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More of the consequences of not vaccinating…

more outbreaks of vaccine-preventable diseases like pertussis:

Erik Ferry thought little of the sniffles and cough his 12-year-old daughter came down with in February.

But the coughs became more frequent and violent, and the bug hung on for days, then weeks.

Concerned it was more than just a cold, Ferry took his daughter to the doctor, and a dose of antibiotics cleared things up. Only later did he learn that several of the girl’s classmates at the East Bay Waldorf School in El Sobrante had the same symptoms.
And it was only this month that Ferry, who lives in Berkeley, learned that a bout of pertussis, or whooping cough, was sweeping through the school like a bad rumor: Sixteen students have been diagnosed, and health officials suspect many more are infected.

The outbreak was so severe that school officials had to shut down the school to control it. The reason for the outbreak? I think you know the answer to that one already:

Contra Costa Health Services temporarily shut down the private East Bay Waldorf School on Friday in an effort to control the outbreak, which health officials say spread quickly because fewer than half the students at the school are immunized.

Students and staff will be allowed to return to school Monday, Contra Costa Public Health Director Wendel Brunner said, but all parents must prove their children are on antibiotics.


What?

Screw antibiotics! They’re at best a short-term measure. Make sure all the children are immunized against pertussis before they are allowed back! Antibiotics are a short term solution. (I’m also surprised that such lovers of “natural” cures will eschew vaccination but require its children to down three weeks worth of the evil, big pharma tool of antibiotics.) A 50% immunization rate is far too low to sustain herd immunity, leaving the population there vulnerable to outbreaks. Unless immunization rates top 90%, there’s little to stop something like this from happening again:

School and health department officials said they have been trying to control the disease — affecting mostly kindergartners — since the first confirmed case in April. But Ferry said he believes the pertussis started making its way around the school in January, when several students initially got sick.

“Closing a school for an outbreak of pertussis is a very unusual action,” Brunner said. “Normally, we’re able to control pertussis cases in schools without closing the school; however, the situation in the East Bay Waldorf School is different. They have a very low rate of immunization among their students.”

About 98 percent of students at other schools in the county — public and private — have been vaccinated. California law allows parents to opt out of immunizing their children for various reasons.

Waldorf Schools, of course, are well known for being places where parents tend to be very open to “alternative” health practices and antivaccination sentiments. However, they could well be the canary in the coal mine as vaccination rates fall. And what is one of the reasons, arguably the major reason, parents are afraid of vaccines and vaccination rates are falling? Well, I think you know the answer to that one too:

Contra Costa Health Immunization Coordinator Erika Jenssen, parent of an 11-year-old at the school who has been immunized, said some parents cite studies that indicate vaccinations may cause autism as a reason for opting out.

Another problem, of course, is that the unvaccinated tend to cluster in crunchy places like Waldorf schools, a nidus for infections that can provide a reservoir of disease that can spread to the rest of the community, endangering those who can’t be vaccinated for medical reasons and the small percentage of the vaccinated who did not develop immunity. Contrary to the insinuations of antivaccinationists, who view diseases like pertussis as not a big deal, pertussis is a huge deal, particularly in infants. The WHO estimates that 294,000 infants died of pertussis worldwide, and in the prevaccination era there were on the order of 10,000 deaths a year from pertussis in just the U.S. alone. The usual causes of death from this disease are secondary pneumonia, dehydration, hypoxia, encephalopathy, or cerebral hemorrhage, the last of which occurs because of the paroxysmal coughing, which elevates intracranial pressure. Moreover, up to 25% of children under 4 and 4% of children over four develop a secondary pneumonia, which often requires hospitalization. Even leaving that aside, the unrelenting cough that the disease causes is horrible to behold and even more horrible for a child to endure.

I fear that this is the sort of story that we will be seeing more and more of in the future. I had thought that they had faded into the woodwork, but antivaccinationists are like cockroaches. They never really went away. They were always there, lurking under the floorboards, and now they’ve managed to get celebrity power in the form of D-list celebrity Jenny McCarthy who, despite being dumb as a rock when it comes to science and medicine (and that’s actually an insult to rocks) while she spreads toxic myths about vaccines, nonetheless thinks her University of Google degree gives her the background and knowledge to tell physicians that they don’t know what they’re talking about. They’ve also been lucky enough to be able to take advantage of a confusing ruling in the Hannah Poling case that opens the door for them to spin it into a “concession that vaccines cause autism” when it is nothing of the sort.

Worse, on June 4, led by the ex-comedienne turned antivaccinationist Jenny McCarthy, hordes (or maybe dozens; it remains to be seen) of activists who disingenuously claim they are not “antivaccine” while attributing all manner of toxins and evils to vaccines, will descend upon Washington, D.C. to protest in a “Green Our Vaccines” rally. They’ll likely get national news attention and scare even more parents about vaccine safety. It’s true that the organizers of the march are trying to hide the more–shall we say?–vociferous of the antivaccinationists in their ranks in order to try to maintain the facade that they are not “antivaccine,” but the rabid antivaccinationists will be there nonetheless. They’ll be meeting with their–and your–legislators and doing their best to influence them.

What’s likely to happen next if pro-science forces don’t get their acts together is a sadly predictable phenomenon. The more vaccination rates fall, the more frequently outbreaks like this will occur. The more vaccination rates fall, the more children and adults will become ill with vaccine-preventable diseases. The more vaccination rates fall, the more deaths there will be. If antivaccinationists get their way, maybe even polio could make a comeback.

All of this leaves the question of what to do. What can those who understand the value of vaccines do to counter this well-financed, well-publicized effort? Three years ago, antivaccinationists were the gang that couldn’t shoot straight. Now they’re appearing on Larry King’s and Oprah’s TV shows to spew their fear to the masses. When the number of vaccine-preventable deaths per year skyrockets from the double digits to three, four, or even five digits, you’ll know whom to blame, but it will be too late. As the U.K. experience over the MMR vaccine shows us, it can more than a decade or more for the damage from such campaigns to be repaired.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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