(light upbeat music) - Welcome back to family health matters.

I'm Shelley Irwin, with me today is Mary Zimmerman, immunization specialist, RN at Spectrum Health, good that you're here Mary, and Alison Clark, communication specialist with the Ottawa County Department of Health.

So we get the best in studio, there we are.

All right, to expand on your occupation, on your daily doings, Mary, tell me more about how you spend your day.

- Yeah, I would say the two biggest bulks of my work are working at increasing immunization rates throughout Spectrum Health throughout the system, which also protects our community.

And then also just education, you know, keeping everyone up to date on CDC recommendations.

I also am under our pharmacy and med safety team.

And so looking at errors that are happening, finding out ways to mitigate those errors, doing the whole med use cycle.

So procurement, storage and handling, administering, monitoring patients.

I tell people anything immunizations, think of me.

- Good, we got that term down.

Tell us a little bit about you Alison.

- I'm a communications specialist at the Department of Public Health in Ottawa County and I'm responsible to communicate about all the wonderful programs that we provide to the community, immunizations, taking care of moms and babies, food safety.

We do a lot of different things.

So I communicate about all of those things.

- No doubt, both of you have been very busy these last couple of years, that's for sure.

Mary, I wanna start with you and do some general 101.

I mean, we're introducing you as an immunizations expert, but we're here to talk about vaccines.

Tell me what a vaccine is and how that relates with immunization.

- Yeah, so a vaccine is actually just used to stimulate your immune system to create antibodies against certain bacteria or viruses.

So this allows your body to build up immunity without having to go through the disease.

- Yes, and then in immunization, how is that defined?

- Yeah, most people use immunization and vaccination interchangeably.

- Yes.

And give us a history lesson, if you would.

Polio, supposedly, is not around because of the vaccine?

- Correct.

- Yes.

- Correct.

So back in the 1950s they had between 20,000 and 30,000 paralytic polio cases per year in the United States.

Back then you would see polio wards full of people in iron lungs, which were breathing machines back then.

And when the polio vaccine first came out, that oral polio vaccine had more additives and antigens, than all of our childhood vaccines today and you had people lined up around the block to get that vaccine because they were so scared of the disease.

Polio was eradicated in the United States in 1979 from vaccinations.

- Yes, Alison, how would you describe your county's public health system and this topic of vaccine immunizations?

- Well, as Mary noted, many of us don't remember the harm that was caused by vaccine-preventable diseases because past campaigns were so successful.

So at the Department of Public Health, our role is to protect the health of the population or the whole community, and so vaccination is really a key tool for us to try to keep vaccine-preventable diseases and outbreaks under control so that the community is not harmed by the effects of those.

- Yes, Mary and Allison, what are a couple of misconceptions about vaccines?

I'll start with you, Mary.

- Yeah, I think kind of going along with our same theme here, I think one of the biggest misconceptions is we don't need them.

I think a lot of parents these days, these young parents have never seen any of these diseases.

So they think, well, you know, why do I have to poke my baby with these vaccines?

I don't even know what this disease is.

We don't see it anymore.

So I think that's the biggest one.

There's some misconceptions about vaccines give me the disease.

Because you can run a fever for 24 or 48 hours after a vaccination, a lot of people think the flu shot gives them the flu, which is it doesn't, it gives them an immune response.

That's their body building up that immunity.

So those are probably the two biggest misconceptions, I think.

Can you think of any?

- Add on that, yeah?

- And I think safety, obviously, people should be concerned about the safety of vaccinations.

But there is a lot of misinformation about whether vaccines are safe and so that's something that we try to educate the community about.

- Yes, 'cause you're Department of Public Health, do you work with other medical facilities or do I come to you for my vaccine?

- We do offer vaccines for people who are uninsured or underinsured on a sliding fee scale.

But we also, and so for things like COVID, we've obviously been working hard to get that vaccine and those boosters out into the community.

On a typical day, we would ask people to go to their healthcare provider if they have a medical home, and if not, then they can come to us.

