Tag: free-riders

Why Are We Worried About 60,000 Unvaccinated Kids?

In the recent New York Times OpEd, How to Inoculate Against Anti-Vaxxers, the editorial board mentioned the 60,000 children in Texas who “remain wholly unvaccinated thanks in part to an aggressive anti-vaccine lobby.”

“But there’s like 74 million children, so I think that’s a pretty small number. I don’t know why you guys are freaking out about 60,000 really healthy babies running around. Do you know?

Hillary Simpson

Hillary Simpson obviously doesn’t understand how herd immunity works.

Do you?

Why Are We Worried About 60,000 Unvaccinated Kids?

First things first, though.

Just how many unvaccinated kids are there in Texas? How about the United States?

It is actually hard to know exactly.

It's easy to forget, with so much talk about anti-vaxxers these days, but the great majority of parents vaccinate and protect their kids!
It’s easy to forget, with so much talk about anti-vaxxers these days, but the great majority of parents vaccinate and protect their kids!

In Texas, for instance, while only a small percentage of kids get non-medical vaccine exemptions, with about 7 million children in the state (yes, there are 74 million children in the United States, but that’s not how you measure herd immunity), that adds up to a lot of unvaccinated kids.

In addition to about 60,000 unvaccinated kids in school, there are homeschooled children who aren’t vaccinated.

“We’re probably looking at more than 100,000 kids in the state of Texas who are not getting their vaccines.”

Dr. Peter J. Hotez: “A Scary Anti-Science Movement Has Become Very Strong in Texas”

But still, should we be worried about 100,000 unvaccinated kids, when there are 7 million kids in Texas?

Don’t those immunization levels still keep us above herd immunity levels of protection?

Well, they likely would, and this would indeed be less concerning if the unvaccinated children were spread out randomly throughout the entire state. Of course, that’s not what happens and we instead get clusters of unvaccinated children (and adults) in very specific schools, neighborhoods, and even churches.

There are higher numbers of unvaccinated kids in very specific parts of the states, leading to pockets where it is more likely that an outbreak could happen.
There are higher numbers of unvaccinated kids in very specific parts of the states, leading to pockets where it is more likely that an outbreak could happen.

So while it can seem like we have herd immunity levels of protection at the state or city level because of high average vaccination levels, these pockets of susceptibles who are unvaccinated and live in the same neighborhood or go to the same school (where is the Waldorf school in Texas?) can mean that we don’t have herd immunity in those places, leading to outbreaks.

And that’s why we get concerned about 60 to 100,000 unvaccinated children who:

Still, remember that the great majority of parents understand the benefits of vaccines, are not scared by anti-vaccine propaganda, and vaccinate their kids.

In 2015, for example, only 1.3% of children in the United States had received no vaccines by age 24 months. And more than 90% of children completed their primary series of vaccines.

That doesn’t mean that we shouldn’t be concerned about those who don’t, but maybe you should be a little bit more concerned about your decision to not vaccinate your kids.

More on Clusters of Unvaccinated Kids

Is My Fully Vaccinated Child at Risk from Your Unvaccinated Kids?

Parents who skip or delay their own child’s vaccines often seem surprised that the rest of us are so concerned about their decision.

If vaccines work, they say, why do we care if their kids aren’t vaccinated?

Vaccines are protecting our kids, so they shouldn’t be at risk, right?

“Think of camping as an analogy. If everyone at a campground properly stores their food, bears won’t be enticed to come around. If even one person leaves their food unprotected, it invites bears in to investigate all the campsites for opportunities to eat.”

How does choosing not to immunize affect the community?

Of course, the issue isn’t just the risk to our fully vaccinated kids, but also the risk to those who are too young to be vaccinated, too young to be fully vaccinated, and those who can’t be vaccinated because of true medical contraindications.

In addition to those who are intentionally unvaccinated, these others often get caught up in outbreaks of vaccine-preventable diseases.

Is My Fully Vaccinated Child at Risk from Your Unvaccinated Kids?

But there is also a risk to those who are fully vaccinated, and no, that doesn’t mean that vaccines don’t work.

It just means that they don’t work 100% of the time.

And most of us don’t think that your vaccine choice should put our kids at extra risk.

Anti-vaccine propaganda pushes some folks to make bad decisions about vaccines.
Anti-vaccine propaganda pushes some folks to make bad decisions about vaccines.

