This is the debate that refuses to go away. The immunization discussion hit critical mass several years ago and has changed the behavior of many American families. It has also changed the rates of disease occurrence, and has led to some deaths from illnesses that would have not occurred if children had been immunized.
Opponents of mandatory immunization, however, have raised issues of their own, suggesting a link between immunization and autism, arguing that many diseases are ones that children would develop natural immunities to, and that there are enough instances of severe reactions to vaccines to warrant parents’ involvement in the decision to have their children vaccinated or not.
Immunization has been one of the most powerful health success stories. Formerly deadly diseases have been essentially eradicated through vaccination. Smallpox only exists in laboratories (in fact, there have been debates about the ethics of destroying the final remaining samples at the CDC). Polio only exists in some remote pockets of the world, where, in some war-torn areas, medical professionals are risking death to try to provide enough vaccinations to stop the disease completely.
But one of the challenges with the tremendous success of immunization is that for instances where vaccines may have caused problems, there are often samples too small to study and few ways of comparing vaccinated groups against non-vaccinated groups. This inability to conduct involved studies has fueled the arguments of the non-vaxxers.
Here’s a quick at some numbers: A 2003 report by researchers at the Pediatric Academic Society noted that childhood vaccinations in the U.S. prevent about 10.5 million cases of infectious illness and 33,000 deaths per year. The study noted that about 30,000 cases of adverse reactions to vaccines are reported every year, with about 13% of those classified as serious (associated with permanent disability, hospitalization, life-threatening illness, or death).
Statistics show that the high water mark for immunizations in the U.S. occurred around 2007—around the time the vaccination debate began. Since then, parents have chosen to opt out of mandatory vaccinations more often. In some areas of the nation, the opt-out rate is as high as six percent.
This has an impact on the effectiveness of vaccinations. When most of a population is vaccinated, the “herd immunity” level is high enough to prevent a disease from traveling through the population, even if some people contract it. When the immunization level drops below this, then the risk factor for the disease rises.
A Mother Jones article notes a number of clusters in California where personal objections to vaccines have risen since 2008 and have tracked situations where herd immunization is faltering. In Marin County, which had a personal-belief exemption rate of 7.8 percent in 2012 (which was more than four times the national rate), stats showed that the incidents of whooping cough had risen to the second-highest rate in the state.
Since pertussis requires a high herd immunization level (93-95% of the at-risk population), some physicians have begun recommending that adults who may come into contact with infants get pertussis vaccinations. The adults aren’t normally at risk, but they could be carriers to the infants as immunization levels drop.
The ethics of immunization are also beginning to be brought more into the spotlight. Parents who choose not to immunize their children and let them contact diseases to develop their natural immunity are making a choice that could affect others. The first child may weather the disease fine, but may pass it to another child who doesn’t. Who is responsible for the outbreak?
And all this is swirling around very iffy research on the big issue around immunization: autism. Celebrities who have sparked the debate have carried a lot of weight toward parental opinions, though some have since retracted their positions against vaccinations. And the CDC’s most recent research still shows no conclusive links between vaccinations and autism—even research by the Institute of Medicine into thimerosal, a preservative in many vaccine formulas that was the prime suspect for an autism connection has rejected any casual relationship between thimerosal and autism.
One positive from the vaccine debate has been an increase in attention to autism and its causes, and ongoing research seems to be uncovering some new information. But there is a need for more—and more importantly, more accurate—information about immunization risks so parents aren’t making decisions that could put their children—or the children of their neighbors—at risk.
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