I haven’t said much in the past about the anti-vaccine movement. I have never been a supporter of it, though my wife and I considered its claims in light of our son’s Asperger’s diagnosis. We decided to space our children’s vaccinations out, so their immune systems weren’t potentially overwhelmed. But they are vaccinated, and we wouldn’t have dreamed of doing anything else. The risk to our children was too great.

Doctors have warned for some time that the anti-vaxxers are putting us all at risk by eliminating herd immunity from common childhood diseases, and now, with measles, it’s happening. From the NYT:

But here in California, anti-vaccine parents whose children have endured bouts of whooping cough and chickenpox largely defended their choice to raise their children on natural foods, essential oils and no vaccinations.

“There is absolutely no reason to get the shot,” said Crystal McDonald, whose 16-year-old daughter was one of 66 students sent home from Palm Desert High School for the next two weeks because they did not have full measles immunizations.

After researching the issue and reading information from a national anti-vaccine group, Ms. McDonald said she and her husband, a chiropractor, decided to raise their four children without vaccines. She said they ate well and had never been to the doctor, and she insisted that her daughter was healthier than many classmates. But when the school sent her home with a letter, Ms. McDonald’s daughter was so concerned about missing two weeks of Advanced Placement classes that she suggested simply getting a measles inoculation.

“I said, ‘No, absolutely not,’ “ Ms. McDonald said. “I said, ‘I’d rather you miss an entire semester than you get the shot.’”

More:

In San Geronimo, Calif., a mostly rural community of rolling hills and oak trees about 30 miles north of San Francisco, 40 percent of the students walking into Lagunitas Elementary School have not been inoculated against measles, according to the school’s figures. Twenty-five percent have not been vaccinated for polio. In all, the state says that 58 percent of Lagunitas kindergartners do not have up-to-date vaccine records.

“A lot of people here have personal beliefs that are faith based,” said John Carroll, the school superintendent, who sent a letter home to parents last week encouraging them to vaccinate their children. The faith, Mr. Carroll said, is not so much religious as it is a belief that “they raise their children in a natural, organic environment” and are suspicious of pharmaceutical companies and big business.

Some parents forgo shots altogether. Others split vaccine doses or stretch out their timeline, worried about somehow overwhelming their children’s immune system. Kelly McMenimen, a Lagunitas parent, said she “meditated on it a lot” before deciding not to vaccinate her son Tobias, 8, against even “deadly or deforming diseases.” She said she did not want “so many toxins” entering the slender body of a bright-eyed boy who loves math and geography.

Read the whole thing. Note especially the anti-vaxx mom quoted at the end who says that “vaccines don’t feel right for me and my family.” Moralistic Therapeutic Medicine!

In case you’re tempted to think this is just a weirdo California thing, it’s not. I ran into a doctor from my area at a social event the other day, and asked about the measles outbreak. The doctor said you would be surprised at all the people around here, in the rural Deep South, who have not vaccinated their kids. “These are all educated professionals,” the doctor said.

“People talk about not wanting to put toxins into their kids’ immune systems,” the doc said. “I tell them that the last time you fed them fries from McDonalds, you put more toxins into your kid’s body than you would with vaccine.”

The “vaccines cause autism” myth has been debunked many times. If people want to believe in anti-vaxxer superstition, that’s their right. But as we are seeing, there is a potentially tremendous cost to the common good of those individuals practicing their “faith”. This is not a matter of people’s feelings being hurt, or them having to endure a slight hardship; this could be a matter of serious illness and permanent disability. It can even be a matter of life and death.

Back in 2013, Julia Ioffe wrote about her experience with whooping cough. Excerpt:

At this writing, I have been coughing for 72 days. Not on and off coughing, but continuously, every day and every night, for two and a half months. And not just coughing, but whooping: doubled over, body clenched, sucking violently for air, my face reddening and my eyes watering. Sometimes, I cough so hard, I vomit. Other times, I pee myself. Both of these symptoms have become blessedly less frequent, and I have yet to break a rib coughing—also a common side effect. Nor do I still have the fatigue that felled me, often, at my desk and made me sleep for 16 hours a night on the weekends. Now I rarely choke on things like water, though it turns out laughing, which I do a lot of, is an easy trigger for a violent, paralyzing cough that doctors refer to not as a cough, but a paroxysm.

