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The Risk of the Intentional Unvaccinated

I was able to celebrate a friend’s coming baby at a shower this past weekend. The parents knew they are having a girl in May, so how were the gifts? Cute…cuter…and cutest! So much pink and brown! Such cute outfits! Such tiny shoes and pretty accessories!

As the mom-to-be opened gifts the conversation turned towards child rearing. The group of women ranged in age from late 20s to grandmothers (about to be great grandmothers), it became clear that, there was a wide-range of gifts but also a wide range of opinions on vaccines.

The younger crowd gave diaper wipe warmers, a stylish breastfeeding Boppy that matched the nursery decor, designer diaper bags that could go from the playground during the day to The MET at night! These were the women who questioned the need for vaccines

What diseases? Haven’t we eradicated them all?

Childhood diseases are a thing of the past, they’ve moved on to more contemporary diseases like AIDS and breast cancer.

The older crowd gave gifts such a delicate hand-knitted dresses, beautifully hand-stitched quilts (no machine stitching for these diehards), and a homemade diaper wipe holder made from what appeared to be a place mat. Born before the routine childhood series was available, these women have seen the ravages polio and diphtheria. They recall classmates paralyzed by polio, months spent in iron lungs, metal leg braces, and babies who coughed themselves to death before their third birthday. When they vaccinated their children, it was a modern medical wonder. It is their hope that their grandchildren would choose to vaccinate, too.

But sometimes children are not getting the vaccines they need to protect them from these nasty diseases. Some parents would rather “risk” the disease. That makes me uneasy for their child and angry because of the risk to all other children. Their “risk” isn’t limited to just their child or even to just their family. We ALL take that risk and here’s why.

When community vaccination levels fall below the recommended effective coverage levels of 90% , it leaves an opening for disease. Think we’ve eradicated disease? Think again. Check out this new report from the Journal of Pediatrics that profiles the case of a 7-year-old whose parents intentionally didn’t vaccinate him. The boy went to Europe and contracted measles, and when he returned to San Diego, he unknowingly exposed 839 people.

Measles are highly contagious spread through the air by coughing and sneezing. Eleven unvaccinated children contracted the disease and an infant too young to be vaccinated was hospitalized. Public Health officials quarantined another 48 infants in order to prevent further spread and infection.

No virus is more contagious than measles. “If a measles-infected person walks into a room with 10 uninfected people,” said Dr. David Sugerman of the CDC in a recent NPR interview, “nine of them will get infected.” Moreover, anyone who goes into that room within the next two hours after the infected person has left is likely to get measles, too
Measles outbreaks like this one due to “intentionally unvaccinated” children are widespread.

From January through July 2008, CDC received reports of 131 measles cases from 15 states and the District of Columbia—the highest year-to-date number since 1996. More than 90% of those infected had not been vaccinated or their vaccination status was unknown. Many of these individuals were children whose parents chose not to have them vaccinated. Fifteen of the patients, including four infants, were hospitalized.

During the 2010 Olympics in Vancouver two different measles virus strains were brought from travelers from Asia and the city continues to try to contain a measles outbreak. Those infected were two Canadians and an American. As a result, 16 people in a large family who are unvaccinated have contracted the disease.

What blows my mind is that this family didn’t decline vaccines based upon allergies, medical reasons or religious belief but because a close family friend who was anti-vaccines convinced them not to get vaccinated!? Here was a pocket of vulnerability which gave the disease an opportunity to spread.

While it appears that measles is a forgotten disease by the young mothers I met this weekend, it infects about 23,000,000 people and kills about 500,000 people each year around the world. Measles can cause a pregnant woman to miscarry or give birth prematurely. About 1 out of 10 children with measles also get an ear infection, and up to 1 out of 20 get pneumonia. About 1 out of 1,000 get encephalitis, and 1 or 2 out of 1,000 die.

There will always be some children and adults who can never be vaccinated or cannot be vaccinated in time. Unvaccinated children also pose a threat to children with legitimate medical exemptions who cannot be immunized because of health complications. These are often our most fragile children including those battling leukemia, cancer or HIV. Even children with allergies to certain vaccine ingredients, like eggs, have to go unprotected.

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