Thursday, March 05, 2015

Shot At Life Summit: Advocating for Global Vaccines

Imagine half the kindergarteners in the US dying from diseases we could prevent. Horrendous. Catastrophic. Over 1.5 million deaths would be unimaginable. Yet this is about how many kids die every year around the world from measles, polio, pneumonia and diarrhea, disease we can largely prevent by vaccines and for very little money. Still, despite great efforts, 1 in 5 kids around the world do not have access to vaccines. 

That’s why I take time out to advocate, remembering the mothers on the other side of the world who walk miles, hours, entire days, if they can, to get their babies immunized. I don’t often use this space to advocate beyond better news and information for parents. But protecting a child from disease shouldn’t be a luxury or choice.

The Fourth SHOT@LIFE SUMMIT: The new champion class of 2015 plus some familiar faces and veterans.

This week I had the honor of attending the fourth annual Shot@Life Summit in Washington, D.C. I’ve been a champion for the global vaccine campaign since its launch by the United Nations Foundation over four years ago. As many of you know, the Shot@Life mission is to raise awareness and funding for access to life-saving childhood vaccines in the developing world. 

Four years ago there were just fifty of us, maybe including the small full-time staff, huddled in a conference room. Now I’m happy to report there are over 600 champions.  Over four years we've helped raise over 3.5 million dollars, resulting in 15.8 million vaccines to kids in desperate need. That’s progress. Still a lot of children are at risk. Really and truly at risk and not just the over-hyped too common risks we US parents read in every other headline. 

Shot@Life Dir. Devi Thomas, Paralympian Dennis Ogbee
So I found myself on Capitol Hill asking my New Jersey congressman and two Senators to support funding for global childhood immunizations. Trust me, four years ago I didn’t think I’d ever be sitting across from Representative Leonard Lance talking about measles and polio. Or for that matter, anything else! He and the others I met with expressed their support for funding global immunizations and their concern over disease outbreaks. Senator Cory Booker, though new in D.C. has shown commitment to the cause. Senator Robert Menendez has been a long-time champion of global health and vaccines. They appeared keenly aware of the importance of eradicating these diseases around the world. I was proud to be a New Jerseyan. Really. You can quote me on that. 

Whether you’re from Jersey, California, or somewhere in between, or for that matter, Canada, yes, we have a champion or two up north, you can join us. I’d be glad to help you sign up or give you the inside scoop. Maybe even hold your hand (or hold on to you) next year outside a senate office, especially if there's another ice storm like the other day. 

I can also report that the Shot@Life champions, they will embrace you too and we're a lively, committed and diverse bunch. Pediatricians, teachers, authors, bloggers, nurses, engineers, Democrats, Republicans, Indepdendents, mothers, fathers, pharmacy students, polio survivors, athletes, at least one Paralympian. A few celebrities. We got it all. Along the way you’ll meet some incredibly inspiring people. This week I finally got to meet Paralympian Dennis Ogbee, also a Shot@Life champion and natural born storyteller who told of his youth in Nigeria where polio had paralyzed him. He’s walking, flourishing, today through his own remarkable strength and determination. Truly a “man of steel, heart of gold.” 

Andrea Riley, Rep. Adrian Smith (R-Neb.), Jo Frost 
Oh and Jo Frost, The Supernanny, she's a champion now. The celebrity child minder and parenting expert also attended the Summit this week and visited a few congressional and senate offices to champion global vaccine funding. For our purposes here at MommaData, I was heartened to hear her call out misinformation in the media (over vaccines) in a casual but impassionate speech. I heard her say “accurate” several times too. At the time I didn't write any of it down as I was busily stuffing paella into my mouth, without either pen or light. 

Fortunately someone from the Washington Post  caught similar comments she made the next day and wrote them down. And yes, in the Post photo accompanying the article that is my friend Andrea Riley and her congressman from Nebraska “getting schooled by the Supernanny” the next day at a reception. I took the picture above so it's not nearly as gripping or professional. 

Join up or learn more at ShotatLife.org

Friday, February 27, 2015

Landmark Peanut Allergy Study: The media is not impressed

Ground-breaking studies are rare. This is one of them. The first randomized trial of peanut consumption in infants at risk for peanut allergies (eczema, egg allergies). A study out of London provides the first strong evidence, experimental evidence, that eating peanuts early in life prevents peanut allergies. Half the kids received nuts between 4 and 11 months and continued eating them regularly (early exposure), the other half, no nuts at all (early avoidance). Later at age 5, children who ate nuts were significantly less likely to have a peanut allergy - only 2% became allergic, compared to 14% who avoided nuts.

Several years ago the current research team, led by Gideon Lack, found Jewish children raised in the UK had 10 times the rate of peanut allergies as Israeli children. The first group generally avoided nuts, the second, ate them as infants. The results got people wondering whether early avoidance was the wrong approach.

Huge implications here. HUGE.

