Why don’t some parents get their children vaccinated? Religious grounds? Maybe for a few. Philosophical grounds? I still haven’t figured out what that means. Misinformation? Probably more of a reason than religious grounds. But I have concluded that it is having no personal history that maybe the biggest reason.
Like most of my generation – born before the early 1960s – I suffered from all the childhood diseases as they were called back then. I had the measles, rubella (then called the German measles), and chicken pox. I was somehow immune to the mumps even though I attended a birthday party after which all the attendees but me got them. I particularly remember chicken pox. It was miserable. I felt terrible and I itched all over. It was worse than having poison ivy which I seemed to get almost every summer until I was old enough to recognize the plant. My experience was typical of almost everyone I knew. Margaret Talbot provided some history in her piece for the New Yorker, “Not Immune”.
Twenty-five years ago, when a doctor named Robert Ross was the deputy health commissioner of Philadelphia, a measles epidemic swept the country. Until this year’s outbreak, which started at Disneyland and has so far sickened more than a hundred people, the 1989-91 epidemic was the most alarming that the United States had seen since 1963, when the measles vaccine was introduced. Nationwide, there were more than fifty-five thousand cases and eleven thousand hospitalizations; a hundred and twenty-three people died. Most of those infected were unimmunized babies and toddlers, predominantly poor and minority kids living in cities. Ross thought that the blame for the outbreak could be placed partly on poverty and partly on crack cocaine, which was “making a lot of families forget how to raise children.”
The epidemic spurred the creation, in 1993, of a federal program, Vaccines for Children, which subsidized shots for children who were uninsured or onMedicaid*. Immunization rates soared. Then a new skepticism about vaccination settled in—this time, more often than not, among affluent parents who were drawn to holistic living and were dubious about medical authority. An infamous 1998 study in The Lancet, which claimed that the rising incidence of autism was linked to vaccinations, was particularly influential with some of those parents—even though the data were found to be falsified and the author’s medical license was revoked. Another theory, tying autism to thimerosal, a preservative added to vaccines, has also been debunked. Since 2001, thimerosal has been used only in the flu vaccine—and there is a thimerosal-free alternative—but the incidence of autism continues to rise.
Nevertheless, the skepticism endured, and one result has been the decisive return of infectious diseases. First, it was whooping cough: in 2012, more than forty-eight thousand cases and twenty deaths were reported to the Centers for Disease Control, the greatest number since 1955. Now it’s measles….
The level of misinformation and fear is incredible. Nothing that anyone says or does seems to lower the volume. There is no known link to autism from any vaccines. What remains are religious ground and some vague notion of philosophical grounds. A couple of Sunday’s ago, Gina Bellafante tackled the question of religious grounds in her New York Times column.
New York already allows parents to seek vaccine exemptions for medical or religious reasons. In effect, philosophical exemptions are superfluous because religious exemptions perform the same function. A state form requires that parents provide a written passage, in their own words, explaining why they are requesting the exemption, and the principles that guide the objection. A head of school can accept the submission or reject it, ask for supporting documents — a letter from a priest or a rabbi, for instance — or not. Anyone whose request is denied can appeal to the education commissioner.
That religious exemptions are available at all to any but Christian Scientists, whose disavowal of medicine is foundational, remains a subject debated not nearly enough. It is not just that the waivers are used to conceal the discredited anti-vaccination sentiments shared by parents with no theological commitments whatsoever. (As one Manhattan school nurse put it to me, “It would be practically impossible, not to mention a huge pain, to prove that they are lying.” Of the 25 percent of students at the School for Young Performers in TriBeCa who received religious exemptions last year, how many have parents prepping them for the seminary?) It is that among the major religions there is virtually no canonical basis for vaccine aversion; the Bible, the Quran and the texts of Sanskrit were all obviously written before the creation of vaccines, and most religions privilege the preservation of life.
Read the end again: “…most religions privilege the preservation of life.”
So today I saw a snopes.com piece debunking (there is that word again) the new internet factoid that
In the last ten years no one has died of measles in the U.S., but more than 100 people have died due to the MMR vaccine.
During a then-current measles outbreak, on 4 February 2015 an alternative health site published an article claiming no one in the United States died of the measles between 2004 and 2015.
Furthermore, the article stated, more than 100 people (mostly young children) had died after receiving the MMR (measles, mumps, rubella) vaccine.
The claim circulated widely during a time of increased debate over parental decisions about vaccinations, particularly among those who are opposed to the practice. In some iterations the claim was amended to specify “child deaths,” but the article itself stated there were zero deaths (among all age groups) from measles in the United States in the timeframe cited. That claim was provably false, as two people in the U.S. died from the measles in 2009, and another two deaths from measles were recorded in 2010. As such, in two of the ten to eleven years cited in the claim, at least four people have died of measles. And according to the World Health Organization, 145,000 people around the world died of measles in 2013 alone.
Likely one of the reasons there have not been more deaths in the U.S. is the push in the 1990s to get kids vaccinated under the Vaccines for Children program. Snopes.com concludes
Few people died of measles in the U.S. between 2004 and 2015 because measles was classified as eliminated in 2000. Relatively few people in the U.S. contracted the viral infection after that, so it stands to reason far fewer would go on to die of it. And while more than 100 reports of suspected adverse reaction or death may have been reported to VAERS in the years cited, that number references unconfirmed public reports, not verified vaccine-related fatalities.
Finally, the possibility of death is not the only reason one should (or should want to) vaccinate a child against measles. As the CDC notes in their measles fact sheet, in some children measles can lead to pneumonia, lifelong brain damage, and deafness.
The number of deaths cited seems rather small compared to the number of persons vaccinated especially since it is not clear that there was a death for each reported case.
Now, of course, the progressive parents who don’t want their kids vaccinated for philosophical grounds have lots of company from the right who have politicized the issue. Talbot writes
On Fox News, Sean Hannity declared that he wasn’t “trusting President Obama to tell me whether to vaccinate my kids.”
I argue that parents are vulnerable to all that is floating out there – the misinformation and the politicization – because they have no history of the diseases. Very few people in the United States born after the introduction of vaccines have had measles, chicken pox, or mumps. I would venture to guess that most adults who have children were themselves vaccinated when they were children. I base that simply of the fact that there have been few outbreaks since the early 1960s. No parent who had any of the once common childhood diseases would want their children to suffer. Unfortunately, I think this cycle has to play itself out which means some kids will die or suffer long-term consequences.
[By the way, if you were part of the generation that had chicken pox be sure to get the shingles vaccine. I watched my mother suffer and you can bet I got vaccinated the first chance I had.]
Photograph: From the CDC