Recent headlines declared, “Whooping cough cases rise dramatically,” “Measles outbreak in Orange County, worst in two decades,” and “Polio declared a global public health emergency.”
What do these diseases have in common? They can be prevented with vaccinations. Recently, however, we started seeing more people choosing not to vaccinate. Anti-vaccination celebrities and others have made emotional but unfounded claims that have fueled an increase in personal belief exemptions (PBEs) to school-aged vaccination.
For example, a significant percentage of parents still question if there is a link between vaccination and autism even though very large, well-done studies from multiple countries have answered that question with a resounding “No.”
As public health officials, parents and community members, we are very concerned about the rise in the number of people choosing not to vaccinate themselves or their children.
The reduction in disease from vaccination is undeniably one of the greatest achievements of mankind. Smallpox, which killed an estimated 300 million people in the 20th century, has been eradicated. The last case of smallpox in the U.S. was in 1949, and people have forgotten how terrible it was.
The world is 99 percent of the way to getting rid of polio, but this year it is re-emerging in countries that were previously polio-free. In the U.S., about 16,000 Americans were paralyzed every year from polio before vaccination. We should not forget that. We need to keep vaccinating until polio, like smallpox, is gone worldwide.
A disease that was declared eliminated from the U.S. is making a comeback: measles. It keeps getting re-imported into the U.S., often from unvaccinated travellers, and it can spread rapidly if people are not protected.
High vaccination rates slow the spread. For example, in 2003, a large measles outbreak occurred in the Marshall Islands — 53 percent of unvaccinated household contacts contracted measles, while only 3 percent of vaccinated contacts did. Other studies have shown even wider differences.
In California, we have had 60 cases of confirmed measles in 2014 already, a large increase from last year. If you have not been vaccinated and were born after 1957, please talk with your doctor about vaccination.
In contrast to the long duration of immunity provided by measles and polio vaccines, the immunity from the whooping cough (pertussis) vaccine is relatively short. We need a better vaccine, but in the meantime we need to use of the one we have to reduce the spread of illness.
In 2013, Nevada County had the lowest kindergarten vaccination rate in California and the highest rate of whooping cough. Babies who are too young to be vaccinated are the most vulnerable to it. And that can have tragic consequences.
This year already has more than a three-fold increase in cases compared to this time last year. Two infants have died from whooping cough in California in the past year, one recently from Placer County.
Pregnant women vaccinated during the last trimester produce enough antibodies to help protect their newborns until the babies are old enough for vaccination. We urge that if you are pregnant or around babies especially as a family member or caregiver, then please get vaccinated.
California is one of 19 states that allow PBEs for immunizations. Predictably, these states have lower immunization rates and more outbreaks. We understand that parents want to do what is best for their children. But when that decision is not to vaccinate, it affects the likelihood of outbreaks in the whole community.
Many have become complacent about vaccine-preventable diseases because we see so much less of them than previous generations. Eight counties in California now have exemption rates at kindergarten above 10 percent. With so many exemptions, we are losing community immunity (often called herd immunity).
We want our children to be healthy, to eat right, be physically fit, and to have a healthy lifestyle. Vaccination is part of maintaining that health. If you have friends who are afraid of vaccines, please encourage them to get the facts from their doctor, their local health department, or from the Centers for Disease Control.
Ken Cutler, M.D., M.P.H., is Health Officer for Nevada County. Robert Oldham, M.D., M.S.H.A., is Health Officer for Placer County.