With fewer vaccinations, is your child’s school safe?Too many parents are seeking exemption from California’s vaccination law.
Across the country, preschools and elementary schools are declaring themselves nut free or peanut free, asking families not to pack lunch foods that could pose life-threatening dangers to highly allergic children. And the prohibitions are expanding beyond nuts. Some schools, for example, have prohibited powdered cheese products to protect children who are especially dairy sensitive.
These measures may be excessive, but as a physician, I understand the desire to protect students. Children with serious allergies really can have severe reactions to trigger foods, so it’s not that surprising that some schools have reacted aggressively.
But the great bulk of children face a far greater risk of harm from disease. If the goal is really to protect children, I’d like to see all schools declared “unvaccinated-free zones.”
The law in California mandates that students in public and private schools be immunized, but it also allows easy-to-get exemptions for personal beliefs.
Although some 90% of the state’s kindergartners are up to date on their immunizations, it is not uncommon for individual public elementary schools to report that more than one-third of their kindergartners are not.
And if you’re thinking this must be a problem unique to schools in low-income neighborhoods, think again. One of Malibu’s three elementary schools reported that just 58% of its kindergartners were up to date on their vaccinations, and some other affluent areas throughout the state have schools with similar compliance rates.
Private schools vary widely, but some have rates of less than 20%. Yes, that’s right: Parents are willingly paying up to $25,000 a year to schools at which fewer than 1 in 5 kindergartners has been immunized against the pathogens causing such life-threatening illnesses as measles, polio,meningitis and pertussis (more commonly known as whooping cough). In order for a school to be considered truly immunized, from a public health standpoint, its immunization rate needs to be 90% or higher.
Parents have varied reasons for choosing not to immunize their children. Some are concerned that vaccinations raise the risk of autism, although study after study has debunked this myth. Others, concerned that small bodies can’t tolerate so many vaccines at once, have decided to spread out the schedule recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention, though there is little evidence to support this practice. Some parents think that because some of the illnesses for which kids get immunized are extremely rare these days, there’s little reason to vaccinate.
But here’s the reality: These diseases do exist, and we’re already seeing some of them make a comeback.
When I was in medical school, pertussis was discussed primarily in the past tense. We learned about how whooping cough had taken the lives of many people in the 1930s, before a vaccine was available. It felt like ancient history. But now, pertussis has made a comeback in California and other states, causing severe illness in kids and adults. Children have died.
There is also a vaccine now to protect against Haemophilus influenzae type b, a bacterial disease that can cause severe respiratory illnesses, meningitis, eye infections, blocked breathing and even death. In the years after the vaccine was licensed in 1985, the disease was nearly eradicated, but now it’s back too.
Dr. Jonas Salk, creator of the polio vaccine, spoke at my medical school graduation. Polio killed millions and paralyzed millions more, but thanks to Salk and Albert Sabin, whose vaccine came soon after Salk’s, we haven’t seen outbreaks in the U.S. since the 1950s.
It used to seem a sure bet that polio was gone for good in the United States and would soon be eradicated everywhere. In 2012, just 223 cases of polio were reported worldwide, all but six of them in the three countries where the disease remains endemic: Afghanistan, Pakistan and Nigeria. One barrier to complete eradication has been suspicion toward the vaccine in remote areas of those countries. It’s ironic that vaccine suspicion is now growing here as well.
It still seems likely we’ll win the war against polio. But it’s no longer looking all that certain with whooping cough, meningitis and measles, to name a few. They could be coming soon to a school near you.
Check vaccination rates at your child’s school.
My client, Dr. Nina Shapiro, Director of Pediatric Otolaryngology and an Associate Professor at the David Geffen School of Medicine at UCLA has her say about parents choosing or not choosing to vaccinate their kids in a recent blog. Dr. Shapiro is the author of Take A Deep Breath: Clear the Air for the Health of Your Child.
“Nut-free”, “Peanut-free”, and the latest and greatest: “Nut sensitive”. The rage in preschools and elementary schools across the country is to protect our nut-challenged children from nut exposure, even if it means not exposing them to nuts in the same building or playground, to minimize their risk of life-threatening allergic reactions. Allergic concerns have expanded beyond nuts, to gluten and dairy, to the degree that some schools now prohibit ‘powdered cheese products’, to protect children who are especially dairy sensitive. Some schools are not ‘nut-‘ or ‘dairy’-free, but are merely ‘nut’ or ‘dairy’-sensitive. I hope that this means that they take special precautions, beyond just discussing the inner feelings and emotions of those ‘sensitive’ to certain foods.
