When the outbreaks occur, they'll start in California

I may have been deluding myself when I talked about 2009 shaping up to be a bad year for antivaccinationists. It turns out that the antivaccine movement is succeeding.

That's right, a cadre of upper middle class, scientifically illiterate parents, either full of the arrogance of ignorance or frightened by leaders of the antivaccine movement, such as J.B. Handley, Barbara Loe Fisher, Jenny McCarthy, or the rest of the crew at the antivaccine propaganda blog Age of Autism, are succeeding in endangering your children. Although the U.K. got a head start in bringing back the measles and mumps, thanks to Andrew Wakefield's falsified research bought and paid for by trial lawyers suing vaccine manufacturers back in 1998, which sparked a scare over the MMR vaccine that has not yet abated. Here in the U.S., reinvigorated by the obnoxiously bubble-brained purveyor of "Indigo" woo, who since her child Evan was diagnosed with an autism spectrum disorder, has become the face of the antivaccine proquackery propaganda group Generation Rescue, the antivaccine movement has managed to become better funded and more visible than ever, so much so that the U.S. could well be at the verge of going where the U.K. has already gone, into the territory of endemic vaccine-preventable illnesses once previously thought eradicated, such as Hib and measles. Contrary to what antivaccine advocates claim, these are not benign diseases, and they are preventable by vaccines.

It's only a matter of time before large outbreaks of vaccine-preventable disease occur, and when they occur, most likely they will start in California:

A rising number of California parents are choosing to send their children to kindergarten without routine vaccinations, putting hundreds of elementary schools in the state at risk for outbreaks of childhood diseases eradicated in the U.S. years ago.

Exemptions from vaccines -- which allow children to enroll in public and private schools without state-mandated shots -- have more than doubled since 1997, according to a Times analysis of state data obtained last week.

The rise in unvaccinated children appears to be driven by affluent parents choosing not to immunize. Many do so because they fear the shots could trigger autism, a concern widely discredited in medical research.

This is exactly the situation in the U.K. Affluent moms, never having seen the diseases against which vaccines would protect their children if they were simply to allow them, decide that they are not in any danger, confident in their delusion that they those sorts of diseases couldn't possibly affect their children. Oh, no. They're good parents and have a more than enough money to provide their children all the good things in life and all the best medical care, not like those unfortunate poor people. Either clueless about the concept of herd immunity or, if they've heard of it, denying it, they convince themselves that vaccines are both dangerous but at the same time as 100% effective, the later claim being how they delude themselves into believing that their precious unvaccinated babies aren't endangering everyone else. But herd immunity requires that approximately 90% of the population be vaccinated, the specific percentage depending upon the disease and the vaccine. When the percentage vaccinated falls below that number the chances of outbreaks increase, becoming higher the lower the percentage of vaccinated falls. Unfortunately, this is already started happening as more and more of these upper middle class parents seek various religious or "philosophical" exemptions. Indeed, antivaccine activists are actively campaigning for these laws and teaching parents how to use them, even if they are not of a religion that opposes vaccination. The results are predictable: More outbreaks occur in states with lax exemption laws.

One thing that this story reports, also, is that the number of unvaccinated kindergartners because of exemptions in California is not uniform. There are clusters where the percentage of unvaccinated children is very, very high. Not surprisingly, at the top of the list are several Waldorf schools, one of which has a nearly 82% exemption rate. A lot of Santa Monica schools pop up, which makes me wonder if pediatrician to the stars' children Dr. Jay Gordon is having a malign influence. In any case, under the false mantra of "empowerment" woo-loving, antivaccine parents flock to these schools:

At Ocean Charter School in Del Rey, near Marina del Rey, 40% of kindergartners entering school last fall and 58% entering the previous year were exempted from vaccines, the highest rates in the Los Angeles Unified School District.

Administrators at the school said the numbers did not surprise them. The nontraditional curriculum, they said, draws well-educated parents who tend to be skeptical of mainstream beliefs.

"They question traditional knowledge and feel empowered to make their own decisions for their families, not deferring to traditional wisdom," said Assistant Director Kristy Mack-Fett.

Some parents at the school, which opened in 2004, said they struggled between what they believed was healthiest for their children and the risk that choice might create for others.

At least some parents do struggle with that question. They really do. In that, they're unlike the leaders of the antivaccine movement, most of whom ooze a self-righteous, smug sense of entitlement. Although they will deny it vociferously, they don't care one whit about anyone else's children but their own; just read some of their discussion boards if you don't believe me. The parents who do struggle with the question aren't the ones who are leading the antivaccine movement; they're the ones who are being duped by the movement. At some level, they still understand that their choice is potentially endangering others and have to find ways to deny it. When outbreaks come and some of these parents' children are injured or even die, they will feel horrible, but will they ever manage to acknowledge their own culpability? Most likely not. The denial reflex in antivaccinationists is legendary.

Los Angeles, it turns out, however, is probably not the worst in California. Sonoma County probably is:

Whether it's a decision of the well-informed, non-traditional, alternative or paranoid, vaccinations are not considered a must-do by many North Bay parents.

Long gone are the days when vaccinating infants and toddlers prior to kindergarten is done as a matter of course and without question. Especially in western Sonoma County.

A study conducted by the Los Angeles Times reveals that the North Bay, and Sonoma County in particular, is a hot bed of anti-vaccine sentiment. Of the 13 schools in the state with the highest percentage of kindergartners with exemptions from vaccination requirements, three are in Sebastopol. Of the 50 schools with the highest rates of exemptions, six are in Sonoma County and two in Marin.

There is not much drop-off after that: of the 255 schools with the highest exemption rates, 34 -- 13.3 percent -- are in Sonoma and its neighboring counties.

Unfortunately, studies don't matter. Study after study have failed to find a detectable association between vaccination and autism or mercury in the thimerosal preservative that used to be in vaccines and autism. The antivaccine movement marches on. Parents keep saying things like this:

Other parents said they feared autism and side effects more than the diseases.

"Is it life-threatening to get the measles . . . or is he potentially going to get a life-threatening reaction by getting the vaccination?" asked Sarah Bjorklund. She vaccinated her two school-age children on schedule but delayed shots for her youngest son. "I think you have to weigh what is the benefit of the vaccination versus the risk."

The problem, of course, is that parents like Bjorklund have a ridiculously skewed view of the risks and benefits of vaccines. The antivaccine movement tells them that vaccines are dangerous, that they cause autism, that they cause large numbers of severe reactions, while also telling them that they don't protect against the diseases they're designed to combat. When scientifically illiterate parents like Bjorkland are fed a diet of misinformation and lies, they don't know enough to distinguish science from pseudoscience. Is it any wonder they come to the wrong conclusion about the risk-benefit ratio of vaccines?

Science doesn't matter, of course. Even fraud doesn't matter to the antivaccine movement. Their hero Andrew Wakefield was revealed to be a scientific fraud, they launched a counterattack that involved playing Rupert Murdoch hating dupe Keith Olbermann for a fool and getting him to attack Brian Deer, the journalist who uncovered Wakefield's misdeeds; set up a website proclaiming "We support Dr. Andrew Wakefield'; and publicized Wakefield's tortured attempt to file a complaint against Brian Deer. Meanwhile, vaccine discussion boards were filled with parents blaming big pharma for a massive conspiracy to "discredit" Wakefield.

