By Dr. Richard L. Bruno
The Centers for Disease Control has reported that 92% percent of US toddlers are vaccinated against polio. Ninety-two percent sounds good, until you realize that leaves more than one million US children unvaccinated. Between 2005 and 2006, polio vaccination dropped in 20 states and in 10 large cities. While any reductions in polio vaccination are troubling, the location of the cities and states where vaccination dropped is frightening. The cities are major points of entry into the US-New York, Philadelphia, Houston, and Seattle-where a nearly 4% drop was reported. It’s no surprise that toddlers living in poverty have the lowest polio vaccination rates-below 87% in Boston, Indianapolis, Memphis, Phoenix, Detroit, Houston, and Seattle-rates lower than in Vietnam.
Equally frightening, the states with drops in vaccination are on our borders with Mexico and Canada. Arizona, Texas, and New Mexico reported polio vaccination reductions as did 70% of the states that border Canada. Even Minnesota had a decrease, which is both frightening and incomprehensible, since five Minnesota children caught polio in 2005 after coming in contact with someone who imported the poliovirus across the US border.
Polio’s recent importation into America and the drops in vaccination have prompted the IPTF to create 2008 “The National Immunization for Polio Prevention in Infants and Toddlers”-or “NIPP IT”-Campaign.
“NIPP IT” aims to “nip in the bud” America’s next polio epidemic by asking each state’s department of health to declare April 19-26 (also National Immunization Week) “NIPP IT Week,” to prompt parents, health care professionals, and state health officials to ensure that all American children receive four doses of the injectable, inactivated polio vaccine. The NIPP IT Campaign was launched in partnership with “Every Child by Two” (ECBT.org), the organization co-founded by former First Lady Rosalynn Carter to promote immunization of all children by age two.
Said Mrs. Carter, “Our country has come so far to protect against polio through universal vaccination. We cannot afford to relax our efforts because polio is still a real problem in parts of the world and can easily be transported back to the US.”
To prove Mrs. Carter’s point, in 2007 an unvaccinated Pakistani college student flew to Australia, bringing with him the naturally occurring poliovirus and Australia’s first case of polio in 21 years. This shows that we must be concerned about poliovirus being fl own into the US, given the ease of air travel from Pakistan, Afghanistan, India, and Nigeria, where polio has never come under control, and from the 10 African and Asian nations that had been polio-free, but where the poliovirus has been reintroduced.
The children who had polio in Minnesota in 2005 and the Pakistani student in 2007 are canaries in the mine shaft. What will happen when a polio-infected traveler arrives in a potential polio pocket, like New York City where 34,000 infants and toddlers are not vaccinated? Please call, write, and e-mail your governor and ask that your state support the “NIPP IT” Campaign (visit www.postpolioinfo.com for more information). America’s next polio epidemic could be just a car or plane ride away.
Medical Access
Few experiences are more exciting then being in the stadium when your team clinches the World Series or scores the Stanley Cup-winning goal. Unfortunately, one goal wasn’t addressed by the Americans with Disabilities Act (ADA) and plagues us today: the lack of physical access to medical facilities for people with disabilities.
There was no provision in the ADA to make the inside of health care offices wheelchair accessible. Doorways are too narrow, exam rooms are too small, and examination and treatment tables are too high for a safe transfer. I have patients who have never had a gynecological exam because they can’t get onto a four foot high table without the danger and embarrassment of being lifted.
The International Post-Polio Task Force (IPTF) has proposed to state legislatures and to Congress the “Internal Access for Medical Care” Bill to plug the gap in the ADA. Ask your Congressperson, Senators and state legislators to require that all health care practitioners’ offices and facilities with imaging and radiotherapy equipment have one adjustable-height table or a height-adjustable, wheeled ambulance stretcher that will allow safe transfers from wheelchair height and access to equipment of a fixed height. Height-adjustable, wheeled ambulance litters only cost about $1,500.
Dr. Richard L. Bruno is Chairperson of the International Post-Polio Task Force and Director of The Post-Polio Institute at Englewood (NJ) Hospital and Medical Center. E-mail PostPolioInfo@aol.com.
Excellent column. Please keep this type of information in the forefront, on immunizations, as well as “Internal Access for Medical Care” bill – a recent flight through DFW in Dallas was a near disaster for a wheel-chair, vent user. There has to be an easier way to avoid such travel nightmare in this era of moon-shot technology.
Carol Thompson, founder (US Member)