It's hard to miss the buzz generated by anti-vaccine advocates, especially since some celebrities who have made "vaccine refusal" their personal cause are using mainstream media outlets to tout their views to the public.
But what makes for a hot talk show topic doesn't necessarily make for good medicine. Particularly alarming, say health experts, is the return of largely eradicated diseases like measles and whooping cough, which can be attributed to some parents' refusal to have their kids vaccinated.
In an analysis published in the New England Journal of Medicine, researchers caution that vaccine refusal "not only increases the individual risk of disease but also increases the risk for the whole community." They cite parental concern about vaccine safety and decreased worry about diseases that have faded from public consciousness thanks to immunization effectiveness as top reasons for vaccine refusal.
But as the U.S. measles outbreak last year (in which a single carrier of measles spread the disease to six others) made clear, just one unprotected person can start an outbreak in a vulnerable community in which immunization rates have fallen. And the Centers for Disease Control and Prevention (CDC) reported that in the first 7 months of 2008, 131 people were infected with measles in 15 states — that's more than twice the average number of annual cases from 2000 to 2007.
The success of an immunization program depends on high rates of acceptance and coverage. But 20 states allow exemptions from vaccinations based on personal beliefs (including California, Texas, Pennsylvania, and much of the West), and their opt-out rates rose from 1% in 1991 to 2.8% last year, according to the CDC. Experts worry that such "geographic clustering of vaccine refusals" can lead to outbreaks.
Kids who aren't fully immunized not only are at increased risk for measles and pertussis (whooping cough), but also can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or were vaccinated but didn't have adequate immunologic response.
What This Means to You
Vaccinations given from infancy to the teen years can prevent some serious illnesses in millions of kids. A CDC study showed that routine childhood immunizations in the United States have spurred the largest-ever decline in cases of many devastating — but now highly preventable — diseases.
Many of the diseases immunizations protect against are no longer prevalent in the United States, but some are still huge problems in other parts of the world. Thus, if immunization rates drop among U.S. children, the spark for a major epidemic could be just an airplane flight away.
Some parents may hesitate to have their kids vaccinated because they're worried about the risks and the possibility of serious reactions. Although some vaccines may cause mild reactions — like temporary fever and soreness around the shot site — serious reactions are very rare. All in all, the risks of serious reactions to vaccinations are extremely small compared with the health risks associated with the often-serious diseases they're intended to prevent.
And before acting on any medically related message you see, hear, or read about — no matter how reliable or believable the source may seem — talk to your doctor first. Discuss the information, ask what it really means, and get the facts before making a decision to delay or skip an immunization — a choice that could affect not only your kids' health but also that of other children.
Reviewed by: Steven Dowshen, MD
Date reviewed: May 2009
Source: "Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases." New England Journal of Medicine, May 2009.