- Yes, we'll get to COVID in a second.

Mary, what vaccines are required at birth?

Obviously, I'm gonna kind of go up the scale here.

- Okay, yeah.

So the very first vaccine we give at birth is your hepatitis B vaccine.

They usually give that in the first 24 hours of life.

The reason for that is most infants that were found to have hepatitis B from their moms at birth were having the chronic type hepatitis B.

So they were having liver failures, liver cancers, needing transplants or dying.

And so that's why we're giving that in that first 24 hours.

But after that, they need their diptheria, their tetanus, they're pertussis.

They get polio, they get pneumococcal vaccination, and they get rotavirus.

Those are what the infants get.

Rotavirus is a severe diarrhea.

And when they get to be a year, now they have live vaccines.

So then they have their MMR, their varicella.

- Let me stop you there, live vaccine, give me- - Live vaccine.

- Yeah, give me your answer.

- Most of the vaccines that you're going to get are inactivated vaccines.

So they take a that virus or bacteria and kill it through a heating process or a chemical process.

There are a couple live vaccines that you can get, rotavirus is a live vaccine.

MMR is a live vaccine, and varicella is a live vaccine.

So when you get a live vaccine, what they do is they actually take a piece of that virus and they weaken it.

So when I get a live vaccine, it multiplies in my system for about seven to 10 days before my immune system kicks in.

So it's a little bit different because that virus does multiply in your system.

But it's weakened, so it can't cause disease.

- Yes, move into an elementary school child.

- Moving into elementary, going into kindergarten, they're going to get their DTaP, their polio, and then that second dose of MMR and varicella.

Then they're complete with those for life.

- Yes, and in general, are those required?

- Those are required for school, yes.

- Thank you for that.

Does this sound familiar to you?

- It does, yes.

We help families get those required vaccinations that they need before preschool or kindergarten.

And then again, in seventh grade, they can come to us for that if they don't have a medical provider.

- Yes, I'm gonna just ask a layman's term.

What about chickenpox?

What did I get for chickenpox.

- That's the varicella vaccine.

- Okay, that's the varicella.

- Great question.

- And the you said polio was more of a child polio?

- They get as infant.

So they get it at two months, four months, six months.

And then they get a dose at four years.

- Nice, move into adults.

Here's the blunt question.

What vaccines are required.

- Required for adults?

- Yes.

- Nothing.

- Elephant out of the room, for sure.

- Recommended for adults, a lot.

- Yes, yes, and that's two different conversations to have.

- Correct, correct.

- And obvious obviously, we're here with you, the experts.

So let's take apart some of the terminology and let's start with the flu shot.

What is it and who should get it?

Do you want me to start with Mary?

- Sure.

- Yes.

- [Alison] You can maybe talk about what it is.

- Flu 101 is everyone six months of age and older should be vaccinated annually.

The flu vaccine, we are right now in September, they're already making next season's flu vaccine.

They're already determining what's going to go into the flu vaccine next year.

So each year there are four strains of influenza that are covered in the vaccine.

And what we do is we determine, we look at what's circulating in the southern hemisphere, and that is what we use for our vaccines coming into the fall.

So we kind of determine how that flu season's gonna look by what's happening in the southern hemisphere.

And as of this year, it looks like we could be in for a heavy flu season.

- Who should be getting of the flu shot?

You're gonna tell me everyone, but are we also gonna niche the elderly?

Are we going to special recommendations?

- I'm not gonna special recommend anyone.

Everyone should get it.

If you are 65 and older, you should either get a high dose flu or an adjuvanted flu, gives the immune system a little bit better boost for those 65 and older, but everyone should be getting it annually.

- Yes, do I come to Ottawa County and ask for my flu shot?

- We usually again, ask for people to go to their provider or to a local pharmacy for their flu shot, unless they are, you know, underinsured or uninsured.

And you know, just thinking about what Mary said earlier about how people don't necessarily always think that they need the vaccine, you know, for many people, flu is not a serious illness, but it can have serious complications, especially for young children.

