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Michael Dunne: I'm Michael Dunne. Vaccines may be one of the greatest medical and scientific achievements ever made. A simple shot can protect children and adults from diseases that used to routinely maim and kill 1000s, if not millions, of people every year, yet due to a decreasing lack of trust in institutions and a massive increase in disinformation online and on social media, many, many people refuse to get these life-saving medicines. Today on the show, you'll hear from the Oregon Health Authority about this concerning low vaccination rate in our state, especially in our schools, and what impact that could have going forward. Then, in the second part of the show, we'll get an update from our reporter about new policies on policing around e-bike usage, and a stark warning from the county about fire risk for the business community. Dr. Howard Chiou, Medical Director for communicable diseases and immunizations at Oregon Health Authority, doctor, thanks so much for coming on and talking with us.
Dr. Howard Chiou: It's great to be here. Thank you for having me.
Dunne: So, let's start simply with this from a purely medical perspective. Talk about the importance and efficacy of getting FDA approved vaccines.
Chiou: It's such a great place to start, and I think something that I want parents to remember is that vaccines exist because the diseases that they protect against can be really awful. So, anyone who has heard the cough of whooping cough or pertussis, if you haven't heard, I do recommend you search for it, just to hear it. It's heartbreaking, it's miserable for everyone, and it can last for up to 100 days and potentially be fatal for babies. You know, measles is another great example. I've taken care of a patient in the hospital with measles, and it really sticks out of my memory, because it's really not just a rash. Fevers, something we don't talk enough about is that measles can cause something called immune amnesia, where your immune system actually forgets how to fight infectious diseases it used to be able to handle fine in the past, and those effects can last up to three years, where your body is actually at increased risk for other infectious diseases, and that's on top of the usual kind of risk we talk about for measles, you know, the possibility of pneumonia, brain inflammation, brain damage, all of that other stuff. So, the vaccines exist to help protect against really severe diseases. I think the other thing that we often don't bring up when we talk about the medical side of things is really the importance of school and learning, right, and kids really need to be in school, and the reality is that kids do not learn well when they are sick. So, one of the things that worries me as a physician is that when you have a lot of kids work together in a school with really low vaccination rates, it raises the risk for an outbreak, and if an outbreak with these happens, you can really affect learning for a lot of students all at once, and kids should have the freedom to be learning in school, and one of the best ways of ensuring they can have the freedom is through vaccines.
Dunne: Okay, conversely, can you do a little bit of myth busting about some of these alleged health risks that people bring up about vaccines?
Chiou: So yeah, there's often, you know, there's been a lot of press coverage and confusion about vaccines, and what I really want parents to remember is that the science around vaccines have not changed, right, and the measles vaccine is a great example where it really was developed in the 1950s right, we have over 70 years of experience and data from the vaccine, but something else I don't think that people recognize is that it's not just about the initial studies when the vaccine first makes it to market. There are all of these rigorous safety monitoring that happens after the vaccine goes to market, so there's really a ton of data around these vaccines, and that data isn't just collected in the United States, but also by collected by other governments around the world. So, when we talk about, you know, these minutes around safety, I think it's really important for people to recognize the systems that are in place to really capture signals and make sure that the vaccines are safe, and those systems have worked here for a very long time.
Dunne: Okay, I'm not going to ask you to weigh into any of the politics of it, but as a medical professional, why do you think there's been this sort of growing skepticism about vaccines? I'd hazard a guess that when you first started practicing meta. And perhaps there wasn't as much skepticism about vaccines as we find today?
