|Dr. Offit presents a flawed argument that “misguided” parents are to blame for the “reemergence” of infectious diseases. A deeper investigation into the statistics he quotes brings about a more accurate argument.
Dr. Offit, one of three inventors of a vaccine now marketed by Merck, presents a flawed argument that “misguided” parents are to blame for the “reemergence” of infectious diseases. A deeper investigation into the statistics he quotes brings about a more accurate understanding of what is truly happening with regard to these illnesses.
He focuses mainly on outbreaks of pertussis in California. First, it must be noted that the raw numbers of pertussis cases reported in the media are not reflective of lab-confirmed pertussis; they also include “suspected” cases which could actually be infection with B. parapertussis, known to cause “pertussis-like illness”. There is evidence in peer-reviewed literature of the mutation of the pertussis bacteria as the direct result of vaccination. The mutated version, B. parapertussis, is not covered by the current vaccine and reports referring to pertussis outbreaks do not distinguish between which patients had lab confirmed pertussis and which had the mutated bacteria. Second, he points to 58 ICU admissions for pertussis so far this year. The AAP has recently recommended early ICU intervention – even for those whose eventual disease progression doesn’t warrant it – because previously doctors had been ignoring the severity of the disease in a subset of children. So, the ICU numbers may not reflect true need for such treatment.
Dr. Offit spends much time on the incidence of pertussis in Los Angeles County, blaming declining vaccination rates in certain affluent areas. In fact, Los Angeles County public health records show that the pattern of whooping cough occurrence there matches not only the rest of California, but also the United States. Further, the rates of transmission among older children seem to be on the rise in the state, which corresponds to what the CDC refers to as “waning immunity” conferred by the DTaP vaccine. The CDC has also concluded that pertussis is a cyclical disease, not one that has ever been eradicated but rather one that peaks every 3-5 years. The CDC acknowledges that the peaks have recently grown larger, but they list “increased awareness, increased diagnostic tests, better reporting, more circulation of the bacteria, and waning immunity” as the causes.
Before one assumes that “more circulation of the bacteria” is due to an increase in vaccine exemptions, note that an FDA study last year found that baboons inoculated against pertussis became silent carriers of the bacteria, spreading the disease unknowingly for several weeks post-vaccination. The same phenomenon was found in a study, cited on the CDC website, that looked at the spread of pertussis in an Israeli daycare setting – children recently immunized were asymptomatic carriers of the disease and were giving it to infants.
Dr. Offit and others have rehashed a quote about vaccination rates in certain LA subdivisions matching those of sub-Saharan Africa. In particular, two private schools are named and their percentages of fully vaccinated students are criticized. However, no one has bothered to explore whether these two schools have had any confirmed cases of “vaccine-preventable” diseases recently. As of the time of this writing, the two schools had not responded to my attempts to contact them.
It seems to me that these private schools are intentionally referenced as a distraction from the facts. According to the California Department of Public Health (CDPH), the percentage of children in the public school system that are fully immunized according to the recommended CDC schedule is nearly 91%. Private school children fall just below that, at nearly 87%. Further, the percentages of public and private school children who have four or more pertussis shots are 94.2 and 92.6, respectively. The herd immunity crisis picture that is painted by Dr. Offit is simply, and quite likely intentionally, inaccurate. The CDPH also reports that immunization coverage peaked across all school types in the 2010-2011 school year. This is significant simply because 2010 marked the last time CA had an “outbreak” of pertussis. If immunization rates among school children correlated with outbreaks, theoretically the 2010 outbreak would never have occurred.
Dr. Offit says that stories about vaccine concerns disappeared after the 1990s because “study after study that these concerns were ill-founded”. I must take issue with that.
He then goes on to make a common argument that parents are simply not afraid of legitimately dangerous infectious diseases anymore because vaccines have been so successful at their elimination. I won’t touch upon whether his claim of success is true, but I will say this: Parents are not unaware of the risks of these diseases. Their older relatives undoubtedly have recounted stories of summers spent in bed with the measles or schoolmates with iron lungs. It isn’t about dismissing those stories, it’s about performing a current risk-benefit analysis for their own children.
As one of those parents, I can tell you that I have spent much time weighing whether my children are legitimately at risk of contracting a virus like the measles and how that disease would likely progress in the age of better and quicker detection and intervention. My personal choice, and that of parents like me, is to take that risk as opposed to subjecting my children, two of whom have had adverse reactions, to the possible risk of chronic illness which I find to be quite alarming and potentially more devastating. I didn’t conclude this because Jenny McCarthy told me so, I actually read the science (all of it) and considered my family’s experiences, both with adverse reactions and previous contraction of vaccine-preventable diseases (I have had chicken pox and shingles; my mother has had measles, mumps, and chicken pox; my husband’s grandmother has told me stories about polio striking in her school as a child). Personally, I had paid little to no attention to Jenny McCarthy’s own stance until after I had made my decision.
It’s time that healthcare professionals cease demeaning parents who question vaccine safety and instead acknowledge the validity of their fears, because they are justified. It is well past time that the media discontinue perpetuating misinformation simply because it makes for good headlines and provides unsure parents a black and white (though wholly inaccurate) picture about vaccine pros and cons. According to recent polling data, over 50% of Americans question vaccine safety and that number will likely increase in the future. This large percentage of people cannot be continually and publicly disdained. By just closing the door on discussions and dismissing people as “misguided” or “stupid” (as the writer of the LA Times article, referenced by Dr. Offit, calls these parents), doctors and other vaccine promoters are further sowing the seeds of doubt.
In Response to “The Anti-Vaccination Epidemic” by Paul A. Offit