Tag: clusters

What Happens When You Research the Disease?

We know how anti-vaccine folks think.

Anti-vaccine math…

And now we know how they do their research

How Anti-Vaccine Folks Research Disease

If you’re like me, you are probably wondering why they picked 2016 as the year to research.

Why look just at 2016?

And, there you see it.

In the past 6 years, 2016 was the year with the fewest cases of measles. Why not choose 2017 or 2018 to do their research?

But let’s look at 2016, even though the information isn’t complete:

  • 86 cases
  • cases in 19 states, including Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, Tennessee, Texas, and Utah
  • a large outbreak in Arizona (31 cases) linked to a private detention center and all that is known is that 7 of 9 staff members who got measles had received at least one dose of MMR, and 3 had received their dose very recently
  • a large outbreak in Shelby County, Tennessee, at least 7 cases, including 6 unvaccinated and one partially vaccinated child
  • a large measles outbreak (17 cases) in Los Angeles County and Santa Barbara County that was linked to the Los Angeles Orthodox Jewish community
  • two cases in Colorado, including an unvaccinated toddler and an unvaccinated adult – outbreaks which cost at least $68,192 to control

And of th cases in 2016, it seems that just 16% were vaccinated.

What about the claim that 26% were vaccinated?

That wasn’t 26% of the total number of cases, but rather 26% of the cases among US residents.

So if you do the math, that’s just 14 cases that were vaccinated, and out of 86 cases, that’s really just 16%. And a lot of those cases are skewed by the one outbreak at the detention center, in which they may have only received one dose of MMR and nearly half may have gotten vaccinated after the caught had already started!

What about the claim that “the odds of dying from the measles are like 0.00000013%” using numbers “before the vaccine was introduced in 1963?”

“Before a vaccine became available in 1963, measles was a rite of passage among American children. A red rash would spread over their bodies. They would develop a high fever. Severe cases could cause blindness or brain damage, or even death.”

CDC says measles almost eliminated in U.S.

In the pre-vaccine era, your odds of getting measles were very high. Remember, everyone eventually got measles.

And looking at statistics of reported measles cases and reported measles deaths, we know that death occurred in about 1 to 3 in every 1,000 reported cases.

So everyone got measles, but not everyone survived having measles.

Even if you use a more liberal count of 1 death in 10,000 cases, when all kids get measles, that’s a lot of deaths. Remember, about 450 people used to die with measles each year.

What about your odds of dying with measles now?

If you are fully vaccinated, then they are extremely low.

They are pretty low if you are unvaccinated too, in most cases, because you are benefiting from herd immunity and the fact that most folks around you are vaccinated, reducing your risk of being exposed to measles. Still, the risk is much higher than most anti-vaccine folks expect, because they often make the mistake of using the entire population of the United States in their calculations. They should instead just use the folks who are unvaccinated and susceptible, a much smaller number.

Want to increase your risk?

  • travel out of the country
  • hang out in a cluster with other unvaccinated people
  • stay unvaccinated

The odds aren’t in your favor to avoid measles if you are unvaccinated. Eventually, your luck might run out.

Starting to see the mistakes anti-vaccine folks make when they say they have done their research?

“How do they know how many people would have gotten measles and how many of them would have died?!?”

It’s not rocket science.

It’s epidemiology.

“We constructed a state-space model with population and immunisation coverage estimates and reported surveillance data to estimate annual national measles cases, distributed across age classes. We estimated deaths by applying age-specific and country-specific case-fatality ratios to estimated cases in each age-country class.”

Simons et al on Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data.

Unfortunately, after years of improvements, measles deaths increased in 2017. And they will continue to increase, as our risk of getting measles continues to increase if folks don’t get vaccinated and protected.

Lastly, why does it “sound like millions of people would have died without the measles vaccine?”

Maybe because millions of people died in previous years, before they were vaccinated and protected.

Indeed, do your research, but you will find that vaccine-preventable diseases aren’t as mild as anti-vaccine folks believe. That’s why it is important to get vaccinated and protected.

More on Researching Vaccine-Preventable Disease

Vaccine-Preventable Diseases – Year in Review 2018

Does it seem like we are moving in the wrong direction?

