Editorial: Vaccine refusal puts community at risk for disease outbreaks

Gateway Community Charter schools in Sacramento County serve primarily Russians and other Slavic immigrants. Waldorf schools throughout the region tend to attract upper- and middle-income, college-educated parents. So do home-study-based public charter schools in our region.

These very different school programs have something in common.

They top the list in our four-county area for having high rates of parents opting not to vaccinate their children. At these schools, 30 to 67 percent of kindergartners are unvaccinated.

By comparison, 90 percent of kindergartners statewide have all the required immunizations, according to the state’s annual report. We need a unified, targeted strategy to reach the clusters of intentionally unvaccinated kids. They put our entire community at risk for wholly preventable and unnecessary outbreaks of serious disease.

Measles is one example. This highly contagious disease in the past brought brain inflammation, heart problems, blindness, deafness or death. It was eliminated in the United States in 2000, but is making a comeback in California because many parents are choosing not to vaccinate their children. So far this year, the state has had 49 cases of measles, 21 in Orange County.

Bruce Pomer, executive director of the Health Officers Association of California, recalls the state’s 1988-90 measles epidemic – 16,400 reported cases, 3,390 hospital admissions and 75 deaths. He notes that the major cause was lack of vaccination among preschool-age children and young adults.

Now, as then, we need to raise vaccination levels, and we need targeted education at the vaccine refusal hot spots.

At the Gateway Community Charters, school officials recognize the problem. They have hired a full-time nurse who meets with every parent that opts out of vaccinations. They have had local Slavic-descent doctors talk at parent education nights. They have run radio ads.

The effort so far has been a success with second-generation parents, but distrust of government remains an issue for first-generation Slavic immigrants who escaped the Soviet sphere. Getting parents to vaccinate their children is an ongoing struggle.

The Waldorf and home-study schools are another story.

There, a full range of views prevails. Some believe that natural immunity than vaccine-acquired immunity; others believe that vaccines overload a child’s immune system; and still others say we shouldn’t worry about diseases that have “disappeared” from the United States.

Then there’s the Jenny McCarthy phenomenon. The former Playboy model and co-host of “The View” has convinced some parents that vaccines cause autism. Where to begin? The one study that linked the measles-mumps-rubella vaccine to autism, by British doctor Andrew Wakefield in 1998, has been discredited as fraudulent, and the published paper was retracted. Autism rates are the same in vaccinated and unvaccinated children.

One unvaccinated child may not get a vaccine-preventable disease. But that child can expose vulnerable populations to serious illness – including infants and individuals who have compromised immune systems. If too many people opt out, the community immunity we take for granted can collapse.

Starting Jan. 1, California tightened its opt-out rules, now requiring parents considering opt-out to get information from health providers about the benefits and risks of vaccinations, unless they belong to a religion that prohibits seeking medical advice. This move has reduced opt-out rates in Washington state and should help in California.

Bioethicist Arthur Caplan of New York University states the moral issue starkly: “If you infect my newborn or my grandmom because you put your liberty over your duty to help protect the weak and the vulnerable and chose not to get vaccinated then you are responsible for the harm you do and you ought to be liable for it.”

Vaccinations are about the responsibility each of us has to the larger community.

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