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Vaccinations in California schools

Googlemap200 Times staff writer Ron Lin and data analyst Sandy Poindexter reported Sunday on the growing number of California parents who are sending their children to school without inoculations for childhood diseases.

The Times found that vaccine exemptions for kindergartners -- which allow them to enroll without having state-mandated immunizations -- had more than doubled in the last decade, leaving hundreds of schools in the state vulnerable to outbreaks.

The rise in unvaccinated children appears to be driven by affluent parents choosing not to immunize. Many do so because they fear the shots could trigger autism, a concern widely discredited in medical research.

The report sparked intense reactions both from those who believe vaccines are harmful and from others upset that a rising number of parents are opting out of immunizations. Check out your local schools using The Times schools database and use our interactive map to see which Southern California school might be at risk.

Keep reading to see answers to:

"What are autism rates among immunized versus non-immunized children?"

"I don't understand why an 'outbreak' is being 'triggered' if the vast majority of students (and others) HAVE been vaccinated."

"Can you please explain what risk the kids without the shots are to the kids that have had all their shots?"

"If people choose to immunize their own children, what is it that they are worried about?"

"What do medical professionals say about advising pregnant women not to eat food high in mercury and then giving babies vaccines that contain mercury?"

What are the autism rates among immunized versus non-immunized children?

The risk of autism was the same for children immunized and not immunized for measles, mumps and rubella, according to a study of more than 500,000 Danish children published in the New England Journal of Medicine in 2002. Researchers analyzed data on all children born in Denmark between 1991 and 1998 using the Danish Psychiatric Central Register, a database that has information on every diagnosis given in a Danish psychiatric hospital and outpatient clinic. Overall, there was no increase in the risk of autistic disorder or other autistic-spectrum disorders among vaccinated children as compared with unvaccinated children, researchers concluded.

I don't understand why an "outbreak" is being "triggered" if the vast majority of students (and others) HAVE been vaccinated. Are the vaccines not working, such that vaccinated persons exposed to measles, for example, are still developing disease?

Outbreaks can occur when there are enough non-immunized people in a group, allowing a disease can spread from one person to another. In a measles outbreak last year that infected a dozen children and infants in San Diego, none had been vaccinated. Three of them were infants too young to receive the inoculation.

If a high percentage of a group is vaccinated, even those who are not immunized are effectively protected by what is known as "herd immunity." In practice, this means a child either too young to be fully vaccinated or unable to get vaccinations for medical reasons, such as allergies or a compromised immune system, would still be safe.

But the U.S. Centers for Disease Control and Prevention estimate that infections can spread quickly within a group when as few as 5% to 10% lack vaccination.

Can you please explain what risk the kids without the shots are to the kids that have had all their shots?

Children are largely protected against the diseases from which they are vaccinated. Still, vaccines can fail to work in a small percentage of cases, when the immune system does not respond to the inoculation. In those cases, they may fall ill. When "herd immunity" is intact, a child whose vaccination failed to work would still be protected, as would others who could not be vaccinated for medical reasons.

If people choose to immunize their own children, what is it that they are worried about? If their kids have the shot, then isn't their child immune to that disease? Wouldn't outbreaks not be of concern to them since they are so-called protected? Talk about control freaks!

Although rare, vaccinations can fail to work. And non-immunized children may come in contact with infants too young to be immunized, and those who cannot be be vaccinated for medical reasons, because they either have a weakened immune system or are allergic to a vaccine's ingredients

In the San Diego case, three infants who came in contact with the infected boy at the doctor's office were sickened. In all, 70 children were quarantined there, including children at a daycare center attended by one of the infected babies.

On a larger scale, public health officials say high rates of immunization help eradicate diseases; smallpox was eradicated in 1979 based on an intense immunization campaign. Until a measles vaccine was available in the mid-1960s, the disease killed 450 a year in the U.S. and caused 4,000 cases of encephalitis, according to the CDC. Measles, which had been eradicated in England and Wales, has seen a resurgence there because of dropping vaccination rates. British public health officials have declared the disease once again endemic.

