Shift on vaccines: First very slowly, then all at once

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July 9, 2015

Whether it’s the drought forcing us to rethink how we use water in the West, or an outbreak of a highly infectious disease at the so-called “happiest place on Earth,” crisis has a way of bringing about changes in policy and public perception that wouldn’t otherwise occur.

The past couple weeks have offered ample reminder. After a decade of declining immunization rates and a year of unusually severe outbreaks of measles and whooping cough, California Gov. Jerry Brown signed one of the country’s toughest mandatory vaccination laws, eliminating religious and personal-belief exemptions for public schoolchildren. Less than five weeks earlier, Vermont signed into law legislation that banned parents from using “philosophical exemptions” to opt their kids out of vaccination (religious exemptions are still permitted). California now joins a small club – fellow members are limited to Mississippi and West Virginia – where only medical exemptions are allowed.

Lest one think a small band of activist legislators is leading the public around by the nose on this issue, a new survey came out on Monday that details the impact that a year and a half of “measles mania” — and sustained news coverage — may have had on attitudes toward vaccines. The poll of more than 1,400 parents, released by C.S. Mott Children's Hospital, part of the University of Michigan Health System, found that “34 percent of parents think vaccines have more benefit than they did a year ago.” That’s compared to 61 percent of parents who think they have about the same benefit, and 5 percent of parents who think they have less benefit.

Despite — or because of — the extensive news attention garnered by anti-vaxxers (some of whom believe vaccines are responsible for conditions such as autism, despite the scientific consensus that they aren’t), 25 percent of parents surveyed said they thought vaccines were safer compared with a year ago, while 7 percent said “less safe.”

This is just one poll, and all the usual caveats apply (for instance, how accurately do these parents even remember “what I thought 1 year ago”?). But if true, those appear to be some pretty remarkable shifts in perceptions over a short span of time.

But it wasn’t just any year. It was a very bad year, especially in California, as the Los Angeles Times illustrates in this helpful infographic showing measles and whooping cough infections. You have to go back to 1958 to find such high rates of whooping cough infection. The state’s 61 measles cases in 2014 are the most it’s had since 1995, when 109 cases were recorded. And that doesn’t fully include the infamous Disneyland outbreak that got under way in December 2014 — between then and April of this year, 136 cases were confirmed.

Nor has the threat fully passed. Just before the July Fourth weekend, news came from Washington state that an undiagnosed measles infection had led to the death of a young woman in Clallam County, the first death from measles since 2003. “The woman was most likely exposed to measles at a local medical facility during a recent outbreak in Clallam County,” the state’s Department of Health said in a release. “She was there at the same time as a person who later developed a rash and was contagious for measles.”

Her infection marked the sixth case in Clallam County alone this year. As Michael Specter wrote in a New Yorker post on the death, “Vaccine rates are particularly low in northwestern Washington, where the measles death occurred, as they are in many other parts of the state.”

It’s obviously too soon to say whether news coverage of such tragedies will inspire other states to follow the lead of states such as California and Mississippi (an odd couple, indeed). But for now, it’ll be worth paying close attention to how California’s tough new vaccination requirements impact the spread of whooping cough and measles infections in the state over the next few years. A persistent lack of outbreaks wouldn’t be much of a breaking news story, but it would be a success story.

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[Photo by eyeliam via Flickr.]