Tag: herd immunity

Update on Vaccine Exemption Rates in California

Vaccination rates in California are dropping.

Wait, what?

Didn’t they recently pass a vaccine law that removed non-medical exemptions? How could vaccination rates be dropping?

Update on Vaccine Exemption Rates in California

While SB 277 did indeed remove all non-medical exemptions to getting vaccinated, some folks found a way around it. Since 2015, when it passed, some doctors are giving kids fake or unnecessary medical exemptions. These extra medical exemptions are likely making up for their previous personal belief vaccine exemptions.

The result?

It isn’t fewer exemptions since 2015.

Explain to me how it is ethical to misrepresent the rates of medical exemptions during a measles outbreak?
Explain to me how it is ethical to misrepresent the rates of medical exemptions during a measles outbreak?

While personal belief exemptions are certainly down, medical exemptions keep going up.

In addition to the 0.9% of medical exemptions, another 1.5% of kids, also up as a percentage, are unvaccinated “for other reasons specified under SB 277.”

There are also about 1.7% of kids in kindergarten who enroll as conditional entrants.

Why is that important? Among those conditional entrants are kids with temporary medical exemptions.

And how many kids aren’t vaccinated simply because they are “receiving IEP services?”

So it is not only wrong, it is unethical to try and say that only 0.9% of kids have vaccine exemptions in California this year.

Update on Vaccine Exemption Rates in California’s Clusters

Still, the big story continues to be what’s going on in the clusters of intentionally unvaccinated kids in California and other parts of the United States.

Are they getting vaccinated and protected under SB 277?

Wait, I thought Dr. Bob said that the vaccine exemption rate was just 0.9%. What happened at this Waldorf school? 30% of the kids have medical exemptions!
Wait, I thought Dr. Bob said that the vaccine exemption rate was just 0.9%. What happened at this Waldorf school? 30% of the kids have medical exemptions!

Some actually are!

The MMR rate at the Waldorf school in San Diego was just 44% back in 2014, as a whopping 56% of kids had a personal belief exemption. As sad as it sounds, even though it is still below herd immunity levels of protection, their current MMR vaccination rate of 68% is a big improvement!

Unfortunately, there are many schools with even lower immunization rates. And of course, that means even more students with “medical exemptions” at those schools.

SchoolPMEs
Marin Waldorf School31%
Yuba River Charter64%
Westside Waldorf School37%
Sebastopol Independent Charter45%
Muse Charter50%
Live Oak Charter41%
Nevada City School of Arts31%
Sunridge Charter47%
Santa Cruz Waldorf School34%
Cedar Springs Waldorf School30%
Journey33%
Waldorf School of Orange County33%
Coastal Grove Charter36%
Mariposa School of Global Ed31%
Waldorf School of the Peninsula36%
Maple Village Waldorf School30%

In addition to these permanent medical exemptions (PMEs), some schools also have high rates of temporary medical exemptions.

Medical Exemptions for Vaccines in California are Unusually High

What’s the usual rate of medical exemptions?

As there are few reasons to skip or delay a child’s vaccines, it is lower than those rates.

A lot lower.

In one recent report, Vaccination Coverage for Selected Vaccines, Exemption Rates, and Provisional Enrollment Among Children in Kindergarten — United States, 2016–17 School Year, the median rate of medical exemptions in the U.S. was just 0.2%, with a range of <0.1 to 1.5%.

Also unusual is that in some cases, many of those exemptions are written by just a few doctors. In fact, families often go to these doctors just to get their kids their medical exemptions!

“…the removal of nonmedical exemptions in California was initially effective in increasing vaccination rates, but the substitution between exemption types may render the repeal partially ineffective in improving immunization coverage and preventing VPDs over time.”

Richwine et al on Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines

How do we fix this and get more kids vaccinated and protected?

“Beyond fostering compliance, tightening the requirements around medical waivers will also aid in promoting public policies that protect public health.”

Richwine et al on Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines

In addition to closing the loopholes that allow some doctors to abuse medical exemptions, it will be important to help parents be more skeptical and see through the anti-vaccine propaganda that other doctors use to scare parents away from vaccinating and protecting their kids.

Vaccines are safe, with few risks, and are obviously necessary.

More on Vaccine Exemption Rates in California

Fact Checking the Truth About Vaccination Rates in California

In general, higher immunization rates should translate into lower rates of disease.

And it is true that in most states, including California, overall immunization rates are up.

So what’s happening?

Fact Checking the Truth About Vaccination Rates in California

Everyone knows what’s happening!

Clusters of unvaccinated kids and adults.

Pockets of susceptibles.

Abuse and overuse of vaccine exemptions.

And folks who continue to scare parents away from vaccinating and protecting their kids.

There are measles outbreaks in this part of northern California...
There are measles outbreaks in this part of northern California…

What’s the truth about California’s immunization rates and the reason they are still having outbreaks of measles and other vaccine-preventable diseases?

“Oh, but wait! What do you mean we have higher vaccination coverage NOW than we did back then? How can that be? I thought rates have been declining steadily for two decades putting us in a terrible position of falling wayyyy below herd immunity levels!?

I thought the reason we are now “in danger of disease outbreaks” is because of the increasing number of children being exempted from vaccines? Hold on, wait. You’re telling me there are LESS kids exempted now than there were in the year 2000 when we were free of outbreaks because of “high vaccination rates”? That can’t be right…can it?”