She mentioned people over the age of 65, people with chronic conditions.

So it really is something to think about and talk to your healthcare provider to see if it's right for you.

- There is an average of 140 pediatric deaths per year from influenza in the United States.

So there are children that die of the flu every year.

- Yes, can we ask if there are side effects of say a flu shot?

- So just like any other vaccine, right, you're building up an immune response.

If you're exposed to a virus, you're running a fever because you're building up that immune response.

If you get a vaccine, you can run a fever because you're building up that immune response.

So you can get some redness, tenderness, or swelling at the site of any injection.

We tell people the more you move your arms or legs around that day, the better.

Can run a fever over 24, 48 hours, just use Tylenol or Motrin for comfort with that.

- Alison, let me have you follow up, this is somewhat in summary.

Vaccinations may not protect from getting an infection, but can protect from severe illness or worse.

That's exactly what- - So some experts have kind of likened getting a vaccine to wearing a seatbelt when you're driving your car.

And a seatbelt might not protect you from getting in an accident.

But if you do get in an accident, you're probably gonna be less severely injured.

Vaccination is like that.

So it's not necessarily going to protect you from all illness, but it will most likely protect you from serious complications from hospitalization, worse, death.

And we really like to ask people to consider not just the risk of getting a vaccination, but the risk of vaccination versus the risk of illness.

There is a risk with all these illnesses that we're talking about, and some of them can be quite severe, especially for kids.

And so we want people to think about it in those terms, not just what might happen to me if I get the vaccine, but what might happen to me if I get the actual infection.

- Mary, follow up?

- Agree a hundred percent.

So when I graduated from nursing school, I worked in the pediatric intensive care unit for 10 years and I saw children with all of these vaccine-preventable diseases and just some heartbreaking stories that could have been prevented.

- Yes.

Take me through a personal story.

And this just came to me.

At age eight, I was stung by a bee and went into a reaction, started itching, swelling.

Obviously I was taken to the emergency room, I survived.

But I did have to take shots for the next three to five years.

What was happening?

What were they doing to me?

- So they were building up antibodies to that so that you weren't going to react.

So, with your allergy shots, that's what it does.

They give you a tiny bit, a little bit more, a little bit more so your body becomes immune to that.

- Yes, so that was an allergy issue versus a virus?

- That was an allergy issue, yes.

- Yes, I think we made it through that.

All right, let's talk about COVID.

First of all, what kind of mode did you, as immunizations expert, what kind of mode did you go into right away?

- We went into a crazy mode, right?

- Yes we did.

- Right away with COVID when everything kind of started shutting down, we closed down some of our primary care offices, kind of consolidated those offices, planning on maybe needing to use that staff to go work COVID clinics.

But I was involved in setting up the DeVos Place Clinic where thousands and thousands and thousands of people were vaccinated.

Just making sure that vaccine was there, that it was stored appropriately, that we were giving viable vaccine.

So, it was a crazy probably year and a half just getting to have most people vaccinated.

- [Shelley] Yes, what was it like with your Department of Public Health?

- Similar.

I wasn't at the Department of Public Health for the entire pandemic, I've only been there for about a year, so not in the real height of the response.

But also most of our staff was deployed to COVID 19, even if they did other things and their regular jobs.

And we worked with community partners, healthcare partners, like Spectrum to also hold mass vaccination clinics and community clinics and trying to go anywhere we can to educate people and vaccinate people as well.

- Yes, educate us, one shot, two shot, booster, booster.

What's happening here?

- One shot, two shot, reach out for it, right?

- That's right.

Yeah, yay.

- So just recently, they have hopefully simplified these recommendations a little bit.

So everyone should receive their primary series of COVID vaccine.

So anyone six months of age and older.

So they'll get a two-shot primary series.

I'm talking about six and over, 'cause if you're talking about that younger, if they get Pfizer, they get three doses.

But everyone should basically get a two-dose series of COVID vaccine plus one bivalent booster two months later.

