Friday, August 29, 2014
Inquirer Daily News

The germinators

Victor Vaccine and other mascots are fighting for shots, public health, and the immunization way.

Inside Victor Vaccine, pumping up the importance of immunizations, is Kyle Schmeck, Montgomery County Health Department supervisor.
Inside Victor Vaccine, pumping up the importance of immunizations, is Kyle Schmeck, Montgomery County Health Department supervisor.
Video: 'Cover Your Bases - Get Immunized'

This mixed-and-matched superhero has boots like Captain America's, gloves that Batman might wear, and a blue outfit that resembles Superman's. His shield, though, is unique: It is made of felt, designed to repel (or hold) Velcro-wrapped "germ balls" tossed by kids.

Meet Victor Vaccine, Montgomery County's new immunization mascot and the latest weapon in the public health corps' battle to keep infectious diseases at bay. Measles, whooping cough, and other highly contagious illnesses, while largely invisible these days, are seeing sudden and sometimes deadly outbreaks - perfect fodder for a superhero.

"A lot of times it takes a disease like measles to hit our community" - Bucks County has had three cases in the last month, and Camden County one probable case - "to catch people's attention," said Janice L. Anastasi, the immunization coordinator in Bucks, which four years ago introduced its own mascot, Bee Diddy, to do just that.

The people with measles have recovered but there were reverberations. Eighteen unvaccinated Council Rock School District students were kept out of school and all related activities, including proms, for three weeks, to the surprise of some parents.

After a single case of measles was identified at Bryn Athyn College last summer, the health department forbade any outside contact for 21 days - classes, work, sports, religious services - for eight unvaccinated students. The same thing happened to 65 to 70 unvaccinated people in Perry County, Pa., in January; the state health department checked compliance with daily phone calls and surprise visits, and was prepared to go to court if necessary to enforce the quarantine, said Stephen Ostroff, the acting physician-general.

Ninety percent of unvaccinated people get infected by measles when exposed, so health workers expend considerable time and money - $142,452 per case, according to one federal study - to track and stop transmission.

When a parent chooses to skip a vaccine, "it is a decision for their child but it is also a decision for their community, because children with cancer cannot get vaccinated," said Jane Seward, deputy director of viral diseases at the National Center for Immunization and Respiratory Diseases.

Babies can't, either.

Colman McCallen was less than six weeks old when he developed a persistent cough last October that neither his pediatricians nor ER doctors suspected was serious until he started coughing himself blue on Halloween.

Driving to Children's Hospital of Philadelphia from their home in Springfield, Delaware County, "I was just panicked, crying the whole way, every time he coughed I was, like, 'Is he going to make it through this time?' " said his mother, Melanie. He was hospitalized nearly two weeks for whooping cough, also known as pertussis, and milder coughing continued for four more months.

Pertussis is at high levels nationally. Pennsylvania reported 979 cases last year, a recent record, and three deaths, all infants. New Jersey had 169 cases.

No vaccine is 100 percent effective. Immunity is conferred partly by the "herd." When enough people are vaccinated, the viruses or bacteria have so few options to infect that they essentially stop circulating within a population and are brought in only from outside.

That is the case in the United States for measles, which killed 450 to 500 people a year and hospitalized nearly 50,000 before a vaccine was introduced in 1963 and strengthened with a second dose in 1989. MMR (measles-mumps-rubella) vaccination rates now top 90 percent, and the last death was in 2003.

Rates were even higher in the United Kingdom before The Lancet in 1998 published a small study that questioned MMR, and its author, Andrew Wakefield, suggested that the vaccine might help explain the mysterious and continuing rise in autism diagnoses.

Numerous studies have failed to replicate the finding, which was widely discredited, and this year Wakefield was accused of outright fraud. Meanwhile, vaccination rates in the U.K. plummeted to 80 percent (they have partly rebounded).

Measles eventually returned with a vengeance and is now spread within the U.K. from person to person year-round. More than 6,500 cases have been reported throughout Europe so far this year. The World Health Organization this month urged travelers to and from the Americas to ensure that they are vaccinated.

The United States typically records about 50 to 60 cases annually but has seen sharp increases the last few years - 118 were reported during the first 19 weeks of 2011, the federal government said last week, the highest number for the period since 1996 - and nearly all were imported. The three Bucks County cases were traced to French foreign exchange students; the suspected Camden County case was linked to an infected woman who traveled here from Italy.

If American vaccination rates drop below their current near-record highs, health officials say, the outbreaks could spread. Some worry that a slight decline in the latest national survey, for 2009, will turn out to be more than a statistical quirk.

More and more parents are claiming religious exemptions to vaccinations required by law for school entry. They rose eightfold in two decades, to just under 1 percent in 2009-10, in New Jersey, which does not allow exceptions simply for moral beliefs. Pennsylvania law is looser.

And a national study found a sharp jump over five years in the number of parents who refused or delayed some doses, to 39 percent in 2008.

"It is totally rational," said Michael Yudell, who studies health-risk communication at Drexel University School of Public Health. "Folks are not seeing measles and mumps and rubella," he said, so the small risks from vaccines appear to outweigh risks posed by the diseases themselves.

On the Internet, personal stories about perceived problems with vaccines are far more compelling and easier to find than scientific evidence of their safety. Even physicians sometimes struggle to explain the dangers of diseases they may have never seen themselves.

Enter Victor Vaccine and his fellow germ-fighting mascots.

In 2009, two years after Bee Diddy started showing up at health fairs and ball games around Bucks County, a slightly more bookish bee named Izzy was hatched by York and Adams Counties. There are several other bees and bears around the country, and a Sir Ringe in British Columbia. But Susan Wenrick had something else in mind.

"We wanted to stay away from a needle. And we didn't want the bee because of the sting," said Wenrick, who chairs the Montgomery County Immunization Coalition and formally introduced Victor Vaccine at a recent dinner.

Victor's alter ego is Kyle Schmeck, a health department supervisor whose past includes stints as a Mummer, Sparky the Fire Dog, and finalist for Nittany Lion.

"I like kind of clowning around a little bit and having fun, and I can entertain people and get them involved," he said, which is exactly what his handlers have in mind.

Vaccines scare kids. "If you have a friendly-looking mascot," said Joanne Sullivan, who cochairs the York/Adams County Immunization Coalition, "it kind of takes some of the fear away." And while Izzy the bee "is shaking hands with little kids and checking out babies in strollers, it gives us an opportunity to talk with the parents."

Victor Vaccine may visit schools. He will have coloring sheets. If all goes according to plan, he might cavort with Bee Diddy and the Phillie Phanatic on Aug. 17 as "Cover Your Bases," a two-minute video by the regional immunization coalition, plays on the giant screen at Citizens Bank Park.

The bottom line on mascots, said Paul A. Offit, chief of infectious diseases at Children's Hospital and author of several books about vaccines: "I just think it makes it fun."

 


Contact staff writer Don Sapatkin at 215-854-2617 or dsapatkin@phillynews.com.

Don Sapatkin Inquirer Staff Writer
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