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SECOND OPINION

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    Vaccination avoiders put everyone at risk

    By Susan Perry | Published Tue, Oct 27 2009 2:40 pm

    For a highly readable and eye-opening article on the anti-vaccination movement, I recommend freelance writer Amy Wallace’s “An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All,” published last week in Wired magazine.

    The article explains why other people’s decision to opt out of vaccinations for their children puts you and your family at risk — yes, even if your family has been fully vaccinated.

    Here’s why you should care: Wallace describes how an Indiana teenager contracted measles in 2005 while visiting Bucharest, Romania, and then quickly spread the illness as soon as she got home — including to 34 of the 500 or so people present at a church gathering she attended the next day. Most of those who caught the illness (32) had not been vaccinated against measles. But two had.

    “The frightening implications of this kind of anecdote were illustrated by a 2002 study published in The Journal of Infectious Diseases,” Wallace writes. “Looking at 3,292 cases of measles in the Netherlands, the study found that the risk of contracting the disease was lower if you were completely unvaccinated and living in a highly vaccinated community than if you were completely vaccinated and living in a relatively unvaccinated community. Why? Because vaccines don’t always take. What does that mean? You can’t minimize your individual risk unless your herd, your friends and neighbors, also buy in.”

    More and more parents, Wallace writes, are acting out of fear and electing not to have their children vaccinated:

    In certain parts of the U.S., vaccination rates have dropped so low that occurrences of some children’s diseases are approaching pre-vaccine levels for the first time every. And the number of people who choose not to vaccinate their children (so-called philosophical exemptions are available in about 20 states, including Pennsylvania, Texas, and much of the West) continues to rise. In states where such opting out is allowed, 2.6 percent of parents did so last year, up from 1 percent in 1991, according to the CDC.

    (Minnesota is also one of those “opt-out” states.)

    UPDATE: I asked Buddy Ferguson, public information officer for the Minnesota Department of Health, if there has been any noticeable change in the percentage of parents declining vaccination for their school-aged children in recent years. Specific numbers are difficult to come up with, he said, but "over the last several years, [the state has] seen some decline in immunization rates among children in Minnesota schools." The percentage of children not immunized is still under 5 percent, he added.

    The persistence of pseudo-science
    Wallace does a good job of explaining how “well-intentioned people … motivated by love for their kids” have become vulnerable to the pseudo-science behind the anti-immunization movement:

    Today, because the looming risk of childhood death is out of sight, it is also largely out of mind, leading a growing number of Americans to worry about what is in fact a much lesser risk: the ill effects of vaccines. If your newborn gets pertussis, for example, there is a 1 percent change that the baby will die of pulmonary hypertension or other complications. The risk of dying from the pertussis vaccine, by contrast, is practically nonexistent — in fact, no study has linked DTaP (the three-in-one immunization that protects against diphtheria, tetanus, and pertussis) to death in children. Nobody in the pro-vaccine camp asserts that vaccines are risk-free, but the risks are minute in comparison to the alternative.
    Still, despite peer-reviewed evidence, many parents ignore the math and agonize about whether to vaccinate. Why? For starters, the human brain has a natural tendency to pattern-match — to ignore the old dictum “correlation does not imply causation” and stubbornly persist in associating proximate phenomena. If two things coexist, the brain often tells us, they must be related. Some parents of autistic children noticed that their child’s condition began to appear shortly after a vaccination. The conclusion: “The vaccine must have caused the autism.” Sounds reasonable, even though, as many scientists have noted, it has long been known that autism and other neurological impairments often become evident at or around the age of 18 to 24 months, which just happens to be the same time children receive multiple vaccinations. Correlation, perhaps. But not causation, as studies have shown.

    But rational thinking seems to have escaped many in the anti-vaccination movement.

    For example, as Wallace outlines in her article, they vilify and even physically threaten Paul Offit, a Philadelphia pediatrician and advocate for mandatory vaccines, for “being in the pocket” of big Pharma because he receives a royalty from a vaccine he co-invented for rotavirus gastroenteritis, the most common form of severe and often life-threatening diarrhea in children. (Public health experts estimate that 600,000 children, including around 40 in the United States, die from this illness each year.)

    Yet those same anti-vaccination crusaders welcome with open arms to their conferences a doctor and supplement salesman who proclaims to parents (without any empirical evidence): “No vaccines + more vitamin D = no autism.”

    As Wallace writes, “If only it were that simple.”

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    In "Second Opinion" Susan Perry will coordinate coverage to help MinnPost readers make their way through the thicket of health happenings, trends, studies and research. Perry has written several health-related books, and her articles have appeared in a wide variety of publications, including Minnesota Monthly, The History Channel Magazine and Woman's Day. She is a former writer/editor for Time-Life Books and a former editor of Nutrition Action Healthletter, published by the Center for Science in the Public Interest. Perry can be reached at sperry [at] minnpost [dot] com.

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