How an Idaho vaccine advocacy org plans its annual goals

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The start of a new year means many nonprofits and community health workers are busy setting goals and reflecting on what’s worked and what hasn’t. For those engaged in vaccine outreach, it also means reflecting on the tools and tactics that help them communicate better with their communities about why vaccines matter.

Across the country, childhood vaccination rates have declined since the COVID-19 pandemic, resulting in a resurgence of preventable diseases like pertussis. 

Also known as whooping cough, pertussis has surged in states like Idaho, said Karen Jachimowski Sharpnack, executive director of the Idaho Immunization Coalition, in a conversation with PGN about the organization’s 2025 priorities. 

Sharpnack shared how spikes in infectious respiratory illnesses can create opportunities to listen better and understand the nuances of the communities they serve.

Here’s more of what Sharpnack said.

[Editor’s note: The contents of this interview have been edited for length and clarity.]

PGN: Whooping cough cases are up in your state. Can you share an example of how your organization is responding?

Karen Jachimowski Sharpnack: If you look at Treasure Valley and Northern Idaho, the majority of those cases have been reported, and it’s like five times as much as we had the previous year. 

So, two things that the Coalition is doing in response: First, we put out radio public service announcements throughout those particular areas about what whooping cough is, how contagious it is, and what you should do if you think your child or anyone you know has it. 

Second, we are contacting every school superintendent, principal, school nurse, with a letter from us at the Coalition [to warn about] the whooping cough outbreaks in schools right now. Here’s what the symptoms are, here’s what you can do, and then here’s how you can protect yourself and your families. 

It doesn’t mean the health district wouldn’t do it, or the Department of Health and Welfare can’t do it. But from our standpoint, at least we are bringing an awareness to the schools that this is happening. 

PGN: How does your organization decide when outreach is needed? How do you take a pulse of your communities’ vaccine attitudes?

K.J.S.: We consistently hold listening sessions. We do them in English and Spanish if we need to, and we go around—and I’m talking about the southern part of the state—and bring people together. 

We’ve done adults, we’ve done teenagers, we’ve done college students, we’ve done seniors, we’ve done all age groups. 

So, we’ll bring eight or 10 people together, and we’ll spend a couple of hours with them. We feed them and we also pay them to be there. We say, ‘We want to hear from you about what you’re hearing about vaccines, what your views are if you’re vaccinated.’ Anytime, by the way, they can get up and leave and still get paid. 

We want to hear what they’re hearing on the ground. And these sessions are extremely informational. For one, we learn about the misinformation that goes out there, like immediately. And two, we’re able to then focus [on how to respond]. If we’re hearing this, what kind of media campaign do we need to get together?

PGN: How do these listening sessions inform your work?

K.J.S.: So, a couple times a year we also pay a professional poller to do a poll. And when we get those results we check them against our listening sessions. We want to see: Are we on target? Are we ahead? 

We just finished putting a one-pager together for legislators, so we’re ready to go with the new [legislative] session. We do this poll every year in August-September to know how Idahoans are feeling about vaccines. We get the results in October, because we’re getting ready for the next year. 

We actually poll 19-to-64-year-olds, really honing in on questions like, ‘Do you believe vaccines are safe and effective?’ ‘Do you believe that school vaccination rules should still be in place?’

And what’s pretty cool is that two-thirds of Idahoans still believe vaccines are safe and effective, want to keep school rules in place, and believe that the infrastructure systems that we have in place for our vaccine registry should remain the same. Those are important to hear, so this is really good information that we can pull out and do something with.

PGN: Like what?

K.J.S.: Here’s the bottom line. It takes money to do this work, so you have to be able to say what you are going to do with the results. 

Doing a poll costs anywhere from $15,000 to $35,000. This is an expensive investment, but we know that the polling is so important to us, along with the time that I have my staff go out and do the listening sessions and get feedback. 

We take those results to educate, to talk to our legislators, and advocate for vaccines. We actually do these high-level media campaigns around the state. So, we are actually doing something with the polling. We’re not just sharing the results out. 

