Tag: pockets of susceptibles

Can You Go to Jail for Not Vaccinating Your Kids?

Believe it or not, parents have been jailed for not vaccinating their kids.

In a recent Michigan case, a mother was jailed for refusing a court order to vaccinate her son. The court had agreed with the boy’s father that the child should be vaccinated and protected.

So this case was not just about vaccines, but about divorced parents who disagreed about how to care for their child…

Can You Go to Jail for Not Vaccinating Your Kids?

Although it isn’t common, historically, there have been other stories of parents going to jail for not vaccinating their kids.

Parents in Maryland were surprised that they might face jail time for not vaccinating their kids.
Parents in Maryland were surprised that they might face jail time for not vaccinating their kids.

Recently, in 2007, parents were warned that they might be sent to jail for not vaccinating their kids. The problem wasn’t just vaccines though, as these parents could have gotten exemptions. And they had several months to do so before the Judge gave his warning…

No one went to jail in Maryland in 2007.

Have you ever heard of John (Jack) Marsh?

Going to jail for not vaccinating his kids became routine for John Marsh.

In 1946, he was put in jail and his daughter, Betty Jane, was taken by child welfare services so that she could get a smallpox vaccine. His son Marlin was also to be taken, but couldn’t be found.

What happened next? We don’t know. That was the last report about John Marsh and his family.

We do know a lot about what happened before this though…

John Marsh was first jailed in 1937 for not vaccinating his kids.

John Marsh’s story started nearly 12 years earlier!

In 1934, he spent 7 months in jail because he wouldn’t vaccinate his children Daniel and Lorna. As in 1946, those children were taken and vaccinated and Marsh was released.

John Marsh was again jailed in 1937 for not vaccinating his kids.

He was also put in prison in 1937 over getting his son Eugene vaccinated.

John Marsh was jailed over and over from 1937 to 1940 because he wouldn't vaccinate his kids.

Why was he against vaccinating his kids?

John Marsh believed that his nieces were vaccine injured.
John Marsh believed that his nieces were vaccine injured.

He believes that a smallpox vaccine caused two of his nieces to go blind. One of them became blind about two weeks after getting her smallpox vaccine. Two weeks later, her sister also became blind. And then another.

What could have affected these girls in 1925 besides Mildred’s smallpox vaccine? Trachoma was once a common cause of blindness in the United States and it was quite contagious.

Even though two weren’t even vaccinated, the family still thinks that they all suffered from some kind of vaccine injury.

“The infrequency of eye involvement following vaccination is very striking when we consider the number of vac­cinations, the doubtful handling that many receive, and the ease with which infection may be transferred.”

Arthur J. Bedell, M.D., F.A.C.S. on Multiple Vaccination of the Eyelids

Interestingly, ocular vaccinia is a known, rare complication of getting a smallpox vaccine. It could occur if you touched the site of vaccination and then touched your eye, and so could also occur if you were in close contact with someone who was recently vaccinated, as the Marsh sisters.

Unlike these girls though, the infection typically only involves one eye, would cause lesions suspicious for vaccinia in or near the eye, which were never mentioned, and often leaves obvious lid deformities.

And doctors did not believe that those girls had a reaction to the vaccine.

John Marsh never won any of his cases and his kids always ended up getting vaccinated...
John Marsh never won any of his cases and his kids always ended up getting vaccinated…

Are there any other cases of parents going to jail instead of vaccinating their kids?

In 1899, apparently there wasn't a religious exemption to getting vaccinated.
In 1899, apparently there wasn’t a religious exemption to getting vaccinated.
Yes, we had anti-vax chiropractors way back in 1926.
Yes, we had anti-vax chiropractors way back in 1926.
In 1942, Bowser's two children were admitted to a county Children's home and vaccinated, as they had never been to school.
In 1942, Bowser’s two children were admitted to a county Children’s home and vaccinated, as they had never been to school.
This was in 1924, but just like today, these parents didn't win their court case.
This was in 1924, but just like today, these parents didn’t win their court case.

Could any of this happen now?

We still have truancy laws and laws about kids getting vaccinated…

Jack Marsh had an alternative to going to jail over not vaccinating his kids...
Jack Marsh had an alternative to going to jail over not vaccinating his kids…

But no one wants parents to go to jail over vaccination decisions.

And no one wants kids to be forced to get vaccines.

Vaccination laws were being strictly enforced to try and control outbreaks and epidemics of smallpox, which still occurred in the 1920s and 30s.
Vaccination laws were being strictly enforced to try and control outbreaks and epidemics of smallpox, which still occurred in the 1920s and 30s.

We also don’t want kids to get sick and disease to spread because of ignorance and unnecessary fear of vaccines.

Who is scaring these parents in the first place?
What is scaring these parents in the first place?

Unfortunately, anti-vax folks create a viscous cycle.

As they scare more and more parents, they create pockets of susceptible children, and larger and larger outbreaks of vaccine-preventable diseases, which eventually require stricter vaccine requirements and mandates to control.

More on Jail and Vaccines

Vaccination Coverage and Exemption Rates

With record numbers of measles cases this year, lots of folks are interested in vaccination coverage and exemption rates.

