More news on preventable diseases

By Phil Plait | April 7, 2011 1:15 pm

I know I just wrote about vaccine-preventable diseases on the rise once again, but even in the past couple of days there’s more news:

1) Houston is seeing the first case of measles in six years. The victim? An 11-month-old baby. Let’s hope she has a full and swift recovery, and no one else falls ill.

2) In that post linked above I talked about a school in Virginia that had to close down due to a big pertussis outbreak. Well, in Canada, they’re telling kids who are unvaccinated they can’t come to school; at least, not until they can show their inoculations are up-to-date. I have mixed feelings about forcing kids to get vaccinated, but in the end we simply cannot have schools be breeding grounds for diseases which are trivially easy to prevent. I read about this story on Fark, and the comments there are interesting, to say the least.

3) Seth Mnookin, who wrote "The Panic Virus" an exposé of the antivax movement, has posted his thoughts on these recent news stories. As usual, I find his comments to be well-reasoned and thoughtful.

CATEGORIZED UNDER: Alt-Med, Antiscience, Piece of mind

Comments (51)

  1. RAF

    I have absolutely no qualms about forcing children that attend school to be up to date with their vaccinations. This is a public health issue.

  2. DrFlimmer

    I agree with RAF. Sometimes people must be forced to their “luck”. And it it is for the benefit of everyone: Go for it!

  3. JR Roberts

    If schools can use draconian measures to keep one child in school with a peanut allergy, they can keep the unvaccinated away.

  4. Lawrence

    This is what people have been afraid of – these little outbreaks of diseases that show the holes that exist in herd immunity. In fact, a lot of the anti-vaxers have been saying that “if herd immunity is such a big deal, why aren’t we seeing outbreaks in low-vax areas” – well, morons, guess what – you got your wish.

    If you look at the Roanoke & MN outbreaks, they occurred exactly where we would expect them to be – in low vaccination areas / populations.

    Thanks a lot you idiots.

  5. I’m just waiting for an outbreak here in NH. And one of my neighbors just had a baby, so I hope it doesn’t happen until after she has had a chance to get her vaccinations. I don’t ever want to read about another case like Dana McCaffery. :(

    And of course, the obligatory http://factsnotfantasy.comvaccines.php

  6. Jim

    Larian, I’m with you on that. I just found out that almost half of my son’s (very small) class is unvaccinated and I’m kind of in panic mode about it.

  7. Phyco

    Both universities and every community college I attended required me to have my vaccinations up to date for preventable diseases, and while I’m not a kid, I don’t see how it’s any different: It’s preventing a school from becoming a breeding ground for preventable diseases.

  8. Jamas

    What about those with medically provable reactions to vaccines? You’re forcing them?
    Presumedly a medical certificate to show that would be sufficient to allow them back into class, however…
    You get one anti-vaxx doctor (I’m cynical, so expect there are more than enough of those) and, boom, made the whole exercise pointless…

  9. As a parent living in Waterloo region, I fully support the school board’s action. From the limited contact I’ve had, it is my understanding most of the unvaccinated are just due to lapses (i.e. busy schedules, unawareness and laziness.)

    These are not new rules, (they wouldn’t have made it to high school without a vaccination record), and there are fewer students this year than last with incomplete immunization records. Waterloo Region has a population of approx 500,000 so 800 kids without vaccinations is a very very low number.

  10. @James

    If you have a proven medical reason for not having a vaccination, you can be exempted. But you need a doctors note.

  11. Brian B

    Catelli… I think the point James was making is that one anti-vaxx doctor can write several notes exempting children from vaccination, thereby destroying herd-immunity in a community.

  12. Paul

    Not being vaccinated is equivalent to a business emitting pollution, or a person driving under the influence of alcohol — you raise the chance that those around you will suffer ill effects. Government has a role in coercing individuals who would otherwise inflict costs on others.

    By the way, I hope the adults commenting here have also kept their vacinnations up to date. Even if you got shots as a child, you may now be vulnerable (and could spread infection if exposed).

