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To vaccinate or not to vaccinate
(Photo courtesy: National Cancer Institute)

By Ernest Gurulé

Growing up is not easy. But forget personal responsibility and all the other things that accompany adulthood, just focus for a moment on the array of illnesses young children face well before becoming adults. A common childhood illness is measles. It might sound routine, but any responsible physician will argue that measles presents a serious public health issue, though not nearly as serious as it was in the days before the introduction of the measles vaccine.

While serious, measles no longer presents the health threat it may have been in the last century. But it still periodically rises up in different pockets of the country. And while health officials respond quickly to an outbreak, there remains a virulent strain of anti-vaccine groups who refuse to get their children immunized against measles, or anything else, for that matter.

The anti-vaccine crowd, which bases some of its strongest arguments on the connection between vaccines and autism, includes a small percentage of doctors, famous names and pop culture personalities. Included among this group are Robert F. Kennedy, Jr. and former Playboy model and more recently, “The View” panelist, Jenny McCarthy whose son is autistic, a condition she attributes to immunizations.

Perhaps their strongest argument against vaccinations is their belief that the MMR (measles, mumps and rubella) vaccine contains the ingredient thimerosal, a preservative that has been included in many vaccines since the 1930’s. Thimerosal has trace amounts of mercury, an ingredient they believe has resulted in a rising number of autism cases. Thimerosal is also found in the list of ingredients in a number of common vaccines.

“This isn’t an issue I want to be involved in,” Kennedy said in an interview last summer. “I just want somebody to read the science and tell me where I got it wrong.” Kennedy has also written a book, “Thimerosal: Let the Science Speak,” that outlines his fight against vaccines.

But despite the Kennedy name, most medical experts have relegated his book to the ‘quack science’ section of medicine.

“Just because they think the vaccine caused it (autism) doesn’t mean it’s true,” says Dr. Sean O’Leary, a Children’s Hospital of Aurora pediatric Infectious disease specialist. “Emotional belief is not scientific belief.” There are plenty of scientific studies, says O’Leary, proving vaccines don’t cause “these problems.” Unfortunately, no amount of study has been able to convince an amazingly large segment of Coloradans to vaccinate. The state ranks near the bottom nationally on childhood immunization.

According to the Centers for Disease Control, Colorado ranks last in childhood vaccination rates for the MMR vaccine with nearly fifteen percent of parents choosing not to immunize. Colorado also had the lowest national ranking for vaccination against varicella, chicken pox. Chicken pox has also been linked to shingles, a painful, blistering condition in adults and related to the same virus.

Interestingly, ranking at the top in childhood vaccination rates is Mississippi. There, parents have no choice; vaccinations are mandatory. In Colorado, parents or guardians wishing to opt out of vaccinating their children can simply sign a standard form.

A bill introduced in last year’s Colorado legislative session would have pushed the state’s vaccination rates dramatically higher. “There was a suggestion by some stakeholders to try and make parent education available before a parent exemption,” says Dr. Rachel Herlihy, Medical Director for State Immunization. “We ended up with a very different bill passing.”

But it is not simply a parent’s objection to vaccination because of their beliefs that the inoculations are harmful. Some parents, says Herlihy, opt out for other reasons, including religious. Other factors boosting non-vaccination rates are new families moving to Colorado who have proof their children were vaccinated prior to coming here. Still, others choose not to vaccinate because their children are being treated for other health issues and they do not want to complicate matters with their child’s immune system.

But state health officials are uniform in the belief that childhood vaccinations provide a greater state of safety for everyone. Measles, as an example, are anything but a routine childhood experience, they say.

Measles is a highly contagious virus passed through direct contact. In its most common form, it causes high fever and rash and lasts up to two weeks. But it can also result in blindness, encephalitis, severe diarrhea and dehydration and death. Exposure to measles has also been linked to miscarriage and pre-term deliveries.

According to the World Health Organization, measles claimed approximately 145,000 lives globally in 2013. WHO also says that measles vaccinations also reduced the disease death rate by 75 percent between 2000 and 2013.

In this country, prior to the 1962 introduction of the measles vaccine, health officials could confidently predict 500,000 annual cases. Ten years after the vaccine was introduced, fewer than 33,000 measles cases were reported. Today, the CDC says measles cases across the U.S. do not even reach triple digits.

The CDC also points to diphtheria, an illness causing swollen glands, sore throat, high fever and trouble swallowing, as a vaccination success story. Once the cause of 10,000 deaths annually, it is today nearly non-existent in this country.

Health officials suggest that a population, or herd, is safe if the vaccination rate is 95 percent. It also means that the five percent who are not vaccinated are also safer.

The winter months generally reflect higher than normal outbreaks from a number of diseases, including measles and influenza. The CDC recently declared a flu epidemic and Colorado has been significantly impacted despite a generally high number of people getting flu shots.

In both Mesa and Pueblo counties health officials have seen uncommon spikes in reported cases. “We’ve had 47 hospitalized cases in December,” says Veronica Daehn Harvey, the county’s Public Health Communications Manager. In normal years, she says, “our normal average is four for December.”
So severe was the influenza outbreak in Mesa County that officials recently decided to bar visitors from the Community Living Center, a branch of the Veterans Hospital. Nearly a third of the facilities 29 patients, all elderly, were diagnosed with the virus.

In Pueblo County, the cases of hospitalized influenza victims is double Mesa County. “Last year we had 75 confirmed cases,” says county health spokesperson Sarah Joseph. “This year from October to December we’ve had 99 cases.” According to state health records, Colorado has had nearly 900 reported cases of flu since the season was declared open in September. Health officials believe that the higher than expected outbreak may be the result of a mutating virus.

For some parents, religion or a belief that government is being less than honest in the information it puts out on vaccines is sufficient to just say no to immunization. For others, it is far more basic; they don’t think they can afford the costs. But, if cost is what is preventing a child from getting vaccination, says Dr. Herlihy, a little research might help.

“Parents have lots of options,” says Herlihy. “A primary care doctor will have vaccines for them or they can go to public health.” There is an administrative fee for the shots but “it’s a small amount.”





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