Editor’s note: This commentary is by Patrick Walsh, who is a consultant at a Williston tech company and a UVM alumni with a BS in chemistry with minor in pharmacology and economics. He lives in Burlington.
[A]s we have seen with the measles outbreak in California – that has spread to many other U.S. states and our northern neighbor Quebec – disease travels extremely fast in unvaccinated communities. Although with adequate medical care measles is normally not fatal, it has the potential to be fatal. Vaccines have been so successful in preventing diseases such as measles, that many alive today (including myself) probably do not know anyone that has had a vaccine-preventable disease. Our huge success with vaccines has enabled many to forget how dangerous these diseases can be. This has allowed a small group of vaccine deniers and staunch libertarians to reject medical consensus on this issue. We need to eliminate exemptions for immunization.
Sen. Kevin Mullin (R-Rutland) has recently (re)introduced an amendment that would remove the exemptions for immunization. I believe everyone should support getting rid of the philosophical and religious exemptions – everyone should be vaccinated against preventable diseases.
Measles is one of the most contagious vaccine-preventable diseases. Incidence of measles typically signifies a weak immunization program – it is the first sign that immunization rates are not high enough to prevent spread of disease. The threshold for herd immunity for measles is between 92-94 percent, this is the immunization level that blocks transmission of the virus throughout the population. The measles vaccine is extremely effective: 94 percent are protected by one dose and with two doses, almost all children are protected for life. Claims that the vaccine “sheds” — decreasing in efficacy over time or vaccinated people being able to transmit measles — are simply unfounded. Most vaccinated adults are protected for life.
One dose of the measles vaccine costs $1, but a case of measles could cost $11,000. This is a huge, preventable social cost – no one should die from a preventable disease. Period.
The rare incidence of measles in our collective memory gives a false sense that there is little to no threat. There is no doubt that being unvaccinated is more risky than being fully immunized (unless there are medical contradictions). There is overwhelming evidence that vaccines are safe (they do not cause autism); vaccines cause an immune response, it means the vaccine is working. Anything we put into our bodies has some side effect. The benign side effects of a measles vaccine do not compare to the potential suffering a case of measles could present. Before measles was declared eliminated in the U.S., there were 3-4 million cases of measles annually in the U.S., leading to 50,000 hospitalizations and 500 deaths. In 2013 worldwide, 82,100 children under the age of 5 died from measles. One dose of the measles vaccine costs $1, but a case of measles could cost $11,000. This is a huge, preventable social cost – no one should die from a preventable disease. Period.
Some other commentaries have claimed that the vaccination rate in Vermont is actually higher than the media claims, citing the “provisional” exemption as the cause of the nominally low vaccination rate. However it is clear from the data that not all of the “provisional” cases will lead to vaccination. In public schools 86.9 percent of students entering kindergarten were fully immunized. Entering kindergartners who were provisionally admitted, defined as neither meeting vaccine requirements or having a valid exemption, was 7.9 percent. The Vermont Department of Health states that the vaccination rate for seventh graders in 2013 was 88.7 percent. These numbers do not add up, and this is why the students who have provisional exemption are counted as part of the philosophical exemption – most will not be vaccinated. The luxury of disease eradication has caused some to question the benefit of immunization; we have allowed our own success to cloud the truth. Some 113 countries now have a higher immunization rate than the U.S. (Vermont’s is even lower). It is time to get serious about this public health issue.
The media is complicit in sensationalizing the vaccine debate. When media outlets and politicians pursue “balance” when addressing these issues, they obscure the truth. By giving an equal platform to bad science they create a false equivalency. This only promotes distrust in science and implicitly gives legitimacy to science deniers. This is also true for the medical community — when you continue to treat patients that deny vaccines, you cede your expertise. By accepting their unhealthy decisions, you expose your other patients and the larger community to unnecessary risk.
Many developing countries now have vaccination rates that are higher than the U.S. (Mexico recently issued a travel warning to its citizens about going to the U.S. where vaccination rates are lower and measles has been spreading). Some however still struggle to contain diseases such as measles and hundreds of thousands still die each year from preventable diseases. Globally, many do not have the luxury of refusing vaccines – they are not available. Exemptions in the U.S. and Europe only exacerbate this problem by helping the spread of disease. This is a global public health and moral issue.
Research has shown that even when presented with all of the information about the efficacy, safety, and huge social benefits of immunization, people will still refuse to vaccinate themselves or their children. This is exactly why we need to remove non-medical exemptions. Philosophical and religious exemptions coupled with required education does not work. By having the exemptions in place, we condone behavior that puts us all at risk.