More:

How responsible are these non-vaccinating parents for my pertussis? Very. A study recently published in the journal Pediatrics indicated that outbreaks of these antediluvian diseases clustered where parents filed non-medical exemptions—that is, where parents decided not to vaccinate their kids because of their personal beliefs. The study found that areas with high concentrations of conscientious objectors were 2.5 times more likely to have an outbreak of pertussis. (To clarify: I was vaccinated against pertussis as a child, but the vaccine wears off by adulthood, which, until recently, was rarely a problem because the disease wasn’t running rampant because of people not vaccinating their kids.)

So thanks a lot, anti-vaccine parents. You took an ethical stand against big pharma and the autism your baby was not going to get anyway, and, by doing so, killed some babies and gave me, an otherwise healthy 31-year-old woman, the whooping cough in the year 2013. I understand your wanting to raise your own children as you see fit, science be damned, but you’re selfishly jeopardizing more than your own children. Carry your baby around in a sling, feed her organic banana mash while you drink your ethical coffee, fine, but what gives you denialists the right to put my health at risk—to cause me to catch a debilitating, humiliating, and frightening cough that, two months after I finished my last course of antibiotics (how’s that for supporting big pharma?), still makes me convulse several times a day like some kind of tragic nineteenth-century heroine?

I think it is time to consider legal action at the federal level to compel vaccination. I don’t know what the limits on federal law should be, but what we have now is not working. Again, if somebody wanted to take the risk of measles, pertussis, and so forth upon themselves, I would respect their right to be foolish. I have a much more difficult time respecting their right to subject their children to these diseases in the absence of scientific grounds for it, but I could be persuaded that respecting the parents’ right in this matter is important.

What I cannot accept is that these people, acting without any scientific grounds for their belief, are putting everybody else, and everybody else’s children, at medical risk (there is a small but nontrivial chance that you will acquire the disease even if you have been vaccinated).

A reader of this blog who is a physician is troubled by the fact that we had a nationwide freakout about Ebola, which almost nobody got, but we are not paying nearly that kind of attention to measles, which many people are getting, and which is entirely preventable. Aside from legal action, we are going to have to make anti-vaxx a culturally unacceptable viewpoint to hold. Again, this is not a matter of being intolerant of an unpopular opinion; this is a matter of preserving public health from a serious communicable disease, one with potentially grave complications. It’s a matter of what we can afford to tolerate for the sake of the common good.

UPDATE: A physician reader sends this short piece that the late author Roald Dahl wrote to encourage immunization:

Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.

“Are you feeling all right?” I asked her.

“I feel all sleepy,” she said.

In an hour, she was unconscious. In twelve hours she was dead.

The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her. That was twenty-four years ago in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her.

On the other hand, there is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunised against measles. I was unable to do that for Olivia in 1962 because in those days a reliable measles vaccine had not been discovered. Today a good and safe vaccine is available to every family and all you have to do is to ask your doctor to administer it.

It is not yet generally accepted that measles can be a dangerous illness. Believe me, it is. In my opinion parents who now refuse to have their children immunised are putting the lives of those children at risk. In America, where measles immunisation is compulsory, measles like smallpox, has been virtually wiped out.

Here in Britain, because so many parents refuse, either out of obstinacy or ignorance or fear, to allow their children to be immunised, we still have a hundred thousand cases of measles every year. Out of those, more than 10,000 will suffer side effects of one kind or another. At least 10,000 will develop ear or chest infections. About 20 will die.

LET THAT SINK IN.

Every year around 20 children will die in Britain from measles.

So what about the risks that your children will run from being immunised?

They are almost non-existent. Listen to this. In a district of around 300,000 people, there will be only one child every 250 years who will develop serious side effects from measles immunisation! That is about a million to one chance. I should think there would be more chance of your child choking to death on a chocolate bar than of becoming seriously ill from a measles immunisation.

So what on earth are you worrying about? It really is almost a crime to allow your child to go unimmunised.

The ideal time to have it done is at 13 months, but it is never too late. All school-children who have not yet had a measles immunisation should beg their parents to arrange for them to have one as soon as possible.

Incidentally, I dedicated two of my books to Olivia, the first was ‘James and the Giant Peach’. That was when she was still alive. The second was ‘The BFG’, dedicated to her memory after she had died from measles. You will see her name at the beginning of each of these books. And I know how happy she would be if only she could know that her death had helped to save a good deal of illness and death among other children.

If you have any anti-vaxx friends, send them a link to this. It’s that serious.