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2011 Vaccine Exemptions Double ’03’s

ALBUQUERQUE, N.M. — The number of Bernalillo County families receiving vaccine exemptions has doubled since 2003 – a fact some experts say is troubling and may be linked to recent cases of whooping cough in Albuquerque schools.

“I think that is a significant trend that we need to be worried about and do something about,” said Albuquerque pediatrician Lance Chilton, who writes a column for the Journal. Chilton is also a former member of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.

The state Health Department is investigating possible pertussis, or whooping cough, cases at A Child’s Garden preschool, Atrisco Heritage Academy High School, Barcelona Elementary, Eastern Hills Christian Academy, Harrison Middle School and Rio Grande Christian Academy. Other cases under investigation in Bernalillo County are not associated with schools. Already this year, the state has identified 144 pertussis cases, 87 of which are in Bernalillo County. That is twice as many pertussis cases as the most recent five-year average for the county.

Vaccine help
With the latest outbreak of whooping cough, the state health department is urging all families to stay current on their vaccines. Babies need a series of three doses of the vaccine, plus a booster dose by the time they are 18 months old. Seventh-grade students also need a booster dose, and a booster dose is available to adults, especially those who work with children. Vaccines are free for any child in New Mexico, regardless of insurance status, under the Vaccines for Children program.

The number of Bernalillo County families receiving exemptions was highest in 2009, with 1,019 families opting out. That’s up from 419 in 2003. So far this year, 856 families have been exempted.

Whooping cough is a highly contagious respiratory infection that can last for weeks and lead to dangerous complications, especially in babies.

Pertussis can be prevented by the DTaP vaccine for young children and its accompanying booster shot for teens, the TdaP. The vaccine is required for all school children in New Mexico, although parents can receive exemptions if they submit in writing that their religious beliefs conflict with vaccinations. However, officials don’t generally challenge parents, and so they may opt out because of non-religious fears or beliefs, Public Health Division Director Maggi Gallaher said.

The percentage of children with exemptions is still less than 1 percent of the school-age population. But Anna Pentler, executive director of the New Mexico Immunization Coalition, said that can still cause problems.

“What we worry about is, the number is small, but it may be concentrated in specific areas,” Pentler said. “If we’re having a community or a specific school that might be more vulnerable than others, that would be a concern.”

Chilton said families skipping vaccines can be harmful to everyone, even vaccinated children. This is because the vaccine relies partly on “herd immunity,” where everyone’s health benefits from being surrounded by vaccinated people. While the vaccine doesn’t protect everyone completely, a community of vaccinated people is unlikely to transmit the infection.

“The pertussis vaccine is probably about 85 percent effective in a given child,” Chilton said. “The more we see people opting out, the more likely we are to have a real epidemic among those who have dutifully gotten their vaccines.”

Chilton said there are probably several factors driving families to opt out of vaccines. He said a major reason is that parents are unfamiliar with many preventable diseases, since they have been mostly eradicated for decades.

“Most people haven’t seen the diseases we protect against, so they think there’s no risk of those,” Chilton said.

Pentler made the same point, and added that misinformation about vaccines has proliferated with the rise of the Internet and with celebrities repeating incorrect information.

“There’s a lot of misinformation about vaccines, and there has been a lot of negative publicity about vaccines that is unfounded,” Pentler said.

Specifically, both Pentler and Chilton talked about the claims of Andrew Wakefield, the discredited former doctor who claimed in 1998 that vaccines were linked to autism. Those claims have now been debunked and rejected by the medical community, and Wakefield has been stripped of his medical license.

But the claims have remained prominent, largely because they have been picked up and spread by celebrities. Chilton talked about media appearances by former Playmate and actress Jenny McCarthy, who went on the Oprah Winfrey Show, Larry King Live and other programs in 2008 and perpetuated Wakefield’s discredited findings.

“I think nationwide, there were effects from that,” Chilton said, adding that it might account for the peak rate of New Mexico exemptions in 2009.

Parents should monitor their children for signs of the infection, which is characterized by fits of coughing that don’t go away within a few weeks. They should contact a doctor as soon as possible if they suspect their child has whooping cough.
— This article appeared on page A1 of the Albuquerque Journal

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