April 7, 2014

USAT: How anti-vaxxers helped breathe new life into old diseases

Daily Briefing

Writing in USA Today this week, Yamiche Alcindor examines why a growing number of parents are choosing not to vaccinate their children and how those decisions are contributing to a resurgence of diseases once considered near eradication.

According to CDC, individuals who chose not to get vaccinated are helping diseases like measles make a comeback in areas across the United States. Anne Schuchat, CDC's director of immunizations and respiratory diseases, says recent measles outbreaks in California and New York are a sign of what could happen nationally if vaccination rates decline.

Measles was considered eradicated in 2000, but the disease is on track to infect three times as many Americans in 2014 than it did in 2009. "We really don't want a child to die from measles, but it's almost inevitable," says Schuchat.

Why declining vaccination rates matter

According Schuchat, less than 1% of Americans forgo all vaccinations. But in some states, the percentage of kindergarten-age children forging vaccinations for non-medical reasons is growing and neared 5% in 2013. California has the largest number of kindergartners who are unvaccinated for their parents' philosophical reasons at 14,921.

The states with the best—and worst—vaccine coverage

"People assume this will never happen to them until it happens to them… It's a shame that's the way we have to learn the lesson," says Children's Hospital of Philadelphia's Paul Offit.

The most vulnerable are infants who are not old enough to be vaccinated, children with compromised immune systems, and kids who are not vaccinated for medical reasons.

Nine-week-old Brady Alcaide was one of those vulnerable children. He succumbed to whooping cough, a nearly forgotten disease that has regained traction in recent years. Brady's parents do not know how he got whooping cough, but a person who was not vaccinated for the disease could have easily carried it without symptoms. "It doesn't have to be on an airplane or at an airport. It could be at a grocery store or the concert you went to," Schuchat says.

High vaccination rates help protect children who are medically unable to be vaccinated by creating herd immunization, in which a disease is less likely to spread within the community and infect individuals because the vast majority of people cannot contract it.

Years later, vaccine scare leaves its mark on Welsh town

Why some parents opt not to vaccinate

Proponents of the vaccine-free movement, such as Sarah Pope, say it is unfair to pressure parents to vaccinate their children because vaccines are not 100% effective and could have harmful side effects. In 2006, all three of Pope's unvaccinated children contracted whooping cough, but she says she was not worried.

"People only see the bad with infectious diseases. But infectious diseases do help children strengthen their bodies," Pope says, who blogs about vaccines on a health website.

Shane Ellison's three children were born at home and have never been to a doctor, aside from one ED visit for a bruised finger. Ellison—who used to work in the pharmaceutical industry designing medicines—says his children are unvaccinated and healthy. "The doctors all have the same script for vaccines," Ellison says, adding, "It's much more soothing to trust emergency medicine than a vaccine, which for me is like playing Russian roulette."

Doctors note that all medicine can have side effects—even aspirin. And although vaccines are considered safe, they can cause reactions in some children, Schuchat says. But the most common vaccine fear—that they cause autism—has been debunked by myriad studies that found no link.

Pushing to boost vaccinations

State authorities and health care providers have been pushing to boost vaccination rates. Some facilities, such as Olde Towne Pediatrics in Manassas, Va., refuse to take patients unless they are or will be vaccinated.

"We don't want to put our patients at risk because people for their own personal reasons don't want to vaccinate," says Anastasia Williams, a managing partner of the practice and a pediatrician. She added, "We are doing our due diligence to protect our children who wait in our waiting room."

Should doctors 'fire' unvaccinated patients?

Some states are approaching the issue legislatively. In Colorado, state Rep. Dan Pabon (D) has proposed a bill that would require parents to obtain a physician's note or watch a video about the risks of going unvaccinated before choosing to not vaccinate their children. About 4% of Colorado kindergarteners in 2013 were unvaccinated for non-medical reasons (Alcindor, USA Today, 4/6).

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