HEALTH CARE/Joan Retsinas

Disease Amnesia: A New Public Health Threat

Disease Amnesia hovers. It afflicts, for the most part, upper-income, upper-educated parents, vigilant over their children’s safety. You can spot the parents buying fiddlehead ferns at Whole Foods, coaching soccer games, volunteering at PTA meetings.

Their mission: protect their children from bad food, bad water, bad air. In short, protect them from harm.

They have latched onto a modern-day harm: vaccinations.

A swatch of parents has always rejected vaccinations, citing religious, or medical, reasons. But in the past decade, that swatch has swelled to include parents with “philosophical” objections. They distrust government mandates to inject their healthy children with vaccines. They don’t believe that those injections will keep their children healthy. Instead, they espy a plot: pharmaceutical companies allied with physicians allied with government. Forget bacteria. Forget clinical trials. These parents see, at best, a needless expense, at worst, an evil cabal.

In the spirit of accommodation, states have expanded the criteria for parents to opt out of children’s vaccinations. Some states require a note from a physician and/or clergyman; some require a signed statement of objection from the parents; in some states, parents need only check a box. Two states – Mississippi and West Virginia – allow only medical exemptions, attested by a physician. The National Vaccine Information Center, “grassroots activists working to protect and expand vaccine exemptions,” has compiled a state-by-state list: (http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements.aspx).

Not surprisingly, in states with “easier” opt-out procedures, more parents have opted out. In 2011, 3.3% of parents opted out for non-medical reasons in states with “easy” exemption policies; 1.3% in states with more stringent ones. Yet in all states, the number of parents sparing their children shots, but exposing them to disease, has grown. (“Vaccination Policies and Rates of Exemption from Immunization, 2005–2011,” Correspondence, New England Journal of Medicine, Sept. 20.) In Washington State, in 2008, 7.6% of kindergarten parents opted out. The new norm seems to be a parental “no” to vaccines.

The result: again not surprisingly, a resurgence of once-rare childhood diseases.

Whooping cough is the first to resurge. In 1950 the country had 120,718 cases; by 1976, the number had plunged to 1,010. In 2010, we had 27,550 cases. The federal Centers for Disease Control and Prevention expects 2012 to top that. In Washington state, physicians reported 3,014 cases as of July 14; the same time in 2011, physicians reported 219 cases. The reason for the initial plunge: vaccinated children. The reason for the upswing: unvaccinated children.

Indeed, statistics show a near- eradication of some diseases, like tetanus and diphtheria. Polio was the great killer: at its peak, in 1952, the country had 57,628 cases. Both measles and German measles were common childhood diseases – sometimes with severe disabling ramifications, sometimes fatal – 50 years ago. But vaccination campaigns worked, and cases plummeted, until recently. Today measles has returned: in 2011 there were 17 outbreaks, with 222 cases. The source: unvaccinated children, and adults who contracted measles overseas.

Disease amnesia is baffling. These parent-sufferers distrust government’s alliance with Big Pharm. But they also suffer from real amnesia: victims have forgotten these diseases, which remain both dormant and contagious. One unvaccinated child in a herd of vaccinated people is safe; a cluster of unvaccinated children invites the disease back. The whooping cough that is benign for one child may be fatal for a newborn. The measles that gives one person a rash may leave another blind. But parents have forgotten that sad history, the reason older generations embraced vaccination campaigns.

Washington State recently made it harder to opt out: the state now requires parents to get a physician’s signature. (Sabrina Tavernise, “Washington State Makes It Harder to Opt Out of Immunizations,” New York Times, Sept. 19). Vaccinations have increased. Presumably once a disease breaks out, other states will follow Washington’s lead.

In the meantime, perhaps all parents should watch the History Channel. They should venture back to the 1950s, before widespread vaccination campaigns, when parents were powerless to protect their children from killer diseases.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, November 1, 2012