David Baxter PhD
Late Founder
Refusal to vaccinate puts kids at risk
by Rob Rogers, Marin Independent Journal
04/11/2009
Health officials say the rising number of Marin parents who choose not to vaccinate their children against infectious disease could be putting other children and adults at risk.
"It's more than a decision about an individual child," said Dr. Anju Goel, deputy public health officer for Marin County. "Your decision not to vaccinate a child has a larger effect in the community. If you do make that decision, you need to be aware."
Marin has one of the state's highest rates of personal belief exemptions, parental waivers that allow children to enroll in kindergarten without receiving vaccinations against diseases like measles, polio or whooping cough. The number of exemptions in the county increased by 6.3 percent from 1999 to 2008, while the state's rate of exemption grew by only 1.9 percent during the same period.
At some Marin schools, such as the Marin Waldorf School and San Geronimo Valley Elementary School, more than half of kindergartners received exemptions, according to the state Department of Public Health.
"In the past when we would look at children not being vaccinated, it was because they lacked access to care and resources," said Dr. Gilberto Chavez, deputy director for the California Center for Infectious Diseases. "Now, the parents of unimmunized children fall more and more in the realm of highly educated, higher-income individuals."
Some parents object to vaccinations either because they doubt their effectiveness, because they fear the injections will cause other medical conditions or because they distrust the government officials who promote them.
"My reason was intuitive," said Larkspur resident Lisa Laursen, whose 20-year-old daughter was never immunized. "I didn't want to put all those poisons in her body. I'm not fanatical about it, but I really appreciated the choice."
But health officials say the growing number of children who aren't vaccinated could be putting other children at risk for infection - even those who have been immunized.
Putting other children at risk
Individual immunizations aren't always 100 percent effective in preventing disease. When a large number of people in a community are vaccinated, however, the group receives a "herd immunity" that collectively keeps its members safe.
"Vaccines are very effective, but there is a small failure rate," said Dr. Rob Schechter, chief of immunization at the state Department of Public Health. "When the whole population is highly immunized, the few vulnerable children are protected by the immunity of the community. But when there is a high rate of exemptions, diseases can spread even to people who are immunized."
Outbreaks also tend to affect those who are particularly vulnerable to disease: newborn babies, the elderly and those whose immune systems have been weakened by cancer or other diseases, Dr. Schechter said.
"As the rates of unvaccinated children increase, the potential of the (herd immunity) effect decreases," said Dr. Fred Schwartz, public health officer for Marin County. "In effect, it's contributing to the greater risk of the community."
An outbreak of chicken pox affected more than 40 students at the Lagunitas and San Geronimo Valley elementary schools in 2007, where 17 and 57 percent of students had received personal belief exemptions from vaccination. In addition, the Lagunitas School District excluded about 70 students from the two schools for three weeks out of concern that they were at high risk of contagion. Many of them had never been vaccinated.
"We hope to get at least 80 percent of the people in our district inoculated," said Denise Santa Cruz-Bohman, president of the Lagunitas School District board. "We have to leave out some older people, those with immune system problems or babies. That means children who aren't immunized are a danger not to other children, but to those around them. If the community does not get inoculated, it causes problems for everybody else."
Yet the outbreak prompted few parents to change their mind about immunizations, Santa Cruz-Bohman said.
'It's harder to unscare people'
Those who refuse to vaccinate their children - or who choose to provide them with only some of the 12 injections recommended by the U.S. Centers for Disease Control - do so for various reasons. Some worry about possible side effects from the vaccines, while others insist that vaccination doesn't work.
"Vaccination is based on the medical fallacy that our bodies are stupid," said Corte Madera chiropractor Donald Harte. "The truth is that the body has a nearly infinite capacity to protect itself against infection as well as other diseases. When I was a kid, everybody got measles, mumps or chicken pox, and nobody died."
In fact, measles killed an average of 432 people and infected 500,000 each year between 1958 and 1962, according to the U.S. Centers for Disease Control; the disease still kills two out of every 1,000 infected. As late as 1999, one child a week died in the United States as a result of complications from chicken pox, the center reported.
"Many of our younger parents are not aware how serious these diseases are," said Dr. Chavez. "They tend to trivialize them as minor infections that go away easily, when some of them can result in debilitating complications or even death. We've already seen in California outbreaks of measles in the San Diego foothills, as well as outbreaks of pertussis (whooping cough) traced largely to schools where there are high rates of unimmunized children because of their parents' beliefs."
Some parents also believe that childhood vaccination may be responsible for the prevalence of autism and other medical conditions.
"Autism was a rare thing 30 to 40 years ago. Now it's affecting one child in 170," Harte said. "It's an epidemic, physician-caused. And it's ruining a generation."
