of situation in our lives? The vaccines are effective and they are safe, and go and get it. We are vaccinating people all the time. If you have questions, you can talk to your health care provider. They have scientific basis, and they can talk to you about the vaccine, its importance, any side effects, those kind of things.”

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Pettit-Majewski: “Right now in Johnson County, we are still recommending that children get their zero dose at 6 months old and that they get their first dose at 12 months, and you can get your second dose as early as 28 days after that first official dose. We want to make sure that folks do get vaccinated against the measles, because it is so incredibly contagious. And also, we want to make sure that when people are making these decisions, because we understand there is just a lot of information out there, and if you’re a new parent, it can feel overwhelming. Especially if you don’t work in health care, if you don’t work in public health, this isn’t something you’ve had to think about a lot. I think it’s really important that we have these conversations with our providers and take guidance from the folks who have been caring for us and for our children on a regular basis. Vaccines are safe and effective. The MMR vaccine has been given worldwide for decades, and it has been the most effective tool we have to stop the spread of measles.”

Q: The federal administration has been considering changes to its infant vaccine schedule, possibly by more closely matching countries like Denmark. Are you concerned with that possible change?

Dwivedi: “I don’t really understand, because Denmark is 6 million people, and they are just citing one country out of what, 180 countries. We cannot compare ourselves with a very, very small country. And our recommendations over the years, for decades, have been based on rigorous scientific data and information. … I cannot speculate on the potential changes at the federal level, but I can say that the existing (vaccine) schedule has a long, long track record of keeping our population safe.”

Pettit-Majewski: “Denmark is a country that is vastly different from the United States. They have socialized, centralized medicine. We do not. They have a predominantly homogeneous population of approximately 6 million people that is very different from our very diverse, very large, 330 million people that are dispersed over a very large country. … I think that we need to consider the risk factors of the country that we live in, and we should follow the vaccine schedule as it is, because it has been proven to be safe and effective. I would be very concerned for the life and safety of children should we forego some of these crucial childhood vaccines. … My fear is that people do not have the institutional memory of what life was like before these vaccines were given regularly to children, to you and I. And the vaccines that my daughter got are much more effective than the vaccines I got. I’m 41. So they have improved. They’ve gotten safer. They’ve gotten more effective because we continue to learn more. But ultimately, vaccines prevent these childhood illnesses. … We could very quickly get back to a place where we have children dying from measles or losing their hearing because of measles, or getting polio. … This is nothing to mess around with.”

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Q: With those possible changes in the news and what people may see on social media, what do you tell people about vaccines?

Dwivedi: “Talk to your health care provider. Come and talk to us. Every county in our state has a health department. Talk to those practicing people who know a thing or two about vaccines or anything related to health. Talk to your health care provider. And certainly look at the information which is available on the websites of the scientific entities in our country.”

Pettit-Majewski: “That you talk to a health care professional. There’s going to be a lot of stuff that you see on TikTok. There’s going to be a lot of stuff you see on Instagram. There’s going to be a lot of stuff you see on social media, on the news. I will promise you, health care professionals, we are not making money off vaccines. That was kind of a common refrain during the pandemic, where it’s like, ‘You’re making money off of pushing these COVID vaccines.’ Absolutely not. When you talk to health care professionals, they are thinking about your overall health. They have studied. They are going to talk to you. They’re going to answer your questions. Because especially when you’re a new parent, it can feel really overwhelming. But I just really encourage people to talk to a trusted health care provider rather than listening to what you might see on social media or putting your faith in someone who doesn’t maybe have your child’s best interest at heart.”

Q: It’s that time of year when there is a lot of stuff going around. Are there any trends out there that concern you, and what are you telling people to help them stay healthy?

Dwivedi: “Stay healthy and get vaccinated. Right now we are in flu season. Get vaxed and certainly, when you are sick, stay home. Don’t go out and make other people sick. Just follow those preventive precautions, wash your hands and those kind of things.”

Pettit-Majewski: “I do just want to stress, if you have not already, please get your flu shot. We do anticipate this being a really hard year for influenza, based on what we’ve seen in the Southern Hemisphere. So we would encourage folks, if you haven’t already, please get your flu shot. We do want to make sure that people are protected. Also, I know everybody wants to see their loved ones. We want to go home for Christmas. We want to see grandma and grandpa. We want to see our favorite brother and sister. If you are sick, if your child is sick, please stay home. We really don’t want to be spreading the flu or COVID or strep and all of the other fun stuff. … So if you or your child are sick, please stay home and don’t spread that to your family.”

Comments: (515) 355-1300, erin.murphy@thegazette.com

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