Vaccination Woo Nutz Are Getting Up My Nose Today

Feb 11 2008 Published by under Biology, Science Politics

Around here at SciBlogs, people who know what the heck they are talking about like Tara, Orac, revere and Abel Pharmboy usually handle the dissection of the anti-sciencenauts who insist on not vaccinating their children against measles and the consequences thereof. Today however a specific, if anonymous, set of anti-vaccine parents are pissing me off. MMR woo-nauts and me, after the jump.


Last week we learned that a family of at least three children had come down with measles because their family didn't believe in vaccinating them:

Two children at a San Diego charter school and a sibling have contracted measles, prompting county health officials Monday to notify parents and students about possible exposure.
Two of the children attended the San Diego Cooperative Charter School, according to the San Diego County Health and Human Services Agency.
They did not have the measles vaccine, according to the HHSA.

Ok, bad enough. However, as we come to find out from the SD UnionTribune (h/t: skepchick) article:

Ten percent of the charter school's 380 students were not vaccinated. The figure for most schools in San Diego County is 1 percent to 2 percent, said Jennifer Gorman of the San Diego district's nursing and wellness program. The statewide average is about 1.5 percent, according to the California Department of Public Health.

Oh man. Are you really surprised that woo types might congregate?

SDCCS was started by a group of parents and educators from a variety of professions and backgrounds, who came together through a parent cooperative preschool. The experience of being a significant part of our children's education led us to feel that a school that emphasized parent involvement and respect for each child's learning style was an appropriate option for all children.

I'm not saying all charter school proponents are woo-nauts but you would think that woo-nauts might be charter proponents to a certain degree. Regardless, this place has a 5-fold increased rate of non-vaccination. Trouble ahead?

To all SDCCS families,
The County of San Diego Health and Human Services Agency (HHSA) has confirmed an additional case of measles at our school. The student is a classmate of one of the two children at school who recently contracted measles while traveling abroad. The newest case was a child who had not received the measles vaccination and has been at home since the first case was reported.

In case the above bulletin from the school doesn't remain on their splash page, the SD UnionTrib weighs in as well:

A fourth case of measles was reported Wednesday in connection with the measles incidence connected to a Linda Vista charter school earlier this week.
The infected student is a classmate of two other children attending the San Diego Cooperative Charter School. School principal Wendy Ranck-Buhr said the child was recovering at home.

That's right woo-nauts, you aren't going to be able to protect your unvaccinated kid from infection by removal, because there may be 4-12 days (Wikipedia) during which an infected child is asymptomatic and yet still infectious. And here lies the part where I start getting ticked off. First, these knuckleheads took one of their unvaccinated children to a region of the world that apparently fails to meet WHO targets for measles vaccination. Not to mention a country which seems to have had very recent measles "outbreaks". Seems like you might want an abundance of caution, right? Maybe not jump right back to school with a host of unvaccinated kids. But they did. And all of a sudden it is a public health nightmare. Which has very real consequences for a very large segment of your community.
Those of you with school age children and below, especially with three of them as this woo-family has, will understand. In the course of "4-12 days" of normal living, your kids interact with a LOT of other children. School is just the start and believe you me they do plenty of sneezing on each other and wrassling around on the playground. Then they have after-school care, activities, etc where they interact with kids from other schools and other parts of town. Did I mention the birthday party circuit? There's at least two per weekend if you have even just two kids, seems like. So that's a whole ton of kids exposed to your measles-child because you think, without any credible evidence, that it is a bad idea to vaccinate your children for measles. No problem, right? I mean, "most" kids are vaccinated. The above-reported stat suggests maybe 98% vaccination so no biggie, eh?
Except, oops. Children only receive the vaccine at 12-18 months. So for kids under a year, we're talking nearly 100% naked to infection. And guess what? Some of those kids your school-age kids interact with have infant siblings. Infant siblings that get dragged around to pick up their school aged brothers and sisters. Infant siblings that school aged kids show a remarkable (to me anyway) interest in at times. Infant siblings that are, in short, exposed to your measles-child.
And now it gets really fun. Because chances are decent that the now-exposed infant also spends some time in daycare with a big room of other under-12 month infants. Likewise unvaccinated. Remember that nifty asymptomatic-yet-infectious interval? And most sources insist, as does Wikipedia, that measles is highly infectious. So now we have the potential for a lot of little infants being exposed to an infectious agent which has some fairly nasty consequences.