However, more than 20 medical studies have shown no link between autism and vaccinations, according to Dr. Anju Goel, deputy public health officer for Marin County. In addition, efforts by anti-vaccine advocates to claim such a link in court have failed - most recently on Feb. 12, when the U.S. Court of Federal Claims ruled that neither vaccines nor the mercury-based preservative formerly used in storing them were connected to the autism that developed in three children.
Recognizing that many parents continue to believe in a link between autism and vaccines, the county Department of Health and Human Services created the Marin Immunization Coalition.
"It's a lot harder to unscare people," said coalition facilitator Alison Clayton. "Parents are scared, and all the data is not going to change anything. People want to be able to talk with pediatricians one on one about these issues."
Health officials say vaccines are safe, and that the danger of infectious disease far outweighs that of any potential side effects. While the measles, mumps and rubella vaccine can cause a severe allergic reaction in one out of every 1 million people vaccinated, for example, measles itself causes pneumonia in six out of 100 patients, encephalitis in one out of 1,000 and death in two out of 1,000.
"Current licensed vaccines have been shown to be safe, and continue to be watched closely," Dr. Schechter said. "There's a perception by some families that they need to balance the risk from vaccines with the risk from diseases. What I would say is that the risk from vaccines is very low, and the risks from diseases are considerable and should not be underestimated."
What schools can do
The issue has troubled school officials in several high-exemption districts, who say they're powerless to convince parents to immunize their children.
"Of course it's a concern," said Goldie Curry, principal of the San Geronimo Valley Elementary School. "But parents have a right to make decisions for themselves."
Other school officials say they aren't worried about the issue.
"It's not a big issue," said Jean Bowler, administrator of the Marin Waldorf School, whose exemption rate of 68.29 is the highest in the Bay Area, according to the state Department of Public Health. "Every few years there's an outbreak somewhere in West Marin. But we haven't had anything extraordinary, besides something like strep throat."
Lisa Laursen agrees. While she acknowledges that others may see vaccinations as important, she believes a healthy diet and good nutrition helped keep her daughter free from disease.
"If we can keep the Earth and its waters clean, instead of putting poisons in our babies - I look on it that way," Laursen said.
Yet health officials say clean living alone won't keep children - or communities - free from disease.
"Vaccine-preventable diseases occur in children of all backgrounds, whether or not they are well-cared-for or receive good nutrition," Dr. Chavez said. "The belief someone may have that their holistic lifestyle prevented disease is not backed by science, and is not going to work protecting anybody. Vaccines are the only way to ensure they will not get these dreadful diseases."
RESOURCES
by Rob Rogers, Marin Independent Journal
04/11/2009
Health officials say the rising number of Marin parents who choose not to vaccinate their children against infectious disease could be putting other children and adults at risk.
"It's more than a decision about an individual child," said Dr. Anju Goel, deputy public health officer for Marin County. "Your decision not to vaccinate a child has a larger effect in the community. If you do make that decision, you need to be aware."
Marin has one of the state's highest rates of personal belief exemptions, parental waivers that allow children to enroll in kindergarten without receiving vaccinations against diseases like measles, polio or whooping cough. The number of exemptions in the county increased by 6.3 percent from 1999 to 2008, while the state's rate of exemption grew by only 1.9 percent during the same period.
At some Marin schools, such as the Marin Waldorf School and San Geronimo Valley Elementary School, more than half of kindergartners received exemptions, according to the state Department of Public Health.
"In the past when we would look at children not being vaccinated, it was because they lacked access to care and resources," said Dr. Gilberto Chavez, deputy director for the California Center for Infectious Diseases. "Now, the parents of unimmunized children fall more and more in the realm of highly educated, higher-income individuals."
Some parents object to vaccinations either because they doubt their effectiveness, because they fear the injections will cause other medical conditions or because they distrust the government officials who promote them.
"My reason was intuitive," said Larkspur resident Lisa Laursen, whose 20-year-old daughter was never immunized. "I didn't want to put all those poisons in her body. I'm not fanatical about it, but I really appreciated the choice."
But health officials say the growing number of children who aren't vaccinated could be putting other children at risk for infection - even those who have been immunized.
Putting other children at risk
Individual immunizations aren't always 100 percent effective in preventing disease. When a large number of people in a community are vaccinated, however, the group receives a "herd immunity" that collectively keeps its members safe.
"Vaccines are very effective, but there is a small failure rate," said Dr. Rob Schechter, chief of immunization at the state Department of Public Health. "When the whole population is highly immunized, the few vulnerable children are protected by the immunity of the community. But when there is a high rate of exemptions, diseases can spread even to people who are immunized."
Outbreaks also tend to affect those who are particularly vulnerable to disease: newborn babies, the elderly and those whose immune systems have been weakened by cancer or other diseases, Dr. Schechter said.
"As the rates of unvaccinated children increase, the potential of the (herd immunity) effect decreases," said Dr. Fred Schwartz, public health officer for Marin County. "In effect, it's contributing to the greater risk of the community."
