Debate Nirvana

Look at what happened in California that triggered the recent legislation to eliminate religious exemptions from vaccinations: a measles outbreak — which began at Disneyland in December 2014 and eventually affected 159 people in the U.S. The California bill’s co-authors, Sen. Richard Pan and Sen. Ben Allen, said California’s lenient vaccine rules were the problem. Pan, a practicing pediatrician, already was alarmed by historically high numbers of whooping cough cases and related deaths since 2010. He looked to the marked rise of personal belief exemptions filed by California parents as a reason for the outbreaks. In 2002, he and others noted, fewer than 0.77 percent of California kindergartners had vaccination exemptions. But by the 2013-2014 school year, the rate had more than tripled to 3.15 percent. “Every year, you have a slightly larger number of kids entering schools without vaccines,” said Pan. “And they just stay unvaccinated, building up the pool of unvaccinated people.”

Eventually there’s a tipping point, he said, and eventually “what you see happening is that someone in the community gets exposed to a disease, and it spreads throughout the community. And there are not enough vaccinated people to keep it contained.”

According to the American Academy of Pediatrics, most childhood vaccines are 90-99% effective in preventing disease.  And according to researchers at the Pediatric Academic Society, childhood vaccinations in the US prevent about 10.5 million cases of infectious illness and 33,000 deaths per year.  Evidence of the success of vaccination programs is easy to find: Smallpox, which had killed two million people per year until the late 1960s, was wiped out by 1979 after a massive worldwide immunization campaign. The number of polio cases fell from over 300,000 per year in the 1980s to just 2,000 in 2002. Two-thirds of developing countries have eradicated neonatal tetanus. Since the launch of the World Health Organization’s Expanded Program on Immunization in 1974, the number of reported measles deaths has dropped from 6 million to less than 1 million per year. Whooping cough cases have fallen from 3 million per year to less than a quarter of a million. Two studies published in the Journal of the American Medical Association found that children who exempted from vaccination requirements were more than 35 times more likely to contract measles and nearly 6 times more likely to contract pertussis, compared to vaccinated children. This research also showed that communities with lower rates of immunization had higher rates of infection among vaccinated children than those with higher vaccination rates. Similar correlations between exemption rates and incidence of vaccine-preventable disease has been found in both the United Kingdom and Japan.  In Boulder, Colorado, fear over possible side effects of the whooping cough vaccine led many parents to refuse vaccination for their children, causing Boulder to have the lowest school-wide vaccination rate in Colorado for whooping cough and one of the highest rates of whooping cough in the US as of 2002.

In the U.S. during the year 2001, routine childhood immunizations against seven diseases were estimated to save over $40 billion per age group in overall social costs including $10 billion in direct health costs.  According to an extensive cost-benefit analysis by the CDC, every dollar spent on immunization saves $6.30 in direct medical costs. The CDC estimated that overall since the Vaccines for Children (VFC) program was implemented in 1994,  vaccination rates have soared to near or above 90 percent, and routine immunization has prevented more than 21 million hospitalizations, saving nearly $295 billion in direct costs (which include the costs of treating an infection) and $1.38 trillion in total societal costs (which include things like lost productivity due to disability and early death), according to the report.