The eradication of smallpox shows just what vaccines can do!
The eradication of smallpox shows just what vaccines can do!

No, smallpox isn’t coming back, but many other vaccine-preventable diseases are.

Vaccine-Preventable Diseases – Year in Review 2018

With the availability of new vaccines and the expanded use of other vaccines, many of us were hopeful of the progress that was being made against vaccine-preventable diseases so far this decade.

Remember, it was just four years ago that the WHO certified India as a polio free country. And after years of declining numbers of wild polio cases, 2018 will be the first year with a higher number of cases than the previous year.

This hasn’t been a good year for measles either. The WHO Region of the Americas has lost its status as having eliminated measles!

In Bolivarian Republic of Venezuela, endemic transmission of measles has been re-established, with spread to neighbouring countries. As a result, the Region has lost its status as having eliminated measles. The Regional Technical Advisory Group, which met in July 2018, emphasized the importance of Regional action and an urgent public health response to ensure re-verification of measles elimination in Bolivarian Republic of Venezuela.

Meeting of the Strategic Advisory Group of Experts on Immunization, October 2018 – Conclusions and recommendations

After years of declining rates, global measles cases and deaths began to jump in 2017, a trend that continued in 2018.

“Outbreaks in North America and in Europe emphasize that measles can easily spread even in countries with mature health systems. Due to ongoing outbreaks, measles is again considered endemic in Germany and Russia.”

2018 Assessment Report of the Global Vaccine Action Plan

And no, this isn’t just a problem in other parts of the world.

Vaccine preventable diseases are just a plane ride away.
Vaccine preventable diseases are just a plane ride away.

More cases in other parts of the world mean more cases in the United States because unvaccinated folks travel out of the country and bring these diseases home with them, getting others sick.

But it wasn’t just measles outbreaks, including the second largest number of cases in 22 years, that we were seeing in 2018:

  • chicken pox – although the 41 cases involving a North Carolina Waldorf school got the most attention, there were at least 6,892 cases of chicken pox last year, which continues to trend down from recent highs of over 15,000 in 2010
  • hepatitis A – clusters of outbreaks in 15 states with at least 11,166 cases, many deaths, with exposures at popular restaurants
  • mumps – from recent highs of over 6,000 cases the last few years, we were “back down” to just over 2,000 mumps cases in 2018
  • pertussis – cases were also down in 2018, with a preliminary count of about 13,439 cases last year
  • meningococcal disease – isolated outbreaks continued last year, with cases at Smith College, Colgate University, and San Diego State University

And of course, we had one of the worst flu seasons in some time last year, with 185 pediatric flu deaths.

Fortunately, there were no cases of diphtheria, neonatal tetanus, polio, or congenital rubella syndrome. At least not in the United States.

Why are some disease counts down when so many folks say the anti-vaccine movement is more active than ever?

Remember, the great majority of people vaccinate and protect their kids!

And vaccines work!

It is best to think of the anti-vaccine movement, which has always been around, as a very vocal minority that is just pushing propaganda to scare parents away from vaccinating and protecting their kids.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad these diseases are, allow themselves to be influenced by anti-vaccine propaganda, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

Also remember that many of these diseases occurred in multi-year cycles in the pre-vaccine era. When an up year hits a cluster of unvaccinated kids, we get bigger outbreaks. And then more folks get vaccinated, starting the cycle all over again. At least until we finally get the disease under better control or finally eradicated.

Want to avoid getting a vaccine-preventable disease this year?

Get vaccinated and protected and encourage everyone else to get vaccinated too.

More on Vaccine-Preventable Diseases – Year in Review 2018

How Are Australia’s New Vaccine Laws Working?

Have you heard about the No Jab, No Play / Pay laws in Australia?

Did Australia's new vaccine laws prompt anti-vaccine folks to put up these billboards that eventually got vandalized?
Did Australia’s new vaccine laws prompt anti-vaccine folks to put up these billboards that eventually got vandalized?

Unlike the No Pass, No Play rules that we have in Texas, in which kids can’t participate in extracurricular activities unless they pass all of their classes, No Jab, No Play / Pay has to do with getting kids vaccinated.