An outbreak of chicken pox affected more than 40 students at the Lagunitas and San Geronimo Valley elementary schools in 2007, where 17 and 57 percent of students had received personal belief exemptions from vaccination. In addition, the Lagunitas School District excluded about 70 students from the two schools for three weeks out of concern that they were at high risk of contagion. Many of them had never been vaccinated.
"We hope to get at least 80 percent of the people in our district inoculated," said Denise Santa Cruz-Bohman, president of the Lagunitas School District board. "We have to leave out some older people, those with immune system problems or babies. That means children who aren't immunized are a danger not to other children, but to those around them. If the community does not get inoculated, it causes problems for everybody else."
Yet the outbreak prompted few parents to change their mind about immunizations, Santa Cruz-Bohman said.
'It's harder to unscare people'
Those who refuse to vaccinate their children - or who choose to provide them with only some of the 12 injections recommended by the U.S. Centers for Disease Control - do so for various reasons. Some worry about possible side effects from the vaccines, while others insist that vaccination doesn't work.
"Vaccination is based on the medical fallacy that our bodies are stupid," said Corte Madera chiropractor Donald Harte. "The truth is that the body has a nearly infinite capacity to protect itself against infection as well as other diseases. When I was a kid, everybody got measles, mumps or chicken pox, and nobody died."
In fact, measles killed an average of 432 people and infected 500,000 each year between 1958 and 1962, according to the U.S. Centers for Disease Control; the disease still kills two out of every 1,000 infected. As late as 1999, one child a week died in the United States as a result of complications from chicken pox, the center reported.
"Many of our younger parents are not aware how serious these diseases are," said Dr. Chavez. "They tend to trivialize them as minor infections that go away easily, when some of them can result in debilitating complications or even death. We've already seen in California outbreaks of measles in the San Diego foothills, as well as outbreaks of pertussis (whooping cough) traced largely to schools where there are high rates of unimmunized children because of their parents' beliefs."
Some parents also believe that childhood vaccination may be responsible for the prevalence of autism and other medical conditions.
"Autism was a rare thing 30 to 40 years ago. Now it's affecting one child in 170," Harte said. "It's an epidemic, physician-caused. And it's ruining a generation."
However, more than 20 medical studies have shown no link between autism and vaccinations, according to Dr. Anju Goel, deputy public health officer for Marin County. In addition, efforts by anti-vaccine advocates to claim such a link in court have failed - most recently on Feb. 12, when the U.S. Court of Federal Claims ruled that neither vaccines nor the mercury-based preservative formerly used in storing them were connected to the autism that developed in three children.
Recognizing that many parents continue to believe in a link between autism and vaccines, the county Department of Health and Human Services created the Marin Immunization Coalition.
"It's a lot harder to unscare people," said coalition facilitator Alison Clayton. "Parents are scared, and all the data is not going to change anything. People want to be able to talk with pediatricians one on one about these issues."
Health officials say vaccines are safe, and that the danger of infectious disease far outweighs that of any potential side effects. While the measles, mumps and rubella vaccine can cause a severe allergic reaction in one out of every 1 million people vaccinated, for example, measles itself causes pneumonia in six out of 100 patients, encephalitis in one out of 1,000 and death in two out of 1,000.
"Current licensed vaccines have been shown to be safe, and continue to be watched closely," Dr. Schechter said. "There's a perception by some families that they need to balance the risk from vaccines with the risk from diseases. What I would say is that the risk from vaccines is very low, and the risks from diseases are considerable and should not be underestimated."
What schools can do
The issue has troubled school officials in several high-exemption districts, who say they're powerless to convince parents to immunize their children.
"Of course it's a concern," said Goldie Curry, principal of the San Geronimo Valley Elementary School. "But parents have a right to make decisions for themselves."
Other school officials say they aren't worried about the issue.
"It's not a big issue," said Jean Bowler, administrator of the Marin Waldorf School, whose exemption rate of 68.29 is the highest in the Bay Area, according to the state Department of Public Health. "Every few years there's an outbreak somewhere in West Marin. But we haven't had anything extraordinary, besides something like strep throat."
Lisa Laursen agrees. While she acknowledges that others may see vaccinations as important, she believes a healthy diet and good nutrition helped keep her daughter free from disease.
"If we can keep the Earth and its waters clean, instead of putting poisons in our babies - I look on it that way," Laursen said.
Yet health officials say clean living alone won't keep children - or communities - free from disease.
"Vaccine-preventable diseases occur in children of all backgrounds, whether or not they are well-cared-for or receive good nutrition," Dr. Chavez said. "The belief someone may have that their holistic lifestyle prevented disease is not backed by science, and is not going to work protecting anybody. Vaccines are the only way to ensure they will not get these dreadful diseases."
RESOURCES
- Marin Immunization Coalition: 473-6351
- Centers for Disease Control and Prevention
- National Immunization Hotline: 800-232-2522
- Information on vaccine testing and licensing
