At the risk of sounding like broken record, I want to return to a topic that I feel very strongly about, and that is this issue of people not vaccinating their children. In the US at least, the opposition to vaccinations of children seems to be something affecting the affluent. These are the people who seem to have latched onto scary tales on the internet and the media that are warning about the dangers of the vaccines, though those claims have been thoroughly debunked.

The current national vaccination rate dipped in 2013 to 91.9%, just below the 92% recommended benchmark that is believed to provide herd immunity for measles. (Pertussis requires 99% vaccination rates to provide herd immunity.) Colorado can claim the dubious distinction of the state with the lowest levels of vaccination at 86%. But I was curious as to why the California affluent seemed to be so susceptible to this anti-vax sentiment, with Disneyland being the place where the current outbreak originated and this news report gives a possible explanation.

According to state officials, there are currently 59 cases of the highly contagious disease in California, which can be spread through the air and results in a fever, cough and rash that can be life-threatening. [The numbers have risen since then-MS]

“Of the confirmed cases, 42 have been linked to an initial exposure in December at Disneyland or Disney California Adventure Park in Anaheim, California,” the California Department of Public Health writes in a press release. There are eight additional cases connected to Disneyland in other western US states and Mexico.
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Perhaps not coincidentally, Orange County – where Disneyland is located – is home to one of the more active anti-vaccination communities, led by Dr Bob Sears, a paediatrician who caters to parents suspicious of the immunisation shots.

“While the vast majority of physicians are troubled by the anti-vaccination movement, Sears, 45, lends a sympathetic ear,” Los Angeles Times reporter Paloma Esquivel wrote in a September 2014 profile. “About half his patients forgo vaccines altogether. To others, he offers ‘Dr. Bob’s’ alternative and selective vaccination schedules, which delay or eliminate certain immunisations.”

She writes that at some Orange County public schools, up to 60% of students had “personal belief exemptions” to required vaccinations.

“The unfortunate reality,” writes Cornell University immunology Prof Cynthia Leifer for CNN.com, “is that more and more parents are choosing not to vaccinate their children for non-medical reasons. Some refuse vaccines on the grounds of religious beliefs; others refuse on the repeatedly disproved argument that vaccines contribute to autism.”

She compares parents who decide not to vaccinate their children to a drunk driver “who makes a socially irresponsible decision that can endanger not only his life, but also the lives of the other drivers and passengers on the road”.

Public health officials hope that the recent scare will cause these skeptics to rethink but such people think that this is a situation where personal choice trumps all else, since they seem to think that their actions affect only themselves.

“It is my choice whether or not I want to be vaccinated,” Clayton Graver writes. “It is your choice whether or not to wash your hands or take basic public health precautions. It is an individual’s choice whether he or she wants to gamble with their child’s life. It is not your place to say what they have to do.”

What these people don’t seem to realize is that not only are they are not entitled to “gamble with their child’s life” (a bizarre way of phrasing it to be sure), they are endangering everyone around them as well. Even the measles vaccine, one of the best, is only about 95% effective so these people are endangering the remaining 5% who are depending on herd immunity to close the gap. The problem is compounded by the fact that people who have measles become infectious four days before the symptoms appear which adds to the ease of the disease spreading.

Eula Biss researched the issue of who does and does not vaccinate children and who dies for lack of them for her book On Immunity: An Inoculation and this is what she found.

I think I saw it first when I was researching the demographics of who does and doesn’t vaccinate, but also who does and doesn’t die of vaccine-preventable diseases. And one of the statistics that was interesting to me was that there’s a group of people who don’t vaccinate at all, who tend to be white, middle-class, well-educated and married mothers. And then there’s a group of people whose children are under-vaccinated – meaning they haven’t received all of their vaccines – and that group of people is more likely to be black, to live below the poverty line, to be a mother who’s not married and has recently moved. So this is a group of people who are not vaccinating not because it’s a choice or a position that they’ve taken, but because of the circumstances of their lives. And so this means that this relatively privileged population can end up spreading disease to people who haven’t made that choice. [My emphasis-MS]

Michelle Dean had a Q/A with Biss that you can read here.

People who don’t want to vaccinate come up with bizarre theories such as that even the polio virus does not cause any real harm and the reason it ravaged people in the past or in other countries is because of poor hygiene.

R.B., a 32-year-old mother of four who, like others interviewed for this article, would not allow her name to be published for fear of being exposed as a non-vaccinator, is not convinced by the overwhelming scientific and governmental consensus that says vaccinating children is necessary for public health.

She maintains that most people who contract polio today have no symptoms at all, while M.D., a local 29-year-old non-practicing nurse and mother of three, says that epidemics of yesteryear — the American Academy of Pediatrics points out that polio killed 6,000 people in 1916 and left another 27,000 paralyzed — had more to do with lack of hygiene.

“The world today is completely different than it was during the polio epidemic,” said M.D. “It was dirty. An average healthy person couldn’t get a disease like polio today. Polio in a healthy person today is usually asymptomatic or it has minor symptoms and comes and goes. Then the person develops immunity forever.”
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Ultimately, M.D. and her husband decided not to continue vaccinating.

In retrospect, the mother has no regrets. She is unfazed by the possibility that her children might contract any of the diseases vaccines are meant to prevent, and she does not believe they are endangering others. She further believes the diseases that vaccines protect against are not that serious and, like R.B., accuses doctors and pharmaceutical companies of being in league together to make more money through vaccine deliveries.

Such people are delusional and the reason why mumps, pertussis (whooping cough) and chicken pox are making comebacks in the US. The only thing that might change their minds is if schools refuse to allow unvaccinated children to attend and quarantine those who get infected along with those in contact with them, as is increasingly happening.

There may be growing consequences for parents who make the choice not to vaccinate, however. In the California town of Huntington Beach, a high school in which a student was diagnosed with measles sent home 24 classmates for three weeks when they could not prove they had been immunised.

In Utah more than 380 people have been asked to self-quarantine after being exposed to two children who returned from Disneyland with the disease.

Carl Krawitt, a father in Marin County in California, another affluent area that has one of the highest rates of parents seeking ‘personal belief exemptions’ from vaccinating their children, has a child who is being treated with chemotherapy for leukemia. As a result, he cannot be vaccinated, in addition to having reduced immunity and thus more susceptible to diseases. Krawitt has asked his school district to bar children who are not vaccinated from attending. Some schools are doing just that. Alex Berezow is so exasperated, wants to go further and send parents who do not vaccinate their children to jail. Perhaps the rising outrage at the risks these anti-vaxxers are posing to everyone will turn the tide. I hope so.

As someone who contracted polio at the age of six but have been able to lead a normal life due to the sheer luck of having a family that was able to get first-rate treatment for me while so many others who were not as lucky suffered horribly and died, I am appalled and angry that people are willing to risk any more children getting diseases that are preventable. Polio cases in Pakistan reached a record number of 202 last year, fuelled by toxic combination religious objections to vaccination plus suspicions sowed by the CIA’s use of a fake vaccination campaign in order to find bin Laden.

These vaccines are some of the greatest benefits that science has been able to provide to all of us. It is a scandal to reject them because of the ignorant scaremongering of a few.