And then we actually ask, what can we do to make a change? What are we hearing that we need to focus on? 

That’s why it’s really important, because we are actually pushing this out for 2025. We know where we’re going in 2025 programmatically with marketing, and we know where we’re going with advocacy work. 

We’re not guessing. We’re actually listening to people. And then we’re making really concrete decisions on how we’re going to move the organization forward to be able to help our communities.

This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Could ADHD drugs reduce the risk of early death? Unpacking the findings from a new Swedish study

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Attention-deficit hyperactivity disorder (ADHD) can have a considerable impact on the day-to-day functioning and overall wellbeing of people affected. It causes a variety of symptoms including difficulty focusing, impulsivity and hyperactivity.

    For many, a diagnosis of ADHD, whether in childhood or adulthood, is life changing. It means finally having an explanation for these challenges, and opens up the opportunity for treatment, including medication.

    Although ADHD medications can cause side effects, they generally improve symptoms for people with the disorder, and thereby can significantly boost quality of life.

    Now a new study has found being treated for ADHD with medication reduces the risk of early death for people with the disorder. But what can we make of these findings?

    A large study from Sweden

    The study, published this week in JAMA (the prestigious journal of the American Medical Association), was a large cohort study of 148,578 people diagnosed with ADHD in Sweden. It included both adults and children.

    In a cohort study, a group of people who share a common characteristic (in this case a diagnosis of ADHD) are followed over time to see how many develop a particular health outcome of interest (in this case the outcome was death).

    For this study the researchers calculated the mortality rate over a two-year follow up period for those whose ADHD was treated with medication (a group of around 84,000 people) alongside those whose ADHD was not treated with medication (around 64,000 people). The team then determined if there were any differences between the two groups.

    What did the results show?

    The study found people who were diagnosed and treated for ADHD had a 19% reduced risk of death from any cause over the two years they were tracked, compared with those who were diagnosed but not treated.

    In understanding this result, it’s important – and interesting – to look at the causes of death. The authors separately analysed deaths due to natural causes (physical medical conditions) and deaths due to unnatural causes (for example, unintentional injuries, suicide, or accidental poisonings).

    The key result is that while no significant difference was seen between the two groups when examining natural causes of death, the authors found a significant difference for deaths due to unnatural causes.

    So what’s going on?

    Previous studies have suggested ADHD is associated with an increased risk of premature death from unnatural causes, such as injury and poisoning.

    On a related note, earlier studies have also suggested taking ADHD medicines may reduce premature deaths. So while this is not the first study to suggest this association, the authors note previous studies addressing this link have generated mixed results and have had significant limitations.

    In this new study, the authors suggest the reduction in deaths from unnatural causes could be because taking medication alleviates some of the ADHD symptoms responsible for poor outcomes – for example, improving impulse control and decision-making. They note this could reduce fatal accidents.

    The authors cite a number of studies that support this hypothesis, including research showing ADHD medications may prevent the onset of mood, anxiety and substance use disorders, and lower the risk of accidents and criminality. All this could reasonably be expected to lower the rate of unnatural deaths.

    Strengths and limitations

    Scandinavian countries have well-maintained national registries that collect information on various aspects of citizens’ lives, including their health. This allows researchers to conduct excellent population-based studies.

    Along with its robust study design and high-quality data, another strength of this study is its size. The large number of participants – almost 150,000 – gives us confidence the findings were not due to chance.

    The fact this study examined both children and adults is another strength. Previous research relating to ADHD has often focused primarily on children.

    One of the important limitations of this study acknowledged by the authors is that it was observational. Observational studies are where the researchers observe and analyse naturally occurring phenomena without intervening in the lives of the study participants (unlike randomised controlled trials).

    The limitation in all observational research is the issue of confounding. This means we cannot be completely sure the differences between the two groups observed were not either partially or entirely due to some other factor apart from taking medication.