  13. Graham

    There has been an outbreak of Measles in New Zealand, another case of people not vaccinating their kids.
    http://www.stuff.co.nz/dominion-post/news/4863361/Measles-outbreak-in-Hastings

  14. Michael5MacKay

    I live in the nearby Mississauga. My teenage daughter got one of these notices this year. In her case, and many others, I expect, the issue was not that she hadn’t been vaccinated, but that the record of her vaccinations hadn’t been filed with the local public health authority.

    In Ontario, each child receives a yellow vaccination record card at birth. Each vaccination is recorded. Parents have to provide a copy to the school to enroll when their child is enrolled in elementary school. Many parents — I was one — are not aware that their doctor does not provide proof of vaccination to the local Public Health Authority.

    In my daughter’s case, after I received the notice from Peel Region Public Health, I (1) took her to the Dr. to ensure that she had received all necessary vaccinations (she had) and made sure her vaccination record was up to date; (2) provided Peel Region Public Health with the details of her vaccinations (I was able to do this online); and (3) gave the school a copy of the vaccination record.

    Problem solved.

  15. Michael Swanson

    @Phil

    “…in Canada, they’re telling kids who are unvaccinated they can’t come to school; at least, not until they can show their inoculations are up-to-date. I have mixed feelings about forcing kids to get vaccinated, but in the end we simply cannot have schools be breeding grounds for diseases which are trivially easy to prevent.”

    No mixed feelings here. Get vaccinated or stay home. If you can’t be vaccinated for medical reasons, come to school: herd immunity should protect you.

    Look, if you’re stuck in Fukushima and you don’t feel like taking an iodine supplement to avoid absorbing radioactive iodine, that your problem and your problem only. But if you feel like being a breeding ground for pertussis, for whatever reason, then you have the potential to affect everyone you come into contact with. It just gets so much better when people foist their paranoid anti-vax garbage on their children!

    My friend was telling me about her time in the Army; they seem to have at least this figured out. You join? You get stabbed with needles like they can’t find a better hobby, and that prevents many soldiers from getting sick. It’s easy math: all soldiers vaccinated against, for instance, the flu = far fewer soldiers getting the flu. Should work equally well with students.

    If I were an employer I’d look into the legality not hiring people who aren’t vaccinated (by choice). Yep, I’m a jerk. But I’m a vaccinated jerk that doesn’t put children at risk for a preventable disease. I think that makes me, and anyone other vaccinated individual, pretty damn cool.

  16. Wzrd1

    The shame of it is, the anti-vax crowd enjoys their “right” to not immunize their child and even hold measles parties to expose their children, THEN permit their sick children to expose others who do not hold to their views. If a child is too young for immunization, the child then becomes ill. If a person is exposed to the infected child and is immunocompromised for ANY of a dozen reasons, they become critically ill and can potentially die.
    It’s literally like my taking my right to own a firearm and running around the neighborhood shooting the thing. Guess what? It’s illegal for obvious reasons. So should the anti-vax nonsense be illegal, save for the very few whose religion forbids it OR for those who DO have a reaction and there is no alternate vaccine available (many vaccines DO have alternate versions for that very reason).
    Honestly, I have a young grandchild now. Were one of these anti-vax dweebs cause her to become seriously ill, I will most likely be in prison. Because, I guarantee that I WILL enlighten that individual in what I did in the military for over 27 years. They’ll briefly not like it. Then, they’ll not care about anything, ever again.

  17. Buzz Parsec

    I think a doctor who falsely claimed a patient was allergic to a vaccine or otherwise provided a false medical exemption would risk losing his medical license and malpractice suits from anyone who got exposed as a result.

  18. @Lawrence,

    But these cases aren’t a result of holes in herd immunity due to lack of vaccination. They’re due to INSERT ANTI-VAX EXCUSE HERE DESIGNED TO CLOUD THE ISSUE AND MOVE THE GOAL POSTS.

  19. I agree with Buzz Parsec. If a doctor was caught knowingly issuing “this child is allergic to vaccines” notices without any real allergy, action should be taken against the doctor, including revoking his medical license. Meanwhile, real medical reasons, such as allergies, immune system issues, etc, should get a free pass from the vaccine requirement. In those cases (and make no mistake, these are exceptions to the rule), the near-certainty of a vaccine-induced reaction is more dangerous than taking a chance that you would catch the disease. (Especially if everyone else is vaccinated like the school is trying to do.)