- [Shelley] What does that mean bivalent booster?

- So, bivalent means two.

So it includes that original spike protein, and now it includes the Omicron variant that's been circulating recently.

So it's covering now two different variants of COVID.

- Yes.

Anything to add with that?

- No, not really.

Except to say that, you know, the vaccines have been doing a good job at protecting people.

But as we've all heard, immunity starts to wane.

So it's a good time to get your bivalent booster if you're eligible because models are predicting a fall surge for COVID 19.

And so just provides that little extra boost to your immune system.

- And important to say, you can get your flu and your COVID bivalent booster at the same time.

- Same arm?

- You can get it in the same arm, if you have to.

I tell everyone if you're only getting two pokes, get 'em in separate arms.

A little less sore.

- What's your crystal ball, Mary?

10 years from now, will we all be getting a COVID booster on an annual basis like a flu shot?

- If you want me to guess my guess is yes.

- Yes, yes, thank you for that.

Let's talk about travel and I'll start with you, Alison, what's required if I want to travel overseas, vaccine wise?

- So as Mary was mentioning, you know, some diseases here in the United States have been eradicated, in other countries, that's not necessarily the case.

And so we might be exposed to things that we are not used to seeing here.

So our travel services can help with people identify what vaccinations they might need if they're traveling to a different country and then walk people through what other health risks there might be in that area so that everybody can not only be healthy on their trip, but you know, be healthy when they come back as well.

So we can consult with you and then also provide you with those immunizations that you need before travel.

- Yes, what would be an example?

What do you know?

- Oh, can you help me with that?

- Yeah, I can help, I love that.

Actually, I don't think we mentioned earlier that I worked at the Ottawa County Health Department in their immunization clinic for five years prior to taking this position at Spectrum Health.

So worked in your travel clinics.

- How nice.

You know where the water.

- So the health departments have great travel clinics.

Spectrum Health has a travel clinic.

It can be hard to get into those.

So anywhere you can go, they're all very good in our areas.

But we look at where are you traveling, we look at your immunizations, what have you had?

What do you need for the area that you're traveling?

So some of the things you could need, we recommend hepatitis A if you're traveling.

We recommend every adult have at least two doses of MMR, that's your measles, mumps and rubella if you're traveling.

Certain areas in Africa, you could need yellow fever vaccine.

And then also, oh, rabies vaccine if you're traveling to an area with rabies, so.

- So glad Mary's here.

(giggling) - Let's do rabies.

Tell me about the rabies vaccine with the three animals that I have called dogs.

- Oh, yes.

- They get theirs, but- - Only your three animals don't have rabies.

- So when would I need a rabies vaccine?

- If you were to wake up in the middle of the night and a bat was in your bedroom and you were sleeping while that bat was in your bedroom, they would recommend that you have rabies vaccine.

If you were to get a bite from a raccoon, a squirrel, a stray cat, and they run away and you don't know, they would recommend that you get rabies vaccine.

Rabies is fatal.

- I was gonna say that always seemed to scare me.

- Yes, rabies is fatal.

So if someone recommends you should get the vaccine, you should get that vaccine.

- Wow.

And I mean, I don't wanna talk worst case scenarios, but obviously, if I don't run and get the vaccine, would I have some signs and symptoms that would cause me to- - The interesting thing with rabies is it could be up to a year before you develop signs and symptoms from rabies.

- Educate us also to tetanus, the tetanus shot.

Again, I'm gonna step on a nail, do I need a tetanus shot if I'm 50 years old?

- You need a tetanus shot.

If you have a dirty cutter wound, you need one every five years.

If you don't, you still should get a tetanus shot every 10 years.

So everybody, their whole life should get tetanus shot every 10 years.

Tetanus, you get from a dirty cutter wound.

It can cause painful tightening of all your muscles.

You may have heard it called lock jaw before, and tetanus can be fatal also.

- Yes, how's the health department doing with education, going out into the schools or going out into community centers to educate us, to remind us to get these shots.

