What is HPV?

Human papillomavirus (HPV) is the most common sexually transmitted infection that is easily spread through skin-to-skin contact. There are over 100 different strands of the virus that are identified as low-risk (minor abnormalities at the cervix and genital warts) or high-risk (precursor lesions and cancer). High-risk types of HPV are the cause of cervical cancer and can also be associated with cancer of the vulva, anus, oropharynx, and penis. Although every case of cervical cancer is caused by HPV, not every type of HPV causes cervical cancer.

Who can get HPV?

It is estimated that 79 million Americans are infected by HPV. Almost all males and females will be infected by at least one strand of HPV at some point in their lives.

How do you know if you have HPV?

Developing genital warts is one way to diagnose HPV. HPV can also be detected during a female’s annual PAP test. If a female has an abnormal PAP smear, the doctor may then perform an DNA test by swabbing the cervix to identify the type of HPV  or a colposcopy which involves examining the cervix, vagina, and vulva with a magnifying device.

Is there a cure?

There is currently no cure for HPV. However, most cases of HPV resolve on their own within 2-3 years.

How can you prevent getting HPV?

The use of condoms provides only 60% protection against HPV because it can still be sexually transmitted through unprotected genital skin areas.  The only primary prevention method among sexually active individuals is to obtain an HPV vaccine.

There are three HPV vaccines, Gardasil, Gardasil 9, and Cervarix. They all protect against HPV types 16 and 18, which cause 7 out of 10 cases of cervical cancer. Gardasil and Gardasil 9 also protect against types 6 and 11, which cause 9 out of 10 cases of genital warts. Gardasil 9 protects against an additional 5 strains of HPV which can cause cervical, vulvar, vaginal, and anal cancer.

Who should get the HPV vaccine?

Ideally, you should get the vaccine before becoming sexually active. However, people who have had sex can also benefit from getting the vaccine. It is recommended that all girls and women ages 9 to 26 get an HPV vaccine. Boys and men ages 9 to 26 can get the vaccine to prevent genital warts, some cancers of the anus and mouth/throat, and to prevent the spread of HPV to women which could potentially cause cancer.

Is the vaccine safe?

There is no live virus in any of the HPV vaccines, so they can not give you an infection. The vaccines make your body’s immune system produce antibodies to certain HPV types which protect you from getting infected with HPV. The most common side effects of the vaccines are bruising, itching, redness, swelling, or tenderness around the area where the shot is given. Women may also experience dizziness, fainting, mild fever, nausea, and vomiting. If you happen to experience any of these symptoms they typically do not last long and usually pass on their own.

Does the vaccine promote sexual activity?

Studies have shown that sexual activity among people who have received the vaccine did not differ from those who did not receive the vaccine. Studies have also shown that people who had gotten the vaccine were actually more aware of the need to practice safer sex than those who did not get the vaccine.

The HPV vaccine does not protect against all types of HPV that can cause cancer. Therefore, it is important to still get routine Pap tests.

For more information you can visit these websites:

American Health Association

The HPV Test

Centers for Disease Control and Prevention

Planned Parenthood

References
   Souho, T., Benlemlih, M., & Bennani, B. (2015). Human Papillomavirus Infection and 
Fertility Alteration: A Systematic Review. Plos ONE, 10(5), 1-9.
doi:10.1371/journal.pone.0126936
   Marek, E., Dergez, T., Bozsa, S., Gocze, K., Rebek-Nagy, G., Kricskovics, A., & ... 
Gocze, P. (2011). Incomplete knowledge - unclarified roles in sex education: results 
of a national survey about human papillomavirus infections. European Journal Of Cancer 
Care, 20(6), 759-768. doi:10.1111/j.1365-2354.2011.01258.x
   Krawczyk, A., Lau, E., Perez, S., Delisle, V., Amsel, R., & Rosberger, Z. (2012). 
How to Inform: Comparing Written and Video Education Interventions to Increase Human 
Papillomavirus Knowledge and Vaccination Intentions in Young Adults. Journal Of 
American College Health, 60(4), 316-322. doi:10.1080/07448481.2011.615355
   Ratanasiripong, N. T. (2014). Human Papillomavirus Vaccine Increases High-Risk 
Sexual Behaviors: A Myth or Valid Concern. Journal Of School Nursing (Sage Publications 
Inc.), 30(6), 456-463. doi:10.1177/1059840513520042
   Barnack-Tavlaris, J. L., Garcini, L., Sanchez, O., Hernandez, I., & Navarro, A. M. 
(2013). Focus Group Discussions in Community-Based Participatory Research to Inform the 
Development of a Human Papillomavirus (HPV) Educational Intervention for Latinas in San 
Diego. Journal Of Cancer Education, 28(4), 784-789. doi:10.1007/s13187-013-0516-7

