Saturday, February 24, 2018

Esther Wynne, public health nurse for Big Horn County, looks through the Blue Cross Blue Shield computer registry last Thursday. Looking on is Dawn Benth, public health nurse at the Crow/Northern Cheyenne Hospital in Crow Agency.

Public health nurses offer back-to-school shots and tips

School is starting up countywide and, according to local health professionals, students need to keep up-to-date with vaccines, sports physicals and more.
The hum of refrigeration units could be heard last Thursday as Esther Wynne, public health nurse for Big Horn County, helped speed up the vaccination process in one of Blue Cross Blue Shield’s Care Vans. Blue Cross had arrived in Hardin on Aug. 3 and last Thursday for the River Valley Farmer’s market. They intend to continue the practice in the future.
Once in the van, students of all ages received the vaccines necessary to start the upcoming year. Big Horn County received no charge for the service, and it was available to those with or without insurance.
Jamey Petersen, Care Van administrator, said her group has provided an estimated 9,000 vaccines since the program started in 2014. Care Van focuses on rural and high-risk communities.
“We are encouraged to call [Blue Cross] and say, ‘We would like to do a clinic on-site somewhere,” Wynne said. “They have the refrigerator and freezer, space so we can make sure our vaccines are kept at an optimum temperature and…we can look on the registry to find out what shots the children need.”
They also can see what shots children already have, she said, giving students the opportunity to avoid superfluous poking and prodding.
To get into kindergarten, Wynne said, children must have their “kindergarten shots” to protect them from polio, diphtheria, tetanus, pertussis, measles, mumps and rubella. Some students can’t get vaccines due to compromised immune systems, she continued, and having fellow classmates vaccinated helps protect them from contracting diseases.
According to data compiled by the Montana Department of Health and Human Services, 3.7 percent of the state’s kindergarteners – 444 in total – received a medical or religious exemption to state vaccine requirements.
Wynne stressed that vaccines “are safe,” despite what people on Internet message boards may say. Due to misconceptions regarding vaccines, she added, unnecessary outbreaks have occurred. 
“We still have outbreaks of measles and pertussis,” she said. “Three years ago, we had a pertussis outbreak. The main thing about pertussis is it can kill babies…especially in the wintertime.
“We get grandparents vaccinated now. We vaccinate a lot for it now.”
Balloons, stickers and a Ninja Turtle plush doll helped the younger children get through the process. Wynne recalled one young patient on Aug. 3 who took the process of getting his vaccines unusually well. Petersen kept him focused on stickers and questions such as, “Who is your favorite Ninja Turtle?”
“I gave him one shot; he did not flinch. He didn’t know he got the shot,” Wynne said. “I’m used to kids [kicking]. I’ll look to make sure they don’t have cowboy boots on before I give them shots.
“This kid was totally mesmerized. It was probably the easiest shot he’d ever gotten.”
Seventh graders, she said, must receive a tetanus booster with a pertussis component. She also has a “line up” of other shots to eliminate disease.
Students ages 11-17 are encouraged by the Montana Immunization Program to check their immunization record. If they received all the appropriate shots and enter a drawing at, they will be put in a drawing to win a $50 Amazon gift card on Oct. 31.
“We’re catching up with [Hepatitis A] and we’ve got the human papillomavirus, which is our first vaccine that prevents cancer,” Wynne said. “We have the meningococcal – MCV4, it’s got four strains of meningococcal – which is something we’ve had in Montana. It’s a rare disease, but it’s a devastating disease.”
In order to keep other students safe, she said, it’s important for parents to not bring sick children into the classroom. 
Dawn Benth, public health nurse at the Crow/Northern Cheyenne Hospital in Crow Agency, added that if parents spot head lice, to treat this problem before sending the child to school. In a classroom environment, she continued, “it spreads like crazy.” She and Wynne have encountered cases of head lice on a regular basis.
“If people think they have head lice, they can come in and get it checked and get it treated,” Benth said. “They can go to any public health center or to Crow nursing. We’re happy to check them before they go to school and it turns into a big [problem].
“If they don’t pull it out and clean up the house, it’s going to come right back.”
On the subject of sports physicals, Wynne said students must get them finished each year in order to determine whether it is safe for them to participate.
“They check your blood pressure, listen to your lungs and listen to your heart,” Wynne said.
Benth added that physicals may also involve testing for sexually transmitted diseases. Many students who have contracted STDs, she said, aren’t aware that they have them.
In addition, she stressed the importance of eye exams.
“One of the big things people don’t do before school starts is get their eyes checked,” Benth said. “[This is] so they can see the board, and when they’re in sports they’re not tripping and falling.”
As fall sports begin such as cross-country, football, golf and volleyball, they will intersect with flu season, which usually starts sometime around October. Fortunately, Benth and Wynne said, there’s a shot for that.