There's one other thing these articles demonstrate once again, namely the tight association between antivaccine views and belief in "alternative" medicine:

A mom at Sunridge Charter School in Sebastopol, where parents of 76 percent of kindergartners obtained exemptions from vaccines, said she has no concern that her daughter, who was immunized, will suffer among peers who are largely unvaccinated

Parents at Sunridge are more conscious and wary of traditional western medical practices but do not look down on her for her decision, she said. She requested that her name not be used.

Good luck with that, given that no vaccine is 100% effective. I also find it telling that this woman claims that other parents don't "look down on her" for her decision, but then didn't want her name to be used.

The optimist in me likes to think that eventually science will win out, that eventually the steady drumbeat of studies that fail to find a link between vaccines and autism will have an effect. The pessimist in me expects outbreaks to begin soon. A lot of them, beginning in California.

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As distressing as these developments are, I agree that science will ultimately prevail. Of course, the advocates of AiB (Anti-intellectual Bologna) could expedite this process for us by all moving to one isolated geographic location. They could invite those who practice GUAs (Godly Uninformed Anti-science) and promote AATM (Any Alternative to Tested Medicine) to move there, too. Then together they could deny evolution (while providing a breeding ground for new strains of diseases), block Big Pharma from exporting any medications (somehow the R. Stones' "Mother's Little Helper" comes to mind) to their island, and hold lots of natural immunity parties with special salves for sale (sort of like Tupperware receptions). They could have their own schools which would miracuously combine Rousseau-ian, Waldorfian, Summerhillian, and parochial precepts around the idea of teaching children no science (other than intelligent design) after age 8 or 9.

And the rest of us could put a quarantine fence around that place.

It is a shame that children are going to get hurt, but until a serious outbreak happens close to home some people aren't going to get the message.
That, it appears, is only a matter of time.

By Richard Eis (not verified) on 31 Mar 2009 #permalink

Administrators at the school said the numbers did not surprise them. The nontraditional curriculum, they said, draws well-educated parents who tend to be skeptical of mainstream beliefs.

"They question traditional knowledge and feel empowered to make their own decisions for their families, not deferring to traditional wisdom," said Assistant Director Kristy Mack-Fett.

The thing about being skeptical is that it;'s a wonderful thing, but you need some way to sort good information from bad for it to do you any good. If parents are going to be asking 'what will vaccines do to my kids?' and not just take their doctor's advice, they better know enough to be able to sort real data from bullshit. (Not like there's any shortage of either on the internet.)

If you can't tell good information from bad, then you are probably better off following the advice of your pediatrician than striking out blindly -- Jay Gordon aside, there's probably lower odds of your pediatrician being a quack than you stumbling on bullshit instead of useful data.

By Becca Stareyes (not verified) on 31 Mar 2009 #permalink

... the realist in me tells me, that most likely there will be outbreaks and than science wins for some time. After a while, when the horrors are forgotten, it might start again, especially if scientific illiteracy is still prevalent at that time.

When a big outbreak happens... "I told you so" will hardly feel like enough, particularly since some vaccinated kids will get sick too.

Too bad that those parents are aiming for Darwin awards via their kids. Especially if you consider that the affluent are more likely to travel to areas of the world where measles are still common, therefor more likely to transport it back to the unvaccinated community their kids belong to. I'm just wondering what they say when they are told "oh, it's just the measles, stay home with your kid for a week" instead of being allowed to dump them off at the local hospital. After all, measles isn't dangerous.

"Parents at Sunridge are more conscious and wary of traditional western medical practices..."

The heck?! A vaccine exemption rate of 76% seems to me to be severely stretching the definition of "conscious."

Anyone know how to find vaccination rate data? I live in Southern California and am curious what the rates are like in my area.

Well everyone knows that measles deaths have nothing to do with vaccination coverage - you only have to look at the data from the '50s and '60's to see that measles deaths were declining due to better sanitation and hygeine.

From the blog post at CounterKnowledge, Measles outbreaks: not just a British tragedy, but a European one as well

So far, so predictable. But what about the outbreaks in Switzerland and Austria? It is with regard to these countries that the story takes on a perverse twist. Switzerlandâs immunization rate is still sub-par, but rising slowly. When infection does appear, it is likely to spread to areas where vaccine uptake is low; it is also areas where local communities are likely to favour âalternativeâ practices, such as homoeopathy and anthroposophy. Jean-Luc Richard, a Swiss federal health official, pointed out that in the canton of Lucerne (where alternative medicine is also popular) vaccination coverage resides at only 78%. The recent outbreak in Austria also occurred within a community in which anthroposophy is commonly practiced. It spread to similar communities in Germany and Norway.

Anthroposophy is a flavour of woo that is probably unfamiliar to British readers. Set up by âmystic and social philosopherâ Rudolf Steiner, it aims to âcombine human development with an investigation of the divine spark found in all of natureâ, and favours natural medicine that utilise the bodyâs ânaturalâ healing system. I think you can see where this is going.

His ideas are taught today through âWaldorf/Steinerâ schools. A comprehensive review of their ideas exists at OpenWaldorf.com. Their health section aims to offer parents advice on vaccination, which manages to be both confusing and dangerous.

There's also the group known as People for Legal And Nonsectarian Schools (PLANS), who aver:

1. Waldorf Schools are Religious Schools
2. Waldorf Is Based on Occult Theory
3. Publicly Funded Waldorf Programs Violate the First Amendment in the United States

Sunridge is a public school with a Waldorf curriculum. Wonder how much Anthroposophy is taught?

February 2009: Chicken pox outbreak at Waldorf School

May 2008 Whooping cough outbreak at Waldorf School

Waldorf schools seem to be public health menaces.

"They question traditional knowledge and feel empowered to make their own decisions for their families, not deferring to traditional wisdom," said Assistant Director Kristy Mack-Fett.

Yet, all you have to do to sell them on an idea is tell them that it's "the wisdom of the ancients" or that it comes from some traditional tribal healing practice (nevermind that the tribe has a 30% infant mortality rate and seldome lives past 50).

When a celebrity's child dies of the woo, or when someone sues the parents of unvaccinated children for the damages caused to their own kid (either medically unvaccinatable or one that fell in the small % of unprotected though vaccinated) in a big nasty publicity-loaded lawsuit ... then the consequences might sink in.

By Tsu Dho Nimh (not verified) on 31 Mar 2009 #permalink

The sad truth is that most patients don't know good science from psuedoscience or woo.
I'm still shocked that celebrity endorsements carry so much more medical wieght than a doctors advice.
Maybe we can get LeBron James to do a vaccination PSA? Or maybe when some famous kid gets measles vaccines will be cool again... Or measles will become cool again.

When outbreaks come and some of these parents' children are injured or even die, they will feel horrible, but will they

but will they what? - your hordes of loyal readers are anxiously awaiting this missing insolence.

I see we have our first antivax whackaloon troll.

By Militant Agnostic (not verified) on 31 Mar 2009 #permalink

I'm old enough to remember getting a smallpox vaccination, to know people who had contracted polio, and to recall getting chickenpox, measles, and mumps. I am the last generation that will have a collective memory of what it is like to deal with epidemics of those diseases (making no prediction of what may arise in the future). Part of the issue is that memory is fading.

But what bothers me is that these parents are supposedly "well-educated" and "intelligent." I'm sorry, but buying into Jenny McCarthy's rants does not give me any indication that these parents are actually well-educated or intelligent.

I assume that these parents went to college. I assume that they actually graduated. Exactly what do they teach in College any more? Oh never mind, I'm sounding like an old man.

I live in California, I'm well-educated and somewhat intelligent, and my kids are vaccinated.