They were enacted in 2016 due to an increase in outbreaks of vaccine preventable disease, a rise in the spread of anti-vaccine misinformation, and more parents choosing to delay or skip their child’s vaccines. As in the United States, the real problem has been clusters of unvaccinated children in certain regions of the country, as the great majority of people in Australia vaccinate their kids.

How Are Australia’s New Vaccine Laws Working?

As expected, Australia’s new vaccine laws have been a success.

On the national level, No Jab, No Pay has meant that children need to be fully immunized “as a requirement for parents to be eligible to receive the Family Tax Benefit Part A end of year supplement, Child Care Benefit and Child Care Rebate.”

Five-year-olds in Victoria are now better protected against diseases prevented by vaccination than in any other state in Australia, new data shows.

Victoria Leads The Nation When It Comes To Vaccination Rates

But it is only in New South Wales, Queensland, and Victoria that children need to be immunized to attend childcare – No Jab, No Play. Additionally, children need to be immunized to attend kindergarten in Queensland and Victoria.

An increase in vaccination rates, by 2 to 5%, has been seen nationwide though.

What about the idea that No Jab, No Play has lead to a drop in preschool enrollments?

KATHARINA GORKA, NON-VACCINATING PARENT: I don’t think it is fair, to be honest. It makes me feel like we are a bit excluded from society, yeah.
PETER MCCUTCHEON: Did you ever think, “I’ll get my son vaccinated so I get around this pre-school problem”?
KATHARINA GORKA: No, I never thought about that.
PETER MCCUTCHEON: Why not?
KATHARINA GORKA: Because I have a set opinion on vaccinations and that is not going to change.

Some pre-schools experience drop in enrolments over ‘no jab, no play’ policy

The law about attending daycare and kindergarten just came into effect in New South Wales, in 2018, but has been in effect since 2016 in Victoria.

We will have to wait a few more months for the 2018 numbers, but preschool enrollment in Victoria was way up after they instituted their strict vaccine requirements!

In Australia during 2017, 339,243 children aged 4 or 5 were enrolled in a preschool program, representing an increase of 2.6% on the previous year’s figure. The largest growth rates were in the Australian Capital Territory (6%) and Victoria (5%).

Australian Bureau of Statistics on Preschool Education, Australia, 2017

Maybe folks just don’t want to go to care centers that had been pandering to anti-vaccine parents

Still, some vaccine advocates don’t think that No Jab, No Play / Pay laws are a good idea for Australia. Many also don’t think that it is a good idea that some Australian doctors are starting to refuse to see unvaccinated children, a practice that seems to have been exported from the United States.

Others don’t see alternatives, as they feel that they have been trying for a long time to educate parents that vaccines are safe and necessary, and this is one of the few ways that can reliably improve vaccination rates.

More on Australia’s New Vaccine Laws

Are Anti-Vaccine Folks Smarter Than the Rest of Us?

For the overwhelming majority of us, it seems like a simple decision – get your kids vaccinated and protected and avoid all of the risks of vaccine-preventable diseases.

After all, we understand that vaccines are safe and necessary.

But folks who choose to skip or delay vaccines want to do what is best for their kids too, even as they come to the exact opposite decision, so who is making the smarter choice?

Are Anti-Vaccine Folks Smarter Than the Rest of Us?

Not surprisingly, anti-vaccine folks think they are smarter.

Why?

“In the end we are left with a powerful sense of knowledge – false knowledge. Confirmation bias leads to a high level of confidence, we feel we are right in our gut. And when confronted with someone saying we are wrong, or promoting an alternate view, some people become hostile.

The Dunning-Kruger effect is not just a curiosity of psychology, it touches on a critical aspect of the default mode of human thought, and a major flaw in our thinking. It also applies to everyone – we are all at various places on that curve with respect to different areas of knowledge. You may be an expert in some things, and competent in others, but will also be toward the bottom of the curve in some areas of knowledge.”

Steven Novella on Lessons from Dunning-Kruger

While it is easy to blame it on the Dunning-Kruger effect, a study that appeared in the July 2004 issue of Pediatrics, Children who have received no vaccines: who are they and where do they live?, is often used by anti-vaccine folks to reinforce the idea that they are smarter.

