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The Danger of Vaccine Exemptions

Are states with less rigorous rules about which children can claim an exception from vaccination in kindergarten putting communities at higher risk of childhood disease?

By | August 30, 2012

image: The Danger of Vaccine Exemptions CDC, Public Health Image Library, Debora Cartagena

States that make it easier for parents to refuse vaccination for their children may put local kids with legitimate medical reasons to avoid vaccines at greater risk of infection, according to a new study published today (August 30) in The Journal of Infectious Diseases. As the percentage of the vaccinated population falls below a critical threshold, the area is no longer protected by the phenomenon of herd immunity, in which the entire community is shielded from disease as a result of too few susceptible hosts for the pathogen.

Conducted between 2004 and 2011, the new study looked at more than 87,500 medical exemptions nationwide and found that parents were more likely to refuse vaccination in states with easier requirements. “Medical providers, parents, school officials, and state health officials are responsible for ensuring that medical exemptions are actually medically indicated,” said senior author Saad Omer in a press release.

 

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Avatar of: Mark Hauswald

Mark Hauswald

Posts: 4

August 30, 2012

Herd immunity is a bit more complex than having " too few susceptible hosts". Since most vaccines do not give complete immunity for life to everybody who responds the real issue is to provide a high enough density of immune and partially immune subjects so that the infectious agent is statistically likely to infect less than one secondary subject. Since immunity is greatest immediately after vaccination and wanes thereafter the affect of a high failure to vaccinate rate grows over time as more of the vaccinated population ages and loses immunity.

Avatar of: Susanna Cohen

Susanna Cohen

Posts: 1

August 30, 2012

Herd immunity relies upon actual immunity - in other words - a state where you are no longer susceptible to contracting the illness you are immune to. Since vaccines do not convey true immunity but instead, a temporary sensitization to the disease being vaccinated against, they cannot possibly be responsible for any form of 'herd immunity'. A perfect example of this is the State of California which saw 10 infants die from whooping cough a year ago. An investigation into that outbreak found that the incidence of the disease was unaffected by the rate of vaccination in the community. In other words - areas with high rates of vaccination did not have fewer cases than those with lower rates. In fact, recent studies are showing that mass use of the whooping cough vaccine can be INCREASING the community's susceptibility to different strains of the pertussis bacteria as well as making it more likely that people will contract b. parapertussis whose symptoms are identical to those of pertussis.

if we are going to be looking at the science of vaccination, we need to start with asking the question - how do vaccines immunize and if they don't, why do we even consider that they can be involved in protecting the community against disease?

Avatar of: Gary  A

Gary A

Posts: 5

September 1, 2012

Oddly no information concerning present disease rates among vaccinated and unvaccinated children.

Avatar of: Charles Raymond

Charles Raymond

Posts: 1

September 19, 2012

"Actual immunity"? In most cases exposure and reaction to an antigen results in immunity--how does your immune system know the difference between an antigen delivered by (for example) inhalation of a virus-laden sneeze droplet and the same virus (or viral particles) delivered by an injection?

As I understand it, the 2010 California outbreak was exacerbated by a decrease in the expected length of protection offered by the acellular booster. Vaccinated children under the age of 8 were protected, but the population of children older than eight (who received a booster at age 5, with another due at age 12) were vulnerable, with a peak incidence at 10-12 years old. Clearly the vaccine/boosters provide immunity in most cases, but not as long as expected. The schedule of boosters may need to be adjusted (at least for this acellular version), but the efficacy of vaccination is not called into question by these results. Vaccination works.

Also, what is your source for the assertion that rate of vaccination did not affect the course of the outbreak? Researchers at the Kaiser Permanente Medical Center in California reported:

"...the lapse of immunity in the vaccinated children punched one more hole in the general “herd immunityâ€쳌 of the local population, which was already undermined by families who refused to vaccinate their children as well as by families who did not strongly oppose vaccines but who vaccinated their children late...in California we have ‘personal belief exemptions’ [from mandatory vaccination] of 3 percent to 10 percent per county...if you have 10 percent unvaccinated, and the vaccine efficacy is 85 percent, then you’re talking about only 75 percent of the population at best who are protected"

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