To Amar and all;

Note that within the LA Times article Orac linked there is a comprehensive search engine on LA county public school vaccination rates.

You can search by individual districts within LA county and even individual schools.

By Uncle Dave (not verified) on 31 Mar 2009 #permalink

Orac concluded;

"The optimist in me likes to think that eventually science will win out, that eventually the steady drumbeat of studies that fail to find a link between vaccines and autism will have an effect. The pessimist in me expects outbreaks to begin soon. A lot of them, beginning in California."

Or as my wife would say;
Unfortuntely, a lot of people are going to have to die before something is done...

By Uncle Dave (not verified) on 31 Mar 2009 #permalink

"Well everyone knows that measles deaths have nothing to do with vaccination coverage - you only have to look at the data from the '50s and '60's to see that measles deaths were declining due to better sanitation and hygeine."

What was happening to infection rates at the same time? Maybe all that was happening was that life support was getting better once you were sick. And how many who would have died before were disabled in some fashion?

By the way, mom was a cleanliness nut, and I still got measles, mumps, german measles, and chicken pox in the fifties and early sixties.

Thought some might enjoy a real post from a real mommy list. Not in California, think further north:

Just wanted to weigh in on the vaccine comments, hopefully without starting a
fracas. As the parent of a partially vaccinated older child and a yet-to-be
vaccinated younger child, I am sure you know where my bias lies!

I think it should be mentioned however, that there is a national vaccine injury
registry because children are actually injured by vaccines. Mercury preservative
is not the only concern of parents who choose to delay or forgo vaccines. And
under the public health model, there is a defined "acceptable risk" which
basically means that public health officials know that some children will suffer
adverse effects from vaccines but those effects are considered acceptable in the
interests of preventing deaths from the illness itself.

Most of us who are delaying or refusing vaccines are doing so very intentionally
with much thought given to our children's particular immune systems, whether or
not they are in daycare, whether they are breastfed and various other factors.
Most of us read most of the studies and then talk with our pediatricians about
them. However, as with any study, one must consider who is doing the research,
the demographics of the people being studied, the type of study being performed,
etc. before you draw any conclusions that might be applicable to your particular
situation.

For my family, we are definitely opting for immunizations for the various
serious illnesses, like polio, and not for the normal childhood illnesses like
chicken pox. While I think herd immunity is a great thing in general, I choose
not to stack vaccine upon vaccine upon my children while their immune systems
are still developing. I think that the current number of vaccines given in such
a short period of time has not been studied long enough.

Most of us alternative vaccinators feel fine with others' choices to vaccinate.
I would appreciate if the discussion on this list weren't all in support of the
traditional vaccine schedule.

By WonderingWilla (not verified) on 31 Mar 2009 #permalink

"They question traditional knowledge and feel empowered to make their own decisions for their families, not deferring to traditional wisdom," said Assistant Director Kristy Mack-Fett.

Translation:

"They are convinced that they know more than people who have researched and studied the field all their adult lives. They feel that their fear of what they do not understand is sufficient justification to disregard the data and just make it up as they go along."

Shorter translation:

"The arrogance of ignorance writ large."

Prometheus

And under the public health model, there is a defined "acceptable risk" which basically means that public health officials know that some children will suffer adverse effects from vaccines but those effects are considered acceptable in the interests of preventing deaths from the illness itself.

@WonderingWilla: Decisions like these are the norm in society. For example, building roads and bridges poses a number of risks, but these risks are considered acceptable in the face of the benefits that roads and bridges provide.

Most of us who are delaying or refusing vaccines are doing so very intentionally with much thought given to our children's particular immune systems, whether or not they are in daycare, whether they are breastfed and various other factors.

What you're doing is not so much based on thought but speculation that rests on unsupported anti-vax ideas. It's unlikely your decisions are evidence-based.

Most of us alternative vaccinators feel fine with others' choices to vaccinate. I would appreciate if the discussion on this list weren't all in support of the traditional vaccine schedule.

By "traditional" vaccine schedule, I suppose you're referring to the schedule that has actually been thought out by scientists, researched and tested. Is there a different schedule that could be seriously considered?

This yet another reason why I sold my property is Sebastopol and moved into Santa Rosa. These fear-addled, smug, self-absorbed west county twats are no better than the Taliban, bound and determined to drag the rest of us back to the 12th century. Sebastopol is the northern terminus of California's infamous Axis of Me-villeâ¢, with the 'bu at the southern end. Sebastopol swarms with fleets creaking, ancient Mercedes diesels converted to vegetable oil fuel, always stuffed with tie-dye clad, unimmunized children called "Otterwind" and "Sunray" who are "indigo". They are "special" and therefore not required to behave themselves in the cramped aisles of Whole Foods. These same parents who are terrified of vaccines harming their little ones are not afraid to ferry them around in cars with dashboards festooned with all manner of potential projectiles: rocks, crystals, shells, potmetal Ganeshas and what have you. They are utterly irony impaired. Sebastopol is pretty in the spring though, so if you visit, be sure to bring your IronMeasure-Protect-o-Magic⢠irony meter, as lesser models will surely explode.

Most of us alternative vaccinators feel fine with others' choices to vaccinate.

Public healthcare becomes middle-class lifestyle choice. May these preening fools choke on their Sunday supplements.

Joseph, just to clarify, I vaccinate. What I posted was another person on a mommy mailing list I am on.

By WonderingWilla (not verified) on 31 Mar 2009 #permalink

WanderingWilla posted: "Most of us read most of the studies and then talk with our pediatricians about them."

I can tell you right now that this statement is half-false. Parents rarely if ever read the original research papers, they rely on either articles that interpret the data for them or just rumors about said studies. Every time I have posted an original research article on a parenting site I have been met with a chorus of "I don't know how to read that." But yet these same people claim know enough to understand their child's immune system? Gah, it's frustrating!

WonderingWilla: <blockquote>...</blockquote> tags are your friend. :)

The optimist in me likes to think that eventually science will win out, that eventually the steady drumbeat of studies that fail to find a link between vaccines and autism will have an effect. The pessimist in me expects outbreaks to begin soon. A lot of them, beginning in California.

These two things aren't mutually exclusive. It's possible for outbreaks to occur for a time, and for improved public understanding to follow, with science winning out in the end, after many people have died. (I do not intend to imply that children suffering and die due to illness will necessarily cause improved public understanding, by 'teaching them a lesson', but there are past examples of broader public understanding of science following tragedies that could have been prevented by broader public understanding of science.)

WonderingWilla indeed.

Always nice to know that the "alternative vaccinators" feel fine with those that chose to vaccinate. That's quite a statement in and of itself.

This is the next retreat point when confronted by current data on the ever present persistance of these serious diseases.
Visit CDC site which has a comprehensive list of the repercussions of contracting various less serious illneses as well as the serious ones. 1990-1994 about 50 children and 50 adults died from varicella each year. Most were listed as healthy. Vaccine is safe and effective, not being vaccinated is not as safe and effective.

When you have any further wondering's about this, ask the teacher in the classroom you child might attend how she feels about some of the children not being vaccinated "according to the new schedule".

Many become a bit nervous over the possibilities. Risk is always an issue of perspective. If you work in an environment where you are surronded by 2 legged Petri dishes your concern tends to grow.

By Uncle Dave (not verified) on 31 Mar 2009 #permalink

@has: I thought my preamble was clear enough for such a smart bunch;-)

By WonderingWilla (not verified) on 31 Mar 2009 #permalink

Yes, measles and polio were declining before vaccines. And we know why: infection control measures were being used more often in more places.