    Specifically, it’s possible lifestyle factors or other ADHD treatments such as psychological counselling or social support may have influenced the mortality rates in the groups studied.

    Another possible limitation is the relatively short follow-up period. What the results would show if participants were followed up for longer is an interesting question, and could be addressed in future research.

    What are the implications?

    Despite some limitations, this study adds to the evidence that diagnosis and treatment for ADHD can make a profound difference to people’s lives. As well as alleviating symptoms of the disorder, this study supports the idea ADHD medication reduces the risk of premature death.

    Ultimately, this highlights the importance of diagnosing ADHD early so the appropriate treatment can be given. It also contributes to the body of evidence indicating the need to improve access to mental health care and support more broadly.The Conversation

    Hassan Vally, Associate Professor, Epidemiology, Deakin University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Healing Cracked Fingers

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝Question. Suffer from cracked (split) finger tips in the cold weather. Very painful, is there something I can take to ward off this off. Appreciate your daily email.❞

    Ouch, painful indeed! Aside from good hydration (which is something we easily forget in cold weather), there’s no known internal guard against this*, but from the outside, oil-based moisturizers are the way to go.

    Olive oil, coconut oil, jojoba oil, and shea butter are all fine options.

    If the skin is broken such that infection is possible, then starting with an antiseptic ointment/cream is sensible. A good example product is Savlon, unless you are allergic to its active ingredient chlorhexidine.

    *However, if perchance you are also suffering from peripheral neuropathy (a common comorbidity of cracked skin in the extremities), then lion’s main mushroom can help with that.

    Writer’s anecdote: I myself started suffering from peripheral neuropathy in my hands earlier this year, doubtlessly due to some old injuries of mine.

    However, upon researching for the above articles, I was inspired to try lion’s mane mushroom for myself. I take it daily, and have now been free of symptoms of peripheral neuropathy for several months.

    Here’s an example product on Amazon, by the way

    Enjoy!

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  • Feeding You Lies – by Vani Hari

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    When it comes to advertising, we know that companies will often be as misleading as they can get away with. But just how misleading is it?

    Vani Hari, of “Food Babe” fame, is here to unravel it all.

    The book covers many areas of food and drink advertising and marketing, and gives particular attention to:

    • Sodas (with and without sugar), and how deleterious they are to the health—as well as not even helping people lose weight, but actively hindering
    • Nutritionally fortified foods, and what we may or may not actually get from them by the time the processing is done
    • Organic food, and what that may or may not mean

    She also covers a lot of what happens outside of supermarkets, way back in universities and corporate boardrooms. In short, who is crossing whose palms with silver for a seal of approval… And what that means for us as consumers.

    A strength of this book that sets it apart from many of its genre, by the way, is that while being deeply critical of certain institutions’ practices, it doesn‘t digress into tinfoil-hat pseudoscientific scaremongering, either. Here at 10almonds we love actual science, so that was good to see too.

    Bottom line: is you’d like to know “can they say that and get away with it if it’s not true?” and make decisions based on the actual nutritional value of things, this is a great book for you.

    Click here to check out “Feeding You Lies” on Amazon and make your shopping healthier!

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  • Why do disinfectants only kill 99.9% of germs? Here’s the science

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Have you ever wondered why most disinfectants indicate they kill 99.9% or 99.99% of germs, but never promise to wipe out all of them? Perhaps the thought has crossed your mind mid-way through cleaning your kitchen or bathroom.

    Surely, in a world where science is able to do all sorts of amazing things, someone would have invented a disinfectant that is 100% effective?

    The answer to this conundrum requires understanding a bit of microbiology and a bit of mathematics.

    Davor Geber/Shutterstock

    What is a disinfectant?

    A disinfectant is a substance used to kill or inactivate bacteria, viruses and other microbes on inanimate objects.

    There are literally millions of microbes on surfaces and objects in our domestic environment. While most microbes are not harmful (and some are even good for us) a small proportion can make us sick.