Chiou: It's funny you say that, because when I think back, I mean one of my favorite things was actually talking to parents about vaccines, and I loved it when people came to me with questions, and I think I think one thing that is incredibly powerful. That may be some things you don't think about, is that everyone wants what is best for their families, right? Like, everyone wants what is best for their kids, and that alone is such a great starting point. I think here in Oregon, we actually don't have a lot of data systems to tell us about what people are thinking or feeling or believing or their intent, you know, so a good chunk of this is, is has to be speculation with the data we have. One thing that I think is also important to recognize is that is that, yes, I think the missed this information and confusion definitely plays a part in this. I think the other, the other thing that we also do know with the limited data that we have is that access can also be a challenge, right? And, and especially with the healthcare system that we have, and I just don't, and I don't mean necessarily just access to healthcare itself, right, but like it takes time to schedule a clinic visit, right? It, you have to make sure you have time off from work, you have, you have to get your kids there. There may be transportation barriers, like all of these factors in place. So, I think there are multiple complexities in our current environment, and I think there's just kind of a perfect storm of factors that are swirling together, together, that is leading to our decreased vaccination rates.
Dunne: There's that a famous literary quote: it was the best of times, it was the worst of times. Sometimes I think about that quote when I look back at COVID, because in the best of times, and I'd like you to kind of talk about this, as I understand it, as a layperson, a non-medical professional, it was nothing short of miraculous the speed in which the medical profession and scientists were able to develop the vaccines that have saved many lives because of Covid. It was the worst of times, because, as we just talked about, there was a lot of skepticism about vaccines in general. Can you kind of remind folks how amazing it was that within a very short period of time we were able to put a vaccine into the arms of millions and millions of people in such a short period of time?
Chiou: It definitely was amazing, and I want to point out that yes, it was the contributions of the scientists and in the scientific community, but there was also a lot of legislative changes that were made that enabled the rigorous studies to be done in a record time, right. So, I think that's one thing that I want to make sure that people understand, it's not that the evidence for the COVID vaccines weren't the threshold for the evidence was not lowered, but it was more making sure that these studies could be done in a way that was efficient to get the same quality of data that we need to bring a vaccine to the market. So, I think that's one key thing that I want to make sure that people understand. I think the other thing is that is when we talk about, you know, the miracle of the vaccines is that is that the death rate from COVID was incredibly high, and in a worry, even just a few years out, that we have forgotten that more people in the United States have died from COVID than from every single conflict and war that the United States has ever been involved in ever, right? So, so having these vaccines, you know, to really protect the population against a completely new disease that no one had immunity for, because it was the emergence of a new virus like that, that, that, to your point, was, was, was really miraculous that, that, that the vaccine could be able to be put together, but, but I think what I want to make sure is that the science and the hard work that drove that miracle, right, like it's not just the vaccine appeared out of nowhere, or through, but it was really through the hard work of all of these folks to make sure that we can bring a vaccine to market for a new dangerous disease that really has caused a lot of death and suffering.
Dunne: As a clinician, what do you think we're going to start to see in our schools, in Oregon schools, because of this low vaccination rate? What are some things that you know, as someone in public health, is going to be looking at and saying, okay, this is what we might start to expect to see.
Chiou: Yeah, I think projecting forward, I think, requires an understanding of what the situation is. So, one thing I do want to point out is that one of the great things about Oregon. Being in Oregon, is that the vast majority of families are still choosing vaccination for their kids, so when you look at the group of students, for you know, from kindergarten all the way through 12th grade, 90% of those students are up to date on their vaccines, and that's amazing. The vast majority of families are still choosing vaccines. What worries me is that one, there's a lot of variation in vaccination rates across schools, so individual schools may have rates that are higher or lower than the state average, and a great example of this is actually measles, so one out of three schools in Oregon are at risk for measles outbreak because their vaccination rate is below that 93% threshold, which is sometimes called herd immunity, but that threshold that's required to really decrease the risk of a measles outbreak in a school. So that variation is really concerning. The other thing that worries me is that the overall trends are moving in the wrong direction, so this year the percentage of students with a vaccination exemption for non-medical reasons, that rate is at 11% This year the number of kindergartners who are not up to date on their vaccines is at 14% and both of those are at historic highs. So, as your immunization rate goes down, then the risk of outbreaks goes up, and to some extent we've already seen this right this year, pertussis, last year for pertussis the cases broke a record that was last set in the 1950s measles was declared eliminated in the United States in the year 2000 so really for decades the normal was zero, and this year nationally we have almost 2000 cases, right. So, so I worry a lot about this, and I think that's part of our message here is that parents and families really should look up their school immunization rates for their specific schools and reconsider their vaccine decisions, because the situation here in Oregon and the United States really has changed.
