Who’s Afraid of a Little Vaccine

by Jeffrey Kluger,

People who are reluctant to vaccinate their kids often think they know better than the doctors.

I’ve felt ridiculous plenty of times in my life, but rarely so much as the day I took my first daughter to the doctor to get her first round of vaccines. It was a routine visit during which her weight, length, alertness and other basic metrics would be checked. But at the end of the appointment would come the shots.

When that time arrived, I held my daughter in my lap, knowing two things she could not: that in a few seconds, she’d be howling in pain and outrage and that the needle that would be plunged into her wonderfully chubby thigh would introduce a stream of viral traces into her otherwise clean and pristine immune system. I was seized by a sudden fear that I was doing a very bad thing.

That’s what the people behind the antivaccine movement would have me believe, but I knew better–and for a long time, so did most American parents. In 1952 there were 57,879 cases of paralytic polio in the U.S. By 1961, just six years after the vaccine was introduced, the number was 1,312–a 98% reduction. Today the figure is zero. In the 1950s, before the introduction of the measles vaccine, 3 million to 4 million Americans contracted the disease each year and 48,000 were hospitalized. In 2012 there were just 55 cases.

But recent outbreaks of measles in New York City and Orange County, California; whooping cough throughout the entire state of California; and mumps in the communities around Ohio State University in Columbus suggest that the hard-learned lesson that vaccines are not only safe but also critical to the health and safety of all children is being unlearned.

For most diseases, vaccination rates must remain very high–up to 95% in some cases–to establish what’s known as herd immunity, the protection provided by an entire community to the handful of people who can’t be vaccinated because of a demonstrable medical condition. In the U.S. at large, the numbers are pretty good, with close to 95% of incoming kindergartners in compliance with vaccine guidelines, according to a 2012–13 survey from the U.S. Centers for Disease Control and Prevention (CDC).

But that figure conceals a lot of holes. Louisiana has an impressive 96.6% rate for the measles, mumps and rubella (MMR) vaccine and a 98.3% rate for diphtheria, tetanus and pertussis. Mississippi leads the nation with a near perfect 99.9% for both. California, meanwhile, clocks in at just 92.7% and 92.5%, and Colorado rolls in last at a woeful 85.7% and 82.9%.

In New York City, vaccination rates in public schools top 98%. But a recent survey of 245 of the city’s private schools revealed that half of them are below 90%, and 37 of them are below 70%. Nine schools fall in a range from 41% down to 18.4%.

In Ohio, it’s not all of Columbus that’s turned against vaccines; it’s mostly places like the Clintonville community, an upscale neighborhood where the antivax movement has gained traction. “There are a lot of university employees living there,” says Misti Crane, a reporter for the Columbus Dispatch who, along with co-investigator Jennifer Smith Richards, analyzed statewide vaccination rates and led the charge in establishing the high-income, low-vax link. “They are dual-income and college educated. It’s a community of ‘Hey, I know better.’”

But what these folks think they know just ain’t so. And not only are their own children being put in danger, but so, potentially, are everyone else’s.

Julie Snoeberger doesn’t care what you want to call her–and there are few names you could come up with that she hasn’t heard before. “I’ve been called a crackpot and a baby killer,” she says.

Snoeberger began steeling herself against this kind of criticism more than 15 years ago, when her baby son began getting his first rounds of vaccines. After his 12-month shots, he developed chronic ear infections. At 18 months, she says, the MMR vaccine transformed him within 48 hours from a happy, verbal child to one who was violent, antisocial and had “lost all his words.”

The medical community has heard stories like this before and patiently refutes them: if her son developed signs of autism, they were linked not to the vaccine but to the simple fact that the disorder often begins to present itself at the same age at which kids start getting vaccinated. And as for ear infections, well, they are practically ubiquitous among babies.

The arguments that have been central to the antivaccine movement for decades are familiar: The shots are overused and teeming with toxins. They cause autism, bipolar disorder, ADHD, allergies and more. They are profit centers for greedy doctors and Big Pharma, and everybody’s keeping the dangers quiet. “The conspiracy theories come up a lot,” says Joan Bowe, director of personal health for the Delaware County General Health District in Ohio, which was hit by the mumps epidemic earlier this year. “They usually involve the government wanting the vaccines out there.”

None of that is true.

“As I perceive it, vaccines should be an elective procedure,” says Dr. Janet Levatin, who practices near Cleveland, citing measles as one argument in favor of that belief.

Other doctors–those who support vaccines–have a number of ways to deal with patients who believe the shots are dangerous. Some simply refuse to treat the family.

Why So Blue?

There are a lot of theories about why vaccine denialism is such a problem in left-leaning communities, and one of the most persuasive is the master-of-the-universe phenomenon. The wealthier you are and the higher your education level, the more you lose sight of the randomness of misfortune and come to believe you can control variables and eliminate risk.

“When people achieve a certain status, they think they’re invincible,” says Roberts. “They think it will never happen to them, and if it does, they’ll have the resources to deal with it.”

Persuading the Avoiders

One way epidemiologists and psychologists have found to open people’s eyes to the dangers of vaccine avoidance is to frame the risks not in general terms–the numerical odds of contracting a disease–but rather the specific consequences. Mumps can cause deafness, for example, and, says Roberts, “once we see those complications, vaccine rates go way up.”

The vaccine opponents are not going away anytime soon, though encouragingly, some are going dark. Playboy model and talk-show host Jenny McCarthy, who more than anyone else lit the antivax fires, speaks little of the matter anymore. Parents who don’t vaccinate increasingly complain that they are becoming pariahs in their communities, resented by parents who seek to protect their own children and see the antivax parents as undermining their efforts. Some doctors view this kind of impromptu, parent-on-parent persuasion as the best way to bring vaccine opponents around.

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