, Salem, MA


November 15, 2013

Column: Vaccine exemptions pose rising risks of disease

The state Department of Public Health, in its most recent (2010) Health of Massachusetts report, wrote that “Massachusetts has always had, and continues to have, one of the highest levels of infant immunization in the United States” and that “most vaccine-preventable diseases of childhood have been essentially eliminated” in the commonwealth.

This enviable record is now in jeopardy. The DPH’s Immunization Program has seen an increasing number of religious and medical exemptions to vaccinations among kindergarten students during 2012-2013.

The rate in Essex County is 1.3 percent, reflecting exemptions for 120 children, and that’s below the state average of 1.5 percent. But exemption rates are much higher elsewhere. Three counties in western Massachusetts are three times above the state average: Berkshire County at 3.2 percent, Franklin County at 6 percent and Hampshire County at 4.2 percent. In Barnstable, Dukes and Nantucket counties, the rate of exemption is also three times the statewide average, 4.5 percent.

The question we must ask is this: Is this a trend likely to continue?

If we need any reason to remind ourselves about the value of vaccines, all we need to do is look around our country and the world. Diseases once thought to be under control, even eradicated, are reappearing with disturbing frequency.

In the U.S., outbreaks have occurred coast to coast. According to the Centers for Disease Control, 2012 was the worst year in six decades for whooping cough, with nearly 42,000 cases. Washington state saw a 1,300 percent jump in whooping cough cases from 2011 to 2012. The number of measles cases in the U.S., recently highlighted by an outbreak centered in a Texas church whose ministers reportedly questioned the value of vaccines, is on track this year to be one of the highest in 17 years. Mumps is returning, as well, as evidenced by more than 100 cases in Virginia.

Measles and mumps outbreaks have occurred in Canada, Europe and the Middle East. Polio has shown a fierce stubbornness, resurfacing in Somalia after six years. The disease has reached Israel, which is vaccinating one million children, from Pakistan, one of three countries, along with Nigeria and Afghanistan, where it remains endemic.

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