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Low polio immunization rates among children in some areas of New York, increasing risk of outbreak

Low polio immunization rates among children in some areas of New York, increasing risk of outbreak

 


Nurse Lydia Fulton prepares to administer the measles, mumps, and rubella (MMR) vaccine, as well as those used to prevent diphtheria, pertussis, tetanus, and polio, at the Children’s Primary Care Clinic in Minneapolis, Minnesota. .

Courtney Perry | Washington Post | Getty Images

In some communities in the New York City metropolitan area, childhood polio vaccination coverage is as low as 37%, and despite mandatory vaccination, the virus spreads locally for the first time in decades, leading to outbreaks. Risk is rising.

In New York, polio vaccination is compulsory for all children attending nursery school or kindergarten through high school, whether public, private or religious.

There are no exceptions to New York State’s vaccine mandate because of religious or personal beliefs. Waivers are offered only if the child actually has a medical condition that prevents them from receiving the vaccine.

Despite this mandate, childhood polio immunization coverage is declining in some communities. In Rockland County, a suburb of New York City, vaccination rates for children under the age of 2 fell from 67% in 2020 to about 60% in 2022, according to the Centers for Disease Control and Prevention. In some parts of the county, only 37% of children in this age group had her polio vaccine.

According to the CDC, children should receive four doses of the vaccine.

Overall, polio vaccination coverage among 2-year-olds in New York State is approximately 79%, according to Department of Health data. According to a CDC study released in October 2021, nearly 93% of her children under the age of 2 in the United States have been vaccinated against polio.

But the incident of a young adult contracting polio in Rockland County this summer has set off alarm bells among public health officials. In Rockland County, Orange County, and New York City, he said, sewage samples collected since May have tested positive for polio, strongly indicating that the virus has been circulating in metropolitan communities for months. increase.

According to the CDC, the Rockland County adult case is only the second instance of the virus causing a local polio infection in the United States since 1979. Dr. Mary Bassett of the New York State Board of Health called the wastewater findings worrying, and the CDC warns the virus poses a continuing risk to unvaccinated people.

According to the CDC, every polio case represents a public health emergency.

“This is a wake-up call that we must solve this problem at the immunization level because we have never seen a child in an iron lung and do not want to see it.” NYU Langone Health Infectious Diseases.

Ratner said New York previously had a religious exemption from mandating vaccines in schools, which led to a decline in immunization. was deprecated in 2019. However, according to the CDC, his Covid pandemic outbreak in 2020 caused a drop in polio doses for him as schools closed and health care providers were disrupted.

“Because many schools were in remote areas, places were not enforcing vaccine mandates even when people started returning to doctors. We have a cohort of children,” Ratner said.

Ratner said the only way to prevent a recurrence of polio is “to get vaccinated. That’s the solution to this problem.”

The Rockland County Health Department launched a campaign to close the vaccination gap in late July, but the CDC says it hasn’t been administered in sufficient doses to significantly increase vaccination coverage in the county. said.

According to the CDC, two doses of the polio vaccine are at least 90% effective in preventing paralysis from the virus, and three doses are 99% to 100% effective.

What is polio?

The poliovirus, which can cause the disease called polio, was a devastating and highly contagious virus that terrified parents’ minds before a vaccine became available in the 1950s.1940s In the second half, more than 35,000 people on average were disabled by polio each year in the United States. There is no cure for polio.

The virus can infect a person’s spinal cord and cause permanent paralysis of the arms and legs. In some cases, polio can be fatal because it paralyzes the muscles necessary for breathing and swallowing. Most people who get the virus don’t develop symptoms, but they can spread the virus to other people and make them sick.

Viruses that live in the gut and throat spread through what doctors call the fecal-oral route. Young children are at particular risk from putting their hands, toys, or other objects in their mouths that have been contaminated with faeces. The virus can also be spread through droplets when people sneeze or cough, but this is less common, according to the CDC.

Successful immunization campaigns dramatically reduced the number of polio paralysis cases per year from over 15,000 in the early 1950s to less than 10 in the 1970s. He hasn’t had a single case of polio in the United States since 1979.

“We put in a lot of effort to get to where we are in the US, and it’s sad to see it go backwards,” said Ratner.

Globally, two of the three naturally occurring strains of poliovirus have been eradicated. According to the World Health Organization. However, travelers have occasionally brought the virus into the United States, and the strain currently circulating around New York City almost certainly originated abroad.

The strain that infected adults in Rockland County is related to the weakened form of the virus used in the oral polio vaccine. The US stopped using this vaccine more than 20 years ago. This means that someone who was vaccinated outside the country brought the virus to the United States. New York wastewater samples are genetically related to positive samples of Israeli and British sewage.

Oral vaccines use an attenuated virus that can replicate in the human body, and in rare cases the strain can revert to a type that attacks the nervous system. It can infect unvaccinated people and cause paralysis.

“That’s one of the reasons we don’t use the oral polio vaccine, because there’s always a risk of infection, especially for people with weakened immune systems or those who haven’t been vaccinated. ” York City. Oral vaccines are used in some countries because they are effective, inexpensive, easy to administer, and generally safe.

The United States uses polio vaccines that are administered as a series of shots that do not replicate, spread, or cause disease because the virus strain is inactivated.

According to the CDC, polio vaccines may protect people from the first round of vaccinations for years, but the exact duration of protection is unknown. An adult who was vaccinated as a child but is at high risk of contracting polio can get a booster her dose. Javaid said anyone with concerns, such as those with weak immune systems, should consult their doctor to see if they are in the risk category and get the vaccine again. .

But Javaid said there is no reason for the general public to panic. Most people are vaccinated and protected from polio. For those who don’t, the solution is simple — get vaccinated.

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