- We're sure doing the best we can to try to get information out as many ways as possible.

So we try to do that through our community health workers, through our nurses.

For example, in our Maternal-Infant Health Program, where they take care of moms who are pregnant or babies during their first year of life, through our social media, through our newsletter, through the schools, really working with school administration and teachers to try to make sure that we provide that information about what's required, when are we having clinics?

You know, the effects of illness, things like that.

So we're working hard to try to keep those vaccination rates up.

- And, you saw, I was gonna add something and I can add that.

- Of course, yeah.

- The health departments work very close with the health systems.

So Ottawa County Health Department, Kent County Health Department, they hold what they call tips meetings or immunization meetings.

And they invite all like frontline clinical staff, they will do lunch for them, do education, and they usually do that every other month or so, every quarter.

A lot of them have not been in person recently, but I think they're headed back to that.

So, you know, those frontline MAs from Spectrum Health will be at the health department getting education.

They partner very well with the community.

- Back to a little biology physiology.

Why are vaccines presented via a needle versus orally?

Or are they?

- There are some that are given orally.

Rotavirus is given orally and FluMist is given nasally.

And I try and get people not to think of it being an injection, but just being a different route of administration, right.

I mean, there are parents, you know, they'll have a medication that comes out that was studied in 200 individuals and they wanna try that medication, it's oral.

But with a vaccine it's studied by tens of thousands of people before it ever comes to the market.

And they're like, "We don't want that."

They're more hesitant about that, even though it's studied more and I think it's because of that injection.

- Do you ever fear a vaccine shortage in any of these, this conversation?

- I don't, you know, there are different manufacturers that make kind of the same vaccine.

So we have had, you know, historically, like Pentacel was shortage, so we use Pediatrix.

It's just a different manufacturer, but it's the same vaccines.

We've seen shortages and things like when Shingrix, which is the shingles vaccine, first came out, they just didn't anticipate the need for it.

So they hadn't manufactured enough.

So there was a huge group of people on wait lists for Shingrix when it first came out.

- And let's go with the shingles vaccine, tell me more.

- Yeah, so the shingles vaccine is a great vaccine.

It's about 98% effective at preventing shingles.

- Everyone- - At preventing, not treating.

- At preventing, not treating, no.

No vaccines treat disease.

But even people that have had the shingles should get the vaccine.

There was an old shingles vaccine.

I don't know if you remember, it was called Zostavax.

It was a live vaccine, not as effective.

They don't make it anymore.

This new vaccine, everyone 50 and older should get it.

It's almost a hundred percent effective at preventing what's called postherpetic neuralgia.

That's a big word.

But sometimes after shingles, people could still have that pain for up to a year, that severe pain from the shingles.

So it it's about 96% effective when you get a really good effective vaccine, you get a really good immune response.

So it's important for people to know when they're getting the shingles vaccine, you're probably not gonna feel great for the next couple of days 'cause you're gonna get a really good boost.

So if you have a wedding on a Saturday, probably, don't get your shingles on a Friday.

- She likes what she does.

(laughing) Alison, what else on behalf of the health department must we know regarding this topic?

- You know, we know that parents especially, have a lot of questions and we know they're the best people to make decisions, not only for themselves, but especially for their children and we want them to be asking those questions and to provide as much information as we can.

So for people who are seeking information, maybe they're, you know, on the fence about whether they should have their child vaccinated, we would love for them to call us and talk to one of our immunization nurses.

If they have a pediatrician that they trust, call that person or their own medical provider, you know, to get those questions answered and to feel good about what they're doing.

- Agree.

They need to have conversations with their providers, have conversations.

Find those sites where you can find good scientific information.

The michigan.gov website has good information, talking to your primary care provider's good information.

I Vaccinate is a Michigan-run website, it's a parent-to-parent website.

Those are all really great resources.

- Yes, and tell us a little bit more about the CDC.

It's come into our rooms so much through the COVID pandemic.

But what is the role of the CDC?

- So Centers for Disease Control and Prevention, it's the CDC and their role is giving us their recommendations.

