Experts: Anti-vaccine view a peril
Carrie Endara believed she was doing the best thing for her unborn child.
Ten years ago, when she learned she was pregnant, the Philadelphia suburbanite embraced natural parenting, a loosely defined movement in which parents raise their children according to natural and ecologically friendly practices. She studied the benefits of breastfeeding versus formula, chose cloth diapers over disposables and planned a drug-free, natural birthing process.
“I was very much about trying to live healthy and raise my kids naturally,” said Endara, 32, a martial arts teacher. “But a big part of it also was that people were against vaccinating their babies. So I decided not to vaccinate. I immersed myself only in the anti-vaccination side, and I never looked at the other side.”
Endara was part of a movement that believes injecting kids with vaccines to protect against potentially deadly diseases causes more harm than good.
The result, experts say: Measles is enjoying a comeback.
Random, isolated cases and widespread outbreaks recently were reported around the country, including a case last month in Allegheny County, the first case here since 2009, said Health Department Director Karen Hacker.
Such outbreaks represent “a major chink in the armor of our national immunity to measles,” said Dr. Amesh Adalja, a UPMC infectious disease, critical care and emergency medicine physician. “People who are not vaccinated are a huge liability. They create holes that these viruses can exploit.”
Since measles was declared eradicated in the United States in 2000, about 60 cases are reported a year, according to the Centers for Disease Control and Prevention. They often begin overseas among unvaccinated people.
Last year, 189 people got the disease, including one outbreak in Brooklyn that infected 59 people, the largest outbreak since 1996, the CDC reported.
Preventing outbreaks is as simple as getting vaccinated, health officials said.
Vaccination rates remain above 90 percent, according to CDC statistics. But for children 19 to 35 months old, the measles vaccination rate dropped to 90.8 percent in 2012 from 92.3 percent in 2006 and 2007.
“If you refuse to vaccinate your child, you are creating a pool of people who are potentially going to be infected,” Hacker said.
For many people, though, concerns remain.
Daniel Torisky, president of the Autism Society of Pittsburgh, said many parents worry about chemical additives in some vaccinations, particularly when multiple vaccines are bundled into one, such as the MMR vaccine, for measles, mumps and rubella.
“We are not anti-vaccine,” Torisky said. “There must be an independent study, without any drug company money, to determine the extent to which additives and preservatives in vaccines do or do not, might or might not, trigger autism. That study has yet to be conducted.”
Health experts say there is no proof of a connection between vaccines and autism.
There is proof, however, that vaccines prevent death, said Dr. Willem van Panhuis, an infectious disease expert at the University of Pittsburgh Graduate School of Public Health.
In the past 50 years, vaccinations have prevented an estimated 35 million cases of measles, he said.
“Despite massive improvements in fighting infectious diseases, we see people who are reluctant to continue with vaccinations,” van Panhuis said. “Health agencies do everything they can to inform and promote the usefulness of vaccinations, (but) the reluctance is amplified, especially through the Internet, by mobilized resistance.”
Endara once was part of such resistance.
She joined online support groups for anti-vaccination parents, some of which banned dissenting opinions. She halted vaccinations for her firstborn, Anna, then refused them altogether for her second child, a son named Valo.
“I felt it was a sign of my love for my kids, that I was looking into the issue and trying to see the negatives,” Endara said. “I certainly didn't feel like I loved my kids any less because I was questioning vaccinations.”
She began to question her beliefs, however, after learning about outbreaks and listening to her doctor urge her to reconsider.
“It was a gradual process,” said Endara, who now lives in North Carolina and has four children, all fully vaccinated. “I stopped being just totally focused on the anti-vaccination side and started to look at the other side as well.”
Endara is the exception.
A recent study from Dartmouth College and published in the journal Pediatrics suggests that anti-vaccination parents refuse to change their minds even after being presented with empirical evidence disproving their beliefs.
“It shows that people have turned their minds off,” UPMC's Adalja said. “You can't really argue with an irrational fixed belief. They take it as an article of faith, and if you question it, it only reinforces their belief. Of course, you don't see this problem in resource-poor countries where people are lining up for vaccines. If they were seeing children dying of measles every day in their neighborhood, maybe they would change their minds.”
A well-known vaccination skeptic is television host Jenny McCarthy, who suggested vaccines caused her son's autism.
Health care officials, who enjoy far less celebrity, say they must change how they deliver their message because they cannot compete with the fame of stars such as McCarthy, who has more than a million Twitter followers and reaches an even larger audience daily as co-host of “The View.”
Van Panhuis suggested enlisting even bigger celebrities to advocate in favor of vaccines.
“Perhaps that would help; I don't know,” he said. “But we really don't understand how easy it is to convince people to not get vaccines and we need to know. People's concerns should be taken seriously. Parents have sincere motivations to do what's best for their children, and that's not something to be mocked; that's something to be seriously addressed.”
Otherwise, larger outbreaks await, he said.
“If more and more gaps appear and our immunity breaks up, there is a threat for mass outbreaks,” he said. “If the gaps are not closed, we may have a large community of infections (with) many deaths. But those things are difficult to communicate to parents.”
Chris Togneri is a staff writer for Trib Total Media.