As vaccination rates decline, old diseases are making a sharp comeback
In less than two decades, the rate of unvaccinated children age 19 to 35 months has quadrupled, growing from 0.3% of toddlers in 2001 to 1.3% of toddlers in 2015.
The increase in the anti-vaccination movement is partially responsible for the steep decline in toddler vaccination rates, as is the trend of lower vaccination rates among the uninsured, Medicaid-insured and those living in rural areas.
In 2017, 2.8% of all children were uninsured, but 17.2% of unvaccinated children were uninsured, according to the Centers for Disease Control and Prevention (CDC). Transportation, availability of doctors and limited clinic hours all are additional barriers to kids getting vaccinated.
“Misinformation is a major driver,” says pediatric infectious diseases specialist Tina Q. Tan, MD, medical director of the international patient services program at the Ann & Robert H. Lurie Children’s Hospital of Chicago. “Vaccine access is also an issue.”
“The vaccines used in the U.S. today are the safest and most effective vaccines that have ever been used. Most contain no mercury and very small amounts of aluminum, which is used to improve the immune response,” she says.
Vaccines do not cause autism
But what about autism, a primary concern among parents who oppose vaccines? The behavioral symptoms of autism spectrum disorder (ASD) start to show around 12 to 18 months of age, which coincides with the standard vaccination schedule, specifically the MMR (measles-mumps-rubella) vaccine. And with autism rates rising — one in 59 children had an ASD diagnosis by age 8 in 2014, a 15% increase over 2012 — many parents are wondering if there’s a connection.
However, the association has been thoroughly researched, and many studies have come to the conclusion that vaccines and autism are not linked.
“There is no link between vaccines and autism,” the CDC says. “Some people have had concerns that ASD might be linked to the vaccines children receive, but studies have shown that there is no link between receiving vaccines and developing ASD.”
Many studies show no connection, including a large study published in JAMA in 2015 that analyzed the health records of 95,727 children and concluded that “receipt of the MMR vaccine was not associated with increased risk of ASD.” Also, a 2014 study in the New England Journal of Medicine points to evidence that autism begins in pregnancy.
Choosing not to vaccinate
Yet some parents are still choosing not to vaccinate. When Alison, a Chicago mother of three who requested that her name be changed for privacy, was vaccinating her first two children in 2001 and 2003, she looked at the manufacturers’ lot numbers for the specific shots they received and found that the vaccines were high in mercury and aluminum, both of which are known neurotoxins.
She says her children experiencedtroubling side effects from the vaccines. Her kids have genetic mutations that make it difficult for them to rid heavy metals from their bodies and to mount appropriate immune responses to several viruses at once, she says.
“The vaccines used in the U.S. today are the safest and most effective vaccines that have ever been used.”
For Alison’s second son, days after the MMR shot, sensory issues quickly developed, and he could no longer tolerate bright lights, loud noises, clothing with tags or sand touching his hands, she says.
Alison says her first two children required years of behavioral and physical therapies along with dietary changes. She chose not to vaccinate her third child, who shows no signs of autism. “I am not anti-vaccine; I am pro-research, pro-feedback and pro-conversation,” she says.
Vaccines can stop the spread of diseases
But while it may be a parent’s choice not to vaccinate their child, there are well-documented consequences for other children and adults around them.
Herd immunity, which occurs when a significant portion of the population is vaccinated either through vaccines or natural disease, can prevent the spread and transmission of disease in the community. The fewer immune individuals in that herd, the more disease that’s being spread.
One of those vaccine-preventable diseases, measles, has been in the news a lot lately following outbreaks in Portland, Vancouver, New York and Texas. Measles cases have been rising due to gaps in vaccination coverage. In 2017, there were 120 cases of measles reported nationwide. In 2018, there were 372, including one confirmed case of measles in Chicago. And by mid-2019, there were 839 cases of measles in the U.S.
“For herd immunity, the portion of the population that needs to be vaccinated differs depending on the disease,” Tan says. For measles, that portion is 95%. “This provides protection for those in the community that are too young to be vaccinated or cannot be vaccinated for a variety of medical reasons,” she adds.
When children are not vaccinated according to the recommended schedule, it leaves them vulnerable to vaccine-preventable diseases, like measles, which they can contract and spread to others in the community.
“There are no shots that we consider being okay to delay,” says pediatrician Scott Goldstein, MD, of Northwestern Children’s Practice. “Any shot that a parent delays leaves their child vulnerable to getting that disease.”
“I think vaccines should be mandatory for attending childcare [and] school, with exceptions for the very small minority of children who have medical reasons to not receive them,” he says.
So where is the vaccine debate headed? It’s hard to tell. But what we do know is that finding ways to increase immunization rates — be it through improving access to care or addressing anti-vaccination claims — is key to getting diseases like measles back under control.