So CDC gets their recommendations from it's called ACIP, the Advisory Committee on Immunization Practices.

And that is a group of non-governmental providers, scientists, nurses, and they look at all the data that has been submitted to the FDA and they give the recommendation to the CDC.

Now the majority of the time, the CDC will follow that recommendation.

But there are times that it strayed a little bit on maybe age range or something, but they're just giving us the guidance on what vaccines are recommended.

They don't give a requirement, they only give a recommendation.

So, when we talked about required vaccines earlier in our conversation, that's a Michigan requirement.

So the states make the requirements.

- So states differ in their vaccination requirements?

- Correct.

- Didn't know that.

Alison, what resources do you often advise if I'm calling you and saying, "I need more information before I can do this."

- About vaccination?

- Yes.

- We would connect you with one of our immunization nurses and you can ask as many questions as you'd like to that person.

And people can just call us at 616-396-5266 for that to be connected with somebody.

- Do you have a physical building?

- We do.

- You know this answer too, being yeah.

(laughing) - We're right on James Street in Holland, that's where our administrative office is and one of our clinics are.

And then we have a clinic in Grand Haven and a clinic in Hudsonville, and those are open by appointment only, and we offer vaccinations there, but also some of our other services like hearing and vision screenings, and some of our sexual health services as well.

- Would you do blood works and cholesterol screenings and I'm getting into the weeds a little bit?

- Yeah, not those kind.

Not cholesterol screenings, but things related to family planning and some of our people's sexual health needs, we do that.

And then as I mentioned, those screenings for kids.

- Great, all right.

What is your take home message from this conversation we're having now, Alison?

- I would just echo what Mary mentioned earlier about seek out information from reputable sources, healthcare providers, even, you know, our local healthcare providers are great at providing reputable, trustworthy information.

So seek that out before you make a decision about whether to vaccinate or not.

- Great, and your best contact would be?

- Either 616-396-5266 or our website is miottawa.org/mihealth.

- Okay, all right, Mary, I'm gonna give you a couple minutes to kind of wrap us up and give us that final thumbs up, thumbs down, thumbs sideways on finding our place in this world of vaccinations.

- Yeah, I just hope that as people seek out the correct information, that they will feel confident being vaccinated, that they will know that vaccines are safe, that vaccines do prevent disease.

If our vaccination rates fall too low, we could see some of these diseases coming back into our communities.

And so we wanna keep our communities safe, we wanna keep our patients safe, we wanna keep our families safe.

- Right and obviously, the experience for your first time shot should be a positive one as possible for your little kiddies.

(laughing) - You know what, the first time shots at two months are way harder on the parents than it is on the baby.

- Nice, all right, so Spectrum Health would offer this conversation, the vaccinations as needed?

- Yeah, they can call any of their primary care providers and they would be happy to.

You know, if they call and say, "Hey, I have some hesitation on vaccines."

They can give that appointment a little bit more time so that they can have time for that conversation with our provider.

- Great, just again, communication, the key.

How do I find out more information in general about Spectrum Health?

- You can go on our website, spectrumhealth.org, and you can pretty much find any way that you wanna go there once you're on there.

- Any advice for Alison at Ottawa County?

- No, she's working with a great group of people.

She's very lucky to be there.

I did love my job there.

But, this position to opened up with Spectrum Health and I jumped on it.

- Do I get the shot in my dominant or my non-dominant?

Does that matter?

- It doesn't matter, it's up to you.

But like I said earlier, the more you move it around, the better it is, 'cause it moves that serum through the muscle.

So it depends on if you just wanna move it and have it be sore or let it rest and be sore.

- Thank you so much for the conversations Zimmerman with the Spectrum Health and you, Alison Clark, the good work you do with Ottawa County- - Thanks for having me.

- Public Health Department.

So thank you for that.

And as always, thank you for watching this edition of Family Health Matters when it comes to vaccinations.

Thanks for watching and supporting WGVU.

I'm Shelley Irwin.

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