  20. shawmutt

    Love the comments on Fark—“weapon-grade stupid” is now part of my vocabulary.

  21. BATman

    Here’s an interesting idea. Take the numbers for cases of autism in Canada (where we’re required to be vaccinated), per capita, and compare it the same in the US. I’ll bet there’s very little if any difference. Any takers?

  22. kpb

    I would take issue with Phil’s wording: “I have mixed feelings about forcing kids to get vaccinated”.

    Nobody is talking about *forcing* people to get their kids vaccinated; they’re just giving them a choice. You don’t want vaccination? Then you’re going to have to home-school. Your decision.

  23. kpb

    Oh, and @Wzrd1: why the exemption for people whose religion forbids vaccination?

    Again, it’s a choice. You want to follow the dictates of your particular set of superstitions? Fine, you have my admiration for sticking to your principles, but that’s your decision, and you don’t get to endanger me and mine for a personal choice.

    (at the risk of being less pithy, I should point out that “you” in this comment is directed at the anti-vax parent, not at Wzrd1).

  24. Pac

    @24
    1. Education is mandated by the government until the age of 18.
    2. In America, you have a protected right to freedom of religion.
    3. You have to pay taxes that fund education in your area. Whether you have children or not.

    If the family’s religion prevents them vaccinating, then their children should still be allowed to attend public school without being vaccinated first. If not, then the family has an open course to sue for religious discrimination.

    Now that being said, it has been found in the past that freedom of religion does not necessarily guranty the free *practice* of religion, just belief. However a case usually has to go all the way to the Supreme Court for a judgement of that caliber to made.

  25. josie

    I wonder if a case for negligent homicide could be made for any deaths occurring as a result of an unvaccinated child contracting and spreading a disease to another child.

  26. @Brian B I got James herd immunity point. The Waterloo Region school board covers three cities with over 20 high schools over a large geographic area. It is unlikely (actually impossible) for all students to get their notes from one unethical doctor. Family doctors are spread all over the region, and most people try to have a doctor that is close to home.

    The evidence is that the kids are getting immunized. When the first warnings went out in February, it was to 4850 students, On Monday it was 795, and on Tuesday that number had dropped to 290.

    Granted, there could be some doctors notes in there, but the anti-immunization movement doesn’t have that much traction here.

  27. JLE

    The Salt Lake Tribune is reporting the first case of Measles in Utah today since 2005. The victim is a teenager at a local high school who has not been immunized. 30 other kids have been sent home. As So in reality there are two people because the teen hasn’t traveled out of state. Bottom line as RAF said, no immunizations, no public school. The parent then can home school their child.

    http://www.sltrib.com/sltrib/news/51585608-78/measles-health-department-immunized.html.csp?page=1

  28. kpb

    @25
    I’m from Canada. I guess that’s why I was thinking about the story Phil linked to about kids in Canada not being allowed to go to school without being vaccinated when I wrote my comment.

    We have freedom of religion here, too. I don’t know how things work in the States, but up here, you have the option of home schooling your kids if you want. Sure it’s expensive, since one parent will probably have to stay home, but it is a choice if the state system is not to your liking.

    Regardless of differences between laws in different jurisdictions, however, I strongly disagree with the idea that unvaccinated children SHOULD be allowed to attend school as long as there is a religious reason for it. Maybe they’ll HAVE to be allowed to attend because of the wording of the law, but I don’t believe that is the way it ought to be. If something is against the law (for a good reason, not just for reinforcing trivial social conventions), simply saying “it is against my religion” should not automatically exempt you from that law.

  29. Monkey

    As a teacher, around kids all day…vax on!

  30. Chris

    BATman:

    Here’s an interesting idea. Take the numbers for cases of autism in Canada (where we’re required to be vaccinated), per capita, and compare it the same in the US. I’ll bet there’s very little if any difference. Any takers?

    I think I need to see some verification of that requirement to be vaccinated. Because near our neck of the woods there was a mumps outbreak. An interesting bit in that article:

    Medical officials say its spread has been aided by conservative Christian groups that are against vaccination of all kinds.

    Well, at least they are not like the Sons of Freedom, a subject of many interesting family stories at a few holiday gatherings (from my in-laws as bemused bystanders).