Handwashing, covering your mouth when you sneeze, and quarantine of infected individuals will decrease the number of viral particles spread among a population. These measures effectively disrupt the natural life cycle of the virus.

But infection control won't make the diseases go away. We still need vaccines.

Too bad that those parents are aiming for Darwin awards via their kids. Especially if you consider that the affluent are more likely to travel to areas of the world where measles are still common, therefor more likely to transport it back to the unvaccinated community their kids belong to.

A-yep. We're going to run into more situations like the guy who was shedding TB virus going overseas and sharing the love. Except that these folks will be spreading measles and other charming things well before they manifest any symptoms.

I totally understood WanderingWilla's post because it looks so familiar to me. Such posts are all too common on parenting boards across the country. I'm shocked by how many parents in our circle of friends in Kentucky are afraid of vaccines and want to delay or skip shots. The situation was no different in our nabe in NYC last year. I've noticed a lot of nice things about involved, educated parents, but the influence of alternative-health (for lack of a better term) practices is alarming. The distrust of scientific medicine is high, and the advice of pediatricians is routinely disdained. And this from people who embrace homeopathic teething tablets.

By WitchFInder (not verified) on 31 Mar 2009 #permalink

WonderingWilla:

I think that the current number of vaccines given in such
a short period of time has not been studied long enough.

Really? Gosh.

I hope you're talking to people like Michael Bishop.He's a virologist who won the Nobel Prize in Medicine in 1989 along with Harold Varmus. These guys know more about viruses than just about anyone else on the planet. Or so I thought until I read your post.

Dr. Varmus and Dr. Bishop both support the vaccination schedule. Boy won't they be embarrassed when you explain how they've got it all wrong. What a major f*ck-up, no?

Oh come on! I know how this will go in the homes of these wealthy "we're too good for real medicine" people. Rich mommy doesn't vaccinate. Rich kiddie gets mumps. Housekeeper takes care of kiddie. Housekeeper goes home, gives mumps to her baby. Rich kiddie goes to the hospital, gets the best care, comes home OK. Housekeeper's baby dies. Housekeeper gets fired for taking time off to care for her baby.

Years later, rich kiddie in therapy: My mother used me as a tool to murder our housekeeper's child.

I know, it seems histrionic, but I do see this happening, and there's just no way it will ever be reported on.

These people make me insane.

By JustaTech (not verified) on 31 Mar 2009 #permalink

colmcq said:
"Well everyone knows that measles deaths have nothing to do with vaccination coverage - you only have to look at the data from the '50s and '60's to see that measles deaths were declining due to better sanitation and hygeine."

Ah no. Measles deaths began to decline with the advent of antibiotics and improved medical modalities for measles complications, not sanitation and hygiene. Measles morbidity however, did not decline until vaccine introduction. Also of interest and accuracy is that the death rate of measles has remained steady since the 1960's at ~1.2/1000 measles cases and the U.S. 1989-1991 measles outbreak saw a death rate of 2.54-2.83/1000 measles cases.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedi…

http://www.ncbi.nlm.nih.gov/pubmed/15106092?ordinalpos=6&itool=EntrezSy…

By Science Mom (not verified) on 31 Mar 2009 #permalink

WonderingWilla:

I thought my preamble was clear enough for such a smart bunch

Form vs. substance. It does help to use tagged formatting:

<blockquote>
Stuff you're quoting
</blockquote>

By D. C. Sessions (not verified) on 31 Mar 2009 #permalink

Regrettably, southwestern Alberta is ahead of Califorinia on this - there is already a pertussis outbreak. Someone from the Chinook Health region "credited" the large population of CAM believers with the low vaccination rate. In a radio interview she described as being like someone whoi is so worried about soemthing fallling on them from above that they get hit by a car because they are looking up when they cross the street.

http://www.chr.ab.ca/bins/content_page.asp?cid=5075-5106-5079-17077-175…

By Militant Agnostic (not verified) on 31 Mar 2009 #permalink

Wandering Willa,

Because of the number of anti-vax "trolls" Orac gets on this 'blog, it is sometimes hard to tell when someone is telling their story and when they are relaying another's story.

In retrospect, your "preamble" does make it clear that you're not telling your story, but it was a bit amiguous about whether you agreed or not. To be honest, I had to read your post twice before I realized that. As mentioned above, the blockquote tags are a good way to let your readers know that you are quoting someone else.

More to the point, my ancient experience (mid 1980's) in the SF Bay area convinces me that the epicenter of the next outbreak of measles (or polio) in this country will be either the East Bay (specifically Berkeley) or Marin County.

Back in the mid 1980's, when I was working for two months at Oakland Children's Hosp., we had a steady influx of children with vaccine-preventable illnesses - pertussis, diphtheria, measles and even tetanus (three cases in a two-month period).

A disconcerting number of parents - even then - were telling us that they wanted their children to get their immunity "naturally". The three children (preschool age) who came down with classic tetanus (with opisthotonus just like the blockprint in my "History of Medicine" book) were from Berkeley. Their parents were surprised to learn that even full-blown tetanus did not produce enough of an immune response to give their children long-term immunity.

Once the population immunity drops below the critical point, I expect to see measles (and worse) erupt out of the SF Bay region and gallop through the country.

Prometheus

Unfortunately, Dr Paul county has more measles cases this year than Dr Bob and Dr Jay county - 3 new ones in Pittburgh:

http://www.post-gazette.com/pg/09090/959574-100.stm

Given that measles are going super strong in Europe this year (already 500 cases in Switzerland, one death, and almost 200 in Hamburg) these 3 will not be the last...

By Catherina (not verified) on 31 Mar 2009 #permalink

greenmom1, you might be surprised about the number of parents of autistic kids commenting here (on the pro-science side, even some with their own MD). Does that mean you take them seriously, or do they also have to undress in a national magazine first?

As to finding arguments that might actually carry weight with these oh-so-clever "I've-done-the-research-and-my eminent-opinion-is-vaccines-are-harmful..." people I think there are a couple here in comments: 1. They think they are socially responsible, so press the point about immuno-suppressed individuals who cannot endure an outbreak of disease; and 2. Remind them of how their views are identical to religious extremists they probably detest. In other words, less Amanda Peet (however nice and well-intentioned, particularly when she feels called upon to apologize for saying something horrid about non-vaccinating parents), and more accusations of victimizing the weak, and imitating doctrinaire fundamentalists. It's obvious that reasoned argument and science won't make a dent.

Wondering Willa's relayed story is very familiar, I see alot of those kind of posts on my mommy forums. Alot of the standard anti-vax talking points regurgitated as "fact" with a dash of selfish "not gonna happen to me because I am edjumacated on this vaccine stuff!". They always cover their ignorance up as "being educated on the subject" when nothing could be further from the truth.

Sadly, it will take a dose of reality slamming home to change their minds and while I might have gotten some satisfaction out of seeing the look on their face when their "plan" falls apart, unfortunately it will not be them that pays the price. It will be the children that they claim to care so deeply about.

Clare, I think I understand the soft underbelly of this crowd: litigation.

Get them to envision the years of court procedings they'll be enjoying once precious little Kylie gets the measles and everyone who came into contact with her at the pediatrician's office, the wholistic daycare, the supermarket, etc., are forced into three weeks of quarantine to the detrimiment of their careers.

That's a guaranteed minimum of trouble. Anyone dies, and it all gets much more unpleasant.

Kids shed virus even during the prodrome when they don't obviously have symptoms. So a parent isn't going to know to isolate the child until it's too late.