The Zika virus is a serious concern for women who are pregnant or thinking about becoming pregnant.  Worried about the devastating effects the virus could have, women are looking for the best prevention methods to protect their unborn babies, and wondering if it’s truly safe to use insect repellants while pregnant.  The thought of using bug sprays laden with numerous unknown chemicals is unnerving to many pregnant women who are looking for more natural products to use while pregnant, for the health and well-being of themselves, and their babies. However, most natural insect repellants on the market, despite their advertising claims, do little to protect individuals from mosquito bites, and the potential Zika virus.

According to the Centers for Disease Control (CDC), infection with the Zika virus during pregnancy can cause severe fetal brain birth defects, most notably, microcephaly (CDC, 2016). Microcephaly is a condition in which the baby’s head size is much smaller than it should be, meaning then, that the brain has not developed properly (CDC, 2016).

The Zika virus is spread by the bite of an infected mosquito, and in some cases, can be sexually transmitted between an individual infected with the virus and his/her partner.  The Zika virus is transmitted to humans via the Aedes species of mosquitoes, the same mosquitoes  responsible for the transmission of dengue fever and chikungunya viruses. The Aedes mosquitoes are very unique; unlike other species of mosquitoes, they are aggressive daytime bitters (Hamel & Hughes, 2016). At this time the only area in the United States with mosquitos confirmed to carry the Zika virus is the southern tip of Florida, in and around Miami.

The CDC recommends that individuals who live in, or are traveling to areas with confirmed outbreaks take the proper precautions to prevent being bitten by an infected mosquito. This includes wearing long-sleeved shirts and long pants when outdoors, removing standing water from areas outside the home where mosquitos can lay eggs, and most importantly, using an insect repellant. The CDC recommends the use of Environmental Protection Agency (EPA) registered insect repellants, the only insect repellants with active ingredients proven to be effective in preventing mosquito bites (CDC,2016). The CDC website states, “When used as directed, EPA-registered insect repellants are proven safe and effective, even for pregnant and breastfeeding women” (CDC,2016).

DEET, according to the Harvard Medical School, is the most effective insect repellant, stating that DEET “the chemical discovered over a half-century ago, is still the best mosquito repellent—and safer than you might think,  natural repellents may give some people peace of mind, but they may also give mosquitoes an extra meal because they wear off much quicker than DEET-based repellents (Harvard Health Publications, 2003).  But are insect repellants containing DEET truly safe for pregnant women to use? The answer is… Yes! The following video clips from CBS News offers some great information about insect repellants containing DEET, and report on the question of DEET being safe for women to use during pregnancy.

Consumer Reports: Natural Bug Spray Less Effective Than Synthetic

References

http://www.cdc.gov/zika/prevention/prevent-mosquito-bites.html

Harvard Health Letter. (2003). DEET is hard to beat: the chemical discovered over a half-century ago is still the best mosquito repellent — and safer than you might think.  Harvard Health Publications. 28(9),1-3.

HAMEL, M. S., & HUGHES, B. L. (2016). Zika infection in pregnancy. Contemporary OB/GYN, 61(8), 16-42.

vid

Human Papilloma Virus is the most commonly transmitted sexual disease, affecting more than 50% of all sexually active women AND MEN.  This blog post attempts to spread the awareness of this potentially cancer causing disease by verifying or debunking common media sources on the virus.

This video on debunking common myths is about popular misconceptions and questions about the disease.  It claims:

• HPV affects 80% of all women by age 50→While this exact percent can not be verified, it is true that at least 50% of all sexually active women and men are affected.
• HPV is the most common STD→TRUE
• Is HPV curable? Or is the disease lifelong? This new clip claims the virus is not curable and certain types may remain dormant in the body for life.→ TRUE. Also, the outcome of cancer related to HPV could be a potentially lifelong condition.
• It only takes 1 sexual encounter to contract HPV, it is not a disease favorable towards promiscuous people.→ TRUE. Skin-to-skin contact could be another possible route of transmission.
• There are 100 different subtypes of HPV and most present asymptomatic (showing no signs or symptoms). →TRUE.  A person could have contracted one of the many types of this virus and not even know it.
• Complete protection is only guaranteed through full abstinence-including no skin-to-skin contact.  Other methods of prevention are delaying age of onset of sexual activity, limiting the number of sexual partners one has, and getting the HPV vaccine.→TRUE.
• While there is no cure, there are treatment options available for certain manifestations, such as genital warts, including creams and laser treatments.→TRUE
• Men are vectors (transmitters) of the virus. →FALSE, transmission is equal in both men and women.
• Cancers, such as penile, anas, and vulvar cancer can be caused by human papilloma virus, and this usually occurs in men.→TRUE, men are more at risk for contracting cancer related to HPV.  Although females can get cervical cancer from certain types of high risk HPV.

