The Hidden Cost of Anti-Vaxxers: The Price of One Measles Outbreak

http://www.wired.com/wiredscience/2011/04/cost-vaccine-refusal/

Before I get to the cost of a measles outbreak, I think Seth Mnookin sets the appropriate frame of reference:

I don't know anyone in the world who likes needles or likes watching needles pierce their child's skin. However, the fact that something is scary does not convey a license to blithely deny reality -- which is why I find the actions of parents who have simply decided for themselves that vaccines and dangerous and at the same refuse to acknowledge the potential repercussions of not vaccinating on those around them to be morally repugnant....

If there's one thing I hope I can accomplish in this debate, it's showing parents the difference between verifiable, reliable data and anecdotal, fear-based myths -- and, as I said, calling someone a total asshole is probably not the way to convince them to rely on evidence and not emotion. But I've spent too much time listening to the stories of people like Kelly Lacek (whose three-year-old spent four days in a medically-induced coma with Hib after her chiropractor convinced her not to vaccinate) and Danielle Romaguera (who held her seven-week old baby in her arms as she died as the result of a pertussis infection) and Toni and David McCaffery (whose four-week-old girl died of pertussis) to have much patience for parents who ignore the science supporting vaccines and also refuse to acknowledge the dangers of infectious diseases.

(Note to NatGeo: PLoS apparently lets its blogger call people assholes. Just saying).

Anyway, Maryn McKenna details the cost of a measles outbreak:

Stopping the measles virus before it can cause serious disease -- and by "serious," I mean deafness, pneumonia, encephalitis and miscarriage -- is incredibly costly and labor-intensive. An account published overnight in the Journal of Infectious Diseases gives a glimpse at just how costly. To stop a 14-person outbreak that began with one unvaccinated tourist visiting a US emergency room, the Arizona Department of Health had to track down and interview 8,321 people; seven Tucson hospitals had to furlough staff members for a combined 15,120 work-hours; and two hospitals where patients were admitted spent $799,136 to contain the disease....

But what this Arizona outbreak makes clear is how many more people are forced to assume that risk without being consulted: not only the infants, elderly and immune-compromised among those 8,321 people exposed in this outbreak, but the hospital shareholders and taxpayers who paid the bill for it to be contained. Until we start counting up those costs as well, we won't achieve an honest accounting of vaccine refusal's true price.

Assholes. But there's another group of assholes that play a role--unvaccinated healthcare workers:

There's an important dimension to this outbreak that may not be evident at first. We tend to blame parents who hold their kids back from vaccination for breaches in the wall of herd immunity. But the people who were infected in this outbreak and shared responsibility for passing it on included adult health care workers who had never been vaccinated and who had missed or declined the chance to get booster shots. By doing that, they put their unknowing patients at risk -- and infected, among others, someone with brain cancer and another person living with Down syndrome.

When the hospitals checked to see who among their staff wasn't vaccinated, they found that 30 percent didn't know or couldn't prove it. The two hospitals where measles patients were cared for actually did blood tests on their staff, and found that 9 percent were non-immune: never-vaccinated, never-infected. If the hospitals had not acted to identify those employees and send them home or vaccinate them, they could have hosted a roaring epidemic that might have been impossible to contain.

In the past, I've been more lenient in my attitudes towards this problem, but the more I think about it, the more I realize I was wrong: unless there is a medical reason (e.g., allergies), healthcare workers--and not just those at hospitals--should be vaccinated. There's no constitutional right to work in a hospital.

And they're being assholes.