What does the medical community have to say about the fact that during pregnancy women are advised not to eat certain fish, due to mercury content, yet when the babies are born they are injected with some vaccines that contain mercury?

There is a difference between the mercury found in fish and the mercury once found in routine childhood vaccines. The version found in fish is known as methylmercury, which can accumulate in fish and humans. The kind that was used in vaccines is known as ethylmercury, which does not accumulate in the body and is actively excreted via the gut, according to the World Health Organization.

The distinction is not trivial, wrote Dr. Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia, who wrote about the issue in his book, "Autism's False Prophets," published in 2008.

"An analogy can can be made between ethylalcohol, contained in wine and beer, and methylalcohol, contained in wood alcohol," Offit wrote. "Wine and beer can cause headaches and hangovers; wood alcohol causes blindness."

The mercury-based preservative thimerosal has been taken out of routine childhood vaccinations since 2001. The preservative does remain in some flu shots; thimerosol-free flu shots are also available.

The preservative was removed from vaccines as a precautionary measure, even though there was no proof that thimerosal was harmful. Researchers later looked to see if thimerosal was causing autism; subsequent studies have concluded that the mercury-based preservative was not at fault. One such study found that autism rates continued to rise in California even after the preservative was phased out of routine childhood vaccinations.

-- Rong-Gong Lin II

Comments () | Archives (26)

This is a public health issue and should not be left to a parent's decision based on religious or airy-fairy pseudo-scientific beliefs.
These childhood diseases disabled millions of children in the past. You might be able to get away with not vaccinating your child if all the other children are, but there is a tipping point when too many are not vaccinated and disease breaks out.

If someone had Ebola virus or smallpox, we would not think twice about running over the sufferers civil liberties to keep the rest of the population safe.

This is exactly the same issue.

Anti-vaxxers are complete idiots. The one reassurance I get from them is that at least when an outbreak occurs there will be a good chance that their defective genes will be removed from the pool. Too bad they may take others with them.

Why are shots only recommended in many other countries and not required like in the US? Why are our children the sickest?
Los Angeles

What about the educational and business issues? If my two vaccinated teenage sons have their schools closed for two weeks due to an outbreak--or the schools stay open and teach the vaccinated--will the post-outbreak curriculum then re-cover the same material for the unvaccinated? If it's half the class that's out, the teachers would have no choice but to re-cover the material. (and the schools are broke--who will fund after school makeup classes, if they need to go that route?). The school year is already too short, the classes in public schools are huge (high school classes have 40 kids in our top-ranked district), so an outbreak has educational consequences as well. And if it's an AP class with a national test at a fixed time, that two week delay has other ramifications. As an employer, how do I run my small business if an employee has to stay home because their child is quarantined? there are all kinds of ramifications to people making these choices that ripple all through society. As long as they are prepared to deal with the non-medical consequences as well and not expect all the rest of society to make a special allowance for them, then it's their choice. I don't have any idea how you protect infants or pregnant women from the unvaccinated, though--that's a tough one.

I am an infectious disease epidemiologist, and I have a personal and professional interest in the topic of vaccination. Thank you for publishing this article. It highlights the uphill battle that the researchers in my field are fighting right now to keep our community (LA County, you are my community) safe from these preventable diseases.

Lin makes an excellent point noting that the bulk of the vaccine exemptions are highest among affluent, educated communities. The problem verges on a class war between the poorer members of community (many of whom are from regions where these vaccine-preventable diseases are both endemic and deadly) and the privileged, educated people who have become completely skeptical of science and policy. Essentially they are too "smart" for the studies and research that don't affirm their health beliefs. Vaccination is quickly becoming a vestige of the working class, and that puts us all in danger.

Thank you for busting through the most common vaccination myths and misunderstandings. But until we can find a way to socially market vaccinations that cuts through the anti-vaxxers' hubris, we will not see an end to the problem. I hope it doesn't take a child's death by measles encephalitis to convince the anti-vaxxers that they are on the wrong side of science.

While we're on the topic, let's not forget that adults need their boosters, too.

Its evolution in action. If parents don't
use their brains/tech their kids may
die. Any questions?