Dunne: Oregon is often described as a very urban and rural state, and I am wondering, from what you're seeing, are we seeing a bit of an urban-rural divide in terms of vaccine rates? Are we seeing perhaps in more rural schools less vaccination rates versus, say, Multnomah County, or even here in Lane County?
Chiou: I think it's actually really hard to make those generalizations, and to some extent, they're less useful, right, because the way that diseases spread is at the local level, right? They spread out the community, they spread in your, in your, in where people gather, they spread in schools, so even within rural settings, we see a lot of variation between individual schools, and that's really why it's so important that parents and students should look up the vaccination rate for the local school, because at the end of the day, that's really one of the most important factors for gaging risk for your family and for your community.
Dunne: Okay, Doctor, my last question for you is simply this: make your pitch to parents who might be listening about vaccinations.
Chiou: I love that. I think for me what is really important is that we are empowering people to make informed decisions. So, for parents who are listening, I'll say just a few things. So, the first is to find your school, right, and you can do that today on our dashboard and see exactly what the vaccination rate is for your school diseases spread in the community, right. So, knowing your school's vaccination rate is so important. The second thing that encourage parents to do is to talk to your pediatrician or nurse or your healthcare provider for their thoughts and advice, I think it's really telling that almost all pediatricians choose to vaccinate their own kids, and I try to remind parents that they're really a great resource for how to think about vaccines, not just because they're a medical professional, but also because they're thinking through their own decisions for their families and themselves, and the last thing I encourage people to do is to talk to older people, grandparents, teachers, anyone who remembers that time period in the United States when a lot of these diseases were more common, and I've heard stories about how there were spontaneous celebrations in the streets when the polio vaccine was first announced, because people were so excited about something to fight against these diseases that they saw on a day-to-day basis, and our vaccines have worked so well that I worry a lot of the history is forgotten, and learning from our past is so important today when we are seeing this return of diseases from the past.
Dunne: He's Dr. Howard Chiou, the OHA medical director for communicable diseases and immunizations, Doctor. Really appreciate you coming on and talking with us.
Chiou: Thank you so much for having me, Mike.
Dunne: Now let's talk with one of our reporters about e-bike policing and how this summer's. Fire season could be a disaster for local business. KLCC's Zac Ziegler. Zach, always great to see you. Thanks so much for coming in.
Zac Ziegler: Thanks for having me.
Dunne: Yeah, I want to focus on two stories you've done recently. The first one is about sort of new policing about e-bikes. Talk about it.
Ziegler: Yeah, so there's already some online reporting tools that EPD offers, well, they're adding e-bike complaints to that, you know, they've had this for anonymous tips, traffic complaints, and some crimes. You can just file real report online. Now that's something that they're asking for a little help with, to basically build up a little data for e-bike issues.
Dunne: Yeah, and I noticed in your reporting, you know, Chief Chief Skinner of Eugene Police Department said they're getting a lot of complaints about this, aren't they?
Ziegler: Yeah, he said when he is out at, you know, a neighborhood association meeting, or just basically out in public, this is the number one issue he is hearing about, is people complaining about e-bike use, and so the hope is that by getting information like this on line one, it frees up the non-emergency numbers, so you're not sitting there for 20 plus minutes waiting to file a complaint, but they'll also know when and where to do some high visibility patrols to help maybe tamp down some issues.
Dunne: I would imagine that probably the popular pathways for walking and running, and, and that sort of thing, probably are popular for e-bikes.
Ziegler: Yeah, I can imagine. You know, I think of when I'm on the, you know, the main river way, and I'm routinely going on a road bike, so I'm moving a pretty decent clip, usually up around that 20 mile an hour speed limit on those paths, and I will occasionally have someone just go sailing past me on an e-bike.
Dunne: And we did a show about this, talking to people at the city, and it is a big deal. And I know that one of the things that when I talk to people, there was some confusion about what kind of vehicles are allowed on paths. Talk about that.