You are at increased to get sick and can spread diseases if you are unvaccinated.
You are at increased to get sick and can spread diseases if you are unvaccinated.

Even though our own kids are vaccinated and protected, many of us are concerned about vaccination and exemption rates because we understand the risks.

We know that some kids are too young to be vaccinated and some kids can’t be vaccinated, as they have true medical exemptions.

Vaccination Coverage and Exemption Rates

So how are our vaccination and exemption rates doing these days?

Some states have rates of vaccine exemptions that are much higher than others, with rates from ranging from a low of 0.1% in Mississippi to a high of 7.7% in Idaho and Oregon.
Some states have rates of vaccine exemptions that are much higher than others, with rates from ranging from a low of 0.1% in Mississippi to a high of 7.7% in Idaho and Oregon.

According to the latest reports from the CDC:

  • the percentage of kindergartners with a vaccine exemption continues to slowly rise and is now up to 2.5%, up from 2.3% during the 2017-18 school year
  • an additional 2.8% of kindergartners were not up to date for MMR and did not have a vaccine exemption
  • the percentage of kindergartners up to date for MMR ranged from 87.4% in Colorado to 99.2% in Mississippi
  • coverage by age 24 months was ≥90% for ≥3 doses of polio- virus vaccine (92.7%), ≥1 dose of MMR (90.4%), ≥3 doses of HepB (91.0%), and ≥1 dose of varicella vaccine (90.0%), and are all up over previous years by 1 to 3%
  • only 56% of toddlers receive two or more doses of the flu vaccine by age two years
  • only 1.3% of children born in 2015 and 2016 had received no vaccinations by the second birthday, which is up from 1.1%
  • up to 7.4% of uninsured children received no vaccines, even though they qualify for free vaccines under the Vaccines for Children program

This doesn’t tell the whole story though.

“During the 2018–19 school year, national coverage with MMR, DTaP, and varicella vaccines remained near 95%. However, coverage and exemption rates varied by state. Recent measles outbreaks in states with high overall MMR coverage, such as New York, highlight the need for assessing vaccination coverage at the local level. ”

Morbidity and Mortality Weekly Report, Volume 68, Issue Number 41 Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2018–19 School Year

Although vaccination rates are generally high and exemption rates low at the state and national level, it is the pockets of undervaccinated kids that are the problem.

In Texas, for example, although state level exemptions are fairly low (2.4%) and immunization rates high, in some communities and school districts, more than 50% of kids are unvaccinated!

“The importance of achieving and sustaining high vaccination coverage across all communities is illustrated by the 22 measles outbreaks occurring in the United States in 2019, with 1,249 measles cases identified during January 1–October 1, 2019. Most cases have been among persons who were not vaccinated against measles. Pockets of low vaccination coverage, because of lack of access to vaccination services or to hesitancy resulting from the spread of inaccurate information about vaccines, increase the likelihood of a measles outbreak. “

Morbidity and Mortality Weekly Report, Volume 68, Issue Number 41 Vaccination Coverage by Age 24 Months Among Children Born in 2015 and 2016 — National Immunization Survey-Child, United States, 2016–2018

Unfortunately, we don’t see that kind of local data in the latest reports on vaccination coverage and exemption rates.

And while we should certainly work to get everyone vaccinated who doesn’t have an exemption, lots of work needs to be done educate parents that they should vaccinate and protect their kids instead of seeking non-medical exemptions.

More on Vaccination Coverage and Exemption Rates

Which Part of the Herd Gets Protected by Community Immunity?

You are a part of the herd.

“I don’t care that you call people a herd. And I don’t care that some people consider themselves to be part of a herd. I am not in a herd. I am not a farm animal.”

Del Bigtree

Of course, we are talking about herd immunity.

Which Part of the Herd Gets Protected by Community Immunity?

What if you aren’t vaccinated and protected?

Del Bigtree is a "free thinking human being," who whether he appreciates it or not, benefits from herd immunity protections.
Del Bigtree is a “free thinking human being,” who whether he appreciates it or not, benefits from herd immunity protections.

Then you are protected by those who are!

“A situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community.”

CDC Vaccine Glossary of Terms

That’s what herd immunity is all about.

In a community, “the herd” includes those with immunity and those trying/needing to “hide in the herd:”

  • those with natural immunity
  • folks who are vaccinated and protected
  • some people who are too young to be vaccinated or fully vaccinated
  • the people who’s vaccines didn’t work
  • anyone who can’t be vaccinated, because they have a medical contraindication

And it also includes those who are intentionally unvaccinated. The free-riders. Those who could be vaccinated, but simply choose not to, often because they have been scared by things they have heard or read about vaccines.

Baby deer need protection from the adults in the herd, but that doesn't mean that they aren't a part of the herd too.
Baby deer need protection from the adults in the herd, but that doesn’t mean that they aren’t a part of the herd too.

This all makes even more sense when you think about it as community immunity, the term that is more commonly used today.

Don’t want to think that you are in the herd?

That’s OK.

The herd still protects you. At least it does if enough folks in the herd are vaccinated and protected.

More on Community 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