Thank you for publishing this article. As a microbiologist working in vaccine development I have been very concerned about the current vaccine scare, especially because of the lack of evidence to support the fear. Please continue to report on this subject so we don't find ourselves in a public health catastrophe.

Most of these parents have liimited knowledge in regard to the disease that vaccinations prevent. They have never seen people at Rancho Los Amigos who spent their entire lives in an iron lung. Or even those who only got a lifetime wheelchair from polio. They have never seen the results of typhus, whooping cough, measles or anything else. But you can bet these folks will the be first to sue when their child is dead or crippled from an outbreak.
We never had the autism rates in prior years that we have now. Its not vaccinations that cause it but something the parent is doing while pregnant or an environmental cause.

Why not encourage people to live in communities that suit their beliefs about medicine?

Science is all about trial and error, and the scientific community cannot claim to ever understand the issue 100%. Thats not science, its dogma. There is always a margin of error, and its very easy to confuse cause and correlation. Sceptics should always be allowed freedom to choose.

So let those who do not want the vaccinations, go to schools that do not vaccinate. The difference between the two, if indeed there is any, should then become apparant to everyone.

What makes me scpetical is that the vaccines do not always work. That shows that the situation is not fully scientifically understood. Often there is a problem called 'experimenter bias', were statistics are deliberately skewed to avoid data that does not fit with the thesis. $ being the motivator.

When you label people as 'idiots' you reinforce the idea that this is not science, but scientism : dogma. Try to keep an open mind.

Vaccines should be spaced out and given on a longer range schedule; instead they are all packed together and given to immune defenseless babies within the first day of birth. Is there any reason (other than an infected parent) for a day old child to be vaccinated for Hep B?

And when SIDS and autism rates unexpected and astronomically rise, no one really investigates the safetly of administering so many vaccinations within a short time span. When Japan limited the amount of vaccinations of their children, the mortality of their babies 2 and under went up. Why does the US have such a low infant mortality in comparison to other developed countries?

As for the Danish study referenced above, how about a comparison of their shot schedule vs that of the US for the same timeframe? And how about more recent data, especially in view of the continuous increases in the number of shots administered to American children versus other countries?

Why have the single vaccines gone away? Many parents would surely give the single shots to their kids on a modified schedule if these were available.

As for those advocating removing the decision out of the parents' control, let the government assume full responsibility for any harm (including autism) and any necessary therapies that occur as a result.

To address Lisa and JA Bain:

1. An apparent rise in the rates of autism is likely caused by both changes in diagnostic criteria plus overdiagnoses by doctors. Remarkably, SIDS deaths are down and have been on the decline since 1992. http://www.cdph.ca.gov/data/statistics/Documents/MO-SIDS-FactSheet.pdf for more info on that. Source is CA Dept. of Public Health.

2. Dogma can pertain to a philosophical debate. But when it comes to vaccinations, the benefit is evident fact. This is not a debate anymore. Science has produced repeatable outcomes showing measurable improvements in preventing morbidity and mortality through mass vaccination campaigns. Do we debate the importance of seat-belts in cars? Do we debate the sum of 2 plus 2? No, we don't. Likewise we don't debate the importance of vaccinations; doing so makes it seem as if both sides are equal when they're not.

3. Lisa implies that autism is being caused by vaccinations. As this story and so many scientific studies have shown, the two are not linked. She brings up the same argument because either she and those who agree with her aren't receiving the updated information (that autism and vaccines are not linked), or they are refusing to acknowledge it.

4. JA Bain plays the $$$ gambit and tries to accuse vaccines of being ineffective. As with all medical interventions, there is always a chance of side-effects (even from that Tylenol you just took for that headache you had this morning), and there is a possibility that the intervention did not work. Nothing is ever 100%, but the rates of truly-attributal adverse events and ineffectiveness are incredibly low in the case of vaccination. As for money motivations, vaccines are not profitable in the least, especially when one considers the price of research & development versus the revenues from administering them. It's hard to make money off a medicine that is price-floored and subsidized to make it available to the poor. It's be so much more profitable for drug companies, hospitals and doctors to just let the kids get sick and treat them when they're really bad off.