This video on HPV and men attempts to let it be known that women are not the only ones at risk, men can have fatal consequences too.  Fact versus fiction:

• Absence of signs and symptoms associated with HPV occurs more in males than females.→TRUE
• 100 different types of HPV exist, including low risk types which cause genital warts, and high risk types which are associated with certain cancers.→TRUE
• Men are 3x more likely to get head/neck cancers from HPV than women are.→TRUE, also Oral HPV Disease is 3x more prevalent in males than females.
• There is no screening for men, only screenings for certain manifestations such as anal cancer. →TRUE.
• Men who have sex with men are at a higher risk for HPV →TRUE, gays, bisexuals, and immunocompromised individuals are at a higher risk.
• Full proof prevention is obtained through abstinence and condoms provide some degree of protection.→TRUE
• Males ages 9-26 are recommended to get the vaccine which protects against the 2 most prevalent low risk types, and 2 high risk types which can cause cancer.  The complete series of shots must be administered to receive the full protection of the vaccine. →TRUE

Finally this possible vaccine gone wrong, might make you question your method of prevention.

• Cervical cancer, which can be caused by HPV, is the 2nd most prevalent cancer in the US, second to breast cancer, for women under the age of 35.→TRUE
• Side effects of the vaccine can include fever, muscle aches, back and neck aches, chronic nausea and loss of strength in hands and legs.→TRUE, but it is important to add these are RARE side effects that must be reported in order to properly inform the public but the chances and occurrence of these side effects occurring are extremely low.
• There is little known about HPV, the vaccine and its potential side effects.→FALSE.  The Center for Disease Control puts vaccines through a rigorous amount of tests and trials, so if the vaccine is CDC approved-there is much known about the condition and it is safe to receive the vaccine.
• In an effort to defend itself, the government claimed the side effects experienced by this particular patient can not be proven to have come from the vaccine.→TRUE, it can not be definitely stated.

In conclusion, if you are cautious about what media sources you expose yourself to, they can be trusted.  Use your judgement, a youtube video shot by a non professional person might not be the most reliable source, while a new clip would probably contain accurate info.

Every time I go out to a restaurant, I take a gander at the children’s menu offerings. I have no children, nor am I out to lunch with a niece or nephew. I choose to look at the menu offerings for children to see how balanced these meals are for their growing bodies that have very specific nutritional needs. Let me clarify that statement by saying that I am NOT a dietician nor do I have any training in the nutritional field. Rather I do this little experiment to examine what restaurants deem nutritional to growing children as a worried member of the general public.

Childhood obesity has become a dangerous epidemic in the United States. The Centers for Disease Control (CDC) , defines obesity as having excess body fat. This excess fat can cause medical difficulties throughout an individual’s life including diabetes, arthritis, pain, and cardiac problems. According to the CDC, the rate of childhood obesity has doubled for children and quadrupled for adolescents in the last 30 years. This is a negative trend that has been worsening due to access to fatty and fried foods, decrease in health education in schools, and home environments. This is not to say that if a child is obese it is due to laziness or the parent’s fault. Obesity can also be a side effect of many diseases as well, such as Polycystic Ovary Syndrome or Hydrothyroidism.

As a country we should be encouraging these young people to be leading healthy, balanced lives with appropriate nutrition and physical activity leading to the development of healthy eating habits as adults. If you are concerned about your child’s weight, talk to the pediatrician about any tips or suggestions that can be made at home to create a well-balanced diet and to motivate physical activity.

