HJAR Jul/Aug 2019

Healthcare Journal of ARKANSAS I  JUL / AUG 2019 49 Nathaniel Smith, MD, MPH Director and State Health Officer Arkansas Department of Health against certain diseases to be able to attend an Arkansas school or licensed childcare facility unless an official exemption is filed. For example, Arkansas requires children ages 16 months and older to have one dose of MMR to attend daycare, and a second dose to attend kindergarten through twelfth grade. The majority of parents in Arkansas do choose to vaccinate their children against measles. In the 2018–2019 school years, an estimated 91.9 percent of kindergarteners had received the required two doses of the MMR vaccine. This is an increase from 85.9 percent in 2012–2013; however, it is not yet high enough to achieve community immu- nity. Indeed, in the 2018–19 school year, 1.4 percent of kindergarten students received an exemption from receiving the MMR vac- cine. Overall, there were 8,016 exemptions inArkansas for the required vaccinations in grades K–12, and most (7,862) were for phil- osophical or religious reasons. Additionally, someArkansans face barriers to vaccination, like health care access. There are several Arkansas counties where the Arkansas De- partment of Health (ADH) Local Health Unit is the only provider of childhood vaccines. Health care providers can play a key role in educating parents about vaccines and encouraging them to follow the vaccine schedule as recommended by the Adviso- ry Committee on Immunization Practices, rather than just the ones that are required by theArkansas Board of Health for school attendance. It’s important when talking with parents to use everyday language; share per- sonal stories; use credible resources to rein- force your message; and provide good infor- mation before, during, and after the visit. The C.A.S.E. model for talking to parents, created by Allison Singer, MD, is a helpful model. C.A.S.E. stands for Corroborate, About Me, Science, and Explain/Advise. This means acknowledge the parents’ concern and find a point you both agree on, describe how you became knowledgeable on the subject, de- scribe what the science says, and then give your advice based on that science. Anyone with questions about measles testing or reporting a case should contact theADHOutbreak Response Section at 501- 537-8969. After-hours calls can be made to the ADH Emergency Operations Center at 1-800-554-5738 to speak to the on-callADH physician or nurse. People who are unsure of whether they need an MMR vaccine should discuss their concern with their doctor or pharmacist. The MMR vaccine is available at many clin- ics and pharmacies. Parents can also make appointments at anyADH Local Health Unit to get the recommended vaccinations for their children, regardless of ability to pay. I myself have vaccinated all four of my chil- dren for every possible vaccine-preventa- ble disease. More information is available at https://www.healthy.arkansas.gov/pro- grams-services/topics/immunizations. n “The C.A.S.E. model for talking to parents, created by Allison Singer, MD, is a helpful model. C.A.S.E. stands for Corroborate, About Me, Science, and Explain Advise.”