“Undervaccinated children tended to be black, to have a younger mother who was not married and did not have a college degree, to live in a household near the poverty level, and to live in a central city. Unvaccinated children tended to be white, to have a mother who was married and had a college degree, to live in a household with an annual income exceeding 75,000 dollars, and to have parents who expressed concerns regarding the safety of vaccines and indicated that medical doctors have little influence over vaccination decisions for their children”

Children who have received no vaccines: who are they and where do they live?

But the part of the study that is often quoted is comparing unvaccinated vs undervaccinated.

In the same study, the education level of unvaccinated vs vaccinated is virtually the same.

And the differences for the unvaccinated vs undervaccinated kids was about their living near the poverty level. If these families grew up with less money, they likely had less opportunities to go to school, and unfortunately, had less opportunities to keep their kids up-to-date on their vaccines.

One study, Maternal characteristics and hospital policies as risk factors for nonreceipt of hepatitis B vaccine in the newborn nursery, did seem to associate a higher education level with refusing the newborn hepatitis B vaccine, but an even bigger factor was being born in a facility that actually had a policy that offered the vaccine.

“Likewise, vaccine refusal now appears to be less a function of socioeconomic status than it once was. Previously, maternal education was strongly associated with vaccine refusal, but now mothers without a high school diploma are even more likely than college graduates to have unvaccinated children . Also, unvaccinated children are no longer found primarily in the highest income households (perhaps a function of income data being top-coded at $50,000), but now are equally likely to live in households with more moderate (or even below poverty) incomes.”

Laura Blakeslee on Trends and Characteristics of Unvaccinated Children in the United States : The National Immunization Survey, 2002 − 2010

Other studies have either showed a higher level of college graduates for those who vaccinated their kids or no difference.

What about all of the experts in the anti-vaccine movement? Remember that the heroes and so called experts of the the anti-vaccine movement mostly includes celebrities, some doctors and scientists who are practicing way out of their field of expertise when they talk about vaccines, and others whose work is not supported by the great majority of experts in their field.

That’s not necessarily the end of the story though.

Yet another study (a small survey), Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model, found that as compared to parents who vaccinated their kids, those who delayed or refused vaccines:

  • were less likely to think that vaccines were necessary
  • were less likely to think that their kids would get a disease if they weren’t vaccinated
  • were less likely to believe that vaccines are safe
  • were more likely to believe that vaccines caused serious side effects
  • were more likely to believe that children get too many vaccines

And surprisingly, considering that the above things are basically anti-vaccine talking points that are easily disproven, they were actually more likely to have gone to college and to be a college graduate. It is not a surprise that they were less likely to have a good relationship with their doctor and were less likely to believe that their doctor had their child’s best interest at heart.

Parents unknowingly gave their infants teething powder made with mercury, causing pink disease or mercury poisoning.
Parents unknowingly gave their infants teething powder made with mercury, causing pink disease or mercury poisoning. Ironically, a decrease in illiteracy levels might have been the cause.

So maybe some anti-vaccine parents are indeed well-educated about some things, but that just gets us back to the Dunning-Kruger effect, as they certainly aren’t making smart decisions about vaccines.

Fortunately, this is still a very small, although very vocal, minority of people, as most parents vaccinate and protect their kids.

What to Know About Anti-Vaccine Intelligence and Education

Parents who choose to skip or delay their child’s vaccines are not making smart decisions about vaccines.

More on Anti-Vaccine Intelligence and Education

The Plano Smallpox Outbreak of 1895

In May 1895, a smallpox outbreak hit west Plano.
1895 Fort Worth Gazette

North Texas is no stranger to outbreaks of vaccine-preventable diseases.

After all, this was the site of a large measles outbreak in 2013 at the Kenneth Copeland Ministries Eagle Mountain International Church.

And it has also been the site of chicken pox parties, mumps outbreaks, and a few clusters of unvaccinated kids.

Mostly though, parents in North Texas do a good job of getting their kids vaccinated and protected.

The Plano Smallpox Outbreak of 1895

Of course, that’s not what’s keeping smallpox away.