Unless you have a child with autism, then you really have nothing to say.

Be sure you say this to parents whose children are crippled or killed by vaccine preventable diseases.

Ababa: It always amazes me that those claiming they are "educated on the subject" haven't had a basic biology course since high school in most cases. They have no underlying knowledge of microbiology or immunology and yet are convincing themselves and other parents that they are experts because they have read whaleto.

That's WonderingWilla not WanderingWilla. So I neglected a block quote, what everyone has done here has sort of lectured me on stuff I already know, even after I clarified my position. I have vaccinated my child accordingly.

*joke* Heck, I even want to double vaccinate just to make up for all the informed delaying and skipping that goes on in my area. *end joke*

You know who is never going to get your wisdom is the woman who wrote that message. I have said it on this forum before, but a vast majority of doctors in their offices are not conversant on what one ill-informed parent is saying to another and do not have an effective script to counter it. Surprised? It happened to me with my ped interview prior to having tot and at a visit with my family doc when I asked him about whether I should have an MMR booster. It even happened with my OB when I asked him about the Hep B shot that's administered shortly after birth. Zero for three ain't great odds, folks.

Even adding a question like 'what exactly is it that you are concerned about with this?' would help a lot in handling the objection (I'm in sales, I do this all the time). See, because a lot of these people have conceded the MMR/autism link and a lot have conceded the thimerisol harm theory and the goal posts have shifted to formaldehyde, aluminum, and other 'toxins' causing everything from ADD to food allergies. They don't understand basic things like the fact that the injection goes into the muscle not the bloodstream. There are a lot of teaching moments here and Amanda Peet can't be the only one doing the teaching.

By WonderingWilla (not verified) on 31 Mar 2009 #permalink

Get them to envision the years of court procedings they'll be enjoying once precious little Kylie gets the measles and everyone who came into contact with her at the pediatrician's office, the wholistic daycare, the supermarket, etc., are forced into three weeks of quarantine to the detrimiment of their careers.

I daresay it won't matter to them in the least, because to them the threat isn't real.

Bear in mind that to too many people, measles (etc.) are "routine childhood diseases," just like colds. Everybody got them, everybody got over them. No big deal -- why, all of their parents (or grandparents) got over the measles just fine!

I am old enough to have had the measles; my youngest brother was in the first cohort to be routinely vaccinated. I was sick and miserable, but was too young to remember it all that well and what I didn't see was how afraid my parents were. They, unlike me, had been around long enough to have seen or at least heard of serious cases.

What that means is that the WWII generation, now slipping away from us, are the last ones to really remember how terrifying these diseases can be. For the rest of us, even those who are old enough to have had them, they're not scary because our social circles at the time were too small to register a 1% mortality rate. Hey, kids came and kids went -- we're a mobile bunch, and on top of that teachers may well have been reluctant to mention that Tommie had croaked the previous week or that he was now blind/deaf/braindamaged to the point where he would be changing schools.

Don't forget that in most parts of the USA, most of us had the measles before we were eight -- and many of the casualties were our younger siblings that nobody our age would miss.

No, measles is a "mild childhood disease" and even necessary for the proper development of the immune system! Or so they will keep telling themselves, because that way it's all black and white: vaccines=dangerous, no vaccines=no danger.

By D. C. Sessions (not verified) on 31 Mar 2009 #permalink

What worries me about this anti-vax woo is that it's pushing the Overton Window towards stupid regarding vaccine schedules (delaying them). That means more kids won't be vaccinated due to forgetfulness and at very susceptible ages that will be unvaccinated for longer periods of time.

Morons.

I'm old enough to remember getting a smallpox vaccination, to know people who had contracted polio, and to recall getting chickenpox, measles, and mumps. I am the last generation that will have a collective memory of what it is like to deal with epidemics of those diseases (making no prediction of what may arise in the future). Part of the issue is that memory is fading.

But what bothers me is that these parents are supposedly "well-educated" and "intelligent." I'm sorry, but buying into Jenny McCarthy's rants does not give me any indication that these parents are actually well-educated or intelligent.

I assume that these parents went to college. I assume that they actually graduated. Exactly what do they teach in College any more? Oh never mind, I'm sounding like an old man.

You're probably older than me, Michael, and I still wonder the same things. I'll give you what I think: "critical thinking" in college these days has been watered down. The word "theory" is translated as "opinion" or "belief" by the non-scientific. Science has a "theory" and crazy anti-vaccinating moms have an "opinion" and both must be given equal consideration and respect. As long as you know at least two opinions on an issue, you are thinking critically. It doesn't matter if one of the opinions is based on rigorous scientific method and one on hysteria, half-truths, and misunderstandings.

Honesty no longer matters as much as presentation. What Oprah says is true. What the bland guy in the white coat says is irrelevant. He's not pretty, he's not a public figure, he's not Botoxed and cosmetically enhanced, he's not dumbing it down or sexing it up. He's boring, change the channel.

I didn't get measles or mumps as a kid, but I got chickenpox and I was so miserable! My mom deliberately infected me by taking me to the house of a cousin who had it. I was playing one day not long after and I felt so horrible that I just laid down where I was and didn't move. The babysitter found a telltale blister and I spent the next week with blisters everywhere (genitals, ears, nose, you name it) and a horrific desire to scratch. I'm still angry that I had to be exposed to that, and it makes me angry that parents think it's "nothing".

Until I came down with a mysterious case of peritonitis in my 30's, it was the most lethargic, most agonizing, most miserable time I ever spent sick. If you've ever had a massive abdominal infection and stopped caring if you lived or died, then you know what I'm comparing it to. I've been bitten by a Lyme-infected tick, suffering through high fevers, chills, and unbelievable full body aches that felt like I had torn every muscle, and I still remember chickenpox as being worse.

Rong-Gong Lin usually writes good stuff. I read LA Times everyday, and yes, that's me in the blog comments. After I went in there to set some folks straight, two more anti-vaxxers jumped in and played the Dr. P.R.Ofitt gambit. Argh. What can one epidemiologist do? It's gonna suck when these dumbasses put extra weight on my case-load.

Read the supplemental stuff in the article. It's fascinating! I was so bummed to see my poor ol' elementary school make the list of regional unimmunized schools, but given where I'm from, it's probably parents whose actual crazy Jeebus beliefs keep them from vaxxing.

Great. I remember a measles outbreak in SoCal in my training. It was very bad among the undocumented workers who were unvaccinated. In a two month period I saw 7 pregnant women with measles. One died from complications, several others lost their pregnancies. I hate to see it happen again on a larger scale.

@greenmom1

I'm a parent of an autistic child. I haven't fallen for the woo. I'm particularly grateful for the evidence based medical bloggers here showing where the "biomedical approach" is nothing but quackery. Our kids deserve better than the DAN! quackery.

@ Pareidolius: thanks for the info- I'm headed that way at the end of the school year.It should be a "scream"(or maybe,it might make me scream).I was in that general area '06,'07,lots of woo; I think maybe Boulder,Co.,is even more drenched in alt med, Eastern religion,eco-green-ness, as I found out last year.Not to worry,it only makes my convictions stronger,plus I live in the Hudson Valley, so I've already been "innoculated".

By Denice Walter (not verified) on 31 Mar 2009 #permalink

Rogue Epi. wrote

"Read the supplemental stuff in the article. It's fascinating!"

I did, and your right, it is very informative.
The search engine on vaccination exemptions the Times provided in the web article was really interesting as well.

