Make 'anti-vax' attitudes unacceptable

Why do we tolerate selfish behavior of those who don't get shots?

January 30, 2015 at 1:08AM
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iStockphoto.com (The Minnesota Star Tribune)

The days are long gone since "one for the road" was a common refrain at bar closing time. Thanks to organizations such as Mothers Against Drunk Driving, there's much greater awareness of alcohol-impaired driving's danger to everyone on the road.

Drinking and driving, a behavior few once questioned, is now socially unacceptable. In the wake of high-profile outbreaks of vaccine-preventable diseases, it's clear that a similar change of attitude is needed to protect the public from another group whose reckless behavior jeopardizes themselves and others — parents who forgo immunizations for their children.

Celebrity-driven anti-immunization campaigns have made it a trendy lifestyle choice among some parents to opt out of immunizations because of discredited concerns about vaccine side effects. But as the recent measles outbreak at Disneyland regrettably illustrates, this ill-informed but supposedly health-conscious decision has become a public health crisis.

Experts such as immunologist Cynthia Leifer of Cornell University, writing on the CNN website, say it's time to make parents aware that forgoing vaccines is risky and irresponsible. Hard-hitting public health campaigns and individual pressure, which were successfully employed to help reduce drunken driving, are needed.

It is not good parenting to leave your own children unprotected against serious diseases. It is also selfish behavior that puts other people's children at risk of serious contagious illnesses that can have life-altering or even life-threatening complications.

The ongoing measles outbreak at Disneyland, in Anaheim, Calif., is an alarming reminder that once-common childhood diseases that routine shots guard against haven't disappeared. When enough parents don't get their kids immunized, pathogens are waiting to swoop in and infect those who have opted out of the shots, babies too young to get them or the small percentage of those vaccinated who didn't get full protection from the shots. (Like most medical interventions, vaccinations aren't 100 percent effective)

Fifty-one measles cases in seven states have been reported so far in the Disneyland outbreak. These illnesses come on the heels of a record-setting year in the United States for reported measles cases. There were 644 cases of measles in 2014, according to the U.S. Centers for Disease Control and Prevention (CDC). That is the highest number since 2000, when the disease was considered to be "eliminated" in the United States, meaning that the disease is no longer native to this nation but that it still can be brought in from elsewhere.

Doctors have been unequivocal about the Disneyland outbreak's cause — declining vaccination rates due to fearmongering about vaccine risks. A recent Washington Post article showed the shocking growth in California for student exemptions from school vaccine requirements. In some private schools, it was 75 percent or higher.

The Disneyland outbreak was "100 percent connected" to anti-immunization campaigns, Dr. James Cherry, a specialist in pediatric infectious diseases at the University of California, Los Angeles, told the New York Times. "It wouldn't have happened otherwise — it wouldn't have gone anywhere.''

A recent mumps outbreak among more than 20 National Hockey League players also highlighted the ongoing risks from serious childhood diseases once thought to be nearly vanquished by vaccines.

Prominent medical ethicists have floated the idea of exposing parents who made this ill-advised choice to civil liability. Some doctors have also considered banning patients from their practices if they don't get the shots.

That's too extreme. But much more intensive efforts are needed to stamp out Internet-fueled conspiracy theories about the shots and make it clear that opting out is irresponsible.

Public health dollars for billboards or other mass media communications may be useful. Health care providers also need to work harder to discourage families from making this risky decision. But likely, the most effective pushes will come from concerned family and friends.

When parents decline immunizations, grandparents and other family members and friends need to firmly ask why, as well as provide solid information about vaccine benefits and risks (this page recommends the CDC and the Minnesota Department of Health).

Vaccines do have side effects, but generally they are extremely rare and not serious. The risk of fainting or developing a fever, for example, pales in comparison to the potential complications of the diseases the shots protect against.

Measles, for example, once sickened 3 million to 4 million people in the United States each year, according to the CDC, and caused about 500 deaths. About 4,000 of those who became ill developed encephalitis, a serious complication.

Minnesota's own vaccination rates leave much room for improvement. While no measles cases here have been linked to the Disneyland outbreak, a measles case was reported this week in a University of Minnesota student, underscoring the risk of the disease coming from other areas.

In one recent survey of Minnesota vaccination coverage, just 63 percent of children ages 24 months to 36 months had the recommended series of shots. It's time to aim much higher and roll out a plan of action to get there. A public health campaign to debunk vaccination myths would be strong first step.

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