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Spokane, Washington  Est. May 19, 1883

Quelling vaccine fear in Spokane’s Russian-speaking community

Ten-year-old Daniel, left, and 7-year-old Philip greet their father, Andrei Yeromenko, as he returns to their Liberty Lake home after work on March 17. Yeromenko is an advocate for childhood immunizations, particularly in the local Russian-speaking community. (Kathy Plonka)

Earlier this month about 20 people from Spokane’s Russian-speaking community gathered to talk – in Russian – about the fear and reluctance to vaccinate their children for diseases such as hepatitis B, measles, mumps, polio and pertussis.

Russian-speaking communities in Washington have the lowest childhood immunization rates of any population, a consistent pattern since about 2008, according to a study conducted by the state Department of Health in 2012.

Washington state in general has a high exemption rate for vaccinations – notably in the 2008-09 school year when 7.6 percent of all kindergarteners had vaccine exemptions.

State law allows parents to opt out of immunizing their children for personal and religious beliefs or medical conditions. This is cited as a reason behind the statewide epidemic of whooping cough declared in April 2012, with more cases reported than any year since the 1940s.

Although exemption rates are decreasing, state health officials still encourage more parents to vaccinate their children, touting that the public health benefits far outweigh the risks.

Part of that mission is reaching out to populations reluctant to vaccinate, including the Russian-speaking. In 2013, Spokane Counts reported 4,215 Russian speakers in the county.

That’s why WithinReach, a nonprofit that helps connect families with health services, put on the vaccine forum for Russian-speakers in Spokane on March 2. The organization is also teaming with Vax Northwest and Group Health to encourage parents who fully immunize their children to speak up and talk openly about their positive experiences, said Sara Jaye Sandford of WithinReach.

Sandford, who attended the forum for Russian-speakers in Spokane, is also working with the Spokane Regional Health District and the local school districts to start a local speak up pilot program. She believes, as does the study, that social networking – often word-of-mouth among friends and family – is the best way to deliver information about the safety of vaccinations.

So much of vaccine hesitance comes down to mistrust.

Some of the conversations during the vaccination forum were tense. One woman held up an immunization request from her child’s school and questioned whether child-protective services would take away her kids if she refused to vaccinate, said Andrei Yeromenko, a Spokane pharmacist who mediated the forum and helped explain why vaccinations are important to preventing disease.

Yeromenko, 37, is Ukrainian, raised in Belarus. He worked in Sweden before coming to Spokane in 2003 and attending pharmacy school at Washington State University. He often works as a translator for patients with health care questions.

He felt the vaccine forum was successful, allowing people to tell their stories and express their fears and then absorb information on the benefits of vaccines, a recent hot topic after a December measles outbreak at Disneyland sickened 145 people in seven states including two in King County. All told, there were 23 measles outbreaks in the U.S. in 2014, including one among Amish communities in Ohio that resulted in 383 cases of measles. Another Washington outbreak early in the year caused 27 cases.

“It’s a big problem in the Russian community,” Yeromenko said about vaccine hesitance. He said more forums, at least annually, are needed to help spread the word that childhood vaccinations are safe and will actually help protect children, not harm them.

He said vaccination is common among the countries of the former Soviet Union, but that they are administered differently than in the United States and that there are sometimes shortages of vaccine.

The concerns raised at the forum mirror the findings in the 2012 Study of Childhood Immunization in Washington State Russian-Speaking Populations report. They include:

• The American health care system is confusing and difficult to navigate, and Russian-speakers don’t always feel like doctors and health care workers listen to their concerns or warn of side effects such as arm soreness and mild fever.

• Health districts and advocacy agencies should provide Russian-language resources online to counter misinformation from medically unsupported websites.

• Parents often want to postpone vaccines if a child is sick, such as with a head cold.

• Parents are wary of giving multiple vaccines at once.

• Some have general anti-government fears often stemming from political corruption, turmoil and economic collapse in the former Soviet Union.

Yeromenko said younger Russian-speakers, those in their 30s, fear vaccination the most, partly because they see themselves as more educated than the older population. They’ll find information online in Russian from dubious sources. He encourages them to find information on legitimate sites such as the Mayo Clinic or the Centers for Disease Control and Prevention.

Misinformation gleaned from the Internet isn’t specific to just the Russian-speaking population. A recent Washington State University study concludes that Internet misinformation is a reason for the high number of unvaccinated children.

Public Health Educator Dannette Dronenburg of the Spokane Regional Health District attended the forum and said the district is interested in having other informational forums for non-English speakers.

The district hasn’t reviewed any findings or suggestions that came from the forum because the transcript is still being translated.

She doesn’t see so much hesitancy to vaccinate, but more of a lack of understanding to the how and why.

“There are new people to our country and we need to be able to offer assistance in navigating the vaccine system,” she said.

That’s why the district is having vaccine clinic fliers and other materials translated into not only Russian, but also Marshallese and Spanish.

According to a July 2013 demographics report, the district calculated that there are more than 14,000 non-English speaking people in the county, and nearly 30,000 foreign-born, of a total population of 475,600. The largest population is Russian speakers, followed by 3,113 Spanish or Spanish Creole speakers and 1,050 Vietnamese.

The anti-vaccination movement isn’t just focused on non-English speakers. It cuts across the socioeconomic and political spectrum, even though health care providers embrace immunizations and conspiracy theories about safety have been debunked.

Yeromenko said it’s important to talk openly about side effects and listen to people’s concerns and then inform them about the importance of immunization. He said that’s especially important for people new to the United States.

“It’s more cultural,” he said, adding that before coming to America he had always heard concerns about vaccinations. “It’s been like that forever where I come from. There is just a lack of trust in general with health care.”