Did you hear about the one measles outbreak in 2011 that was started by someone who was fully vaccinated?

“She had documentation of receipt of MMR vaccination at 3 years and 4 years of age. There was no travel during the incubation period and no known sick contacts. However, the index patient worked at a theater frequented by tourists.”

Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011

The thing about that outbreak, is that of the 222 cases that year, she was the only one known to be vaccinated. So she was almost certainly exposed to measles by someone who wasn’t vaccinated.

As someone who was fully vaccinated, is it fair that she got caught up in those outbreaks?

It is especially unfair that our kids are at extra risk for vaccine-preventable diseases because some folks make a decision to leave their kids unvaccinated and unprotected because they believe anti-vaccine misinformation like:

  • you have nothing to worry about because your child is vaccinated – again, vaccines aren’t 100% effective, so there is still some risk until a disease is finally eradicated
  • someone who is vaccinated could also get your child sick – yes, but someone who is vaccinated would be less likely to get sick than someone who is unvaccinated
  • vaccinated kids are shedding virus, making everyone sick – no, they aren’t, not even during “shedding season
  • getting vaccinated doesn’t prevent disease, it just makes it so you have fewer symptoms, but you still get others sick – in most cases, vaccines keep you from getting sick altogether – they so prevent disease in most cases, but yes, if you still got sick, you will likely have milder symptoms than if you were completely unvaccinated
  • you can’t spread a disease you don’t have – that’s true, but if you are unvaccinated and unprotected, you are at much higher risk to get these diseases and then spread them to others
  • vaccines don’t prevent diseases from spreading anyway – if you don’t get a disease because you are vaccinated, you aren’t going to spread it
  • getting vaccinated just turns you into a carrier – this is about the study in baboons, but it doesn’t mean you shouldn’t get vaccinated

What about the idea that you will just keep your unvaccinated kids home if they do catch something?

What are the chances that you could be exposed to measles during an outbreak?
What are the chances that you could be exposed to measles during an outbreak?

Looking at all of the places that the folks in the Clark County measles outbreak exposed others, it should be clear that waiting to quarantine your child if they get sick isn’t very effective.

What’s the problem?

An infant with measles during the 2014 outbreaks in the Philippines.
An infant with measles during the 2014 outbreaks in the Philippines. Photo by Jim Goodson, M.P.H.

With many diseases, you are contagious before you show symptoms. That is especially true with a disease like measles, when you may not even realize it is measles until you finally break out in a rash, after having 3 to 5 days of high fever.

That’s why it is important to vaccinate and protect your kids. When you skip or delay a vaccine, it is not just your own family that you are putting at risk.

More on Risks from Unvaccinated Kids

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

People with Cancer Are at Risk from Unvaccinated Kids

We know that kids with cancer aren’t at risk from shedding if someone has recently been vaccinated.

Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.
Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.

The real risk comes from those who are unvaccinated.

People with Cancer Are at Risk from Unvaccinated Kids

Confused on how that works?

Kids with cancer typically have a compromised immune system, so are at greater risk for getting sick and catching infectious diseases. This includes a risk from vaccine-preventable diseases because they often can’t be vaccinated and any vaccines they had in the past might no longer provide protection.

Don’t believe me?

Want some examples?

  • a 6-year-old girl who was in remission for ALL and had just received her final dose of chemotherapy was admitted with fever and neutropenia, found to have measles, and died after 28 days of intense therapy (1989)
  • an 8-year-old being treated for leukemia developed chicken pox and died two weeks later (1998)
  • a partially vaccinated 4-year-old girl who was being treated for acute lymphoblastic leukemia (ALL) was exposed to a cousin with chicken pox and later developed multi-organ failure and died (2012)
  • a 26-year-old man who was being treated for chronic lymphocytic leukemia died in Switzerland after he became infected with measles (2017)
  • a 6-year-old boy with leukemia died in Italy after catching measles from his intentionally unvaccinated sibling (2017)

Of course, there are many more, including many kids with cancer who get exposed to a vaccine-preventable disease and have to get treated with immunoglobulin and hope they don’t get sick. And many more who do get sick and are treated in the hospital for weeks and months and thankfully, get better.

And there are even more who get caught up in quarantines because they have true medical contraindications to getting vaccinated, and so have to stay home from school with the intentionally unvaccinated kids whenever there is an outbreak of measles or chicken pox, etc.

What can we do about this?

Vaccinate our kids! We have a choice. These kids with cancer don’t.