    Although disinfection can include physical interventions such as heat treatment or the use of UV light, typically when we think of disinfectants we are referring to the use of chemicals to kill microbes on surfaces or objects.

    Chemical disinfectants often contain active ingredients such as alcohols, chlorine compounds and hydrogen peroxide which can target vital components of different microbes to kill them.

    Gloved hands spraying and wiping a surface.
    Diseinfectants can contain a range of ingredients. Maridav/Shutterstock

    The maths of microbial elimination

    In the past few years we’ve all become familiar with the concept of exponential growth in the context of the spread of COVID cases.

    This is where numbers grow at an ever-accelerating rate, which can lead to an explosion in the size of something very quickly. For example, if a colony of 100 bacteria doubles every hour, in 24 hours’ time the population of bacteria would be more than 1.5 billion.

    Conversely, the killing or inactivating of microbes follows a logarithmic decay pattern, which is essentially the opposite of exponential growth. Here, while the number of microbes decreases over time, the rate of death becomes slower as the number of microbes becomes smaller.

    For example, if a particular disinfectant kills 90% of bacteria every minute, after one minute, only 10% of the original bacteria will remain. After the next minute, 10% of that remaining 10% (or 1% of the original amount) will remain, and so on.

    Because of this logarithmic decay pattern, it’s not possible to ever claim you can kill 100% of any microbial population. You can only ever scientifically say that you are able to reduce the microbial load by a proportion of the initial population. This is why most disinfectants sold for domestic use indicate they kill 99.9% of germs.

    Other products such as hand sanitisers and disinfectant wipes, which also often purport to kill 99.9% of germs, follow the same principle.

    A tub of cleaning supplies.
    You might have noticed none of the cleaning products in your laundry cupboard kill 100% of germs. Africa Studio/Shutterstock

    Real-world implications

    As with a lot of science, things get a bit more complicated in the real world than they are in the laboratory. There are a number of other factors to consider when assessing how well a disinfectant is likely to remove microbes from a surface.

    One of these factors is the size of the initial microbial population that you’re trying to get rid of. That is, the more contaminated a surface is, the harder the disinfectant needs to work to eliminate the microbes.

    If for example you were to start off with only 100 microbes on a surface or object, and you removed 99.9% of these using a disinfectant, you could have a lot of confidence that you have effectively removed all the microbes from that surface or object (called sterilisation).

    In contrast, if you have a large initial microbial population of hundreds of millions or billions of microbes contaminating a surface, even reducing the microbial load by 99.9% may still mean there are potentially millions of microbes remaining on the surface.

    Time is is a key factor that determines how effectively microbes are killed. So exposing a highly contaminated surface to disinfectant for a longer period is one way to ensure you kill more of the microbial population.

    This is why if you look closely at the labels of many common household disinfectants, they will often suggest that to disinfect you should apply the product then wait a specified time before wiping clean. So always consult the label on the product you’re using.

    A woman cleaning a kitchen counter with a pink cloth.
    Disinfectants won’t necessarily work in your kitchen exactly like they work in a lab. Ground Picture/Shutterstock

    Other factors such as temperature, humidity and the type of surface also influence how well a disinfectant works outside the lab.

    Similarly, microbes in the real world may be either more or less sensitive to disinfection than those used for testing in the lab.

    Disinfectants are one part infection control

    The sensible use of disinfectants plays an important role in our daily lives in reducing our exposure to pathogens (microbes that cause illness). They can therefore reduce our chances of getting sick.

    The fact disinfectants can’t be shown to be 100% effective from a scientific perspective in no way detracts from their importance in infection control. But their use should always be complemented by other infection control practices, such as hand washing, to reduce the risk of infection.

    Hassan Vally, Associate Professor, Epidemiology, Deakin University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The End of Food Allergy – by Dr. Kari Nadeau & Sloan Barnett

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We don’t usually mention author credentials beyond their occupation/title. However, in this case it bears acknowledging at least the first line of the author bio:

    ❝Kari Nadeau, MD, PhD, is the director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University and is one of the world’s leading experts on food allergy❞

    We mention this, because there’s a lot of quack medicine out there [in general, but especially] when it comes to things such as food allergies. So let’s be clear up front that Dr. Nadeau is actually a world-class professional at the top of her field.