Only one vaccine exemption at the school where my wife teaches. Thank god. Interestingly enough it is an area represented by a higher number of the less educated population. Never thought I would be glad for that as well.

By Uncle Dave (not verified) on 31 Mar 2009 #permalink

D.C. Sessions said:

No, measles is a "mild childhood disease" and even necessary for the proper development of the immune system!

I hate people like that. I got into a huge argument with a mom who told me that polio was no big deal because only 1% of cases resulted in paralysis.

Y'know what I **REALLY** hate about the folks who say stuff like, "If you don't have an autistic kid, shut up 'cause you don't know"? It's that it implies that you must be the victim to know anything about it.

I used to study STDs. I'm very well-versed in the epidemiology of sexually transmissible infections as well as adolescent sexual behaviors.

But the same kind of applied "logic" and appeal to personal experience implies that until I contract raging chlamydia for myself, then I don't know jack shit about the topic. I was also not sexually active as a high schooler. Should I have been? Maybe I should have thought about that as a career enhancer instead of doing things like taking AP classes and applying to universities.

By Rogue Epidemiologist (not verified) on 31 Mar 2009 #permalink

think of anti-vaccination as evolution-extinction, and we're all in the same boat...

so why aren't vaccinations required by law?

By working class (not verified) on 31 Mar 2009 #permalink

think of anti-vaccination as evolution-extinction, and we're all in the same boat...
That would be nice, but it's too simple. Not all who get vaccines are covered. If 1% don't gain immunity from vaccines, it doesn't sound like much until you multiply it by 10 million people in a community. Suppose an outbreak struck all the people who didn't have immunity despite vaccinations. That's 100,000 people who would fall ill! We need complete vaccination to limit the chances of the disease attacking the herd.

so why aren't vaccinations required by law?

Because you have the right to remain stupid.

By Rogue Epidemiologist (not verified) on 31 Mar 2009 #permalink

Dammit! Preview! Dammit!

By Rogue Epidemiologist (not verified) on 31 Mar 2009 #permalink

Rogue Epidemiologist - i know, that's why i said we're all in the same boat.

By working class (not verified) on 31 Mar 2009 #permalink

greenmom1, you may not realize it but you are also on a site where there are undoubtedly many physicians responsible for administering vaccines; is yours the only anecdotal evidence that counts( if any counts at all)? Forgive me but your response is a completely sanctimonious self indulgent pout that does nothing to change the image of antivaxers.

Forgive me but your response is a completely sanctimonious self indulgent pout that does nothing to change the image of antivaxers.

Antivaxxers have an image? Like, mirrors and everything?

(Speaking of "sucking the marrow" and all that.)

By Yagotta B. Kidding (not verified) on 31 Mar 2009 #permalink

Another retort to the "If you don't have an autistic kid, shut up 'cause you don't know"? gambit is this...

To comment in public about (insert complex health problem here) you need a brain. Since you don't have a brain you should shut up.

By antipodean (not verified) on 31 Mar 2009 #permalink

I was lucky enough that the measles vaccine was licensed before I had the chance to acquire immunity "naturally". However, I did get chicken pox (and well remember what a miserable experience that was) and mumps - with encepalitis as a complication. Result: ten days hospitalization for me, and for my mom, before the diagnosis was in, hours of freaking terror that I would die or be disabled.

Now that I've read the CDC's recommendations for adult vaccinations, I pledge that within the next two weeks, as an act of personal protest against the spread of wooish lunacy, I will visit a doctor and ensure that I get whatever immunizations are indicated for a person of my age and medical history.

By Ktesibios (not verified) on 31 Mar 2009 #permalink

Ekindu said: I hate people like that. I got into a huge argument with a mom who told me that polio was no big deal because only 1% of cases resulted in paralysis.

Yeah no kidding, get a load at a post on my local forums by a particularly dumb anti-vaxer from a few months back:

As long as you stay away from refined sugar, you should be safe from polio. Dr Benjamin Sadler did research (I have a copy of it) back in the 50s that polio cases dropped 90% in NC when sugar consumption was cut by 90%. When the soda & ice cream manufacturers said it was hogwash & parents returned to feeding their kids soda & ice cream, up the polio rates went by 90%. Polio is really not a concern for me at all. Especially since paralytic polio is rare. Many people got polio in the 50s but it was nothing more than cold symptoms. My m-i-l got polio & is fine.

Edited to say: he could have gotten the opv when he was in Mexico & it showed up in his stool once he got to the States. But in any case, if you eat right & don't have a compromised immune system you don't have anything to worry about.

And this isn't even her shining moment. Me and some friends of mine have been building up quite the collection of her "advice".

I have friends who couldn't vaccinate their youngest children due to immune problems and they got whooping cough from adults who had never been vaccinated in their youth - they were sick for months, went through antibiotic after antibiotic to find one that eased the problem (the doc refused to diagnose whooping cough because it is supposed to be rare), and my friends were scared for their children's lives, the little one wheezing so heavily in her sleep and the coughing - my god, the coughing coming out of that little chest.

It's not just kids that the anti-vaxers are around now that they're endangering - it's every child they ever come into contact with throughout the course of their life.

Enkidu said I hate people like that. I got into a huge argument with a mom who told me that polio was no big deal because only 1% of cases resulted in paralysis.

Well, you would all get a kick out of this loon:
http://blogs.discovermagazine.com/badastronomy/2009/03/28/antivaxxers-a…

Measles - made up disease
Varicella - made up disease
Polio - made up disease
Hemophilus influenza type b - made up disease
Influenze - made up disease
HPV - made up disease
HIV - made up disease

AAARGH!!! That kind of stupid is thermonuclear!

AAARGH to the stupid preview on this site! Okay, without the blockquote the idiot said:

Measles - made up disease
Varicella - made up disease
Polio - made up disease
Hemophilus influenza type b - made up disease
Influenze - made up disease
HPV - made up disease
HIV - made up disease

Ababa

Was it worthwhile pointing out that going down by 90% and then going up by 90% doesn't get you anywhere near back to where you started?

...probably not, I guessing.

By antipodean (not verified) on 31 Mar 2009 #permalink

Yeah, this is a dangerous misperception that needs to be corrected;Pertussis is not rare at all but the largest population that harbors the organism is the over 20 group, where morbidity is lowest.It's still out there to give to the most vulnerable among us. Incidentally this is why we give pertussis vaccine at such a young age. The highest mortality is in patients less than 12 months of age.

Greenmom1 :

"Unless you have a child with autism, then you really have nothing to say."

Sorry, but it don't work that way. You have the right to an opinion, and even to have a wrong opinion, but not to limit what I have to say.

high fructose corn syrup is to blame now ?
I'd like to see the proposed mechanism by which HFCS causes autism. I'd be willing to bet it's every bit as scientifically sound as the proposed mechanism for mercury in vaccines causing autism. Oh wait. . . you mean there wasn't one ? Gee. fancy that.

the real problem here is people conflate chemical with unnatural with bad. Well, I hate to be the one to break the news, but "natural" is not necessarily good for you, and chemicals often keep you from dying.

