More Musings on Measles

Does this ring a bell for anyone?

“Texas Megachurch at Center of Measles Outbreak?”

This happened only about a year ago in September, 2013, when 21 members were infected, a majority of whom were unvaccinated children.  I remember at the time thinking it was a big deal. Yet, I haven’t heard it referenced at all in the midst of our current measles outbreak.

I’m guessing its omission is partly because an outbreak of 21 cases is chump change compared to the now 121 cases throughout 17 states, as of February 2015. But perhaps it highlights another issue at play: Why isn’t there much, if any, heat on the religious exemption for childhood vaccinations?

This isn’t the first time unvaccinated communities, in the name of religious exemption, have gotten themselves (and others) in trouble.

Turn back the clock way back to 1991, and some (not me… only in 2nd grade at the time) will remember the measles outbreak that infected more than 1400 people in Philadelphia, which included 9 dead children. About 33% of those infected belonged to one of two large churches, which emphasized prayer over medicine (and vaccines, for that matter).

Dr. Paul Offit, now an infectious disease specialist, witnessed the outbreak firsthand. He talks about his experience in this recentNew York Times article.  Since the disease has become so ‘out-of-sight, out-of mind’ to many, I’ll quote his experience:

“Children would come in, covered in rashes, squinting in the bright light (a side effect caused by eye irritation), struggling to breathe, and often dehydrated. It was like being in a war zone.”

200 kids came through his ER, 40 needing hospitalization, and with a handful of deaths.

It required this bucket of cold-water reality for something remarkable, and probably unthinkable for many of us: a court order to vaccinate children against their parents will.

So what would the ACLU (American Civil Liberties Union) have to say about that? Would they decry this sacrilege on individual freedom and the first amendment?

Nope. As Deborah Levy, of the Philadelphia ACLU chapter defaulted, “…parents don’t have the right to martyr their children.”

Or, to get downright Libertarian, “the only purpose for which power can by rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.” That’s John Stuart Mill. On Liberty. Boom.

So what happened? Well, kids got vaccinated against their parents’ wishes, outbreak ended, and kids didn’t get sick.

I wish I could also report that we remembered the dangers of measles and other vaccine preventable illnesses, and when we beat measles into submission and eliminated it from this country in 2001, it stayed down. But that, of course, didn’t happen.

Which brings me back to the topic at hand. Currently, most people are hung up on states (currently 19) that allow personal belief or philosophical exemptions from vaccines. Some of them are thinking this wasn’t such a good idea (I’m looking at you, California). 

But what about the 48 states, sans Mississippi and West Virginia, that allow religious exemptions?  Look, freedom of religion and separation of church and state are foundational tenets for this country.  My parents have always instilled in me the importance of the right to believe (or not to believe), and the right to express one’s religion freely. But when the rubber hits the road, and kids are being harmed in the name of martyrdom, we begin to recognize there are more important rules at play.

Truly, I believe that with what we are witnessing in these last two months, mandating vaccinations for all children bears more attention and consideration.

-Tony GiaQuinta, MD FAAP

@IndyPedsDoc

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