  31. Hugo Schmidt

    Does anyone else get the distinct feeling that we are retreating slowly to the Dark Ages? I mean, this is real Dark Age hysteria, the sort of stuff you see in the wilder areas of Pakistan.

  32. IsobelA

    Good grief – this gem was in the comments over there (spoken by an anti vaxxer, obviously):

    “Out of ten vaccinated children, three will develop autism and two others will face significant developmental challenges”

    Are people just randomly making these things up, now? She’s actually attempting to claim that fully half of all vaccinated children either end up with autism or developmental challenges?????

    I think certain choices need to be taken out of parents hands, and vaccinations is one of them. Parents who do not vaccinate their children are guilty of intentional neglect, in my opinion.

  33. Teshi

    The whole “you can’t come to school until your vaccinated” has been around for a while. When I moved, as a child, from England to Canada, I was given a window of time to get up to date with my vaccinations, or face exclusion from school.

    At the time, before Jenny McCarthy, this seemed to be a perfectly natural and normal thing to do.

  34. Nigel Depledge

    Wzrd1 (17) said:

    It’s literally like my taking my right to own a firearm and running around the neighborhood shooting the thing. Guess what? It’s illegal for obvious reasons. So should the anti-vax nonsense be illegal, save for the very few whose religion forbids it OR for those who DO have a reaction and there is no alternate vaccine available

    I agree, apart from the religious exemption.

    After all, would you allow someone to go around their neighbourhood indiscriminately firing a gun at people because their religion demanded it?

  35. Nigel Depledge

    Pac (24) said:

    @24
    1. Education is mandated by the government until the age of 18.
    2. In America, you have a protected right to freedom of religion.
    3. You have to pay taxes that fund education in your area. Whether you have children or not.

    If the family’s religion prevents them vaccinating, then their children should still be allowed to attend public school without being vaccinated first. If not, then the family has an open course to sue for religious discrimination.

    Perhaps that is the situation that exists now.

    It should not. No-one should be allowed to use their own personal superstitions as an excuse to endanger public health.

    Now that being said, it has been found in the past that freedom of religion does not necessarily guranty the free *practice* of religion, just belief. However a case usually has to go all the way to the Supreme Court for a judgement of that caliber to made.

    Yeah, the freedom to believe whatever you wish should end at your own skin. It should not extend to your beliefs impingeing (sp?) on other people.

  36. If the family’s religion prevents them vaccinating, then their children should still be allowed to attend public school without being vaccinated first. If not, then the family has an open course to sue for religious discrimination.

    While almost anything will give someone a reason to sue, the results of that aren’t anywhere near set in stone. People who let their kids die of easily curable diseases because “doctors are a sin, we prayed for him instead” tend to get arrested for child abuse, neglect, murder, what have you.

  37. plutosdad

    I remember reading about a study recently that said kids don’t catch the flu from school, they catch it from their playmates. And that closing schools doesn’t really help. Aha here is the link:
    http://query.nytimes.com/gst/fullpage.html?res=9B04E3DD1238F93BA35751C0A9679D8B63

    If that is true, will keeping unvaccinated kids away from school help? Maybe instead, let them go to school, but parents should not let their kids play with unvaccinated kids.

    That sounds kind of mean but it if it works better than keeping them out of school … at least the kids gets an education. The state can’t force kids to have friends. (if it did us socially awkward nerds would have been better off :) )

  38. Dustin

    Utah also just had a case of measles reported for the first time since 2005.
    http://www.sltrib.com/sltrib/news/51585608-78/measles-case-department-health.html.csp

  39. Christy

    I’m from Canada. I live in Ontario and it’s been public health policy here for decades that kids in school need to have their vaccinations and keep them up to date. (There are some exemptions.) Most people have no problem with that.

  40. Christy

    Exemptions include religion and medical reasons, I believe.

  41. Andy

    @ James

    I understand your concern about anti-vax doctors, but from what I can tell there really are very few of them. I come from a medical family, and I myself am an attorney with a wife working in cancer research, so I’ve come to know a very large number of people in the medical community. I can tell you (and I know this is anecdotal evidence, so not particularly effective) that I do not know a single physician who buys into the anti-vax nonsense. I’m sure that they are out there, but I really believe that they aren’t as prevalent as you seem to think they are.