I'm just waiting for the backlash. What happens when these parents lose a child to measles, or end up with one who is severely handicapped due to polio? What I hope is that they'll get mad and go on Oprah. Seriously, bring out a parent with an autistic child, oh, that's so sad... then bring out someone whose child is dead. Maybe they'll see the problem then.
Who am I kidding? That would mean admitting they were wrong...
(see HIV denialists)

I grew up near Sebastopol, and this does not surprise me in the least.
As a matter of fact, I was at Harmony Elementary (4th grade, I think) during the outbreak of pertussis mentioned in the article. Fortunately, I didn't get sick, but several of my friends did, and one nearly died. I remember some heated arguments between parents about the vaccine, which I didn't understand at the time and wouldn't truly understand until I'd been away from home long enough to gain some perspective and critical thinking skills.
Pareidolius' comments are right on; the West County really is a hotbed of woo and general anti-rationalism. Alt-med and the "natural" lifestyle are so pervasive that otherwise reasonable people seem to pick them up by osmosis (which is, incidentally, the name of a holistic health spa in nearby Freestone). My dad, a smart and reasonable guy, told me a year ago that he thought the jury was still out on thimerosal. It can happen to the best of us.
The impenetrable heart of the crazy has always been the well-off boomers with arts degrees whose intellectual narcissism prevents them from understanding arguments that contradict their own (what Orac would call the arrogance of ignorance). The area is so densely populated with such people that many of them rarely hear contradictory views from a live human, and consequently become childishly antagonistic when you argue that no, accupuncture won't really cure their kid's allergies, or that not all GMOs will kill them. It's like trying to have a conversation about evolution with a fundamentalist Christian.
I love Sonoma County, and some (okay, most) of its residents are not nutjobs, but the undercurrent of irrationality really bothers me, as you can probably tell. I've always known that I wouldn't raise my own kids there, and now I have a good reason: it's a cesspool of disease!

By argonaute (not verified) on 31 Mar 2009 #permalink

Rogue Epidemiologist said: "Y'know what I **REALLY** hate about the folks who say stuff like, "If you don't have an autistic kid, shut up 'cause you don't know"? It's that it implies that you must be the victim to know anything about it."

It's funny, because they're the same folks that will similarly dismiss an opinion given by someone who is themselves on the spectrum, stating that their experiences are irrelevant because they are either lying or "not autistic enough." Incidentally, even disagreeing with them is enough to merit disenfranchisment or accusations of being abusive in this horribly, nonsensical discourse.

Methinks that the antivax parents are the true, horrible legacy of the work of Bruno Bettleheim - the counter-movement idealizing the opinions and values of the parent, where any criticism is instantly dismissed as being heartless or cruel due to one lacking the same experiences, regardless of whether those opinions have scientific merit or not.

So why is it that more affluent are more likely to be anti-vax? They have more money to spend on alternative medicine and woo, so they're more likely to get exposed to those espousing anti-vax ideas?

What happens when these parents lose a child to measles, or end up with one who is severely handicapped due to polio?

They'll blame it on environmental toxins, electro-magnetic radiation from power lines, pesticides from non-organic foods the child somehow managed to sneak past the parents. If they took their child to a conventional doctor/hospital when the symptoms started getting severe they'll blame "allopathic" medicine for worsening things to the point of fatality or permanent injury.

By Matthew Cline (not verified) on 31 Mar 2009 #permalink

Wow. It's not often that I get chicken pox flashbacks, but I remember. I'm old enough. I remember chicken pox sores everywhere, in my mouth, everywhere. I got it around Christmas one year. There is a photo of me propped up on a new bicycle in the living room, in my jammies. My father carried me out of bed for the picture. I remember how sick I felt. I'm pretty sure I had mumps, too, and definitely measles, but the chicken pox was the most miserable for me. So lucky to have been born as the polio vaccine was starting to take hold. I recall getting dosed by vaccine on a sugar cube, then later by this air-powered gun thingie that didn't hurt except for we were sure it would kill us because it was so big and lethal-looking. And I have a big shiny smallpox vac scar on my left shoulder, the kind you don't see so often any more.

I don't have kids, so I don't have a kid with autism. But I like children quite a lot, and I have an interest in society not getting fractured from the stress of preventable epidemics, not to mention an interest in sparing people from unnecessary suffering. So my opinion counts, greenmom.

Matthew:

So why is it that more affluent are more likely to be anti-vax? They have more money to spend on alternative medicine and woo, so they're more likely to get exposed to those espousing anti-vax ideas?

That's almost certainly part of it. Another part, I think, is that less-affluent parents have more realistic things to worry about. It's almost as if everyone has a fixed quota of things to worry about, and in an environment where sources of real worries have been eliminated, imaginary worries expand to take their place.

Ababa: the quote you posted reminds me that a large part of the appeal of woo is the notion that diseases and other bad things can be prevented by righteous living, specifically by living more righteously than the "sheeple." It's nothing more and nothing less than the old-fashioned belief that disease is the wages of sin.

-Well everyone knows that measles deaths have nothing to do with vaccination coverage -

Then why did about 9 out of 10 of the measles sufferers in the recent outbreaks happen to be unvaccinated?

Perhaps then that means antivaxxers don't wash their hands...

By Richard Eis (not verified) on 31 Mar 2009 #permalink

I think antivaxxers are cowards. If you vaccinate your child, then there is a very small risk of adverse effects as a result of the decision of the parents. If an unvaccinated child dies from measles/chicken pox/... then this is due to karma/act of god/destiny but not due to the neglect by the parents.
Those people simply do not want to make decisions, they do not want to take responsibility. They are afraid.

antipodean said:

"Was it worthwhile pointing out that going down by 90% and then going up by 90% doesn't get you anywhere near back to where you started?

...probably not, I guessing."

The anti-vaxers are too busy searching for bad "science" that fits their agenda. They have no time for that pesky math nonsense.

By gpmtrixie (not verified) on 01 Apr 2009 #permalink

I think that a lot of the non-vaccinating parents know exactly what they are doing, and I think a lot of them feel guilty and thus defensive about it, because they know that their children's health absolutely depends on herd immunity, which means that they are aware that they are essentially using other people's children as cannon fodder. I suspect that this is part of what's fueling the continued autism claims. Everyone knows that there is a small risk of bad side-effects from vaccination, and that those side-effects can be catastrophic. We also know that the "side-effects" of epidemics are even worse, and so we are obligated, as members of society, to take the risk of vaccination absent specific individual contraindications.

But if you add the risk of autism to the mix, it serves as a justification to abstain. If the "experts" are withholding the "truth" because "big pharma" doesn't want us to know, then it's a "conspiracy". Blah blah blah, better "safe" than sorry. I'd bet money that a lot of non-vaccinating parents are aware of all of this, and that the autism link is bogus, and they're taking the chance anyway, because one of the side-effects of affluence is an out-sized sense of entitlement, a la Leona Helmsley, paraphrased as "Vaccines are for little people".

Do you think it's risky for someone whose childhood immunity was wiped out by a bone marrow transplant to go to meetings in California?

Some are in the Bay Area and others in San Diego. It's technical types, probably not the crunchiest group, and there shouldn't be a lot of children.

You have to wait a year before you can be re-vaccinated.

Yes!! It's fear. Coupled with math/science illiteracy as a nation. At least that is my opinion. Intelligent, wealthy, yes - able to evaluate the data as a basis for decision-making - no.

Amar asked whether vaccine exemption rates could be looked up for individual schools in California. The Times package on the rising number of belief exemptions for vaccines includes a searchable database for all elementary schools in the state, as well as lists of school with the highest rates both statewide and by county.

You can also check out our Q&A to see what questions readers had.

Megan Garvey
Los Angeles Times

Larkspur, one doesn't have to be very old to remember chickenpox; I'm barely at my quarter-century and the chicken pox is seared into my memory. Firstly, because I was miserably itchy, and secondly, because when my little brother got it years later he had 15 pox. Total.