Vaccinate Your Child

Today in the media we all hear about how vaccines are bad. They cause autism, bowel problems and many more issues. Do you ever wonder if these are true facts about vaccines or if they are just myths? Here are some statistics of children who are not being vaccinated:

• Nearly 600 cases of Measles have been report in the year of 2014. According to Dr. Anne Schuchat, “The current increase in measles cases is being driven by unvaccinated people” (Gonzalez, 2014).
• The L.A. Times reported that parents in California are at twice the rate of not vaccinating their children compare to about 7 years ago.
• In 2013, 90% of children who died from the flu were not vaccinated (CDC Reports, 2013).
• In 2008, 93.5% of children were vaccinated for MMR but in 2009 that dropped to 90.6%.
• In 2008, 87.2% of children were vaccinated for chickenpox but in 2009 that dropped to 85.4%.
• In 2008, 92% of children were vaccinated for diphtheria, tetanus, and whooping cough but in 2009 that dropped to 90.6%.
• In 2011, 15, 216 cases of whooping cough were reported due to a lack of vaccinations in children but in 1996, only 7.796 cases were reported (Refusing Protection, 2015).

These facts show how the rates of parents not vaccinating their children are growing throughout the years. With that, more cases of illnesses are growing due to children not being vaccinated. When families travel out of the United States and they are not vaccinated, they don’t realize they are bringing back diseases. With most things in life there are positives and negatives to everything. With that being said, let’s look at all the negatives and myths about vaccines and let’s put them to positives and facts.

Vaccines

Facts vs Myths

Myth: Vaccines cause autism.

Fact: It is a known myth that MMR causes autism and stomach problems. Well this known myth doesn’t exist. With recent studies, it shows that vaccines are not related to serious illnesses (Recame, 2012). Since 2003, there have been 9 funded studies to prove that there is no link between MMR and children who have autism (Vaccines Do Not Cause Autism, 2015).

• So where did this myth come from?
  • This came from a study back in the 1990s. Mr. Wakefield tried to conclude that MMR caused crohn’s disease and autism. He stated that 9 out of 12 children who were vaccinated with MMR were diagnosed with autism. This statistic caused an increase of children not getting vaccinated (Recame, 2012).
  • In 2004, the Autism Speaks Foundation did a study and showed that 15% of individuals with autism show a genetic link. This proving that autism is related to hereditary factors (Recame, 2012).

Myth: Vaccines cause serious reactions and can cause the child to get the disease.

Fact: The vaccine exposes the child to a weakened or dead virus. The child is experiencing the body’s immune response to the vaccine and it is not the disease itself.

• Less than 1 in 1 million cases show symptoms in children from the vaccine (Understanding Vaccines, 2016).

Myth: Since most children are vaccinated, my child does not need to be vaccinated.

Fact: Vaccines protect the entire community not just the individual person.

• Unvaccinated people are at serious risk for getting diseases and spreading them.
• Even though some are vaccinated and protected, the ones at risk at people with weakened immune systems, children during their vaccination schedules, pregnant women, and infants (since their immune systems are strong enough yet) (Heusel, 2016).

Myth: Since some diseases are not even in the United States anymore, my child doesn’t need those vaccines.

Fact:  Just because some of these diseases like polio and diphtheria have been completely gone in the United States, it doesn’t mean it can’t come back.

• Due to traveling and other countries, we can bring back diseases into the United States and without vaccines for it, we are susceptible for getting these diseases and bringing them back into the United States (Heusel, 2016).
• Even though hearing about children getting MMR is rare. In 2003, 13 children died from it because they didn’t get the vaccine.
• Unvaccinated children are more susceptible to getting disease and spreading them to infants and the older adult population who have weakened immune systems (Howard, 2016).

Myth: Vaccines overwhelm my child’s immune system.

Fact: It is a fact that a child can have up to 23 vaccines by the time they are 2 years old. Yes that is overwhelming but not overwhelming to the child’s immune system.

• “Children have an enormous capacity to respond safely to challenges to the immune system from vaccines,” says Dr. Offit. “A baby’s body is bombarded with immunologic challenges—from bacteria in food to the dust they breathe. Compared to what they typically encounter and manage during the day, vaccines are literally a drop in the ocean.” In fact, Dr. Offit’s studies show that in theory, healthy infants could safely get up to 100,000 vaccines at once” (Howard, 2016).

Vaccine

Myth: Vaccines contain preservatives that are dangerous for my child.

Fact: The compound thimerosal contains a form of mercury, ethylmercury and in large quantities it can inhibit a child’s developing brain. This worry changed vaccines in 1999 and it was removed from all vaccines but it is still present in some flu vaccines but they do have thimerosal-free ones.

• According to Dr. Offit, Methylmercury is a metal found in the environment that can cause harm to a child’s brain development and ethylmercury does not because the body is able to eliminate it (Howard, 2016).

Myth: Hygiene and sanitation are better for preventing diseases than vaccines.

