Editorial: Public health needs a shot in the arm

To vax or not to vax?

Some parents struggle with that question. But as they ponder it for the health of their children, some infectious diseases thought to have been eradicated from the planet are regaining a toehold.

As The Ledger's Eric Pera reported Tuesday, the 963 cases of the measles reported by U.S. health officials this year, including two in Florida, has already exceeded the total number of cases reported in 1994.

Measles is the harbinger of ill times ahead. As Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, explained to U.S. News & World Report in February, "Measles is the most contagious of the vaccine-preventable diseases, so it's always the first to come back when you see a drop in herd immunity."

U.S. health officials formally declared America rid of measles in 2000. Turns out that was premature. As it was with other illnesses as well. Officials say mumps, whooping cough and chicken pox are also rising.

Public health authorities attribute the rebound of such illnesses to the so-called vaccine "refusers," or "anti-vaxxers," who have opted against immunization, particularly for their children. Such folks have been with us as long as vaccines have. Yet the contemporary vaccine resistance arose from a two-decade-old study that purported to link the MMR (measles, mumps rubella) vaccine to autism.

The study was later shown to be fraudulent, based on contrived data, and it's underlying premise has been debunked several times since, including by a study published last month of almost 660,000 Danish children.

Nonetheless, resistance persists. The U.S. Department of Health and Human Services notes, however, that anti-vaxxers are not the only cause of these diseases. Increased international travel and trade, immigration, the importation of foods and agricultural products and possibly bioterrorism can all help spread illnesses we thought we once defeated.

The good news is Polk County residents may have less to fear than other parts of Florida.

The state of Florida requires children to provide proof of immunization before entering kindergarten and the seventh grade.

According to state Health Department data from 2003 to 2019, the immunization rate for Polk kindergartners has exceeded that of the state as whole for 15 of the last 17 years. Polk also has exceeded the target rate of 95% immunizations for eight consecutive years.

For seventh-graders, Polk's rate has surpassed both the state's overall rate and the 95% mark for 13 consecutive years.

But, possibly because of the anti-vaxx mindset, more Polk children seek to be excused from vaccines on religious grounds.

Health Department data indicate the number of kindergartners and seventh-graders seeking such exemptions reached record highs in 2019.

For kindergartners, the exemption total has risen in five of the last six years, and the number of exemptions for 2019 (170) more than tripled that of a decade ago. For seventh-graders, meanwhile, the number of exemptions has increased for three consecutive years, and the 2019 total (111) more than quadrupled that of 10 years ago.

Polk is also part of a statewide trend. The Health Department reports that almost 11,000 kindergartners and seventh-graders received religious exemptions this school year, pushing the ratio for both, relative to total students, to all-time highs. Students in private schools are a significant factor in that. The statewide religious exemption rate in private schools is double that of public schools for both kindergartners and seventh-graders. Within Polk, the private school rate is beyond doubling the public school ratio.

Dr. Joy Jackson, director of the Polk County Health Department, is troubled by that.

"I am pleased that our kindergarten and seventh-grade vaccination rates exceed the state rate; however, I am concerned to see an upward trend in the number of exemptions," she told us in an email. "This is concerning because children are vulnerable to vaccine-preventable diseases which put other children who have a medical contraindication to vaccination at greater risk."

She's correct. We shouldn't infringe on others' religious beliefs or faith. But if these parents claim religious exemptions because of an anti-vax mindset, they should understand they are contributing to an increased public health risk. They also should understand that the "herd" protection they rely on — that is, every other child around theirs being vaccinated — erodes as more parents opt out, threatening all.

If you're in this group, please do more research. Overwhelming evidence shows vaccines are safe, and they make the whole community healthier.