Complications with measles are relatively common, ranging from relatively mild and less serious diarrhea, to pneumonia and encephalitis (subacute sclerosing panencephalitis), corneal ulceration leading to corneal scarring

Now, I exaggerated above about being "naked" to infection. The thought is that there is a degree of maternal immunity that lasts for the first year. This does nothing about the PIA aspects. Oh, yeah, the PIA aspects.
Layered on top of the worry about whether or not your particular infant will come down with measles given that s/he was exposed, the 4-12 day incubation period means...quarantine. For a long time. And if your infant does get sick, you can extend this quarantine at least another two weeks. Let's just suppose that it goes down like I have described. And just one daycare room of about 20 infants gets hit. That's twenty families who normally depend on some amount of daycare being disrupted fairly seriously for at least two weeks. Possibly for a month while they deal with an infant who actually gets measles. Quarantined. No going to parks, supermarket or anywhere else other infants might be exposed. If you were good about it, you might want to even avoid taking the infected infant along to daycare or school where you pick up his/her older sibling(s). Because who knows? You might be at one of those 10% woo-naut schools!
That, my anti-vaccine nutcase friends, is just one of the many things you are putting the community through because of your selfishness. Your theological belief in something that IS NOT TRUE is causing this. This is the sort of crap that should get you voted off the island.
Idiots.
----------
Update 2/12/08: Aaaaand we're rolling. The SD paper is reporting an additional 5 patients awaiting probable confirmation of measles bringing us to 10 (yes, my scenario above was not just a 'scenario'). A total of 50 kids reported as under quarantine.
An idiot over at Tara's place says that "3 kids getting the measles is not a big deal". Well, it is getting to be a bigger deal as we're finding with each newspaper cycle.
Update 2/13/08: And as noted in the article linked by luna in the comments, my agent was correct in the rumor, now confirmed, that one kid with measles was on a plane to Hawai'i. So now we are turning from a mere curiosity and opportunity to bash the anti-vaccine people into some pretty interesting infectious disease epidemiology. Stay tuned, I guess. It'll be interesting to see first, how this breakout spreads and second how the public health system damps it down.

38 responses so far

  • PalMD says:

    They're not idiots, there DAMNED idiots. We should call it what it is---a cult. A bunch of people with odd beliefs and dangerous practices congregating together---they kool aid (ok, flavr ade) is rapidly quenching their thirst as they endanger children.

  • _Arthur says:

    According to Ginger, on another blog, if she hears there's an epidemic in her small town in Maine, _then_ she'll think about getting her 2 kids vaccinated for measles and rubella.
    Imagine, there have been no epidemic in her state in 10 years !
    Besides, she thinks rubella is harmless, a mere inconvenience.

  • You did just fine there, chief. I'd have nothing to add if I did my own post.
    It's one thing if these misguided folks don't understand the threat they pose to their own children. But for God's sake, don't put everyone else's kids at risk, especially infants. Failing to vaccinate your child constitutes child abuse in my mind.
    And I only say this half-jokingly but bringing a measles-infected kid to a childcare center with infants could be conceived by our government authorities as biological terrorism.

  • Dave Munger says:

    As an added bonus, there are racist comments in that thread blaming "immigrants" for the problem.
    Pure ignorance, of course. Mexico has a higher vaccination rate than the U.S.

  • JSinger says:

    Is "woo" some new bit of smarmy, self-congratulatory, inside-joke name-calling? If so, I find it even more annoying and off-putting than the usual grade of smarmy, self-congratulatory, inside-joke name-calling.

  • Dave Munger says:

    I don't know the word's history, but it's been around for an eternity (>1 year) in the blogosphere.
    It's a handy term to describe pretty much all varieties of pseudoscientific nutjobbery.

  • DrugMonkey says:

    "Is "woo" some new bit of smarmy, self-congratulatory, inside-joke name-calling?"
    Yes. It has legs however and the "inside" is rapidly expanding. Unless your locution is completely free of slang I imagine you are familiar with other exemplars that started out in a similar vein.
    Do you have another bit of name calling that would perform a similar role? Because most of the alternatives I think of tend to be NSFW...
    I will also note that my usage here may be slightly non-canonical. I'll leave that up to the linguists and pedants, however.

  • PhysioProf says:

    Is "woo" some new bit of smarmy, self-congratulatory, inside-joke name-calling? If so, I find it even more annoying and off-putting than the usual grade of smarmy, self-congratulatory, inside-joke name-calling.

