Pediatricians spend a lot of time discussing the importance and safety of vaccines with parents.  Occasionally, parents will refuse vaccinations — putting their children, their neighbors and classmates, their grandparents and elderly acquaintances, their pediatricians and staff, and total strangers in potentially grave danger.  Some parents express to us their desire to split up or delay vaccinations, even though there is absolutely no logical, practical, or scientific reason for doing so.  Somehow some parents have gotten it into their heads that all this is acceptable. And informed.  And reasonable.  And common.

Except it’s not.

According to the CDC, national vaccination coverage rates have been increasing, not decreasing.  In fact, by 2011:

The percentage of children who had not received any vaccinations remained at <1%.


So who are these children who receive no vaccines, and where do they live?  A 2004 study published in Pediatrics remains relevant today:

The study found marked differences in the characteristics between children who were completely unvaccinated, those that either received some vaccines, and those who were fully vaccinated as recommended.


The reasons for children being under-vaccinated are totally different from those who are un-vaccinated.  And their ranks may be increasing due to the economic downturn beginning in 2007:

Children who had received some but not all recommended doses (undervaccinated) tended to be black and had a younger, often-unmarried mother who had less education than fully immunized children. These underimmunized children were more likely to live in a household below the poverty level, with more children, and had moved across state lines.


How about those parents who outright refuse vaccines?  How different are they?

Compared to undervaccinated children, unvaccinated children were more likely to be non-Hispanic white, have a mother who was older, married and who had a college degree. These children were more likely to live in a household with an annual income exceeding $75,000.

Compared to fully immunized children, unvaccinated children were more likely to be non-Hispanic white and live in larger households. Educational levels, family income and other factors did not differ.


And where do these pockets of anti-vaccine people live?

Many children with no vaccinations lived in counties in California, Illinois, New York, Washington, Pennsylvania, Texas, Oklahoma, Colorado, Utah, and Michigan.

States that allowed philosophical exemptions to immunization laws in schools had many more unvaccinated children than states that do not have philosophical exemptions.


Elimination of religious exemptions to immunization laws is out of the question, but Amy Norton finds in this week’s JAMA that personal belief or philosophical exemptions are on the way out:

In the new study, researchers found that although lawmakers in other states have tried to introduce personal belief exemptions in recent years, none has been successful.

On the other hand, three states that allow the exemptions — California, Vermont and Washington — have recently passed laws to curb them. Basically, the states have increased the red tape parents face when applying for an opt-out on philosophical grounds.


There are real life and death reasons why parents who opt-out of vaccines for their children for “personal beliefs” are now getting the hairy eyeball:

That’s at least partly in response to concerns about disease outbreaks. In 2010, for example, California had an outbreak of whooping cough that sickened more than 9,000 people and killed 10 infants — most of whom were too young to be vaccinated.

In a recent study of that outbreak, researchers at Johns Hopkins University found that whooping cough cases tended to concentrate in areas of the state with the highest rates of personal belief exemptions.


The lead author of the JAMA study wants the science to inform parents of the need to get vaccinated:

“Previous studies have shown that high vaccine refusal rates tend to increase the risk of vaccine-preventable disease in the whole community — including for those who are vaccinated,” Omer said. “So it is in everyone’s interest to ensure that their community has high vaccination rates.”


John Duffy has pretty much had it:

A week or two ago I posted in a blog elsewhere about the anti-vaccination crowd, noting I’ve seen 2 lines of thought. The first are the ones who truly believe they have properly researched the evidence and are making the best decision. Unfortunately, and sadly, they really don’t have a clue how to scour critical literature and make the proper inferences. They often regurgitate what they have seen on alt medicine websites…information that is simply wrong and has no scientific merit. Their children often lose in this scenario…..sometimes with their life.

I’ve had discussions with these people…and it’s pretty easy to quickly shoot down all their supportive “evidence”.

The other group feels there is some vast conspiracy going on…with big pharm making vaccines just to make big money, and create new problems that will mean even more big money. They also believe planes are spraying us with chemicals and other secret processes….you know..the same government that can’t even get a website up and running or have an effective postal service. I doubt we’ll ever change the minds of this group.


I can’t post the spot-on-but-completely-inappropriate-for-The PediaBlog video Duffy links to, but you can watch it here.

Recent PediaBlog on vaccines here.