Routine smallpox vaccination, which was typically given when children were about 12 months old, ended in 1972 in the United States. And smallpox was declared eradicated in 1980.

“Today, Preston Lakes is a quiet, manicured neighborhood in an affluent area of Plano. Almost 120 years ago, it was the site of one of Plano’s darkest hours.”

Plano Smallpox Outbreak of 1895

Driving around Plano now, it is hard to imagine that this city once battled smallpox.

While that is probably true of any modern city, the curious thing is that the area in and around Plano wasn’t settled until the early 1840’s, at which time an effective smallpox vaccine had been available for over 40 years.

Remember, Edward Jenner developed his smallpox vaccine in 1796. And before that we had variolation.

“On May 6, 1895, Plano City Council called an emergency meeting, establishing a strict quarantine “to protect our citizens from this loathsome disease.” Anyone within the area between what is now Spring Creek Parkway, Park Boulevard, Coit and Preston Roads was forbidden to leave. An armed guard patrolled the border.”

Plano Smallpox Outbreak of 1895

Farwick Collinsworth, whose family owned large portions of what is now West Plano, lost his 11-year-old granddaughter in the smallpox outbreak.

Next, his wife and two sons died.

Then two more grandchildren and a nephew.

All together, at least 15 people died in the smallpox outbreak of 1895 in Plano, Texas.

“In 1806 the first smallpox inoculations were administered in San Antonio de Béxar. After initial resistance to the experiment, the townspeople came to accept the procedure, and the threat of smallpox was lessened for a time.”

Texas State Historical Association Public Health

While the Plano outbreak is certainly sad, it is truly tragic that smallpox was already a vaccine-preventable disease at this time.

History of Smallpox in Texas

Still, as late as 1900, 894 people died of smallpox in the United States. Globally, at least 300 million people died of smallpox during the 20th century.

So why weren’t folks vaccinated against smallpox in the late 19th century in North Texas?

In 1901, the editor of The Texas Medical Journal discusses the "prejudice against vaccination" in Texas at the time of a widespread smallpox epidemic.
In 1901, the editor of The Texas Medical Journal discusses the “prejudice against vaccination” in Texas, at the time of a widespread smallpox epidemic.

While some people talking about issues with vaccine availability, remember that this is just after almost 100,000 people participated in the Leicester Demonstration March of 1885 to protest the smallpox vaccine.

While Leicester is quite a ways from Plano, a little bit closer to home we had the Laredo Smallpox Riot.

“When he realized that Laredoans were not fully embracing the quarantine program, especially the mandatory inoculation, he asked the governor to send in Texas Rangers. A contingent of rangers under Captain J.H. Rogers arrived on March 19, 1899, and began enforcing the health official’s orders more vigorously than some of the city’s residents thought proper. Milling protestors pelted rangers and health workers with harsh words and harder rocks, leading to a couple of minor injuries.
The next day, when the rangers got word that someone had telephoned a local hardware store to order 2,000 rounds of buckshot, the officers began a house-to-house search of the part of town where the order had come from. The situation soon deteriorated into a riot, with the rangers killing two citizens and wounding 10 others. It took cavalry from nearby Fort McIntosh to restore order.
The inoculation and fumigation program continued, and by May 1, Dr. Blunt lifted the quarantine in the border city.”

Frontier Medicine: Texas Doctors Overcome Disease and Despair

And we had folks pushing homeopathic vaccines, anti-vaccine talking points about the “evil results from vaccination,” all contributing to a “prejudice against vaccination.”

The Texas Medical Journal, in 1902, describes how other areas have controlled or eliminated smallpox with vaccines - but not Texas.
The Texas Medical Journal, in 1902, describes how other areas had controlled or eliminated smallpox with the vaccine – but not Texas.

It maybe shouldn’t be surprising that the last smallpox outbreak in the United States was in Texas – in 1949. Eight people got sick, and one person, Lillian Barber, died.

But Texas wasn’t at the center of the anti-vaccine fight against protecting kids against smallpox. In Utah (the McMillan bill), Minnesota, and California, laws were passed banning mandatory vaccination for attending school. While the governors of Utah and California vetoed their bills, in Utah, legislators overcame the veto.

