Herd Immunity and Vaccinations

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    On April 22nd, 2014, the Colorado Senate failed to pass House Bill 1288, which would have required parents who didn’t want their children to receive state-mandated immunizations to either complete an online educational course developed by the state’s health department or complete an exemption form with a certificate from a medical professional saying the parent or parents was given information on the dangers of non-immunization multiple times during their children’s lives. The defeat of this education focused bill was met with an outburst of criticism from the medical community.

Is it a good idea to require all children to be vaccinated? Credit: Wikipedia Commons.

     One outspoken organization in favor of the bill’s educational focus, the Colorado Children’s Immunization Collation, said increasing “the frequency of exemptions is valuable to ensuring parents actively affirm their decision of whether or not to vaccinate their children with some regularity . . .  Parents may want to reconsider their choices and this provision ensures that they do so on a regular basis. 

     On the other hand, the National Vaccine Information Center (NVIC) opposed the passage of the bill because they felt that the bill “singles out and discriminates against a minority of parents with sincerely held personal beliefs about vaccination by incorrectly assuming they are uneducated.”

     Dawn Richardson, a spokesperson of the NVIC, said that the bill also “threatens the medical privacy of the children and sets them up for harassment” because of their exercise of their right to refuse immunization. The opposition to the bill was strong enough that those in favor of the bill were forced to water it down in an attempt to get something passed.

          According to the National Conference of State Legislatures, all states require students attending school must have specific vaccines, like the vaccination for polio and measles. However, all 50 states, except Mississippi and West Virginia, provide exemptions based on religious reasons, while 19 states, including Colorado, also allow exemptions on the basis of personal reasons.

         The Colorado Children’s Immunization Coalition [PDF] found that in 2012, Colorado ranked only 22nd in the United States for childhood immunizations with more than 20% of children not being immunized in the first three years of their life.

     A vaccine consists of proteins that act like the virus, such as the flu. These proteins are then shown to the immune system where it is able to create antibodies, which will attack the actual virus.

     Dr. Todd Porter, a family practitioner at Children’s Medical Center in Denver, CO, said when we are then exposed to the actual virus or bacteria “the body’s immune system already has been primed to respond with specific antibodies that fight off the infection.”  

         Dr. Alberto Cardelle of East Stroudsburg University in Stroudsburg, PA has studied public health for over 25 years and is himself a parent who had his children vaccinated. He argues that “if you compare the rate of vaccine preventable diseases between now and the 1950’s when we didn’t have as strong of coverage…we significantly lower infant deaths due to whopping cough and measles.” 

     An August, 2013, survey [PDF] conducted by the Centers for Disease Control (CDC) shows that compared to the pre-vaccine era the numbers of death due to measles in children less than five years old has dropped over 99%.

         Cardelle explains not vaccinating children “lowers that ‘herd’s immunity’ and pockets of individuals who are susceptible to these outbreaks.” Porter describes herd immunity as similar to if an infected cow is on the edge of a herd and a non-vaccinated cow in the middle of a herd of vaccinated cows, the non-vaccinated calf is not likely to get sick, serving as a “barrier” of disease for the calf in the middle. In humans, he said, “vaccination rates typically have to be greater than 80% to maintain herd immunity.”

     Some parents who choose not to vaccinate their children worry about what is referred to commonly as the “pincushion effect” where injecting so many needles into a child within the first 2 years of their life is dangerous.

     Professor Dan Kahan, a professor at Yale University Law School, found in a 2013 study that 25% of parents believed that vaccinations increased their child’s risk of autism, while 10% believed it would increase the chance of diabetes.

         The misconception that people who get a vaccine are still susceptible does have some validity, as CDC explains, since no vaccine is 100% effective. However, the CDC said, if there was a school of 1000 students who never had measles, all 5 of the students that weren’t immunized would get the measles and less than 1% of the children vaccinated—approximately 9 students—would get the measles. Therefore, while the efficacy rate of a vaccine is not 100%, it is much more effective than no immunization at all.

         While Porter feels strongly that children should be immunized, he believes “the decision to vaccinate or not is no longer a personal decision but rather a public health decision, meaning that your decision to not vaccinate does affect the health of other around you.”

         Cardelle feels that the best way we can stop these misconceptions is through education. “[Educating the public] is an area where many students end up working, like maternal health care programs, working in hospitals that push for greater vaccination.” He also thinks that all children should be vaccinated, with very few exceptions.  Doing so will vastly improve the health of our society and decrease the number of deaths due to preventable diseases, he says. Dylan Rozansky

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