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Inoculation
program targets
older teens

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By Pat Gee
Star-Bulletin

Hawaii is "way ahead of almost every other state in the nation" in immunizing its children against the dangerous hepatitis B virus since starting an aggressive campaign four years ago, says state epidemiologist Dr. Paul Effler.

Hepatitis B is a serious viral disease that attacks the liver and can lead to cancer or chronic liver disease.

Hawaii's hepatitis B rate was four to six times greater than the national average before the state Health Department began its public education campaign, according to Steve Terrell-Perica, a Health Department liaison representing the national Centers for Disease Control and Prevention.

Effler, chief of the Health Department's epidemiology branch, said the next target group of the state's campaign will be 16- to 18-year-old teen-agers, "the independent thinkers, the most difficult age group to reach because parents have less control over their kids' schedule."

Effler announced findings on the immunization campaign at a press conference yesterday at the Hawaii Immunization Coalition Conference at the Halekulani hotel.

The Health Department has made free hepatitis shots for children age 5 and under a school entry requirement. But is reluctant to make it a mandate for those 6 to 18 years old until every voluntary compliance plan is exhausted, he said.

"I'm not a believer in putting mandates on parents. I don't want to come down heavy-handed," Effler said. "We just want to make it as easy as possible for parents to get this done with no cost," he said.

Within the next two years, public and health care professionals will have a chance to comment on mandated immunization, he said.

At least 40 percent of children in the 6-18 age group have been immunized, he said, but most have only received two of the three shots required. "But all the data is not in," Effler added.

The Health Department's current public education push is called TEEN VAX, which provides not only the hepatitis vaccine, but also chicken pox, measles, mumps, rubella, tetanus and diphtheria vaccines for children 6-18.

The state has also identified "pockets of need," rural communities that are "underimmunized," including Hamakua on the Big Island, Kalihi Valley, Waianae and Waimanalo, Effler said. The DOH is working with community health centers in these areas to immunize children.

Effler said "parents are the real heroes" in getting their children immunized, but health insurance companies donated their administrative services to enable youngsters to get the federally funded vaccine without charge or at a very low cost. Normally, a three-shot series costs well over $100.

The private Queen Emma Foundation also donated funds, so there was "no cost to the state," he said.

In 1996 a pilot program immunized 90 percent of all fourth- and fifth-graders attending 180 public and private schools and was the state's most successful voluntary compliance campaign.

Hepatitis B can be transmitted either through sexual relations, close family relationships, sharing needles for drug use, and blood transfusions, Effler said. You can get the disease from using an infected toothbrush or razor, but that's a low-percentage way, he said.

"You can't get it by ingesting it (from food) or from a sneeze or cough, or by casual contact," Effler said.