Fact: It is true that hygiene and sanitation help prevent diseases. It is also true that vaccines are not 100%. But getting vaccines and using proper sanitization can really help protect children from diseases.

• Even though good hygiene and nutrition are key to being healthy is is proof that vaccines also help with being free of diseases and healthy.
  • Back in 1963, there were around 400,000 cases of measles but when the vaccine was introduced that number went down to 25,000 by 1970 (Refusing Protection, 2015).

Save Lives

Why Vaccines are Important

Many years ago, vaccines were the leading cause of death but with the creation of vaccines, children are able to celebrate their birthdays. According to (), they show a table of cases and deaths the year when these diseases were high compared to 2011 with the number of cases reported and the number of deaths. Since vaccines have been created for all of these diseases there hasn’t be one death reported in 2011 when this study was done. Even though there are some side effects to vaccines, those risks don’t outweigh the benefits of vaccines. Vaccines are the reason why children can live longer and healthier lives (Anderson, 2015). It is important to always ask questions about vaccines and the first person to go is your child’s doctor. Doctors and nurses want to support parent’s decisions and give them the proper information about vaccines and how they work (Casey, 2016). In the long run, children can be protected from so many diseases and be a part of eliminating even more diseases in the United States.

Helpful Online Resources:

Vaccine Safety

CDC

Vaccines.gov

Pros & Cons About Vaccines

Vaccinations

References

Anderson, V. L. (2015). Promoting Childhood Immunizations. Journal For Nurse Practitioners, 11(1), 1-10.

Casey, G. (2016). Vaccines – how and why they work. Kai Tiaki Nursing New Zealand, 22(1), 20-24.

CDC Reports About 90 Percent of Children Who Died From Flu This Season Not Vaccinated. (2013, March 22). (CDC, Producer) Retrieved August 30, 2016, from Centers for Disease Control and Prevention: http://www.cdc.gov/flu/spotlights/children-flu-deaths.htm

Gonzalez, R. (2014, September 6). CDC Statistics Show What Happens When You Don’t Vaccinate. Retrieved August 30, 2016, from io9: http://io9.gizmodo.com/what-happens-when-you-dont-vaccinate-1631423511

Heusel, C. (2016). Vaccination Facts. (M. Corporation, Producer) Retrieved August 30, 2016, from Parents: http://www.parents.com/health/vaccines/facts/vaccination-facts/

Howard, B. (2016). 10 Vaccine Myths—Busted. (M. Corporation, Producer) Retrieved August 30, 2016, from Parenting: http://www.parenting.com/article/10-vaccine-myths—busted

Recame, M. A. (2012). The Immunization- Autism Myth Debunked. International Journal Of Childbirth Education, 27(4), 76-78.

Refusing Protection: The Decline of Childhood Vaccination in the U.S. (2015). (O. M. Health, Producer) Retrieved August 30, 2016, from Online Masters in Public Health: http://www.onlinemastersinpublichealth.com/vaccination/

Understanding Vaccines. (2016). (P. Health, Producer) Retrieved August 30, 2016, from Public Health: http://www.publichealth.org/public-awareness/understanding-vaccines/vaccine-myths-debunked/

Vaccines Do Not Cause Autism. (2015, November 23). (CDC, Producer) Retrieved August 30, 2016, from Centers for Disease Control and Prevention: http://www.cdc.gov/vaccinesafety/concerns/autism.html

To Vaccinate or Not to Vaccinate

By: Rotary Club of Nagpur

In today’s society the questions of whether or not to vaccinate children brings up very strong opinions. In 1998, Dr. Andrew Wakefield claimed that there was a direct link from the Measles, Mumps, and Rubella (MMR) Vaccine to autism and bowel disease. The claim made by Wakefield has now been discredited, but is still raising many opinions and ideas of whether to vaccinate children or not. The products used in vaccinations have caused some queries for withholding vaccines as well. Today nearly 40% of U.S. parents do not vaccinate their children due to many groundless fears.  Not vaccinating children not only puts them at risk but puts others at risk as well.  Prior to the 1920s before the diphtheria vaccine there were thirteen to fifteen thousand deaths per year from diphtheria, today there are 0 reported cases of diphtheria in the U.S. Before the Salk vaccine for Polio was developed in 1952 there were about fifty thousand cases of polio, today there is an estimated 1 case reported.  Vaccinations are crucial to control and eradicate disease.  Are there specific issues that still cause people to withhold vaccinations for themselves and their children? Is the safety of vaccinations credible and should vaccinations schedules be instituted to prevent the recurrence of previously eliminated diseases.