The WHO recommends early avoidance of nuts. In 2000 the American Academy of Pediatrics started recommending children should delay eating nuts until age 3, those at most risk, not until age 8. Naturally, pregnant and breastfeeding women were also told not to eat nuts. Then in 2008 the AAP retracted its early avoidance recommendation citing a lack of evidence for its support. So the pediatric group now doesn't push early avoidance but it does not recommend early exposure as a prevention of allergies. Maybe it will soon. Some high-profile doctors are calling for immediate changes, namely testing at-risk infants for peanut allergies and for those not yet allergic, providing them with small doses of peanuts.

What a reversal. This kind of sweeping change does not often visit the parenting public, certainly not results with such life-altering consequences. Savor it. Relish it. Empirical evidence answering some very important questions.

This is a big moment. Big news. No, I am not being snide, I really mean big news this time.  

"This is a major study — really what we would call a landmark study," says Scott Sicherer, who advises the American Academy of Pediatrics on allergies. "There's been a huge question about why there's an increase in peanut allergy and what we can do to try to stem that increase. And this is a study that directly addresses that issue." NPR 
"For a study to show a benefit of this magnitude in the prevention of peanut allergy is without precedent. The results have the potential to transform how we approach food allergy prevention." Anthony S. Fauci, M.D., National Institute of Allergy and Infection Disease, Science  Daily
"This is transformational, it's the first time it's ever been done...Recent advances in research have shown that you can be desensitized once you have it. Up until now, there hasn't been any research on how to prevent it," says Dr. Lee Tak Hong, director of the Allergy Centre of the Hong Kong Sanatorium and Hospital. CNN

The media, of course,  responded to the enormity of the occasion:

Early Consumption May Prevent Peanut Allergies, New Study Suggests CNN 
Feeding Babies Foods With Peanuts Appears To Prevent Allergies NPR 
Feeding Infants Peanut Products Could Prevent Allergies, Study Suggest Well Blog, New York Times 
Eating Peanuts Early Could Prevent Allergy in Infants Yahoo News

 Could. May. Appears. Suggests. 

This was the moment, my dear headline writers, to pull out the causal language, the GROUDBREAKING STUDY - as opposed to the times writing about all those studies of questionable or limited societal or scientific import. You know, the ones that get the causal, dramatic treatment every other day. I mean, seriously, now you get hesitant? This is what happens when we become de-sensitized to dramatic news articles and headlines. If every study reportedly shows A Causes B, when the big study comes along showing A causes B, then people don't recognize it. The little studies start looking big and the big ones, not so great. Yikes. 



You can read the study for free right now at The New England Journal of Medicine. 

Friday, February 20, 2015

If Only Online Comments Were Just Mindless Entertainment

By now it's no surprise that people don't base their opinions of public health recommendations only on health information alone. That would be boring. Very boring. We have known for a long time that prior beliefs, friends' beliefs, mood, etc. influence judgments.

But now we also have to consider the effects of the online comments sections. A growing body of research has shown online comments matter. A few years ago a now oft-cited study found negative comments can heavily influence perceptions of health or science-related articles. Now comes word that the credibility of the comment, the poster's perceived authority or expertise matters too.

According to a new study out of Washington State University, if a source is deemed credible, say a health expert, their comments influence perceptions of health information. And if you're not totally tuning out the current media frenzy over vaccines (yes, I said that after complaining for 14 years that the media was not providing enough nuanced, accurate coverage of the issue!) - the team of researchers tested if "perceived source credibility" influenced readers' reactions to pro- and anti-vaccine messages.

So did commenters who appeared to have some measure of expertise sway anyone? You bet. People were more persuaded by a highly credible commenter, here, a medical doctor, than the actual content of the PSA. This is good news if perceived experts comment with some degree of accuracy. But if Dr. So and So posts inaccurate or flat out wrong remarks, well, not so good.

The New York Times had a piece worth reading about online comments, including a blip about the study above, this past week. They didn't quite get the headline right though: What Your Online Comments Say About You. It's more a matter of What Others Think About You From Your  Comments.

The Danger of Reading the Comments. Slate didn't quite get the headline right in their article. Comments aren't all dangerous. If a credible, informed person makes a nuanced, accurate remark then  reading the comments can be beneficial. Especially if the health article contains incorrect information and a credible source debunks it. Debunking is still a good thing!

Now go forth and post accurate, nuanced comments. Speaking of online comments....

Eula Biss, author of On Immunity and Dr. Jerome Groopman, Harvard M.D. and New Yorker staff writer are talking about vaccines and measles right now on the Brian Lehrer Show at NPR. The Stories We Tell Ourselves. Haven't heard the whole interview yet.

But check out the comment section.

The most recent comment, the one right below the podcast right now (Consuelo, NYC). It's a long-winded argument against vaccination. The first several comments, in fact, are all anti-vaccination. My favorite part, though it that the posters are bashing Brian for only presenting one side of the issue - and not including someone who opposes vaccination.

So rich.

How many times over the years I have sat and listened to more than a few NPR interviews with Brian or other hosts talking to supposed experts who questioned vaccines or promoted a link between vaccines and autism!! Just so rich.

It is still a crap shoot of credibility, misinformation and absurdity in the NPR comments section. If only we could sit back and view it as mindless entertainment.