My Blog
June 06, 2019
Category: Uncategorized
Tags: Untagged

Today I listened to a one hour Georgia Chapter of the American Academy of Pediatrics about imminent guidelines for proof of receipt of immunization against Meningococcal Meningitis vaccine at age 16 hears on entry to the 11th grade in high school. Parents should expect to hear or have heard about this updated requirement. The school system has about 14 months to effect procedure to make this a reality by August of 2020.  

At the end of the medical presentation, Jamie Shanbaum, shared her personal story of Meningococcal illness when she was 20 years old in college in Texas. All parents should hear her experience in her own words. I hope to attach an MP3 file of her talk in the near future. Meanwhile her is her story on her web page,

The Meningococcal ACWY vaccine is offered at age 11 years and needs a booster at age 16 for protection against this rapidly invasive bacteria with serious debilitating or fatal consequences from illness that can occur in highschool and college. 

CDC Vaccine Information Sheets:

May 31, 2019
Category: Immunizations
Tags: immunizations   Vaccines   Facts   History   Timeline  

Here's a look at information and statistics concerning vaccines in the United States.


There are 14 different vaccines that are recommended for childrenbetween birth and age six, including those for diphtheria, pertussis, tetanus, influenza, measles, mumps and rubella.

For more than 100 years, there has been public discord regarding vaccines based on issues like individual rights, religious freedoms, distrust of government and the effects that vaccines may have on the health of children.

Exemptions to vaccines fall into three general categories: medical, religious and philosophical.

Median immunization coverage for state-required vaccines was approximately 94.3% for children entering kindergarten during the 2017-2018 school year, according to the Centers for Disease Control and Prevention (CDC).

As of May 2019, 47 states and the District of Columbia allow religious exemptions from vaccines, and 16 states allow philosophical (non-spiritual) exemptions.


1855 - Massachusetts mandates that school children are to be vaccinated (only the smallpox vaccine is available at the time).

February 20, 1905 - In Jacobson v. Massachusetts, the US Supreme Court upholds the State's right to compel immunizing against smallpox.

November 13, 1922 - The US Supreme Court denies any constitutional violation in Zucht v. King in which Rosalyn Zucht believes that requiring vaccines violates her right to liberty without due process. The High Court opines that city ordinances that require vaccinations for children to attend school are a "discretion required for the protection of the public health."

1952 -Dr. Jonas Salk and his team develop a vaccine for polio. A nationwide trial leads to the vaccine being declared in 1955 to be safe and effective.

1963 - The first measles vaccine is released.

1983 - schedule for active immunizations is recommended by the CDC.

March 19, 1992 - Rolling Stone publishes an article by Tom Curtis, "The Origin of AIDS," which presents a theory that ties HIV/AIDS to polio vaccines. Curtis writes that in the late 1950s, during a vaccination campaign in Africa, at least 325,000 people were immunized with a contaminated polio vaccine. The article alleges that the vaccine may have been contaminated with a monkey virus and is the cause of the human immunodeficiency virus, later known as HIV/AIDS.

August 10, 1993 - Congress passes the Omnibus Budget Reconciliation Act which creates the Vaccines for Children Program, providing qualified children free vaccines.

December 9, 1993 - Rolling Stone publishes an update to the Curtis article, clarifying that his theory was not fact, and Rolling Stone did not mean to suggest there was any scientific proof to support it, and the magazine regrets any damage caused by the article.

1998 - British researcher Andrew Wakefield and 12 other authors publish a paper stating they had evidence that linked the vaccination for Measles, Mumps and Rubella (MMR) to autism. They claim they discovered the measles virus in the digestive systems of autistic children who were given the measles, mumps and rubella (MMR) vaccine. The publication leads to a widespread increase in the number of parents choosing not to vaccinate their children for fear of its link to autism.

2000 - The CDC declares the United States has achieved measles elimination, defined as "the absence of continuous disease transmission for 12 months or more in a specific geographic area."

2004 - Co-authors of the Wakefield study begin removing their names from the article when they discover Wakefield had been paid by lawyers representing parents who planned to sue vaccine manufacturers.