What came next?

Outbreaks of smallpox.

In 1906, AMA President William J. Mayo, a Minnesota physician, charged that his state’s “inability to enforce vaccination” had unleashed a smallpox epidemic, infecting 28,000 of the state’s citizens – “all due to a small but vociferous band of antivaccination agitators.”

Pox: An American History

That was over a hundred years ago.

What comes next?

Will we let today’s “vociferous band of antivaccination agitators” guide  vaccine policy and put our kids at risk for vaccine-preventable diseases, as they push the same old anti-vaccine propaganda and fight against vaccine mandates, which are only necessary because they scare parents away from vaccinating and protecting their kids?

Let’s hope not.

What to Know About the Plano Smallpox Outbreak of 1895

Fifteen people died in Plano, Texas in 1895, even though a smallpox vaccine was available at the time that could have prevented this and most other smallpox outbreaks and epidemics. Tragically, the fight against its use mirrors much of what we see in today’s anti-vaccine movement.

More on the Plano Smallpox Outbreak of 1895

The First Measles Case of 2018 is at IU Bloomington

And the first measles case of 2018 is in…

  • Bloomington, Indiana

Unvaccinated children exposed to measles are quarantined for at least 21 days.

A student at Indiana University in Bloomington was diagnosed with measles on January 6.

The student may have exposed others between the time they arrived on campus on January 2, moved into her dorm (McNutt Residence Hall), and got diagnosed on January 6.

Fortunately, classes haven’t started yet, so exposure to others might have been lower than they typically might have been.

She likely did expose others on January 2:

  • on a flight from Mumbai, India to Newark Liberty International Airport
  • during a layover in Newark Liberty International Airport
  • on a flight from Newark to Indianapolis International Airport
  • at Indianapolis International Airport

Because measles has a long incubation period, remember that it might not be until January 23 that you develop symptoms if you were exposed are not immune (two doses of vaccine or natural immunity).

Indiana Measles Outbreaks

Surprisingly, this is not the first case of measles at this campus in recent years. Just four years ago, another student at Indiana University Bloomington was diagnosed with measles.

Or maybe it shouldn’t be so surprising.

Indiana has had some large measles outbreaks triggered by unvaccinated travelers returning to the state.
Indiana has had some large measles outbreaks triggered by unvaccinated travelers returning to the state.

There has been a lot of measles in Indiana in recent years:

  • an outbreak caused by an unvaccinated traveler who got 13 other people sick in 2011
  • another outbreak in 2012, also triggered by an unvaccinated traveler, also got 13 other people sick

In fact, since 2010, there have been at least 34 cases of measles in Indiana, including the latest case at IU Bloomington. Almost all have been unvaccinated.

And that’s with a pretty good vaccination rate.

Why?

Pockets of susceptibles, or so-called clusters of unvaccinated people, who get measles and then put the rest of us at risk.

Get educated.

Stop the outbreaks.

Vaccines work. Vaccines are safe and vaccines are necessary.

What to Know About Measles in Indiana

Indiana has been one of the states where we have seen measles outbreaks linked to clusters of unvaccinated people and is home to the first measles case of 2018.

More on Measles in Indiana

Updated January 13, 2018

Ask Amy About Intentionally Unvaccinated Kids at a Holiday Party

How do you avoid fighting with friends and family when you get together at the holidays?

Some say to talk about whatever you want, but just have empathy for others when you talk about controversial topics.

Other experts say to simply avoid talking about things like politics, religion, and sex.

Going that route, it is easy to imagine that the list of things that you can’t talk about can get pretty long in some families.

Topics Too Dangerous To Avoid

Are some topics too dangerous to avoid talking about?

I’m not talking about in the long-term, what’s going to happen to our world kind of dangerous, but short term dangers to your kids and the rest of your family.

For example, what if you instinctively think that you should avoid talking about guns when visiting your uncle’s house, because you remember seeing all of his Facebook posts about the NRA. But you want to make sure there aren’t any unsecured guns lying around the house that your toddler could find. Do you ASK about guns in the house?

