ANNAPOLIS – Persuading small children to hold still for their shots sounds like one of the hardest jobs a nurse could have.
Actually, says Lisa Raab, a nurse with the Anne Arundel County Department of Health, it’s often much harder to get hold of the parents in the first place.
Anne Arundel County nurses not only have to tend to their patients’ medical needs, they have to assess them. This means acting as outreach workers, visiting families at home.
Across the state, “Project Immunization ’97,” launched by Gov. Parris N. Glendening in August, has placed emphasis on making sure Maryland children are fully immunized by age 2.
“Making certain [children] have their full array of immunizations on time is one of the most important steps we can take to start them on the right path,” Glendening said in kicking off the program.
Although county health departments get referrals from hospitals, doctor’s offices and schools, tracking down individual cases often takes detective work. If a family moves away or its phone is disconnected, an outreach worker sometimes has to start asking neighbors where to find them.
“Once the public knows who outreach workers are, they’re willing to help,” Raab said.
“We’re not the ones who say, ‘You can’t do this if you don’t have that,'” said Mary Ann Woodzelle, who runs the county immunization program. “Our primary goal is to get them back to their primary-care physicians.”
The federal government offers free vaccines for uninsured children through participating medical centers. The Anne Arundel County Health Department provides taxicab service for people who cannot reach the nearest health center on their own.
“Immunization ’97” is being coordinated by the Department of Health and Mental Hygiene and the Office for Children, Youth and Families and assisted by the state National Guard. It began the first week in August, although it was not formally announced until August 13.
The project also features two new mascots, blue herons named “Baby Blue” and “Betty Lou” — chosen, Glendening said, as a symbol of the “great quality of life we enjoy in Maryland.”
The diseases that vaccines guard against are generally under control, but still have the potential to appear periodically. Raab said that her health center sees a few cases of whooping cough every year, whereas the polio virus is almost extinct.
“I was around when we had the measles outbreak in the early ’90s,” said Woodzelle. “Today we see very few cases.”
Department of Health and Mental Hygiene spokeswoman Karen V. Poe said the statewide project was “piggybacked” on the normal back-to-school immunization drive in August and early September, when 4-and-5-year-old children get shots before entering kindergarten. The state used this opportunity to remind parents that children under age 2 also need shots.
According to the Department of Health and Mental Hygiene, 80 percent of Maryland children are fully immunized by age 2, slightly above the nationwide rate of 78 percent. Nonetheless, this still leaves almost 14,000 children in the state incompletely immunized, or not immunized at all, until age 5.
According to state guidelines, by the time a child is 24 months old he or she should have received the following:
* four doses of DTaP, which guards against diphtheria, tetanus and pertussis (whooping cough);
* one dose of MMR, which guards against measles, mumps and rubella (German measles);
* three doses of polio vaccine;
* one dose of chicken pox vaccine;
* three or four doses of Hib vaccine, which guards against haemophilus influenzae type B, a form of meningitis which primarily strikes children under age 2;
* and three doses of Hepatitis B vaccine.
Immunizations are given by local health centers through county and Baltimore City health departments. Many hospitals provide a dose of Hib vaccine at birth.
Here are telephone numbers for local health departments across Maryland: