When I was in elementary school, my mother mistakenly thought I had a blister on my neck and sent me to school. I returned that afternoon covered in spots. By the end of the week my entire class of 36 was out sick with chicken pox. My mother’s mistake demonstrated just how virulent a disease with an 85 to 90-percent chance of transmission can be in an unvaccinated population. Chicken pox is relatively mild among children, but these days it’s common for school-age children to have vaccinations against it, along with measles, mumps, rubella, whooping cough, and meningitis. However, these vaccinations are not mandatory. The result? An increasingly large anti-vaccination movement that is convincing parents not to vaccinate, particularly against measles.
Measles is an infection that causes an itchy rash, high fever, and flu-like symptoms. In serious cases it can enter the eyes, ears, or brain causing permanent damage or even death. It has a 90 to 95-percent chance of transmission, higher even than chicken pox. But most importantly, it’s entirely preventable.
Even though a measles vaccine has been available since 1963, the CDC has seen an uptick in measles cases across the country since 2008. That’s because parents are choosing not to vaccinate their children, and are using the personal-belief exemption in our school system to opt out.
The anti-vaccination movement stems from fear linked to a now widely discredited medical study that correlated vaccines with autism. The movement is especially strong in wealthy, white, liberal areas. In California an estimated 3% of school-age children are unvaccinated against measles, and in neighboring Oregon, that number is over 6%. While these percentages may not seem high, the medical community estimates that 93-95% of the community needs to be vaccinated in order to prevent an outbreak. Already this year, a minor measles outbreak in San Diego has infected 53 people.
People can opt out of vaccinations, but they can’t opt out of public health. Not getting vaccinated puts vulnerable populations—such as infants too young for vaccination, the elderly, and otherwise immuno-depressed individuals—at risk. These are the people who will be susceptible to infection and complication in a measles epidemic.
Many states’ current policies allow unvaccinated children to attend public school if their parents cite a personal-belief exemption. In economic terms, these parents are acting as free riders, trusting that enough other children in the public school system will be vaccinated and therefore will not contract measles, whooping cough, or other preventable diseases. As a result, their own children will stay safe. This is putting the vaccinated children at an unfair risk by potentially exposing them to dangerous diseases and spreading those diseases to susceptible family and community members.
Proponents of the personal-belief exemption support parents’ right to choose the best health decision for their children. No vaccine is completely without side effects, and in extremely rare cases those side effects are severe. But, out of fear of the small risk of side effects, parents are exposing their children to the larger, known risks of actually contracting measles, mumps or whooping cough. 1 in 100,000 babies may suffer a coma from a reaction to an MMR vaccine, but 1 in 1,000 die from actually contracting measles.
Several states, including North Carolina, currently prohibit unvaccinated children from attending public school if there is an outbreak of disease. They’ve taken an important step toward protecting public health, but it is often reactive and ineffective; just look at the outbreak occurring in San Diego. States now need to require vaccinations for children to attend public schools in order to prevent outbreak and to protect the greater community. Requiring home schooling for all unvaccinated children will encourage vaccination and reduce the risk of outbreak. Parents have the right to make health decisions for their children, but states need to recognize they have the responsibility to make health decisions for the community.