More on People with Cancer at Risk from Unvaccinated Kids

Do More Vaccinated or Unvaccinated Kids Get Pertussis?

While this seems like a simple question, the answer is a bit more complicated than most people imagine.

Do More Vaccinated or Unvaccinated Kids Get Pertussis?

For anti-vaccine folks, the answer is clear – more vaccinated kids get pertussis. They put all of the blame for pertussis outbreaks on waning immunity. Of course, that’s not the whole story.

While 10% of kids got pertussis, unless you are at a Waldorf school, it is unusual to find that many completely unvaccinated children.
While 10% of kids got pertussis, unless you are at a Waldorf school, it is unusual to find that many completely unvaccinated children. Plus, we don’t know the vaccine history of 40% of these kids.

While it might technically be true that more vaccinated kids get pertussis in the average outbreak, that’s only because there are many more vaccinated kids!

A more accurate and useful answer, taking into account attack rates, makes it clear that a higher percentage of unvaccinated kids get pertussis in these outbreaks.

“In conclusion we have described a school-based outbreak of pertussis that may have been fueled by moderate vaccine effectiveness combined with a failure to vaccinate.”

Terrenella et al on Vaccine effectiveness of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine during a pertussis outbreak in Maine

In a pertussis outbreak in Maine, attack rates were much higher in unvaccinated kids, even though more vaccinated kids got pertussis. While 29 of 214 vaccinated kids got pertussis, a much higher percentage of unvaccinated kids got sick – 6 of 28.

That means your risk of getting pertussis was much higher if you were unvaccinated.

A 2013 pertussis outbreak in Florida is a good example that even with all the bad press it gets, the DTaP and Tdap vaccines work too. This outbreak was started by an unvaccinated child at a charter school with high rates of unvaccinated kids. About 30% of unvaccinated kids got sick, while there was only one case “in a person who reported having received any vaccination against pertussis.”

In another 2013 pertussis outbreak in Florida, this time in a preschool, although most of the kids were vaccinated, the outbreak started with “a 1-year-old vaccine-exempt preschool student.” And the classroom with the highest attack rate, was “one in which a teacher with a laboratory-confirmed case of pertussis who had not received a Tdap booster vaccination, worked throughout her illness.”

Why do so many unvaccinated kids get pertussis these days?

“We found evidence of an increase in exemption rates, spatial clustering of nonmedical exemptions, and space-time clustering of pertussis in Michigan. There was considerable overlap between the clusters of exemptions and the clusters of pertussis cases.”

Omer et al on Geographic Clustering of Nonmedical Exemptions to School Immunization Requirements and Associations With Geographic Clustering of Pertussis

Besides the fact that they are unvaccinated and unprotected?

“Children of parents who refuse pertussis immunizations are at high risk for pertussis infection relative to vaccinated children. Herd immunity does not seem to completely protect unvaccinated children from pertussis.”

Glanz et al on Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children.

They can’t get away with hiding in the herd.

Another important consideration – in addition to the fact that more unvaccinated kids get pertussis, when they get pertussis, it is more severe than those who are vaccinated.

“Serious pertussis symptoms and complications are less common among age-appropriate number of pertussis vaccines (AAV) pertussis patients, demonstrating that the positive impact of pertussis vaccination extends beyond decreasing risk of disease.”

McNamara et al on Reduced Severity of Pertussis in Persons With Age-Appropriate Pertussis Vaccination-United States, 2010-2012.

Still thinking of skipping or delaying your child’s pertussis vaccine?

More on Do More Vaccinated or Unvaccinated Kids Get Pertussis?

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

Ethics and Vaccines

A lot of ethical issues come up around discussions of vaccines and vaccination.

Of course, when you talk about ethics and vaccines, you shouldn’t just think about vaccine mandates and informed consent, but also about the ethics of skipping or delaying vaccines and putting others at risk of getting a vaccine-preventable disease.

And there are also ethical issues around spreading misinformation and propaganda about vaccines (misinformed consent) to scare people away from getting vaccinated and protected.

Ethics and Vaccines

Does it surprise you that many folks don’t actually understand what the real ethical issues are in the “vaccine debate?”

Questions about ethics often come up when Dr. Bob talks about vaccines.
Questions about ethics often come up when Dr. Bob talks about vaccines.

To begin with, there is no real vaccine debate.

Vaccines are safe, effective, and necessary.