Ask Amy About Intentionally Unvaccinated Kids

What about vaccines?

That’s another topic that’s too important to avoid talking about.

Ask Amy took on the issue of the risk of an intentionally unvaccinated child to the rest of the family.
Ask Amy takes on the risk of an intentionally unvaccinated child at a holiday party.

What’s the problem? Some family members don’t want to come to a family gathering if their sibling is going to bring their intentionally unvaccinated child.

And why is that a problem if they are all fully vaccinated (a common argument posed by anti-vaccine folks)?

It should be clear that they are not all fully vaccinated. At least one of the grandchildren is just 6-months-old, so is too young to be fully vaccinated. She will not get her first dose of MMR and chicken pox vaccine, for example, until she is at least 12 months old.

But she isn’t the only one at risk. The other children and adults could be at risk because no vaccine is 100% effective. Vaccines work and they work very well. They just aren’t perfect.

What Ask Amy Gets Right and Wrong

Ask Amy was smart to turn to a pediatrician for help on this question.

And Dr. Thoele is right, this intentionally unvaccinated child is getting away with hiding in herd (at least so far) and won’t get anyone else sick unless he is exposed first and gets sick himself.

“If you choose to delay some vaccines or reject some vaccines entirely, there can be risks. Please follow these steps to protect your child, your family, and others.”

CDC on If You Choose Not to Vaccinate Your Child, Understand the Risk and Responsibilities

Many of us would take exception to the part that it is “highly unlikely” that this child could get a vaccine-preventable disease though. There are usually one or more outbreaks of chicken pox, mumps, pertussis, and measles, etc., going on in different parts of the United States throughout the year. And because parents who don’t vaccinate their children often cluster together in groups, it increases the chances that their kids will catch something.

Have they traveled out of the country? Have they been exposed to someone who has? That increases their risk too.

And what about the flu?

“(Dr) Thoele and I both hope that everyone attends the family get-together and that all family members should try their best to be nice to one another. There is, fortunately, no vaccine preventing that.”

There is also nothing preventing those parents from vaccinating their child.

Unvaccinated Kids at a Holiday Party

So should this intentionally unvaccinated toddler come to the holiday party?

Should other kids come if the unvaccinated child will be there?

While no one wants a family to be split over such a matter or for grandparents to be put in the middle, it is a much more complicated issue than wishing that everyone play nice.

Not Vaccinated? No Kisses!
A billboard advocating that teens and adults get a Tdap booster.

Not surprisingly, pediatricians get asked about these kinds of situation all of the time:

  • Should new parents allow family members to visit if they won’t get a flu shot?
  • When can they allow a family member to see their new baby if they won’t get a Tdap booster?
  • What do they do about the family members who don’t get vaccinated and don’t even take their kids to the doctor for regular checkups?

And what’s the answer?

Understand that kids aren’t at least partially protected against:

  • pertussis until after the third dose of DTaP at six months
  • the flu until after getting a first flu shot at six months, keeping in mind that they are actually going to need a second flu shot for full protection, since it is the first time that they are being vaccinated against influenza
  • measles, mumps, and chicken pox until they get their first dose of MMR and the chicken pox vaccine when they are 12 months old

And that’s why many parents would not, if they had a choice, expose their children to an intentionally unvaccinated child until after they had at least had their 12 to 15 month vaccines. By this time, they have also gotten 3-4 doses of Hib and Prevnar, and have completed their rotavirus vaccines.

Of course, if the child, or any of the adults, had an immune system problem, were getting treated for cancer, or had any other condition that would put them at higher risk for getting a vaccine-preventable disease, then they would likely never voluntarily expose themselves to someone who was intentionally unvaccinated.

I say voluntarily, because we often don’t have a choice.

In most states, folks are allowed to send their intentionally unvaccinated kids to school and daycare. And those kids put us all at risk.

And yes, there are vaccines to prevent that.

What to Know About Unvaccinated Kids at a Holiday Party

Many parents would avoid voluntarily exposing their kids to an intentionally unvaccinated child until they have at least completed their primary series of vaccines, when they are 12 to 15 months old.

More on Unvaccinated Kids at a Holiday Party