The Immunization Debate—Knowledge is the Best Protection

Last December an outbreak of measles—which likely started with one infected person at Disneyland—caused an outbreak of the highly contagious illness that spread from California to six other states and Mexico. The incident also sparked a highly controversial debate on vaccinations that has parents on both sides of the issue seeing red.

It’s Back
Once considered an eliminated condition as of 2000 (with the lowest reported incidence of measles—just 37 cases—reported in 2004), last year that number jumped to 644 infections in the United States, according to ABCNews.com.

Possible causes for the resurgence include “clusters of unvaccinated people and increased international travel.” According to the Centers for Disease Control and Prevention (CDC), countries in Europe, Africa, Asia, and the Pacific still experience outbreaks of the disease.

Although the rate of fatalities from a case of Measles is relatively rare (1 or 2 out of every 1,000 infected people, based on incidences before the vaccine was first introduced in 1963) and there have been no reported deaths from the recent outbreak, measles is still considered dangerous. In some cases it can lead to encephalitis (swelling of the brain). But the main concern is its highly contagious nature.

In a recent article in The New York Times, Retro Report’s Clyde Haberman explained, “Someone who has it can sneeze in a room, and the virus will linger in the air for two hours. Any unvaccinated person who enters that room risks becoming infected and, of course, can then spread it further.”

What the Law—and Individual Schools—Allow
All 50 states have laws that require students to be vaccinated. But some schools allow exemptions to these laws for parents who have not vaccinated their children because of religious or personal reasons (so-called “personal belief exemptions”).

Still other unvaccinated children enter as “contingent” students with the stipulation that they will get the vaccinations, but the school fails to do the required follow-up.

Safety in Numbers
The public outcry against vaccination objectors mainly hinges around the concept of herd immunity.

With herd immunity, it is the large majority of people in a community who are vaccinated against a disease who help protect those who are not vaccinated—say infants under the age of 12 months and those with compromised immune systems—from contracting the disease. You need somewhere around 92 to 95 percent of people to be vaccinated to achieve the herd immunity benefit.

In some places—like Marin and Orange Counties in California—the vaccination rate is below the threshold needed to assure herd immunity. That has led some parents, including those who have children undergoing Cancer treatments who can’t be vaccinated for medical reasons, to appeal to their children’s schools to restrict those who have not been vaccinated from attending classes, especially when a case of measles has been identified in their area. But even some parents of healthy vaccinated children have gone as far as not allowing unvaccinated children to play with their kids or visit their homes.

Lashing Out at a Minority
In the meantime, those who oppose vaccinating their children for religious reasons or because they are concerned that the vaccine contains toxins that are harmful to their child (in other words, they believe the cure is worse than the disease) feel bullied into sacrificing their principles and beliefs to satisfy the majority and avoid social ostracization.

Some anti-vaccination parents are convinced that a now-discredited article published in a medical journal in 1998 linking the Measles, Mumps, and Rubella (MMR) vaccine to autism is indeed fact. Others aren’t certain of a link, but are erring on the side of no vaccine or using “natural” methods of immunization, like exposing their child to the disease in the hope that they’ll build a natural immunization to it.

In The New York Times’ TheUpshot, Brendan Nyhan suggests that the current vaccination debate threatens to polarize the two sides much like partisan politics. He also stresses the need to take a step back and actually study the numbers. Nyhan writes,

“News articles focusing on an extreme and unrepresentative group of anti-vaccine parents and celebrities may cause others to wrongly infer that their views are mainstream… In fact, the social consensus in favor of vaccination is overwhelming. Even after recent increases, for instance, only 3 percent of kindergartners in California had an exemption from vaccination.”

Is my child at risk?
The majority of children in the United States have been vaccinated for measles. According to the CDC, among those who have been vaccinated, about 3 out of 100 people will still get measles. But they are more likely to experience a mild case of the disease and are less likely to spread it to others.

If you are Massachusetts resident, you’ll be assured to know that there were 0 cases of measles reported in the Commonwealth between January 1 and February 20 of this year. In fact, there were 0 cases in any of the New England states.

The medical establishment recommends that all children whose immune systems are not compromised be immunized at about 12 months and then again at age 5 or 6. Of course every parent should start a dialogue with their child's pediatrician to discuss any concerns they might have about vaccinations and to help determine the best course of action for their family.