    This book is, by the way, about true allergies—not intolerances or sensitivities. It does touch on those latter two, but it’s not the main meat of the book.

    In particular, most of the research cited is around peanut allergies, though the usual other common allergens are all discussed too.

    The authors’ writing style is that of a science educator (Dr. Nadeau’s co-author, Sloan Barnett, is lawyer and health journalist). We get a clear explanation of the science from real-world to clinic and back again, and are left with a strong understanding, not just a conclusion.

    The titular “End of Food Allergy” is a bold implicit claim; does the book deliver? Yes, actually.

    The book lays out guidelines for safely avoiding food allergies developing in infants, and yes, really, how to reverse them in adults. But…

    Big caveat:

    The solution for reversing severe food allergies (e.g. “someone nearby touched a peanut three hours ago and now I’m in anaphylactic shock”), drug-assisted oral immunotherapy, takes 6–24 months of weekly several-hour-long clinic visits, relies on having a nearby clinic offering the service, and absolutely 100% cannot be done at home (on pain of probable death).

    Bottom line: it’s by no means a magic bullet, but yes, it does deliver.

    Click here to check out The End of Food Allergy to learn more!

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  • In Vermont, Where Almost Everyone Has Insurance, Many Can’t Find or Afford Care

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    RICHMOND, Vt. — On a warm autumn morning, Roger Brown walked through a grove of towering trees whose sap fuels his maple syrup business. He was checking for damage after recent flooding. But these days, his workers’ health worries him more than his trees’.

    The cost of Slopeside Syrup’s employee health insurance premiums spiked 24% this year. Next year it will rise 14%.

    The jumps mean less money to pay workers, and expensive insurance coverage that doesn’t ensure employees can get care, Brown said. “Vermont is seen as the most progressive state, so how is health care here so screwed up?”

    Vermont consistently ranks among the healthiest states, and its unemployment and uninsured rates are among the lowest. Yet Vermonters pay the highest prices nationwide for individual health coverage, and state reports show its providers and insurers are in financial trouble. Nine of the state’s 14 hospitals are losing money, and the state’s largest insurer is struggling to remain solvent. Long waits for care have become increasingly common, according to state reports and interviews with residents and industry officials.

    Rising health costs are a problem across the country, but Vermont’s situation surprises health experts because virtually all its residents have insurance and the state regulates care and coverage prices.

    For more than 15 years, federal and state policymakers have focused on increasing the number of people insured, which they expected would shore up hospital finances and make care more available and affordable.

    “Vermont’s struggles are a wake-up call that insurance is only one piece of the puzzle to ensuring access to care,” said Keith Mueller, a rural health expert at the University of Iowa.

    Regulators and consultants say the state’s small, aging population of about 650,000 makes spreading insurance risk difficult. That demographic challenge is compounded by geography, as many Vermonters live in rural areas, where it’s difficult to attract more health workers to address shortages.

    At least part of the cost spike can be attributed to patients crossing state lines for quicker care in New York and Massachusetts. Those visits can be more expensive for both insurers and patients because of long ambulance rides and charges from out-of-network providers.

    Patients who stay, like Lynne Drevik, face long waits. Drevik said her doctor told her in April that she needed knee replacement surgeries — but the earliest appointment would be in January for one knee and the following April for the other.

    Drevik, 59, said it hurts to climb the stairs in the 19th-century farmhouse in Montgomery Center she and her husband operate as an inn and a spa. “My life is on hold here, and it’s hard to make any plans,” she said. “It’s terrible.”

    Health experts say some of the state’s health system troubles are self-inflicted.