Melissa Floyd

You aren’t going to get it from anti-vaccine folks…

73% is actually pretty good for a Waldorf school!
73% is actually pretty good for a Waldorf school!

But it’s not surprising that you get misinformation about herd immunity from folks who think vaccines don’t actually create herd immunity.

And it shouldn’t be surprising that you can’t hide in the herd when your herd is a cluster of unvaccinated kids at a Waldorf school.

Vaccines are safe, with few risks, and are obviously necessary. Vaccinate your kids and help stop the outbreaks.

More on Fact Checking the Truth About Vaccination Rates in California

Did CBS and Hulu Remove the Brady Bunch Measles Episode?

Have you heard the latest anti-vaccine conspiracy theory?

Measles is highly contagious, which is likely why all of the Brady kids got sick.
Measles is highly contagious, which is likely why all of the Brady kids got sick.

Remember the Brady Bunch measles episode?

The one where all the kids got sick and two different pediatricians had to visit the house to check on the kids?

Did CBS and Hulu Remove the Brady Bunch Measles Episode?

While anti-vaccine folks apparently use the fact that the Brady Bunch did a measles episode as a reason to skip or delay their own child’s vaccines, they have gone a little further now, coming up with a conspiracy theory about efforts to keep people from watching the episode.

Are CBS and Hulu part of a conspiracy to silence anti-vaccine folks?
Are CBS and Hulu part of a conspiracy to silence anti-vaccine folks?

The episode, Is There a Doctor in the House?, aired during season 1 on December 26, 1969.

For reference, this was just after the updated measles vaccine was approved in 1967, and when there were at least 25,826 measles cases in the United States and 41 deaths.

Why didn’t they talk about any of that during the episode?

Although some folks read a lot into the episode, it was basically about how Carol and Mike each called separate pediatricians to the house for the kids, one for the boys and one for the girls, instead of just calling one for the newly formed Brady bunch.

But think about it… If measles is so mild, why did they have to call their pediatricians?

And if nothing else, remember that it shows how contagious measles really is. All of the kids got sick!

But was the episode removed so that you can’t watch it anymore?

Where's Episode 13?!? Where are episodes 5, 6, 9, 10, 15, 17, and 18? Were they all about measles too?
Where’s Episode 13?!? Where are episodes 5, 6, 9, 10, 15, 17, and 18? Were they all about measles too?

Since a lot of other episodes are missing, and not just from season 1, it doesn’t seem very likely.

Why did they pull Season 6, Episode 4 Little Ricky Gets Stage Fright of I Love Lucy? Was that the one where he was got a smallpox vaccine?
Why did they pull Season 6, Episode 4 Little Ricky Gets Stage Fright of I Love Lucy? Was that the one where he was got a smallpox vaccine?

And keep in mind that it’s not uncommon for there to be missing episodes when you try to stream these older shows online.

Mostly remember that when you think that everything is a conspiracy, everything looks like a conspiracy, even when it is easy to find a more reasonable explanation.

More on the Brady Bunch Measles Episode Conspiracy

How to Avoid Getting Caught up in a Measles Outbreak

By now, you have likely heard the news that we are on track for record-breaking numbers of measles cases this year, both in the United States and around the world.

You may also have heard that some of the folks getting caught up in these outbreaks weren’t actually anti-vaccine, but were people who thought they already had measles or thought they were already vaccinated and protected.

How to Avoid Getting Caught up in a Measles Outbreak

Are you and your family protected against measles?

Six ways to avoid measles.

You might be thinking, “of course we are, we get all of our vaccines!”

But you still might want to double check, keeping in mind that:

  • only people born before 1957 are thought to have natural immunity to measles, because measles was very common in the pre-vaccine era
  • the original measles vaccine that was used between 1963 and 1967 was not thought to be effective, so if that’s the only dose you had, it should be repeated
  • a recommendation for a second dose of MMR didn’t come until 1990, so many people born before that time have only had one dose, especially since there was never a catch-up program to make sure older people had two doses. Even now, adults don’t necessarily need two doses of MMR unless they are in a high-risk group (foreign travel, healthcare workers, living with someone who has a compromised immune system, people with HIV, and students).
  • children don’t routinely get their first dose of MMR until they are 12 to 15 months old (one dose is 93% effective at preventing measles), with a second dose at age 4 to 6 years (two doses are 97% effective)
  • a third dose of MMR isn’t typically recommended for measles protection

Still think you and your family are protected?

In addition to routine recommendations, to avoid measles in a more high risk setting (traveling out of the country or during an outbreak), you should:

  • get infants an early MMR, giving them their first dose any time between 6 and 11 months of age (repeating this dose at age 12 to 15 months)
  • get toddlers and preschoolers an early second dose of MMR, giving them their second dose at least 28 days after the routine first dose that they received when they were 12 to 15 months old, instead of waiting until they are 4 to 6 years
  • get older children and adults two doses of MMR if they haven’t already had both doses

What if your baby is exposed to measles before you have a chance to get him vaccinated?

Younger infants who are less than six months old can get a dose of immunoglobulin within 6 days if they are exposed to measles. Older infants, children, and adults can get a dose of MMR within 72 hours if they are not vaccinated and are exposed to someone with measles.

And the very best way to avoid measles is to keep up herd immunity levels of protection in our communities. If everyone is vaccinated and protected, then we won’t have outbreaks and our kids won’t get exposed to measles!

More on Avoiding Measles