TIP In The News

Amid measles outbreaks, non-vaccination movement grows

By Todd Ackerman | February 04, 2015

Originally published in the Houston Chronicle

Krystal Bettilyon, with her daughters in Deer Park, said after researching vaccines, she became uncomfortable. "It's a personal choice," she said. Photo: Billy Smith II / © 2015 Houston Chronicle

Photo: Billy Smith II |  Krystal Bettilyon, with her daughters in Deer Park, said after researching vaccines, she became uncomfortable. "It's a personal choice," she said.

City official: Parents with babies 'should be alarmed'

Until her first daughter was 2 years old, Krystal Bettilyon was a faithful follower of the recommended vaccination schedule, not averse to shaking her head at those who oppose what's generally considered the 20th century's great public health advance.

"Once I started reading about all the ingredients in vaccines, the poisons and potential side effects, I became uncomfortable with the idea," says Bettilyon, a LaPorte stay-at-home mom. "It's a personal choice. Everyone does what's best for their kids."

Around Texas, an increasing number of parents are adopting Bettilyon's philosophy. Though the overwhelming majority of Texas parents still opt to have their children vaccinated, the ranks of "conscientious objectors," as the state calls them, have tripled in Texas and Harris County in the last six years - much to the dismay of infectious disease and public health specialists concerned it will lead to outbreaks of preventable diseases.

In all, more than 38,000 Texas and 5,000 Harris County schoolchildren were exempted from required vaccinations in the 2013-2014 school year, up from about 10,400 and 1,100, respectively, in 2007-2008, according to state health department statistics. Those numbers represent less than 1 percent of eligible students, but in six counties, the number now exceeds 3 percent.

"Those are scary numbers," said Dr. Peter Hotez, dean of the National School of Tropical medicine at Baylor College of Medicine and Texas Children's Hospital. "Considering how non-vaccinators tend to cluster, they make Texas extremely vulnerable to an outbreak."

Still, Kathy Barton, spokeswoman for the Houston health and human services department, said Houston-area parents "should be alarmed if they have children under 12 months old," when children are not yet eligible for the first dose of the combination measles, mumps and rubella vaccine. She said parents of children who have been immunized should feel confident the vaccine is safe and will protect their child. She added that such parents "deserve a pat on the back for protecting not just their child, but the community."

Barton's comment refers to herd immunity, the idea that the vaccination of a significant portion of a population, typically at least 90 percent, provides a measure of protection for individuals who don't have immunity to a contagious disease. Experts worry that an increasing number of parents not vaccinating their children could threaten herd immunity, particularly given the occurrence of clusters.

One such cluster occurred in north Texas in August 2013. Sixteen measles cases in Tarrant County and five in Denton were traced to Eagle Mountain International Church in Newark, which is northwest of Fort Worth. Some of the congregation became infected when a visitor who had recently returned from an international mission attended a service.

Measles, a highly contagious respiratory disease, spreads through the air through coughing and sneezing. It starts with a fever, runny nose, cough, red eyes and sore throat, followed by a rash that spreads all over the body and, in some cases, diarrhea, ear infections or pneumonia. It is fatal in one to three of every 1,000 people who contract the virus.

It was considered eradicated in the U.S. in 2000 - before the measles vaccination program started in 1963, 3 million to 4 million Americans annually got the disease - but the numbers again have been climbing, which experts attribute to the anti-vaccination movement. In 2014, there were 664 cases reported in the United States, the most in 20 years.

Some of the rhetoric has become fevered, with people making the case for suing, and even criminally charging "anti-vaxxers."

Barbara Loe Fisher, president of the National Vaccine Information Center, a group in favor of allowing parents "voluntary, informed consent" about medical interventions, said the Disneyland outbreak has touched off a "media frenzy." She suggests the increased cases of measles might bebecause of "waning immunity of the vaccine rather than exemptions" and calls for the CDC to provide information tracing the cases at Disneyland to unvaccinated children.

"Everyone needs to take a step back and understand what's happening instead of pointing a finger of blame at a very small percentage of people not vaccinating their children," said Fisher. "It's gotten so bad that non-vaccinating parents won't speak to the media and are afraid to see pediatricians, many have such a 'my way or the highway' attitude."

In La Porte, Bettilyon said she had to switch doctors because her old pediatrician was so opposed to her decision. But she said she isn't bothered by the rhetoric against those who share her philosophy and said her kids and vaccinated kids of her friends enjoy play dates together.

Doctors and vaccine advocates contacted by the Chronicle favor overturning the "conscientious objection" law. But in the short term, the strategy appears to be to make it more difficult for parents to obtain exemptions for their child, such as requiring a doctor's signature that the parent was counseled about vaccine risks and benefits at his or her office. Studies have found such hurdles decrease the number of conscientious objectors.

Under the Texas law, a parent currently must provide the health department information about themselves and request in writing the exemption. An affidavit subsequently sent to them must be notarized within 90 days and submitted to the school.

The Immunization Partnership, a Houston-based pro-vaccine group, is working with several legislators to sponsor a bill this session that would require that all schools make available to the public the number of students exempted. Currently, the Texas department publishes such information about school districts, but in most districts parents don't know the difference in numbers from one school to another.

"I understand the people of Texas are proud of their independence and individual rights, but vaccination is something you do for yourself that protects the general community," said Anna Dragsbaek, president and CEO of the partnership.

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