May 14, 2004 - The Institute of Medicine releases a report "rejecting a causal relationship between the MMR vaccine and autism."

February 2010 - The Lancet, the British medical journal that published Wakefield's study, officially retracts the article. Britain also revokes Wakefield's medical license.

2011 - Investigative reporter Brian Deer writes a series of articles in the BMJ exposing Wakefield's fraud. The articles state that he used distorted data and falsified medical histories of children that may have led to an unfounded relationship between vaccines and the development of autism.

2011 - The US Public Health Service finds that 63% of parents who refuse and delay vaccines do so for fear their children could have serious side effects.

2014 - The CDC reports the highest number of cases at 667 since declaring measles eliminated in 2000.

June 17, 2014 - After analyzing 10 studies, all of which looked at whether there was a link between vaccines and autism and involved a total of over one million children, the University of Sydney publishes a report saying there is no correlation between vaccinations and the development of autism.

December 2014 - A measles outbreak occurs at Disneyland in California.

2015 - In the wake of the theme park outbreak, 189 cases of measles are reported in 24 states and Washington, DC.

February 2015 - Advocacy group Autism Speaks releases a statement, "Over the last two decades, extensive research has asked whether there is any link between childhood vaccinations and autism. The results of this research are clear: Vaccines do not cause autism. We urge that all children be fully vaccinated."

May 28, 2015 - Vermont Gov. Peter Shumlin signs a bill removing the philosophical exemption from the state's vaccination law. Parents may still request exemptions for medical or religious reasons. The law goes into effect on July 1, 2016.

June 30, 2015 - California Gov. Jerry Brown signs legislation closing the "vaccine exemption loophole," by eliminating any personal or religious exemptions for immunizing children who attend school. The law takes effect on July 1, 2016.

January 10, 2017 - Notable vaccine skeptic Robert F. Kennedy Jr. meets with President-elect Donald Trump. Afterwards, Kennedy tells reporters he agreed to chair a commission on "vaccination safety and scientific integrity." A Trump spokeswoman later says that no decision has been made about setting up a commission on autism.

August 23, 2018 -A study published in the American Journal of Public Health finds that Twitter accounts run by automated bots and Russian trolls masqueraded as legitimate users engaging in online vaccine debates. The bots and trolls posted a variety of anti-, pro- and neutral tweets and directly confronted vaccine skeptics, which "legitimize" the vaccine debate, according to the researchers.

October 11, 2018 - Two reports published by the CDC find that vaccine exemption rates and the percentage of unvaccinated children are on the rise.

2019 - As of May 24, the CDC has reported 940 individual cases of measles confirmed in 26 states.

January 2019 - The World Health Organization names vaccine hesitancy as one of 10 threats to global health in 2019.

March 26, 2019 - Rockland County, New York announces the "extremely unusual" step of banning unvaccinated individuals under age 18 from public places. One week later, a judge puts a hold on that and prohibits the county from enforcing the ban.

May 10, 2019 - Washington Gov. Jay Inslee signs legislation removing the philosophical exemption for the MMR vaccine from the state's school immunization requirements.

May 24, 2019 - Maine Gov. Janet Mills signs a bill into law removing all non-medical exemptions to vaccinations. The law will take effect in September 2021, and schoolchildren who claim a non-medical exemption prior to the law taking effect will be allowed to attend school if their parent or guardian provides a written statement from a healthcare professional indicating they've been informed of the risks of refusing immunization.

May 26, 2019
Category: Healthy Kids
Tags: Vaccines   Books   family   sleep   Meals   Play   Thankfulness   friends   kindness  
Focus on 10 Things to Be Thankful For

