Editor’s note: This commentary is by Sandy Reider, MD, who is the medical adviser to the Vermont Coalition for Vaccine Choice. He lives in Lyndonville.While vaccination rates have never been higher, Vermont physicians and politicians are claiming that Vermont has a “disturbing low childhood vaccination rate,” stirring fear over measles, painting a perfect picture of vaccines always working and never causing harm, and finally concluding: “The time is now to mandate vaccination.”
However, a close examination of the Vermont 2013-2014 school data reveals that vaccination rates in Vermont are actually quite high, not “alarmingly low” as many allege. Our exemption statistics are misleadingly skewed by the number of children enrolled in kindergarten with “provisional” exemptions (i.e., those kindergartners who are not yet caught up with all the required vaccinations on autumn enrollment, but intend to be so within six months). With this in mind, the first grade numbers (96 percent MMR coverage in first grade public schools, rising to 98 percent by 12th grade) are actually more accurate proxies for vaccine coverage in kindergarten. Also, the number of students claiming philosophical exemptions has really not increased so much since the sharp jump from 2.5 percent to 5 percent following addition of chickenpox and hepatitis B to the schedule some years ago. If a child opts out of just a single vaccine they are, misleadingly, lumped into the philosophical exemption statistic with children who decline several or all vaccines.
As a primary care physician who has been practicing in Vermont for 44 years, I am old enough to remember how common measles used to be, and how little fear or alarm was associated with it. While never mentioned in vaccine promotional brochures, mortality in the United States from most childhood infectious diseases had already dropped precipitously (98 percent decline in the case of measles) prior to the use of vaccines. Better nutrition, refrigeration, sanitation, clean water, less crowding, and so on were most decisive, not vaccines. Measles in parts of Africa and other developing countries, or in overcrowded refugee camps, resembles more the difficult living conditions seen in the U.S. in the early 1900s, and is potentially dangerous. The risk/benefit may favor vaccination in those situations, but that is a very long way from Vermont today. Here, measles carries little risk for the average well-nourished child. Over the past decade there have been about 1,500 reported cases of measles in the U.S. (one in Vermont in 2011), zero deaths, but 88+ deaths following MMR vaccination, and over $3 billion awarded by federal court to parents of all vaccine-injured children.
There are also some problems with the measles vaccine itself. Cancer centers, such as Johns Hopkins and Sloan-Kettering, warn their immune-compromised patients to avoid any contact with individuals who have recently received any vaccine, like the MMR, containing live virus, because these vaccinated individuals can shed vaccine virus for weeks to months, putting others with compromised immune systems at risk. Measles vaccination may cause “vaccine measles” that is indistinguishable from wild measles. There is at least one reported case of a vaccinated child transmitting vaccine-strain measles to their healthy sibling. Many may recall that it was for this reason that the live Sabin polio vaccine was abandoned in this country in 2000 in favor of Salk’s inactivated polio vaccine.
While wild measles confers robust lifelong immunity, some individuals completely fail to respond to the vaccine (2-10 percent primary failure), while immunity in others wanes significantly (secondary vaccine failure), so that measles is increasingly a problem for adults, with many affected who have been fully vaccinated (note: it is now acknowledged by the CDC and our health department that vaccine failure was the driver behind the recent whooping cough outbreak, not unvaccinated children).
A hundred or so cases of measles in the U.S. does not by any stretch represent a public health crisis, though mainstream media coverage, thriving on sensationalism, would have us think so.
Also, because vaccine immunity fails or wanes over time, women vaccinated in childhood often lack sufficient antibodies against measles by the time they reach childbearing age, and as a result cannot pass this crucial protection on to their nursing infants. Ironically, more very young vulnerable infants are now at increased risk for measles as a direct consequence of the vaccination campaign against measles. “Herd immunity” here is a misnomer, better call it “vaccine herd effect.” With an ever-growing number of adults in whom vaccine immunity has failed or waned, it is easy to predict that there will be more and larger measles outbreaks in the future, blamed, incorrectly, entirely on the unvaccinated.
Finally, consider the following, not so uncommon, predicament: immediately following a particular vaccination(s), the child has a prolonged fever, a shrill cry, and loses muscle tone, but after a few days or weeks appears to recover. The parent then, rightly, determines not to repeat that vaccine, but is unable to obtain a medical exemption (parents report these are impossible to get because contraindications are increasingly narrow in definition). Lacking support from their doctor, and without access to the philosophical vaccine exemption, what choice remains for such a caring parent or guardian … homeschool, move to another state, jail ?
A hundred or so cases of measles in the U.S. does not by any stretch represent a public health crisis, though mainstream media coverage, thriving on sensationalism, would have us think so. And vested interests pushing mandatory vaccination, so willing to ignore the ethics of medical informed consent, appear delighted to take advantage of this.
Let’s support Gov. Shumlin’s decision to leave well enough alone, maintaining the critical right of parents to make medical decisions for their children, and adults for themselves.