After one of the worst whooping cough (Bordetella pertussis) epidemics in 70 years in Washington state, there is some good news. The New York Times has reported that the state, after passing a law that made it more challenging for a parent to get a personal exemption for a vaccination for their children, the exemption rate in Washington state has dropped by 25 percent. This is good news, because until recently Washington state was dead last in the immunization rate, or, if you like exemptions, it was number 1!
In 2011, the state’s legislature passed a law making exemptions a bit more difficult, by requiring parents to actually speak to a healthcare professional about the risks and benefits of vaccinations. That person then must sign off on the exemption. Parents who opted out of state immunization requirements for kindergartners peaked at 7.6 percent in the 2008-2009 school year, setting off alarms among public health experts in the state, according to the New York Times.
“You think we’re a cut above the rest, but there’s something in this culture out West,” Maxine Hayes, the state health officer for Washington’s Department of Health, said, according to the Times’ article. “It’s a sort of defiance. A distrust of the government.”
It’s possible that the success of vaccines against diseases like measles and polio has made parents think the immunizations are less necessary. The cultural knowledge of these diseases has lapsed, with few parents of young children having a memory of classmates or friends who have suffered from these diseases. Polio fell from 35,000 in the 1950’s to only 60 or so cases by the mid-1960’s in the United States (as a result of polio vaccinations), so parents just have forgotten how vaccinations have made children’s lives so much better.
“Vaccines are the victims of their own success,” said Paul A. Offit, the chief of infectious diseases at Children’s Hospital of Philadelphia. “When they work, nothing happens.”
Furthermore, distrust of the medical establishment and pharmaceutical companies, along with the spread of false information about vaccines from vaccine denialists have also added to the exemption rates. A study published recently in the New England Journal of Medicine concluded that despite efforts at educating the public about the benefits of immunizations (and the lack of serious adverse reactions), “results show that nonmedical exemptions have continued to increase, and the rate of increase has accelerated.” They also found that the opt-out rate is growing faster in states that make vaccination exemptions easier. Obviously, more stringent rules, like what was done in Washington state, reduces the rate even further.
My opposition to exemptions is rather more strict. There should be none, except for a few rare medical exceptions. But at least some states are going in the right direction.
Vaccines Save Lives.
For more information about vaccines, there’s a new book on the market, Your Baby’s Best Shot: Why Vaccines Are Safe and Save Lives (hardcover) and Your Baby’s Best Shot: Why Vaccines Are Safe and Save Lives (Kindle) by Stacy Mintzer Herlihy and E. Allison Hagood (with a foreword by Paul A. Offit, yes that Paul Offit mentioned in this article). The book is written for the parent who’s bombarded by information about vaccinations. It debunks common myths about vaccines, and tries to calm parents fears about vaccines. It makes a great baby shower gift for expectant parents.