As soon as you see the name "Dr. Paul Offit" in any article about vaccines, you know that you're reading a pro-big pharma piece that will only give you one side of the story.

Offit is constantly on the TV espousing the wonders of vaccines. What he tries to obfuscate is the fact he benefits financially from the extremely profitable vaccine industry. Here are some facts about Offit.

In August 2000, the Committee on Government Reform of the US Congress issued a highly critical document called Conflict of Interest in Vaccine Policy Making. Dr. Offit was reprimanded by Congress and his actions were a primary focus of the report. The report singled Dr. Offit out for questionable voting as a member of the Advisory Committee ("ACIP") affiliated with CDC that adds new vaccines to the vaccine schedule. The report stated, "Dr. Offit began his tenure on ACIP in October of 1998. Out of four votes pertaining to the ACIP's rotavirus statement, he voted yes three times, including voting for the inclusion of the rotavirus vaccine in the VFC program. In 2006, Dr. Offit's vaccine, Rotateq, was added to the CDC's recommended schedule.

In May 2008, it was reported that, "Later in 2007, the Centers for Disease Control and Prevention reported that there were 117 confirmed cases of intussusception (twisted intestines) among recipients of Rotateq between March 2006 and June 2007." The FDA recalled the vaccine from the market, Rotashield.

This "life saving" vaccine was for a disease the primarily affects children living in developing countries. More kids died of the vaccine than die of the disease each year in the USA. Google Offit's name and see what he's really all about! Wake up America, because Big Pharma is going to be pushing more new vaccines every year, like the $900 course of Gardasil that has been getting so much bad press recently for killing and maiming young girls. Read about Texas Governor Rick Perry's role in Gardasil. Read about outbreaks of measles among vaccinated populations. Don't have blind faith in the APA, the CDC or the FDA. Educate yourself!

Congratulations on another one sided mainstream article on childhood vaccines. Similar articles have appeared all around the country over the past few months. I look forward to the day when a journalist does their OWN research on this subject and doesn't simply repeat talking points spoon fed to them from govt agencies or people in the field who make money off of these vaccines. The L.A Times article shows us that we'll unfortunatly have to wait a bit longer for such an article.

Responding to Rogue Epidemiologist, to extrapolate on her logic that, "Do we debate the importance of seat-belts in cars? Do we debate the sum of 2 plus 2? No, we don't. Likewise we don't debate the importance of vaccinations; doing so makes it seem as if both sides are equal when they're not," is absurd. We learn more and more each day about immune systems, and we find they are terribly complex. The physics of car crashes and simple addition cannot compare to the intricacies of immune systems, which react to all the food we ingest (including those that contain casein, glutein, phenols, etc.), antibiotics, other medicines we ingest and give our children, etc. No one person's body is like another, so broad generalizations do not work. We know we do not "know" everything about the effects of vaccinations on immune systems, nor should we assume that Big Pharma has our best interests in mind.

"When you label people as 'idiots' you reinforce the idea that this is not science, but scientism : dogma."

No, what you do is reinforce the idea that anti-vaxxers have no clue what they're talking about and that there is no credible link between vaccines and autism. That's not dogma, anymore than it would be to insist that those who want to teach that the earth is flat are 100% wrong. That's science.

And the Big Pharma canard is without merit. While it's true that they are motivated by profit, their assertions that vaccines are safe could only legitimately be questioned if there were ANY credible evidence that vaccines caused autism. Then anti-vaxxers might have a point. For example, the credibility of doctors employed by the tobacco industry that found no link between cigarettes and cancer was called into question, not simply because they worked for tobacco industry, but because of the OVERWHELMING contrary evidence that linked cigarettes to cancer.

But there is no such evidence linking vaccines and autism. So the notion that they sell drugs for money is true, but irrelevant. And it ignores the overwhelming number of pediatricians who strongly recommend vaccinations in the interest of public health and safety.

