Sonoma County physicians draft public health message urging vaccination of children

The Centers for Disease Control and Prevention reported there has not been a U.S. measles outbreak this extensive since 1994.|

Each morning, Santa Rosa pediatrician Brian Prystowsky checks the number of measles cases in the U.S. as part of his daily routine. As of Friday, there were 764 confirmed instances, 60 more since the end of April.

As the number of children contracting measles grows nationwide and in California, so does Prystowsky’s fear that an outbreak soon will occur in Sonoma County. The west county, where there are two schools that last year were among the top 10 in the state with the highest rate ofthe most unvaccinated kindergarten students, is more vulnerable to an outbreak, he said.

“I think in the ’90s was the last time where there was this many kids with measles,” said the pediatrician who has worked for Sutter Pacific Medical Foundation since 2017.

The Centers for Disease Control and Prevention reported there has not been an outbreak this extensive since 1994, and that half of all reported cases so far in 2019 are children under age 5. “The count that the CDC is doing every few days is just so scary compared to all previous years,” he said.

The alarming risk to the local community prompted the pediatrician to help lead a group of over 200 medical professionals to take the unprecented step of launching a grassroots public health campaign to urge parents to have their children vaccinated and educate them on the ramifications of rejecting immunizations.

“We, the physicians and health care professionals of Sonoma County, agree that vaccines are not only safe and effective, but critical to protecting individuals and our community from serious life-threatening infectious diseases,” according to the public health statement written by Prystowsky on behalf of the group of mainly county physicians. “The best way to protect yourself, your loved ones and your community is to get vaccinated.”

Although county health department officials have been spreading the word about the importance of immunizing children, the doctors still felt compelled to play a key role in vaccination education, the pediatrician said.

To reach a broad audience and promote a sense of urgency, the group of medical professionals paid for a half-page advertisement in Sunday’s Press Democrat touting their public health message on vaccinations.

“We have to address this public health crisis locally and reach out to educate our patients more deliberately so they know the consequences of their decisions,” said Dr. Patricia May, the president of the Sonoma County Medical Association and one of the doctors who endorsed the public health message. She has worked as assistant chief of surgery at Kaiser Permanente in Santa Rosa since 2012 and has 22 years of surgical experience.

Although no cases of measles have been reported in Sonoma County, so far in 2019 California is experiencing a measles outbreak with 40 confirmed cases as of Saturday, according to the CDC. It is one of six states with ongoing outbreaks.

The physicians’ public health advocacy has spread across the North Bay, as well as in Sacramento, where a group of doctors from Sonoma County recently traveled to urge state leaders to pay more attention to concerns stemming from medical vaccination exemptions that have skyrocketed here, Prystowsky said.

The state’s first vaccination law, enacted in 2015 based on legislation introduced by Sen. Richard Pan, D-Sacramento, barred personal and religious belief exemptions. But this has led to a spike in what some doctors are calling fake medical exemptions.

“People found these doctors that are for hire, and you pay cash, and they write a medical exemption,” Prystowsky said. “It’s fringe medicine.”

To further close vaccination loopholes, Pan unveiled a bill in March aimed at giving the state health department the ability to verify medical exemptions. The new legislation also would require physicians to explain why they are giving an exemption, provide their license number and certify that they examined the patient for the exemption to be approved by the California Department of Public Health.

The bill passed the Senate Health Committee last month, despite pushback from parents and groups against vaccinations.

May said she knew there were high unvaccinated rates in pockets of the North Bay, but she was shocked to learn that four Sonoma County schools were among the top 10 schools statewide last year with students who had vaccine exemptions.

Before the introduction of the measles vaccine in the 1960s, an epidemic occurred every few years and caused an estimated 2.6 million deaths a year, according to a 2018 report by the World Health Organization.

“Why would we want to go back to those statistics?” May said. “Immunizations save lives.”

Wendy Young, executive director of the county medical association, said when her children were of vaccination age a pediatrician in Windsor advised her not to immunize them, an opinion she trusted without any doubts. Young later regretted that decision and got her children vaccinated, because she said they were put at unnecessary risk.

“The vaccine-wary parents will only get the information they are looking for and with the internet, we can find all the ammunition we want for or against vaccines,” Young said. “The county is just another resource that we hope the community will look to when doing their research, but the most pivotal voice will be the voice of the physician provider.”

While a public health warning of this magnitude is believed to be a first for local physicians, the serious threat of a preventable disease warranted their action, Prystowsky and other medical professionals said.

“I certainly worry about the community’s immunity being at risk when there are so many unvaccinated children in the area,” said Dr. Vanessa DeSousa, who has worked as a pediatrician in Santa Rosa for five years and also endorsed the public health statement supporting vaccinations. “My goal is to be a trusted source for parents in a community where there is a lot of misinformation out there.”

Prystowsky put it more bluntly explaining why area doctors were moved to become public health advocates.

“Rarely do we go out on a limb on our own preferring instead to rely on institutions and science,” the pediatrician said. “We are waiting around for the first kid to die or have a measles complication and that is a terrible way to approach medicine, just cleaning up.”

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