November 2018 | Issue No. 175

I encourage all families to subscribe to this excellent website.    Dr. T

#1. Vaccines
Vaccines are one of medicine's greatest discoveries, saving an estimated 42,000 lives in the U.S. each year. We are fortunate to live in a country that makes vaccinations available. Here are 14 diseases you almost forgot about THANKS TO VACCINES! 
Also on our list:
#2. Kindness. Now more than ever, it's important to recognize kindness. Model it; children learn by watching. Be thankful when others show you that same respect.
#3. Our Village"It takes a village to raise a child." Hooray for grandparents, neighbors, teachers, friends, and others who touch your life directly or indirectly.
#4. Time to Play! Put down your smartphone. Play with your children. Be thankful for this magical age where fun and games help children thrive. 
#5. Our Differences. We live in a melting pot. Teach your children to honor those differences and celebrate the ways that make our country unique and awesome! 
#6. Our Children's Friends. They come into their lives for reason. Be grateful for the lessons each relationship brings, espeically about helping them feel secure outside the family. 
#7. Books. A really great book has the power to teach and inspire us, and that is a gift. Instill a love of books from a young age, and read with your child.
#8. Sleep. A good night's rest for everyone in the family is often what many parents are thankful for; we understand!   
#9. Family Meals. Eating at least three family meals together each week is associated with healthier kids. Give thanks each time you are able to sit down, talk, and eat together; not just on Thanksgiving.  
#10. Healthy Children. Here's a no brainer, right? By visiting, you know a reliable and trusted source when you see one. You've got this, and we appreciate your support!   



May 26, 2019
Category: Safety
Tags: Boating   Water Safety   Swimming   Pools   Life Jackets   Coast Guard  

Drowning is the leading injury-related cause of death for children age 1–4. It doesn’t only happen when you are by the pool or at the beach; drowning can happen anywhere, even in one inch of standing water. Among children under age 4, 70% of drownings happen during non-swim times. It is quick and it is silent, but it is preventable.

Memorial Day has come & gone, but summer is upon us and more families will be active around water. Join the American Academy of Pediatrics and be an advocate for Drowning Prevention. We all can reduce drowning and save children’s lives by working together to implement safety measures we know will protect children. 

Drowning can happen to any family. It’s quick, and it’s silent. Drowning is the No. 1 cause of death among children aged 1-4, and is a leading cause of death among teens. We can lower these rates if pediatricians, parents and policy-makers work together to implement the types of solutions we know will keep children safe. Please share these resources with parents and caregivers. 

An Important Message on Drowning from Grieving Parents:

Dear Doctors and Families, 
We write this from a place of grief, a sense of urgency, and a hope that no other family experiences what we have this summer. On June 10, 2018, we each lost a child to drowning during a non-swim time: Emmy Miller (19 months) and Levi Hughes (3). In the midst of our grief, we are honored to be partnering with the American Academy of Pediatrics on a National Drowning Prevention Awareness Project. We respect our own pediatricians tremendously and hope this message conveys to you that high level of respect as we ask for your partnership with us on this endeavor. 
Drowning is the #1 cause of preventable death between the ages 1-4 and the #2 cause in ages 5-14. Raising awareness of physicians, parents, and communities about this underrecognized killer is a shared responsibility that we must embrace. As health care providers, you are perfectly positioned to educate families about the importance of water safety and drowning prevention. We realize that well-child visits are busy, and there is much you must cover. However, you remain a deeply trusted source of information for parents.  We hope our stories can help spur you to action and prevent future tragedies.  
Over the last two months, we have been stunned to learn how often drownings occur during times when children are not swimming but slip away and drown in pools, ponds, streams, lakes, bathtubs, and even toilets. If you and your colleagues already share information on water safety, including drowning during non-swim times, we THANK YOU. If our stories inspire you to think about how you currently address water safety, we are grateful for your honest reflection.

We will be working with the AAP to develop resources to help you promote awareness using evidence-based approaches at multiple levels, from individual interactions to community and policy interventions. Pediatricians are, by nature, child advocates. If we can help elevate the prevention of drowning, it could save many lives. We believe in the power of the medical community, which is why we are reaching out to you. 
Developing quality materials will take time, but we want to provide an action step that can be taken now, so we don’t lose valuable time in spreading awareness. We have developed a PDF flyer that we hope you will print out and hang in your clinics or include in your educational materials for families. Increasing parental awareness of the dangers of water can also lead to discussions of a “water safety plan” for all families. The development of these plans can be immediately implemented into well-child visits, without the need for any materials. 
If you would like to know more about the stories of Emmy and Levi, here are the links to the TODAY Show interviews: 

We are incredibly grateful for your time and attention to this urgent matter. 
With much respect,

The Hughes Family and the Miller Family 


Swim Lessons: When to Start & What Parents Should Know


Infant Water Safety: Protect Your New Baby from Drowning


Drowning Prevention for Curious Toddlers: What Parents Need to Know


Beach, Boating, and Lake Swimming Safety Tips


Pool and Swimming Safety Tips


Parents and Caregivers: What You Should Know

  1. Parents and caregivers should never (even for a moment) leave young children alone or in the care of another child while in or near bathtubs, pools, spas, or wading pools and when near irrigation ditches, ponds, or other open standing water.