So there's no excuse that all of these parents are "too young" to remember chickenpox. They're simply vindictive. "I had to suffer through the chickenpox, you can too." Mature and smart? No way. Human? Pretty much.

By JustaTech (not verified) on 01 Apr 2009 #permalink

Megan

Great article and I really liked the database that was provided. Very very helpful and informative for us Southern California residents and teachers to know.

Keep up the great work.

Thank you.

Dave H
High Desert resident

By Uncle Dave (not verified) on 01 Apr 2009 #permalink

I wouldn't call what your website posts "respectful" -- terms like "scientifically illiterate" and "bubble-brained purveyor of "Indigo" woo," are not what most people would consider respectful terms. To question someone's judgment, or to disagree with their conclusions is one thing, but simply to insult the person is not respectful or helpful.
Please read the book, "Just a Little Prick," by Hilary Butler, before you go trying to condemn all anti-vaccine folks as religious zealots or superstitious space cadets.
See: http://www.whale.to/vaccines/butler88.html

Oh, JenJen... you have invoked Scopie's Law http://rationalwiki.com/wiki/Scopie's_Law): "In any discussion involving science or medicine, citing Whale.to as a credible source loses you the argument immediately ...and gets you laughed out of the room."

You actually think that John Scudamore, a pig farmer who claims that satanic ley lines burned his bum is a reliable source of medical information?

Oh, and Hilary Butler is not much better:
http://jabsloonies.blogspot.com/2009/02/angladrion-is-liar.html

Come back when you have actual factual evidence that the MMR (which has been used in the USA since 1971, and has never contained thimerosal nor aluminum) is worse than measles, mumps or rubella. The evidence has to be in a journal I can access at my local medical school library, and not in "Medical Hypothesis", nor one that was paid for by a lawyer (anything by Wakefield or the Geiers).

Er, um... Orac, can I say that great minds thing alike?

(oh, by the way, I think it has been more than four years. I remember you and I tangling with Scudamore on Usenet before you started your first blog in 2004!)

Dawn asked;
"Aren't you guys like overdue for the "Big One"? "

Great! thanks for reminding me. Not only do I need to find out if it has been over ten years since my last Tetanus update, I Need to check my earthquake kit now.

This site does nothing for my paranoia....

By Uncle Dave (not verified) on 01 Apr 2009 #permalink

Meh, California's been due for the Big One since I was in first grade.

My quake kit is in my car. Water, protein bars and a space blanket.

I think it's funny that Dawn tries to scare the Californians by invoking the Big One. Whatever. Quakes hit all the time, and they're nothing. I've had plenty.

Chances of dying in the Big One are a helluva lot lower than dying of the polio and diphtheria she and her ilk wish to resurrect on us all.

By Rogue Epidemiologist (not verified) on 02 Apr 2009 #permalink

Hey Dawn! We're all about due for "The Big One" - even people living in the Central or Eastern US (see: New Madrid Fault Zone).

In the event of a replay of the 1812 New Madrid earthquake, being up-to-date on your vaccines (esp. tetanus) may mean the difference between telling the tale to your grandchildren (or having grandchildren, if you're not vaccinating your kids) and being a name on a memorial marker.

But you don't have to wait for an earthquake to feel the effects of not vaccinating your children - you might be one of the "lucky" parents who re-discover the fact that many of these so-called "childhood illnesses" are not as benign as you have been led to believe.

Do people honestly believe that researchers spent years of their lives trying to develop vaccines for ilnesses that are harmless - that don't kill and disable a significant number of children (and adults)?

Of course, "Dawn" would believe anything that fit her delusional world view, no matter how patently ridiculous it was. I am assuming that most of the people reading this 'blog are capable of reason.

Prometheus

Rogue E wrote;

"I think it's funny that Dawn tries to scare the Californians by invoking the Big One."

I didn't realize that that was the intent. Living in Cal for many years now the only quake that had any effect on my life was the Northridge quake quite a few years back now.

I am quite honestly more afraid of an outbreak of a preventable disease at the school or district where my spouse works than I am of the "Big one".

Every now and then our friend whom is the district nurse has a story or two about exemptions from vaccination not by just by anti-vaccine parents but by parents and foster parents to lazy to take the child they are responsible for to the doctor or to get necessary care.

Our district would likely be considered one of the less affluent areas so there are less exemptions for vaccinations than some other areas (although there a few religious exemptions whether or not that is the real reason), however there is still quite a large group of immigrant population that makes the probability more of an issue.

By Uncle Dave (not verified) on 03 Apr 2009 #permalink

OK, so I am unfamiliar with the hatred that is targeted at Hilary Butler, mostly because I have not read much from your side about the anti-vaccine side.
One thing to note: I had all my shots on schedule (my mother was very pro-vaccination), yet I still contracted the mumps in the second grade. Why wasn't I protected?

Jen, we all know and accept that vaccines are 100% effective. However at 97-99% effectiveness, when combined with >99% population coverage, the likelihood of outbreaks occurring becomes so much smaller. I'm sorry that you were one of the unfortunate ones whose vaccine didn't take.

We're all angry at Jenny McC because she is a leading contributor to lower vaccine coverage. As that coverage percent falls, there will be more chance that kids like you -- vax'd but not immune -- will become sick.

As for Hilary Butler, I'll admit to not having read her book, so I can't say anything particular against her. But most of the anti-vaccination beliefs we encounter in other folks are grounded in ideas completely unfounded in science. While we would otherwise not object to other people's right to ignorance, this is an issue that has broad ramifications. Namely it makes unvaccinated infants and people whose immunity didn't take highly vulnerable to infection.

Those who say the risk of death or complication by disease is miniscule have not considered the possibility of multiplying by enough cases that people DO start dying. No one in the US has died, yet, but they're already starting to die in Europe, and I wouldn't exactly accuse the UK of being a Third World country with shoddy health care.

By Rogue Epidemiologist (not verified) on 03 Apr 2009 #permalink

Argh. I meant "NOT 100% effective"

Got distracted by incoming fax while posting.
I should know better by now. Previews, dammit.

By Rogue Epidemiologist (not verified) on 03 Apr 2009 #permalink

JenJen, I got mumps twice. Obviously getting the actual disease does not confer permanent immunity.

Like Rogue Epidemiologist said: no vaccine is 100%, which is why herd immunity needs to be high to protect those where the vaccine does not work, plus those who cannot for medical reasons get the vaccine.

Actually, kids have died in the US. There were four cases of death by pertussis (whooping cough) in Oregon last year. This year so far there have been deaths by Hib (haemophilus influenzae type b) in Minnesota, Pennsylvania, and New Jersey. I am not aware of any deaths by measles, but I haven't gone looking either.

JenJen

The reason people get measles after having been fully vaccinated is a combination of all vaccines not being 100% protective and a lapse in herd immunity.

The lapse in herd immunity is caused by free-loaders of various persuations who won't get immunised. When the numbers of these free-loaders get too high there are enough people in the population that a disease can spread and multiply. Then the unfortunate people, like yourself, who are responsible but in whom the vaccine did not confer immunity pay the price.

By antipodean (not verified) on 05 Apr 2009 #permalink

vaccines not being 100% protective and a lapse in herd immunity.

The lapse in herd immunity is caused by free-loaders of various persuations who won't get immunised. When the numbers of these free-loaders get too high there are enough people in the population that a disease can spread and multiply. Then the unfortunate people, like yourself, who are responsible but in whom the vaccine did not confer immunity pay the price