Get the Shots

As if the anti-vaccination lunancy were not bad enough, now we have the Governor of Kentucky declaring that, not only is he opposed to his state’s mandatory chicken pox vaccination requirement, he sent his nine children to a “pox party”, so they could contract the disease while they were children.  They were “miserable for a few days” he reported, but they “all turned out fine.”

Although chicken pox is considered by many to be a relatively benign disease, the Centers for Disease Control reports that in the early 1990’s, before the vaccination was developed, 10,500 to 13,000 people were hospitalized and 100-150 died each year from the disease. I wonder what the Governor’s kids think of their father playing the odds with their health and lives?

There have been reports in the press about an outbreak of measles in the state of Washington in an area in which a relatively large number of children are not vaccinated. According to the CDC, the country seems to be on the way to a banner year in measles outbreaks.  Although the outbreak in the Northwest got  most of the attention earlier in the year, the biggest number of cases have been in New York City, particularly in Queens and Brooklyn. Now, a suburban New York county has banned unvaccinated minors from from public spaces.  It is well known that measles can lead to serious health conditions and can be fatal.

I can personally attest to the effects of measles. I had the disease as a child, but suffered no after effects. My brother and sister were not so lucky. Both developed serious hearing loss as a result of their bouts with measles.  lso, for many years, I worked in an office with a man who had almost total hearing loss due to having measles as a child.   

Then there is the case of the unvaccinated six-year old boy who contracted tetanus after getting a cut on his head. By the time he got to the hospital, his condition was perilous. He survived, but had to spend 57 days in the hospital, at a cost of over $800,000. His doctors had to keep their voices low to avoid stimulating him and triggering painful muscle spasms. His doctor said she never wanted to see such a case again. “It was difficult — for many of us — to see him suffer,” she said.

When the boy arrived at the hospital, the doctors gave him an initial vaccine for tetanus. But, when it came time for his second round, the parents declined it and all other recommended vaccinations.

Some parents who refuse to immunize their children cite links to autism. Although such fears have been fanned by social media for years, they have been thoroughly disproved.  For some individual studies disproving them, see here and here.  The CDC has flatly declared there is no link and autism organizations have reported that extensive research has shown there is no link.

Other parents decline to have their children vaccinated due to their religious convictions. Others cite “philosophical” reasons. Most states recognize religious objections and some allow for exemptions due to philosophical objections.

The Commonwealth requires all school children to have the following immunizations before they can be admitted to classes: Diptheria, Tetanus, and Pertussis; Hepatitis B; HPV; Measles, Mumps, and Rubella; Polio; and Chicken Pox. Parents may opt out of having their daughters receive the HPV immunization. For the other required immunizations, the state allows an exemption for religious or medical reasons. These requirements apply to all public and private elementary, middle, and secondary schools; child care centers, nursery schools, family day care homes, and developmental centers.

The state does not know how many children have not been adequately immunized. The Virginia Department of Health analyzes school data annually for compliance with the statutory requirements and provides the results to the CDC.  In 2017 (the latest year for which the data is available), the compliance rates were approximately 83% across all age groups. However, that report covers only those children in daycare facilities, head start programs, kindergarten, and sixth grade. Not included in that survey were children in child care homes, in grades other than kindergarten and sixth grade and over 40,000 students home-schooled or granted a religious exemption from attending school. Presumably, a significant portion of those populations, equal to or greater than those in the base survey, did not receive the vaccinations. (Disclosure: My grandchildren are home-schooled. They have been vaccinated.) The total number of children not in compliance with the state’s legal requirements for vaccination is easily several hundred thousand.

When asked about the relatively large percentage of children not in compliance with the immunization requirements, state officials engaged in some inevitable, but probably justified, finger-pointing. As far as the Department of Health is concerned, the requirement is one that school and child care facilities are required to enforce and refer any child not in compliance to the local health department. The state Department of Education says that “local policies and practices may result in the enrollment of students when the school has documentation that arrangements and appointments have been made for the required immunizations, with school nurses or other division staff responsible for following up to ensure that the students are properly immunized.”

Virginia, fortunately, has not had any serious outbreak of measles in recent years. Travelers from overseas, either foreigners coming in or U.S. citizens returning, are the most common source of outbreaks. The CDC has issued measles travel alerts for Israel, the Philipines, and several countries in Western Europe, among others. Because it has a large population of foreign-born residents and a large military population, both of whom are likely to have contact with residents from other countries, the Commonwealth may be at risk.

The state should take the following steps to reduce the risk of communicable diseases even further:

  1. Repeal the religious exemption for vaccinations. The number of children and adults unvaccinated due to religious reasons is not known. The Department of Health reported that, at the beginning of the 2018-2019 school year, there were 1,350 students in public and private kindergarten exempted for religious reasons, but that is just a small portion of the potential population. This proposal may raise freedom of religion objections. However, three states—California, Mississippi, and West Virginia—currently do not provide a religious exemption. (What a strange group of bedfellows.)
  2. Enforce the immunization requirements. Based on their own data, schools are not ensuring adequate compliance. Therefore, another agency should verify immunization compliance. Initially, there would need to be a review of the record of each child in every grade, public and private, to determine his/her immunization status. After that initial review, reviews only at the school entry level and at sixth grade would have to be conducted (a pertussis booster is required prior to entry to sixth grade).  The agencies to conduct such record reviews would be the local health departments. To take on that task, they would need additional personnel. School districts that did not meet a specified level of compliance would lose a portion of their state funding. Parents who refused to comply would be fined.
  3. Require parents of home schooled children to submit documentation of immunization annually to the Department of Education or the local health department.

By the way, because they have now contracted chicken pox, those children of the Kentucky governor may develop shingles, a painful condition, later in life, unless they get a two-dose shingles vaccination. That is another thing for which they can thank their father.