  2. Parents and caregivers must be aware of drowning risks associated with hazards in the home.

    • Infant bath seats can tip over, and children can slip out of them and drown in even a few inches of water in the bathtub. Infants should always be with an adult when sitting in a bath seat in a bathtub.

    • Water should be emptied from containers, such as pails and buckets, immediately after use.

    • To prevent drowning in toilets, young children should not be left alone in the bathroom, and toilet locks may be helpful.

    • Parents and caregivers should prevent unsupervised access to the bathroom, swimming pool, or open water.

  3. Whenever infants and toddlers (or noncompetent swimmers) are in or around water, a supervising adult with swim skills should be within an arm’s length, providing constant touch supervision. Even with older children and better swimmers, the eyes and attention of the supervising adult should still be constantly focused on the child. This “water watcher” should not be engaged in other distracting activities that can compromise this attention, including using the telephone (eg, texting), socializing, tending chores, or drinking alcohol, and there needs to be a clear handoff of responsibility from one water watcher to the next. Supervision must be close, constant, and attentive. In case of an emergency, the supervising adult must be able to recognize a child in distress, safely perform a rescue, initiate CPR, and call for help. Parents need to recognize that lifeguards are only 1 layer of protection, and children in and near the water require constant caregiver supervision, even if a lifeguard is present.

  4. To prevent unintended access, families should install a 4-ft, 4-sided isolation fence that separates the pool from the house and the rest of the yard with a self-closing, self-latching gate. Detailed guidelines for safety barriers for home pools are available online from the CPSC. Families of children with Autistic Spectrum Disorder or other disabilities who are at risk for wandering off should identify local hazards and work with the community on pool fencing and mitigation of hazards.

  5. Although data are lacking, families may consider supplemental pool alarms and weight-bearing pool covers as additional layers of protection; however, neither alarms nor pool covers are a substitute for adequate fencing and adult supervision. Importantly, some types of pool covers, such as thin plastic solar covers, should not be used as a means of protection because they might increase risk of drowning.

  6. Parents, caregivers, and pool owners should learn CPR and keep a telephone and rescue equipment approved by the US Coast Guard (eg, life buoys, life jackets, and a reach tool such as a shepherd’s crook) poolside. Older children and adolescents should learn CPR. See See American Red Cross.

  7. Children and parents should learn to swim and learn water-safety skills. Because children develop at different rates, not all children will be ready to learn to swim at exactly the same age. There is evidence that swim lessons may reduce the risk of drowning, including for those 1 to 4 years of age. A parent’s decision about starting swim lessons or water-survival skills training at an early age must be individualized on the basis of the child’s frequency of exposure to water, emotional maturity, physical and cognitive limitations, and health concerns related to swimming pools. Parents should be reminded that swim lessons will not drown proof a child of any age. It is critical that swim instructors stress this message as well as the need for constant supervision around water. Swim ability must be considered as only 1 part of water competence and a multilayered protection plan that involves effective pool barriers; close, constant, and attentive supervision; life jacket use; training in CPR and the use of an automated external defibrillator; and lifeguards. Children need to be taught never to swim alone and never to swim without adult supervision.

  8. Parents should monitor their child’s progress during swim lessons and continue their lessons at least until basic water competence is achieved. Basic swim skills include ability to enter the water, surface, turn around, propel oneself for at least 25 yards, float on or tread water, and exit the water.

  9. Any time a young child visits a home or business where access to water exists (eg, pool, hot tub, open water), parents and/or guardians should carefully assess the premises to ensure that basic barriers are in place, such as sliding door locks and pool fences with closed gates in good working order, and ensure that supervision will be consistent with the preceding recommendations.