The pharmaceutical companies have their study of vaccine injury records in Denmark as proof that vaccines are safe. As the parent of a child with autism, I have a child who was taken to the hospital because of a high fever within hours of receiving his 18 month vaccines. Our child then lost his language and social skills over the next few weeks. Despite these concerns, his doctor refused to file a vaccine injury report. Based on informal polls are support groups and conferences, our son's situation is quite common.

We need to research children with autism and quit limiting ourselves to epidemiological studies on injury databases. The number of children with profound autism is alarming. If you doubt this statement, go talk with a local special education teacher. These kids will need care far beyond their parent's lifespan. This rise in profound autism will have long term impacts on our society.

David – I am sorry to hear of your child’s condition, but you make a basic error in logic: correlation does not equal causation. Just because two events happened near the same time, that does not mean that one caused the other.

You also show a clear misunderstanding of science. One anecdote does not equal proof. If there were any connection between vaccines and autism, that connection would become CLEARER when you look at larger numbers of children. That is what the Danish study did. Among the 500,000 children they examined, some number undoubtedly were diagnosed with autism. So the study DID research children with autism, as you suggest. And it found NO connection between autism and vaccines.

The long-term impact to society will be far greater if hundreds, or thousands, of children are permanently damaged from preventable diseases like measles, rubella, etc.

beeblebrox and others here suggest that, "...there is no such evidence linking vaccines and autism." Look at the recent Hannah Poling ruling, as well as the award for the case of Bailey Banks. In both cases, direct links were made between these children's regression into autism and the vaccinations they received. Thus, despite other cases that have been overturned, there is evidence of such a link. Even authorities such as Dr. Bernadine Healy, former head of the National Institutes of Health, has said, "I think public health officials have been too quick to dismiss the [vaccine-autism] hypothesis as 'irrational,' without sufficient studies of causation... without studying the population that got sick. I have not seen major studies that focus on 300 kids who got autistic symptoms within a period of a few weeks of the vaccines." So, rather than being an "anti-vaxxer," I'm a "pro-sciencer," investigating links that seem evident to many parents of kids with autism.

Rogue epi:

To say that 'this is not a debate, whilst clearly debating the issue, goes beyond reason in blatantly illogical terms.

The two sides of the DEBATE are not equal, or else there would be no debate. Clearly. Once more the pro-vaxxers sprout illogical unreason.

My point of view was one of sceptism, not pro or anti. Its one of science which clearly points out, that there being two points of view, then they should be tested by any who choose to test them. You underscore my point that the pro-vaxxers have a dogmatic approach - this sways the argument against them being reasonable scientists.

You wish to prevent science from being tested! What are you so afraid of?

I am now anti-vaccine. And would equate positive advance in mortality rates to improved sanitation and better eating habits.

Viruses are not understood. Bacterium are understood. Chalk and cheese.

To Christine P: You seem to have a profound misunderstanding of not only science, but logic as well. You stated that "correlation does not equal causality," when the arguments for the alleged benefits of vaccination hinge on exactly that argument. If an inexplicable illness that begins the day, or even the week, of vaccination cannot be considered proof that it was caused by vaccination, then neither can the dropping rates of illness that occur once a vaccination program is instituted.

So by your reasoning, there is no proof of the health benefits of vaccines. And by my reasoning, there can be no scientific proof that they prevent disease, because you cannot use science to prove a negative.

The reason we all believe that vaccines save untold thousands of lives is because for years we were told during filmstrips and movies in elementary school, on TV specials and in movies--simply stated, the "knowledge" has been conditioned into us. As children we lack critical thinking skills, and the beliefs that form often last a lifetime, regardless of their validity. To come to the truth of a matter inculcated in this manner requires mature critical analysis of all the evidence, not just exposure to headlines and sound-bites that are designed to reinforce the original conditioning.

Brian - To the contrary, there is overwhelming evidence that vaccines prevent illness. How do you think that polio was eliminated from developed countries? (To name just one of many examples.)

To suggest that the health benefits of vaccines are nothing but a matter of belief, based on "filmstrips and movies," takes your argument into the realm of complete absurdity.