Please don’t take any of this as sarcasm. I am fully aware that food allergies are bona fide, and when they occur to the point of danger, kids can die, or nearly die, from a severe food reaction. An elementary school girl recently died of a previously undocumented allergic reaction recently, while at school. So an institution’s decision to either ban or, well, ‘sensitize’, potential food allergens, for the greater good, becomes a public health issue, even on the small scale of a school’s microcosm. This is a good thing. By not sending your child to school with their favorite PBJ or cheese puff, you are protecting others. Not necessarily your nut-insensitive child, who happily gobbles powdery cheese products and peanut butter cups in the comfort of your BPA-free hybrid vehicle, but others. Your child’s sacrifice for the greater good is worth it; seeing a small friend go into anaphylactic shock can scar a tyke for life, not to mention the allergic child himself. And this protection of others is important. Equally important is teachers knowing and being re-certified in CPR (which, by the way, might have saved that elementary school girl, had it been initiated before paramedics arrived). Maybe even as important as getting immunized.
Is there a lunch table for the vaccine-sensitive? We promise not to serve nuts. I just wonder if schools would consider instituting ‘vaccine-free’ zones. You know, for the greater good? Just as we are protective of the nut-challenged from life-threatening reactions, what about protecting children from life-threatening illnesses? Public schools can mandate that all must be immunized, but do allow for exemptions, which are pretty easy to get. Many public schools report immunization rates of less than 50% of their students. Private and parochial schools can strongly encourage immunizations, but they cannot mandate that all must be immunized. Some private schools have immunization rates of less than 20%. Yes, that’s right a parent might pay $25,000 a year to a school where less than one in five of their classmates are immunized against life-threatening illnesses such as measles, polio, bacteria which cause meningitis, or pertussis (the one that causes whooping cough). In order for a school to be considered truly immunized, from a public health (or ‘greater good’) standpoint, that particular school’s immunization rate needs to be 90% or higher. Parents have varied reasons, primarily personal, why they choose not to immunize their children. Some parents are concerned about autism risk, even though all of the studies connecting the rise in autism with immunizations have been debunked. Some are concerned that their child’s body is too small to tolerate a large dose of so many vaccines at once, so they spread out the schedule recommended by the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC) to create their own ‘tailor-made’ schedule. Some parents think that the illnesses kids are getting immunized against don’t exist anymore, so why bother getting immunized, since illnesses such as polio, measles, mumps, and tetanus have been eradicated anyway.
But here’s the reality: these diseases do exist, and we’re going to see more of them come back. I read about pertussis, the bacterium that causes whooping cough, when I was in medical school. We would learn about this horrible respiratory disease and how it afflicted and took the lives of so many of those poor shlubs from the 1930’s, who hadn’t figure out prevention yet. We would read about them as if they were some primitive Neanderthal tribe, barely able to put two sticks together to make fire. Occasionally a crusty old professor would tell tales of the ‘days of whooping cough’. Ho hum. Well, it’s back. Not so ho-hum anymore. The hundred-day cough, which became an outbreak in California and other states, resulted in many children dying. During the tail end of medical school, I saw H. flu infections, a bacterium that caused severe respiratory illnesses, meningitis, eye infections, and blocked breathing. The miracle of the vaccine for H. flu, which became widely used in 1999, nearly wiped it out. Until now. It’s back, too. Dr. Jonas Salk, the co-creator of the polio vaccine, spoke at my medical school graduation. Polio killed millions, and paralyzed millions more. Thank you, Jonas Salk, and your sidekick Albert Sabin. We haven’t seen polio outbreaks in the U.S. since the 1950’s, when Salk and Sabin’s vaccine began being given widely. Well, we haven’t seen outbreaks yet. We might have to wait until the immunization rates drop some more. But let’s hope not. Polio, whooping cough, meningitis, and measles, to name a few, are still out there – and they could once again be coming to a school near you.