  10. All children and adolescents should be required to wear US Coast Guard–approved life jackets whenever they are in or on watercraft, and all adults should wear life jackets when boating to model safe behavior and to facilitate their ability to help their child in case of emergency. Small children and nonswimmers should wear life jackets when they are near water and when swimming. Parents and caregivers should ensure that any life jacket is approved by the US Coast Guard because many do not meet safety requirements. Information about fitting and choosing US Coast Guard–approved life jackets is available at the US Coast Guard Web site. Parents should not use air-filled swimming aids (such as inflatable arm bands, neck rings, or “floaties”) in place of life jackets. These aids can deflate and are not designed to keep swimmers safe.

  11. Jumping or diving into water can result in devastating spinal injury. Parents and children should know the depth of the water and the location of underwater hazards before jumping or diving or permitting children to jump or dive. The first entry into any body of water should be feet first.

  12. When selecting an open body of water in which their children will swim, parents should select sites with lifeguards and designated areas for swimming. Even for the strongest of swimmers, it is important to consider weather, tides, waves, and water currents in selecting a safe location for recreational swimming. Swimmers should know what to do in case of rip currents: swim where there is a lifeguard, and if caught in a rip current, remain calm and either swim out of the rip current parallel to the shore (do not try to swim against the current) or tread water until safely out of the current and able to return to shore or signal for help.

  13. Parents and children should recognize drowning risks in cold seasons. Children should refrain from walking, skating, or riding on weak or thawing ice on any body of water.

May 26, 2019
Category: Infectious Disease
Tags: immunizations   measles   update   2019   Vaccinations   Public Health  

Measles – 2019 Outbreaks


Total Number Of Measles Cases In US Climbs To 25-Year High Of 971, CDC Reports

The Washington Post (5/30) reports there have been 971 cases of measles in the US so far this year, “the greatest number since 1994, when 963 cases were reported for the entire year,” according to the Centers for Disease Control and Prevention (CDC). The agency announced the new total on Thursday, rather than waiting for Monday when it typically updates the count, “because it had reached this new milestone.”


The New York Times (5/30) reports CDC Director Robert Redfield said, “Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated.” Redfield added, “Again, I want to reassure parents that vaccines are safe, they do not cause autism. The greater danger is the disease that vaccination prevents.” The Times adds that the “measles was eliminated as an endemic disease in the United States in 2000,” but if the current outbreak continues then the US could lose that status, “meaning the disease would be considered endemic in the country for the first time in a generation.”


Updated 5/22/2019 

Pediatricians are monitoring multiple outbreaks of measles across several U.S. states.


  • Current outbreak locations:
  • Number of infections: 880 cases in 24 states (from 1/1/19 through 5/17/19)
  • Pediatric population affected: All pediatric populations at risk. Patients 19 years or younger have accounted for 77% of the cases so far; 48% have been younger than 5 years old.
  • The main outbreaks have been associated with travelers who brought measles back from Israel, Ukraine, and the Philippines.
  • Cases have been reported in Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Pennsylvania, Oklahoma, Oregon, Texas, Tennessee, and Washington.


  • Infants and children aged less than 5 years, adults aged more than 20 years, pregnant women, and people with compromised immune systems, such as from cancer, chemotherapy, or HIV infection, are at high risk for severe illness and complications from measles.
  • Measles can cause serious illness requiring hospitalization, even in previously healthy children.
  • Consider measles in patients with fever and rash and ask about recent international travel, exposure to international travelers, or exposure to people with measles
  • During an outbreak, MMR vaccine should be offered to all people exposed or in the outbreak setting who lack evidence of measles immunity. During a community-wide outbreak that affects infants, MMR vaccine has been shown to be effective in preventing symptoms after exposure and may be recommended for infants 6 through 11 months of age.
  • Involvement of state and local health departments is often advisable for any diagnosis of measles, as there may be specific ways these departments wish to receive specimens and manage patients.

Actions as recommended by the American Academy of Pediatrics and the U.S. Public Health Service


10 Things You Should Know about Measles:

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