According to a new study published in Pediatrics, the number of New York state parents who skipped at least one required vaccine for religious reasons has increased over the past decade. And New York counties that had this increase in religious exemptions to vaccinations also had more whooping cough (Bordetella pertussis, or simply pertussis) cases, even among children that had been fully vaccinated.
For this study, the researchers tracked data from the New York State Department of Health on both religious exemptions and new whooping cough cases. Children were reported as having a religious exemption if they had been allowed to skip at least one required vaccine for non-medical reasons.
The key results from the study were:
- The overall state annual mean rate of religious exemptions increased significantly from 0.23 % in 2000 to 0.45% in 2011, almost doubling the rate over the decade.
- The prevalence of religious exemptions varied greatly among counties with no obvious trends, although all of the counties around New York City showed large increases in religious exemptions.
- Counties with mean religious exemption rates of >1% reported a higher incidence of pertussis. For counties with higher exemption rates, the rate of pertussis was 33 per 100,000 compared to counties with lower exemption rates, which had a pertussis infection rate of 20 per 100,000. The researchers determined that this difference was statistically significant.
- In addition, the risk of pertussis among vaccinated children living in counties with high exemption rate increased with increase of exemption rate among exempted children, also statistically significant.
The increase in whooping cough rates is particularly troubling since unvaccinated children not only put themselves at risk, but also those who have been vaccinated (as result of the lower effectiveness of the currently available pertussis vaccine). Also, as the exemption rate increases and there is a lower than expected effectiveness of the vaccine, the herd immunity becomes weaker.
Whooping cough is not a trivial disease. According to the Centers for Disease Control and Prevention, pertussis (whooping cough) can cause serious illness in infants, children and adults. The disease usually starts with cold-like symptoms and maybe a mild cough or fever. After 1 to 2 weeks, severe coughing can begin. Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. In infants, the cough can be minimal or not even there. Infants may have a symptom known as “apnea.” Apnea is a pause in the child’s breathing pattern. Pertussis is most dangerous for babies. More than half of infants younger than 1 year of age who get the disease must be hospitalized. Approximately 1-2% of infants who are hospitalized from pertussis will die.
According to one of the researchers in the new study, Dr. Jana Shaw, “Particularly in New York State, I do believe that parents are using religious exemptions for their personal beliefs.” This abuse of the religious exemption system is because there are more flexible standards for religious exemptions than for so-called personal exemptions, that is, exemptions based on some personal belief that vaccines aren’t safe or effective (or both).
The authors concluded that:
The prevalence of religious exemptions varies among NYS counties and has increased during the past 12 years. Counties with high exemptions had overall higher rates of reported pertussis. Undervaccination in 1 community puts not only unvaccinated but also vaccinated children at increased risk. More studies are needed to determine the impact of exemptions to school immunizations on other vaccine preventable diseases in NYS. Religious reasons behind parental refusal deserve additional study because they drive the exemption rates in NYS.
I stand by my previously stated opinion that vaccine exemptions should made more difficult to secure. Religious exemptions have become a travesty, where parents abuse the religious exemption because they are personally opposed to vaccinations and some states made it increasingly difficult to obtain the typical philosophical exemption. Since most mainstream religions have no doctrinal concerns with vaccinations, it is clear that these parents are inventing a religious belief to not vaccinate their children, putting them and other kids at risk. If a parent wants a religious exemption then put their kids into a religious school. Of course, most of those demand full vaccinations.
Vaccines save lives.
- Imdad A, Tserenpuntsag B, Blog DS, Halsey NA, Easton DE, Shaw J. Religious Exemptions for Immunization and Risk of Pertussis in New York State, 2000–2011. Pediatrics 2013;132:1–7. doi:10.1542/peds.2012-3449.
- Klein NP, Bartlett J, Fireman B, Rowhani-Rahbar A, Baxter R. Comparative Effectiveness of Acellular Versus Whole-Cell Pertussis Vaccines in Teenagers. Pediatrics. 20 May 2013. doi: 10.1542/peds.2012-3836
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