Vaccines save lives. It is not a matter of debate. It is a fact. They have saved thousands of lives, and will save thousands more. The idea that a parent would risk their child being killed by a completely preventable disease, based on a groundless fear, sickens me.

I am going to try and synthesize both points of view:

1) Vaccines prevent illnesses
2) Multiple Vaccination causes autism

There are strong arguments for both.

A viable conclusion would be that it is something in the vaccination process (not the chemical agent) which is causing the autism.

Autism is not clearly understood. It seems to me that it is a psychological condition (extreme introversion), and that it is caused by the severe trauma (psychological fear) that the child experiences when undergoing multiple and mass vaccinations.

Is it possible to administer the vaccine without injection (needles)? Perhaps if the parent went with the child, and also had a shot, also got a sweetie (from a random lucky packet would focus the childs attention away from the shot).

Telling the child 'this is not going to hurt', when it does clearly hurt, reinforces the psychological withdrawl. They also then tell the other children that the nurse/doctor is going to lie to them and hurt them. For a child to suffer thus, when they are not sick, and have not done wrong is extremely traumatic.

This is of course theoretical, and there is nothing to lose from trying to detraumatise the vaccination process.

It may of course simply be that autism is a side effect of the shot. In which case the two points cannot be reconciled and it would be up to the parent to take whatever risk they consider to be the least risk.

Christine, it may seem like a fact to you, but making a definitive statement does not impart validity to it, no matter how popular the belief is. I'm glad you mentioned polio, because this is an excellent example of misinformation being delivered precisely through the means I described.

According to the Physician's Desk Reference (PDR) and The Natural History of Infectious Disease (1972), 95% of the people exposed to the polio virus, even under epidemic conditions, will show no symptoms. Muscular paralysis only occurs in approximately 1 in 1000 persons. In comparison, autism affects 1 in approximately 150 children in the US, and as many as 1 in 66 boys.

It's scientific fact that the cancer-causing simian virus SV-40 contaminated the polio vaccine that millions of Americans received. Scientists speculate that it may be a major factor in the cancer epidemic we're experiencing today.

Speaking of scientific facts, Associated Press reported US Government Statistics showing that when the US began mass-inoculation with polio vaccines in the early 1950s, the number of polio cases in the US increased two-fold overall. The percentage of those who died, when compared to the percentage of those who died from polio before vaccination began, also increased significantly. Many medical professionals refused to vaccinate their children after the report was released. (continued...)

(continued...) There are problems with both polio vaccines. Science proved more than 50 years ago that injecting any vaccine or antibiotic increases the risk for paralytic polio. When England began injecting diphtheria and pertussis vaccines in the 1940s the number of paralytic polio cases skyrocketed according to the esteemed Lancet, and later confirmed by Great Britain's Medical Research Council in 1949.

In 1992, it was again confirmed by The Journal of Infectious Diseases that children receiving the DTP shot had increased chances of contracting paralytic polio over the next 30 days. Happily, there is another option: the oral vaccine--which Jonas Salk testified in 1976 was the "principal if not the sole cause" of all reported polio cases in the US since 1961 (Washington Post). The CDC's figures confirm this.

During a 5-year period in the 1990s, researchers found 13,641 documented adverse reactions to the oral polio vaccine, including 540 deaths, in the CDC's own database.

Luckily, paralytic polio is very rarely permanent, according to the American Journal of Epidemiology, The British Medical Journal, and the Can Med Association, and complete recovery usually occurs within 12-24 months--unless you contract it from the vaccine.

You have done an admirable job of reinforcing my arguments with your dogmatic statements that contradict the well-established scientific facts. Certainly, there is much to debate as to whether vaccines have "saved lives" at all, and polio is an excellent example because it is so typical when you look at the science and not the headlines. So where did you get these ideas that polio vaccination has such an unassailable track record? The evidence suggests that in the case of polio, the vaccine has harmed far more than it possibly could have helped.

Master of Public Health:

Are there now 20 more diseases in the world that we need to eradicate with vaccines? Why then are there now 20 more vaccines than there were 20 yrs ago. listen to the arguments pal open your eyes.

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