  42. Sean

    I have mixed feelings about forcing kids to get vaccinated, but in the end we simply cannot have schools be breeding grounds for diseases which are trivially easy to prevent.

    Thank you. Half my sister’s family got pertussis last year – brought home by my niece from someone at her High School. They were all vaccinated, but the pertussis vaccine is only about 85% effective and wanes over time; so unless you have a very high vaccination rate, you can still have outbreaks – even among the vaccinated.

    I’d argue that we not only need a high vaccination rate, but we could do with a little more research into making the pertussis vaccine more effective.

    -S

  43. Tom

    A follow-up on the Houston case–the case apparently was contracted elsewhere while traveling, and the baby was too young to have been vaccinated under normal guidelines. The Harris County health department reports a vaccination rate among children of over 80%, so they do not expect further cases. The herd immunity concept does work! The case got a lot of local media coverage, all of it pointing out the importance of the 80% vaccination rate.

  44. Chris

    Tom:

    A follow-up on the Houston case–the case apparently was contracted elsewhere while traveling, and the baby was too young to have been vaccinated under normal guidelines.

    Yes, the child got it at Orlando, FL. There have been more who took measles home as a southerner: Health officials investigate measles outbreak in Orlando tourists.

  45. Pac

    @29,

    I agree the situation is wrong. Your point about have to versus should is, in this case, semantics as that was the point I was attempting to make.

    @36

    The problem is that not always the case with religion. Parents are freely allowed to inflict their views on their children not just in raising them but also in choicing, or refusing, medical care. They are endangering public health in this situation but until it gets to a court where a judgement to that effect is made, anti-vaxxers are going to keep insisting it is their right because it only affects their child.

    @37

    We have yet to see an anti-vax parent brough up on charges of child abuse or negligent homicide. I WOULD LOVE TO SEE THIS. That would be the nail in the coffin of this particular issue. The reason the law-suit matters is because schools do everything they can to prevent them even if they are shaky or unfounded. They don’t have much of a legal defense budget or a desire for that sort of publicity.

  46. Mike H

    I was once suspended for two weeks due to lack of immunization, during what was either a measles or meningitis outbreak in my area. In my case I didn’t have my vaccinations because of an allergy to eggs (used in the manufacture, at least then). I don’t know if a doctor’s note would have sufficed to let me go to school, so it’s possible that my parents decided not to expose me or that they didn’t know that a note would get me back. I was old enough to stay home on my own though, so it wasn’t a huge deal. Had friends bring me homework and such. The fact that this happens really isn’t news, I think it’s just the sheer quantity in this case. The school board probably just got around to finally checking its records.

  47. Chris

    Tom:

    A follow-up on the Houston case–the case apparently was contracted elsewhere while traveling, and the baby was too young to have been vaccinated under normal guidelines.

    Yes, the child got it at Orlando, FL. There have been more who took measles home as a souvenir. The Orlando Sentinel had an article called “Health officials investigate measles outbreak in Orlando tourists.” The article says:

    Three tourists from Texas, Michigan and Minnesota who traveled to Orlando in the past month have come down with the measles — leading health authorities to investigate how they caught the disease and from whom.

  48. How can religious reasons even be an excuse for not vaccinating? It’s not like any of the mainstream religions sprung up after the vaccine was invented. None of them can possibly have a say on the matter. Allowing people to be a danger to others because of their religious beliefs is always wrong.

    The only reasons for not vaccinating should be valid medical reasons.

  49. “I have mixed feelings about forcing kids to get vaccinated, but in the end we simply cannot have schools be breeding grounds for diseases which are trivially easy to prevent.”

    Why do you have mixed feelings? As P.Z. said recently in another context, when the blood is so red, some things have to be black and white, with no shades of grey. Doesn’t your second clause convince you that you’re mixed feelings are just as delusional as the beliefs of the antivaxxers?

    When science and libertarianism are in conflict, science wins, every time. Get used to it. Get over it and move on.

    Next thing you know, Jenny McCarthy will be saying “even Phil Plait has mixed feelings about forcing kids to get vaccinated”.

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