“But how can anything with known side effects be forced, knowing some will definitely be harmed?”

Dr. Bob Sears

Dr. Bob’s statement helps illustrate why this isn’t a debate.

No one is forced to get vaccinated.

And how can you say that “some will definitely be harmed” without defining what some actually means?

Severe reactions to vaccines are very rare. Fortunately, they are even more rare than the risks of a complication from a vaccine-preventable disease. And that’s why the great majority of people choose (they aren’t forced) to vaccinate and protect their kids.

Remember, a vaccine mandate that says you have to be vaccinated to attend daycare or school does not force anyone to get vaccinated. Folks still have a choice to not get vaccinated, even without access to non-medical vaccine exemptions, although they might not like what that choice entails, such as homeschooling or not being able to attend daycare or summer camp.

What about the idea of community responsibility?

Should you vaccinate your child just to protect everyone else in the community or should you just try to hide in the herd?

“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”

The National Catholic Bioethics Center FAQ on the Use of Vaccines

Of course you should vaccinate them. But in getting them vaccinated and protected, you are not just protecting everyone else in the community. Getting vaccinated also protects your own child!

Similarly, when you skip or delay your child’s vaccines, it is not just your own child that is put at risk. If they get sick, especially since many vaccine-preventable diseases have long incubation periods and you can be contagious before you show symptoms, they can expose others and get them sick too. Where’s their choice?

If the people they expose are too young to be vaccinated, too young to be fully vaccinated and protected, or anyone with a problem with their immune system, the results can be tragic.

Is it ethical that someone decides to skip or delay their child’s vaccines and then, through no fault of their own, someone else dies after getting exposed to this unvaccinated child when they develop measles or chicken pox?

Remember the measles outbreaks of 2015? In addition to the large Disney Land measles outbreak, 2015 was infamous for a smaller outbreak in Clallam County.

“The death of a Clallam County woman this spring was due to an undetected measles infection that was discovered at autopsy. The woman was most likely exposed to measles at a local medical facility during a recent outbreak in Clallam County. She was there at the same time as a person who later developed a rash and was contagious for measles. The woman had several other health conditions and was on medications that contributed to a suppressed immune system. She didn’t have some of the common symptoms of measles such as a rash, so the infection wasn’t discovered until after her death. The cause of death was pneumonia due to measles. This tragic situation illustrates the importance of immunizing as many people as possible to provide a high level of community protection against measles.”

Measles led to death of Clallam Co. woman

There were five measles cases in that 2015 Clallam County, Washington outbreak, including four who were not vaccinated. The outbreak cost at least $223,223 to contain and led to the death of a woman who just happened to be at a health clinic as one of the infected people.

Want to dismiss this case as being too rare to worry about? Just look at what is happening across Europe, with the rise in measles cases and measles deaths over the last few years.

Ethically, why should you vaccinate?

That’s easy, so that your kids don’t get a life-threatening vaccine-preventable disease. And so that they don’t expose others, potentially giving them a life-threatening disease that they are too young to be vaccinated against, couldn’t be vaccinated against because they had a true medical exemption, or were vaccinated against but are still susceptible to because they now have a problem with their immune system.

Are vaccine preventable diseases not common enough for you to be concerned about these days? You know that’s because most folks vaccinate their kids, don’t you? Do we need to go back to the pre-vaccine era before more vaccine-hesitant parents will start vaccinating their kids?

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”


Dr. Bob Sears in The Vaccine Book

What about the risks of vaccines?

While vaccines are not 100% safe, they do not cause all of the vaccine injuries and vaccine-induced diseases that anti-vaccine folks push. The real risk is believing their propaganda and leaving your child unvaccinated and unprotected.

“It is UNETHICAL to expect me to sacrifice my child for yours—especially when I know that sacrifice won’t even stop the disease from spreading. It’s time for people to stop touting their “moral superiority and selflessness” when it comes to this topic; because if you really understood how this all works, there would be nothing for you to be proud of.”

Melissa Floyd (she apparently does a podcast with Dr. Bob)

Here is where the misinformed consent comes in and ethics go out the window:

And for the record, few of us think that we are morally superior to anyone else for vaccinating and protecting our kids. We just understand that many anti-vaccine folks are victims of their cognitive biases and need to do more research. And we know that it is UNETHICAL for parents to sacrifice their kids to anti-vaccine propaganda.

More on Ethics and Vaccines