Vaccine “Exemptions” still rising…

“To exempt: to free from an obligation or liability to which others are subject”

As a pediatrician, I will admit that a few words make me cringe.  “Exemption” is right up there near the top, especially when prefaced by the words “personal” or “philosophical.”  Because when I hear these words together, I know I’m about to have a long and frustrating conversation.

Vaccination exemptions are a large and growing problem all over the country.  They are a problem because they put vulnerable students at risk.  Parents seek vaccination exemptions when they would like their children to avoid being vaccinated and yet be able to attend a school, camp, or other group activity (like a sports team) which requires vaccinations.  Medical exemptions exist because (rarely) children may be allergic to or have a serious adverse reaction to a vaccine.  In these cases, a child should rightly be exempted from that particular vaccine.  But a personal, or philosophical exemption, essentially means that a parent does not want his or her child to be vaccinated against one or more diseases.  (Some parents also make a claim of religious exemptions, but there are NO major religions which forbid childhood vaccinations see this posting from whyimmunize.org).

Why is this important?  Because the success of vaccination lies in the numbers.  Infectious diseases are spread by an infected person, animal (including insects) or something environmental (aka a fomite) which has been contaminated by an infectious person or animal.  Most of the vaccines we use protect the patient by giving that person antibodies to fight off the infection if they are exposed.  The more people in a community, workplace, classroom, etc that are protected, the less chance that that infectious organism will infect someone who is not vaccinated or who does not respond to a vaccine.  This is called “herd immunity,” although I prefer “community immunity.”  When a parent seeks to exempt his or her child from getting some or all vaccines, they are relying on everyone else who DOES get vaccinated to protect their child via community immunity.  I would suggest this is selfish and foolish.  If the number of vaccinated children in a classroom dips much (below 90% in a lot of diseases), then one no longer has adequate community immunity, and exposure to a disease could take hold and become epidemic.  In the case of measles, with a high percentage of infected children experiencing complications and an extremely high infection rate, this becomes a disaster.

Those who voluntarily avoid vaccines for themselves take the risk of contracting a disease and possibly spreading it to others.  But when you voluntarily do not vaccinate your child, you are not only decreasing community immunity, but you are also deciding for your child (and others) that it is ok for them to get that disease if they are exposed.  Moreover, if they do get that disease, they might then infect other children who might not be able to get the vaccine for medical reasons, or who may not respond to a vaccine, such as in immune system problems.

I keep waiting for the day that a NV parent gets sued because their child developed a serious preventable disease and then infected another child who required hospitalization, causing lost school, work, medical expenses, etc.  How much is missing 2 weeks of school worth when the child’s school costs $50,000 a year?  How much is a parent’s time worth when she has to miss work and stay home with that same child?  How about a hospital bill to a family without health insurance?

See the article from Medscape quoting a new study done at the Baylor College of Medicine here:

Here’s an article on the issue from Mother Jones Magazine from June 12, 2018:

Also, see this journal article on the rise in non-medical exemptions: The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties

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Author: marcgrella

Primary care pediatrician; vaccine advocate; hunger fighter; refugee supporter.

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