It's September and the kids are back in school, along with their required boxes of tissues and hand sanitizer for the classroom. These can help prevent the spread of colds, but students may be at risk of more serious illnesses. We're seeing an uptick in outbreaks of measles, whooping cough, rubella, mumps, and polio, some affecting more than 10,000 people in just one year.[1]
Diseases like measles, whooping cough, and meningitis are highly contagious and in many cases can be life threatening. Prior to the start of national vaccination programs over a generation ago, 500 people died, 1,000 became disabled, and 48,000 were hospitalized every year from measles infections alone.[2]
At least two factors contribute to these outbreaks of disease. One is complacency about the seriousness of these diseases, since many parents have never experienced the devastation of polio or whooping cough. They don't take vaccinations seriously.
The other factor is a complete rejection of childhood immunizations, often by Christian homeschooling families, or wealthy, well-educated parents.[3]
While there are many dimensions to this issue, I'd like to look at this from the perspective of public health and caring for others.
One of the principles behind childhood immunizations is that if a sufficient number of people are immunized, they form a kind of barrier around an infected person, protecting against the spread of that disease. This is known as community immunity. At least 90% of the group needs to be immunized to achieve protection for those who are vulnerable—let's call them our neighbors. They include some immunized people who don't develop adequate immunity. Others cannot be immunized, because they are too young, or because their immune systems are compromised, such as a child with leukemia. Community immunity protects them. Lately, their risk has gone up. Community immunity has fallen to dangerously low levels in some school districts.
Diseases that could have been avoided with adequate immunizations can hurt a lot of people.[4] Both immunized and unimmunized children can contract a disease, or be a carrier that passes it to those who are most vulnerable to be- coming seriously ill or dying. This is where parental rights run up against moral responsibilities. Parents need to make decisions based on credible evidence, not the inflammatory rhetoric that can surround this issue.[5] This is not to ignore concerns about side effects, the moral questions about the source of the vaccines, or rights of privacy and liberty.
Yet, despite our primary responsibility for our own children, we also are called to care for those around us. Immunization is one application of our commitment to neighborliness, a tangible act of caring for others.
Immunization isn't just about one individual, but the health of the community. The answer to "Who is my neighbor?" just might be the children in your daughter's classroom. Think about it.
[1] In a six-month period, nearly 2,000 people—mostly young men—in New York and New Jersey had mumps. In 2010, there were nearly 12,000 cases of pertussis, or whooping cough, in just three states. In the first eight months of 2011, there have been over 300 cases of polio, primarily in two African nations.
[2] Centers for Disease Control, "Overview of Measles Disease," May 16, 2011 http://www.cdc.gov/measles/about/overview.html (accessed July 20, 2011).
[3] Kevin Crowe and Roxanna Popescu, "Local parents Increasingly Skip Children's Immunizations."U-T San Diego, August 18, 2011. http://www.utsandiego.com/news/2011/Aug/18/region-local-parents-increasingly-skip-childrens/ (accessed August 30, 2011).
[4] The mumps outbreak (referred to in footnote 1) was triggered by an 11-year-old boy who had been in the United Kingdom, where mumps is rampant, and immunizations are down. In 2003, an infected Japanese tourist triggered an outbreak that caused 703 cases of measles and 3 deaths. National Network for Immunization Information, "Community Immunity." June 23, 2006. http://www.immunizationinfo.org/issues/general/community-immunity (accessed September 1, 2011).
[5] Two informational websites are: http://www.cdc.gov/vaccines/ and http://www.healthychildren.org/english/safety-prevention/immunizations/Pages/default.aspx. Adverse Effects of Vaccines: Effect and Causality, the recent report from the Institute of Medicine is available online at http://www.nap.edu/catalog.php?record_id=13164.