A public good

Vermont has one of the lowest rates of vaccination in the U.S. -- and that needs to change

WILLIAMSVILLE — When we were expecting our first child, my husband Tim and I visited local cemeteries in search of old-fashioned, New England names.

I was drawn to the flat, black slates that predate the Revolutionary War. I read with some foreboding about 20-year old Elizabeths and Susannahs who were buried with their infants in their arms. As an older first-time mom, I knew pregnancy carried risks for me as well as our child. But I was healthy, optimistic and had access to 20th-century health care.

My husband, a physician, was drawn to clusters of marble headstones from 1918, the year of the Influenza Pandemic, which killed more than 20 million people around the world.

He stood before two large stones with a half dozen small ones between them: a whole family wiped out. Vermont was hard hit, with more than 6,000 cases reported in one week.

Tim pointed out the miniature headstones marking the graves of infants, toddlers, and young children.

“Whooping cough, croup, German measles - these were all fatal diseases back then,” he said.

He pointed to a stone of a man who died in his 30s. “My age,” he said. “This guy could have died from a cut. Without the tetanus vaccine, lockjaw was common - and lethal.”

* * *

Our children were all born healthy, which is a mercy in itself. They were immunized against polio, pertussis, tetanus, diphtheria, rubella, and mumps. Except for chicken pox and an occasional ear infection, my children had healthier childhoods even than I had.

I'm old enough to remember my whole family trooping down to the local junior high, where we ate sugar cubes laced with the new polio vaccine. My parents, who'd spent summers avoiding movie theaters and public swimming pools in fear of contracting the disease, were vaccinated then as well.

My children have flourished in Vermont and have traveled to less healthy corners of the world.

Before leaving for Turkey and Russia, they were vaccinated against hepatitis A and B. For trips to India, Rwanda, the Rift Valley, Siberia, Northern Thailand, and Morocco, they were inoculated against typhoid, yellow fever, and Japanese encephalitis. They also had polio and tetanus boosters, and they took medication to prevent malaria.

Back home and off to dorm life, they had shots to prevent HPV and meningitis. Every year, they are inoculated against influenza.

I get a yearly flu shot, too. But none was available for H1N1, the swine flu, the first year it circled the globe - and put me in bed for four miserable days.

Global travel is a boon to the spread of disease; no fence along a border can keep viruses out. Only our own immune systems, triggered by virus or vaccines, can effectively do that.

* * *

My physician husband calls vaccines the most profound medical advance in human history. I call them peace of mind.

But I'm a mom, so I still worry.

Thanks to immunizations, my children are not likely to contract deadly, communicable, and preventable diseases. They are in much greater danger of being hit by a drunk driver on the roads in Vermont.

But there are many people in Vermont who don't vaccinate their children, some for religious reasons, some for medical reasons, and some for “philosophical differences.” As a result, Vermont has one of the lowest vaccination rates in the nation.

Legislators in Montpelier are currently debating whether to eliminate the philosophical exemption in an attempt to improve vaccination rates in particular and public health in general.

Requiring childhood immunizations is no different from requiring passengers in motor vehicles to wear seat belts. Seat belts save lives. So do vaccines.

Seat belts, however, are a relatively recent invention, as are the cars in which we daily risk our lives. Vaccines, on the other hand, have been used to good effect for centuries - and probably longer. In the relatively new field of western medicine, the advent of successful inoculation against disease dates to 1796, just a few years after Vermont became a state.

Yes, there is a small risk that a child will have an adverse reaction to a vaccine, but it's a considerably smaller risk than that child being hurt in a car accident (even if that child is strapped into the appropriate - and mandatory - child safety seat).

And the risk that is feared most - an increased rate of autism in response to the mumps, measles, and rubella (MMR) vaccine - maintains hold in people's imaginations, even though the “science” behind it has been debunked, and Dr. Andrew Wakefield, the author of the research, has been exposed as a fraud.

Wakefield's study, originally published in a prominent British medical journal and given great media attention, was based on only 12 patient histories, histories that he falsified to make his claims!

In Vermont, supporters of the philosophical exemption claim that it's their parental right to determine their children's health care. Governor Peter Shumlin has proposed a compromise that would allow the exemption to remain, but would require parents to undergo mandatory education before they could opt out.

Would these parents also be held responsible for any costs associated with the care of their child should she or he become sick, as well as the costs for others exposed to a communicable and preventable disease by the unvaccinated child? Would they pay higher insurance premiums, as those with bad driving records do?

Subscribe to the newsletter for weekly updates