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June 2012
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Local vaccination rate high, but more resist

By Leanne Fullerlfuller@paducahsun.com

A local pediatrician said he sees more Paducah-area parents who are choosing to delay or opt out of vaccinating their children today than in years past, a choice he does not agree with. 

"I've been doing this 31 years now, and basically we almost never used to have any parent opt out of vaccines," said Dr. David Schell of Pediatric Group of Paducah. "But we're having more and more people opt out. Not a huge number, but more than we ever used to have."

Vaccines - dead or weakened infectious organisms which are administered to produce immunity in people without contracting the diseases the living organisms cause - have become a bigger issue in the United States as more people are contracting vaccine-preventable illnesses in various parts of the country.

Measles is one such illness. According to the Centers for Disease Control and Prevention, between Jan. 1 and June 27 of this year, 539 cases of measles were reported in 20 states. Those states include Illinois, Missouri and Tennessee but not Kentucky.

The CDC's running tally of reported measles cases and outbreaks - the latter accounting for 88 percent of reported cases so far this year - is available on its website. The government health organization notes "this is the highest number of cases since measles elimination was documented in the U.S. in 2000" and "the majority of the people who got measles are unvaccinated."

Pertussis, also known as whooping cough, has reached epidemic levels in California, where the California Department of Public Health reported the total number of cases reached 4,558 as of June 24. Three infants have died in the epidemic so far.

Brandi Day, regional epidemiologist for the Purchase District Health Department, said Region One - made up of Ballard, Calloway, Carlisle, Fulton, Graves, Hickman, Marshall and McCracken counties - has had no confirmed cases of measles this year and none in 2013 or 2012.

"But of course, we're not saying we don't think it's going to happen," Day added. "We have to be alert because of outbreaks in Ohio."

According to the Ohio Department of Health, that state's measles outbreak began when unvaccinated travelers were exposed to the disease abroad. The state has recorded 368 cases and 10 hospitalizations so far this year.

Looking at pertussis, Day said no cases have been confirmed in Region One so far this year, but there were a few - less than five, she said - confirmed in the past two years. 

Schell said although more local parents are choosing to delay or forgo vaccinating their children, Pediatric Group of Paducah hasn't seen any measles cases and hasn't seen any recent case of pertussis. 

"So far, around here, we've been lucky, but that's because, in our general area, most people still vaccinate. But in the bigger metropolitan areas, where you have more people in closer populations that are electing not to vaccinate, it's going to be tested more," he said.

Population and rate of vaccination matter, Schell explained, because of what is commonly known as "herd immunity." The principal holds that if enough people in a community are immunized against an illness, those who aren't, whether because they weren't vaccinated or their bodies failed to build immunity from vaccines - something Schell said happens in a very small percentage of people - are somewhat protected.

"(That's) because the incidence of disease in that herd, so to speak â or that group of individuals â is so low, they never get challenged," Schell explained. "But if you're not vaccinated and more and more of the herd aren't vaccinated, then you can start having outbreaks."

Schell said he believes a high rate of vaccination in Paducah, combined with the lower population of the area, has protected the few who choose not to vaccinate so far.

"But again," the doctor added, "we're getting more people electing not to do it, so that's a big concern."

Schell said nearly all the parents he's seen who don't want to vaccinate their kids or want to wait until their children are 18 months to 2 years old to vaccinate are worried that vaccines will cause their kids to develop autism. Schell said even though the 1998 research paper that claimed a link between the MMR (measles, mumps and rubella) vaccine and autism was found to be fraudulent and has been disproven, the idea still circulates on the Internet.

"And young parents read these things, and they don't know who to believe. They're afraid their children are going to be harmed," Schell said.

Day pointed out that 10 of the 12 authors of the 1998 research paper later published a retraction refuting the proposed link between autism and the MMR vaccine. Schell noted the fraudulent work ultimately resulted in the most well-known author - Andrew Wakefield - losing his medical license in Britain. The entire paper, Schell added, was eventually retracted by the medical journal that published it. 

Day said people who refuse vaccinations based on misinformation put more than just themselves at risk.

"Those people - whether at school or even adults - they're exposing others in the community," the epidemiologist said.

Day noted the importance of the pertussis vaccine in particular in protecting the youngest members of the community.

"I want to emphasize that pertussis vaccination (for adults) is critical because an infant cannot have this vaccination before a certain age," Day said. "It's very important for caregivers to be vaccinated immediately, because that protects that child because their immunity is still building."

Schell said it has become easier in recent years for Kentucky parents to opt out of the vaccines children are required to have to attend public school.

"Used to be, it was the law. You had to do it. Now you can go one of two routes: You can do a religious exemption, or you can do a medical exemption," Schell said.

Medical exemptions are provided by a child's doctor when he or she has a condition that would make vaccination harmful, Schell explained.

"But then there's this religious exemption, and some people really may not have a religious exemption. They just use that as an avenue to not vaccinate their children," he said.

While the folks at Pediatric Group of Paducah wants parents to allow their children to be vaccinated, Schell said the clinic won't turn away those who don't, which is what some pediatricians in other parts of the country have done in an effort to protect their other patients.

"We prefer to take a different approach," Schell said. "It's a tough decision to tell people you're not going to take care of their children. So we haven't gone to that, but a lot of pediatricians are.

"I try to keep talking to them as they come in for their well checkups ... and a lot of those I'll get to eventually vaccinate," he added.

Schell and Day each recommend the CDC website as an excellent source of information for parents and others who have questions about vaccines and other health issues.

Schell said he knows some who have doubts about vaccines may believe he's just falling in line with "the medical establishment," but he doesn't accept that view. 

"I truly believe in these," he said. "I mean, all of us doctors here have children and grandchildren, and we've all fully vaccinated our children. So, it's not like we're asking people to do something we wouldn't do."

Contact Leanne Fuller, a Paducah Sun staff writer, at 270-575-8653.

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