Vaccines: Separating Facts from Fear

Vaccines are necessary for the following reasons:

•  Common disease, like chicken pox, vaccines prevent common diseases.
• A choice not to get vaccinated is a choice to get the disease
• Chicken pox is not deadly but can be deadly for a small percentage
• Vaccines keep uncommon diseases uncommon
• Vaccines protect against remote disease- diseases not eradicated in other parts of the world
• Vaccination is safer than natural infection
• all vaccines have mild side effects, pain, tenderness at the site, the new pertussis vaccine can cause listlessness, inconsolable crying, and high fever
• Vaccines don’t cause MS, DM, or IBS, Autism, or DIS
• MMR vaccines-autism study- this report in the UK has never been reproduced. Brent Taylor studied 400 children and the MMR vaccine does not cause autism, two other studies tried to replicate the UK study and they could not, which means that the first study in the UK can be discredited

By: Jon Grainger

Statistics about Vaccines

• Measles can be a fatal disease 1 in 1,000 kids will die if infected
• Vaccines are always changing and have changed and are safer than 30 years ago
• In the 1980s children received 23 doses of 7 vaccines, in 2010 children receive 69 doses
  

  By: Partha S. Sahana

  of 16 vaccines

• 9 billion vaccines given and 18,000 documented poor outcomes
• 1 in 5500 diseases of vaccines cause a problem
• 1 in 600 kids/year will catch vaccine preventable disease
• Life expectancy in the US is higher than ever before because of vaccines

THE VACCINE DEBATE

The controversy regarding vaccines

• FDA has not studied ingredients in vaccines and has not researched how human bodies process it
• High doses of mercury don’t cause autism but contribute to brain dysfunction
• Aluminum studied on mice showed immediate changes and brain dysfunction
• Doctors are financially benefiting from vaccines
• There are severe consequences due to the current vaccine policy and schedule, many of which are simply dismissed as coincidence or diagnosed improperly
• Vaccination system is not working well for today’s society

What YOU Need to Know

The experts that support vaccination schedules and the safety of vaccinations far outnumber the experts who did not agree with vaccination safety and their effectiveness.  The biggest reason that people refuse to vaccinate is because of false information provided by society. Research concludes that vaccinations are safe and effective in eradicating diseases. When individuals refuse to vaccinate it not only puts them at risk but it puts others who are immunocompromised and cannot receive vaccinations at risk. Noncompliance with a vaccinations schedule will not only lead to potential reemergence of previously eradicated diseases but also the deadly complications of these diseases. Vaccinating is important for the future of the society and their safety.

Still Have questions?  Don’t Worry!

• Make an appointment and talk to your pediatrician about your concerns
• Visit  a credible website like the CDC Website for more information (http://www.cdc.gov/vaccines/hcp/patient-ed/conversations/downloads/talk-infants-color-office.pdf)
• Or visit the online education center at the Children Hospital of Philadelphia for more infromation (http://www.chop.edu/centers-programs/vaccine-education-center#.V77B6_krLDc)

References

Driver, C. (2015). Case studies in childhood vaccination. Nurse Prescribing, 13(3), 122-126. Retrieved October 24, 2015

Jarrett, C., Wilson, R., O’Leary, M., Eckersberger, E., & Larson, H. J. (2015, April 18). Strategies for addressing vaccine hesitancy – A systematic review. Vaccines, 33, 4180-4190. Retrieved Ocotber 24, 2015, from http://dx.doi.org/10.1016/j.vaccine.2015.04.040

Maglione, M. A., Das, L., Raaen, L., Smith, A., Charr, R., Newberry, S., . . . Gidengil, C. (2014). Safety of Vaccines Used for Routine Immunization of U.S. Children: A Systemic Review. Pediatrics, 134(2), 1-13. Retrieved October 24, 2015

OYE Global .(2015, January 23).The Greater Good[Video File] retrieved from https://www.youtube.com/watch?v=o_nWp6ZHA2Q

The Children’s Hospital Of Philadelphia.(2009, November 16).Vaccines: Separating Fact from Fear – The Children’s Hospital of Philadelphia[Video File} retrieved from https://www.youtube.com/watchv=7CrvznJOt2I&feature=youtu.be&list=PL054F3874DB216361

The Doctors. (2008, December 3).Child Vaccinations – The Doctors Debate [Video File] retrieved from https://www.youtube.com/watch?v=eMrFV2rnHlo