Ziegler: So there are three types of allowable e-bikes that the city kind of lays out, it's based on, you know, maybe the max speed it can go, how it's controlled, if it has a speedometer or not, but there is also this classification of something that looks almost like more like a dirt bike, like it's meant for going a little more off road, called an E-MOTO, and those are the things that seem to be the big concern. Those can go, you know, over the over 28 miles an hour, I believe, and you know they really are more akin to something that would be on the road.
Dunne: Yeah, I know nationally there was a case in New York where an e-bike was involved in a fatal accident, I imagine the police are looking at this as sort of preventative. They want to hopefully get to a situation where we're not talking about fatalities.
Ziegler: Yeah, and oftentimes, you know, a big thing that Chief Skinner also mentioned to me was just education.
Dunne: I want to switch gears and talk to something we're all used to experiencing, and that's Oregon's wildfire season that we're pretty much entering. Talk about, you know, you had a story about Lane County warning businesses about this upcoming fire season. Talk about that.
Ziegler: Yeah, that's one thing that we're always talking about, people being fire ready and being prepared, having your property ready. Well, businesses need to think about that too, and there is a host of other issues that they might need to think about, beyond what you know a homeowner or just a typical resident would think about, and so Lane County laid out some of those basics that business owners should also be thinking about.
Dunne: One thing that struck me in your reporting is the idea that you know businesses, in addition to destruction, might face real halts in their business operation. Talk about that.
Ziegler: Yeah, that's something that could come up if you know your product line gets disrupted if they close down the road to your business, or if your building does catch fire. There are various ways that you could end up with a halt in your business, and there's also various forms of insurance and various terms used that they lay out in a nice handy guide about insurance to make sure that you have these things, if and nicely explain certain scenarios that might come up, like the ones we were just talking about. Yeah, and you also talked about the fact that your business doesn't have to be like right next to a fire-prone area to see impacts, right there. It doesn't have to be proximity, it can really be community-wide, couldn't it? Yeah, I think about back when I was in college, working on an outdoor construction crew, and there was a wildfire in the general area. Well, they had to give us, you know, basically some kind of air filter, because things were so bad, and that was one thing that was mentioned, is Oregon OSHA's wildfire smoke rules, and Lane County's air quality guidance are things you need to think about, because smoke can drift a long way, especially when you get these really large fires that are 10s of 1000s, even hundreds. Of 1000s of acres,
Dunne: Well, let's finish up with this, because you had a nice part of your story talking about some of the recommendations that Lane County's economic development organization is mentioning to businesses.
Ziegler: Yeah, so the first one is one that they mentioned for everyone, you know, signing up for those Lane Alert emergency texts is a big thing, or if you're outside of Lane County, some of the corresponding ones could also be helpful. You know, they have a wildfire preparedness checklist that talks about things for your business and for your employees to think about, such as those insurance rules in the OSHA things we were talking about, you know, they also encouraged, you know, companies to talk to their employees about being ready at home, because there are times where, hey, maybe you end up in a situation where you have to leave. I remember covering a wildfire once that was on a Sunday, and the reporter I was working with, I was on there. The reporter slid some copy in front of me that talked about where an evacuation order had just happened, and he said, I gotta go, my home's in there, I gotta go get my go bag and make sure my family's ready. So that preparedness helps, you know. They talk about some of the things we hear in Firewise with keeping combustible materials clear within five feet of your building, and plenty of other ideas that could help people out, make sure that just like their home is safe, their business is safe.
Dunne: Yeah, I think the old, the old saw, you know, hope for the best but plan for the worst is certainly, I think, good advice in our fire-prone area. Zac, always appreciate you coming in, Zac Ziegler, our reporter for KLCC. Thanks so much.
Ziegler: Sure thing.
Dunne: That's the show for today. All episodes of Oregon on the Record are available as a podcast at KLCC.org. It's Pride month, and tomorrow you'll hear interviews from the Eugene Gay Men's Chorus, as well as some of their amazing songs. I'm Michael Dunne, host of Oregon On The Record. Thanks for listening.