    Unlike most states, Vermont regulates hospital and insurance prices through an independent agency, the Green Mountain Care Board. Until recently, the board typically approved whatever price changes companies wanted, said Julie Wasserman, a health consultant in Vermont.

    The board allowed one health system — the University of Vermont Health Network — to control about two-thirds of the state’s hospital market and allowed its main facility, the University of Vermont Medical Center in Burlington, to raise its prices until it ranked among the nation’s most expensive, she said, citing data the board presented in September.

    Hospital officials contend their prices are no higher than industry averages.

    But for 2025, the board required the University of Vermont Medical Center to cut the prices it bills private insurers by 1%.

    The nonprofit system says it is navigating its own challenges. Top officials say a severe lack of housing makes it hard to recruit workers, while too few mental health providers, nursing homes, and long-term care services often create delays in discharging patients, adding to costs.

    Two-thirds of the system’s patients are covered by Medicare or Medicaid, said CEO Sunny Eappen. Both government programs pay providers lower rates than private insurance, which Eappen said makes it difficult to afford rising prices for drugs, medical devices, and labor.

    Officials at the University of Vermont Medical Center point to several ways they are trying to adapt. They cited, for example, $9 million the hospital system has contributed to the construction of two large apartment buildings to house new workers, at a subsidized price for lower-income employees.

    The hospital also has worked with community partners to open a mental health urgent care center, providing an alternative to the emergency room.

    In the ER, curtains separate areas in the hallway where patients can lie on beds or gurneys for hours waiting for a room. The hospital also uses what was a storage closet as an overflow room to provide care.

    “It’s good to get patients into a hallway, as it’s better than a chair,” said Mariah McNamara, an ER doctor and associate chief medical officer with the hospital.

    For the about 250 days a year when the hospital is full, doctors face pressure to discharge patients without the ideal home or community care setup, she said. “We have to go in the direction of letting you go home without patient services and giving that a try, because otherwise the hospital is going to be full of people, and that includes people that don’t need to be here,” McNamara said.

    Searching for solutions, the Green Mountain Care Board hired a consultant who recommended a number of changes, including converting four rural hospitals into outpatient facilities, in a worst-case scenario, and consolidating specialty services at several others.

    The consultant, Bruce Hamory, said in a call with reporters that his report provides a road map for Vermont, where “the health care system is no match for demographic, workforce, and housing challenges.”

    But he cautioned that any fix would require sacrifice from everyone, including patients, employers, and health providers. “There is no simple single policy solution,” he said.

    One place Hamory recommended converting to an outpatient center only was North Country Hospital in Newport, a village in Vermont’s least populated region, known as the Northeast Kingdom.

    The 25-bed hospital has lost money for years, partly because of an electronic health record system that has made it difficult to bill patients. But the hospital also has struggled to attract providers and make enough money to pay them.

    Officials said they would fight any plans to close the hospital, which recently dropped several specialty services, including pulmonology, neurology, urology, and orthopedics. It doesn’t have the cash to upgrade patient rooms to include bathroom doors wide enough for wheelchairs.

    On a recent morning, CEO Tom Frank walked the halls of his hospital. The facility was quiet, with just 14 admitted patients and only a couple of people in the ER. “This place used to be bustling,” he said of the former pulmonology clinic.

    Frank said the hospital breaks even treating Medicare patients, loses money treating Medicaid patients, and makes money from a dwindling number of privately insured patients.

    The state’s strict regulations have earned it an antihousing, antibusiness reputation, he said. “The cost of health care is a symptom of a larger problem.”

    About 30 miles south of Newport, Andy Kehler often worries about the cost of providing health insurance to the 85 workers at Jasper Hill Farm, the cheesemaking business he co-owns.

    “It’s an issue every year for us, and it looks like there is no end in sight,” he said.

    Jasper Hill pays half the cost of its workers’ health insurance premiums because that’s all it can afford, Kehler said. Employees pay $1,700 a month for a family, with a $5,000 deductible.

    “The coverage we provide is inadequate for what you pay,” he said.

     

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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