    If it bugs you, just mentally replace it with "cockamamie bullshit".

  • neurlover says:

    I agree completely with your entire post. But, you're preaching to the choir here.
    When my daughter (first child) was one, and ready to be vaccinated for measles, I stumbled into the controversy about the MMR (this was the early days). My doctor also knew about the controversy, and broached the subject of vaccination in the most tender terms possible. I interpreted her to say of course we're vaccinating -- can't imagine denying my children one of the two miracles of modern medicine.
    But, then, I started talking to a broader group of parents of one-year-olds and realized that the arguments that worked for me didn't work for them. They wanted to hear something different in order to make the right decision. So, I started educating myself on how to talk to the vacci-nuts. The prime problem is that the data doesn't convince them. (Can you imagine that?). What seems to work is personal testimonials: a trusted nurse, a trusted doctor, a trusted friend telling them "I thought long and hard about it and then decided to vaccinate." The person has to appear to not be an authority (no "CDC recommendations"). I've even had to employ this technique with my engineer friends (who I would have imagined to be as data driven as me).
    So, apparently my doctor was using the right technique except for me. It was important for her to broach the subject in a way that made the decision a parent's decision and not the doctor's decision.

  • DrugMonkey says:

    neurlover, I'll cop to a little ranting to the choir here. But look. The most effective possible solution would be for the local and possibly national news to pick up exactly the above tone. To excoriate these particular parents for their socially-unfriendly selfish idiocy and explain why when you are a member of a community there are certain things you have to do. Like not endanger the health and welfare of others, just because you choose to believe some completely unsubstantiated crap. Kinda like those anti-methadone politicians. And like the anti-water-fluoridation thing that someone brought up in a comment.
    We frown on driving under the influence, do we not? Because it endangers others in the community. We expect someone with drug-resistant infectious disease to maintain quarantine, do we not? Because it might endanger others in the community.
    This is no different and it is not necessary to "coddle" idiots into good community behavior in those other cases. We just establish a law and penalties. Why not this?

  • neurolover says:

    Drugmonkey: I'm all for excoriating the folks who don't vaccinate, IF I thought it would increase vaccination rates.
    The outcome of not vaccinating is scary, and as you point out, folks are endangering other people's children by not vaccinating their healthy children (the few for whom a vaccination is actually medically counter-indicated, immuno suppressed individuals, infants under the age of one, unborn children. . .). I have no desire to coddle the evil do-ers. I think they are wrong and morally bad. But, I don't think excoriation works. I think when excoriated, they retreat, further where we can't talk to them and influence their decision. I base this opinion on both personal experience (I spent a lot of time talking to other parents just around the time when this whole crazy phenomenon started), but also based on the research I tried to do at that point on how "first responders" should treat the issue.
    Let's make the analogy to drug use "do we coddle the addicts" or do we throw them in jail for a hundred years? You know that the throwing in jail is an ineffective tool for treating addiction. In the same way, we could excoriate, criminalize (though we probably don't have the political will) and demonize the vacci-nuts. Or, we can try to treat the craziness and help people do the right thing in spite of their irrational fears (or counter-productive behavior). The bottom line for me is which is more effective (which is a question to be answered with data, not morality).

  • DrugMonkey says:

    oh, don't get me wrong. I think we should excoriate politicians that argue for policies that are so patently incorrect as well. It is not that I think we should shame and legislate those who do not agree with us across the board. It is those who are just plain wrong, the evidence is overwhelmingly clear, the societal compact is obvious....
    Or are you suggesting that parents who won't vaccinate have a mental disorder akin to drug addiction and we need to bring all of the counseling / therapy / behavior modification tools to bear? I could entertain that argument...

  • neurolover says:

    "parents who won't vaccinate have a mental disorder akin to drug addiction and we need to bring all of the counseling / therapy / behavior modification tools to bear?"
    I think I am, except that I fear that it's one of those disorders (i.e. irrationality, and an inappropriate weighting of evidence) that's well within the range of normal behavior (don't know enough about drug abuse, to take a position on the atypicality of the brain disorders that results in addiction).
    So, perhaps not quite willing to call the anti-vacci people neurally atypical, but believe that counseling/therapy/ behavior modification will be more effective tools in increasing the vaccination rate than coercion and anger.
    (I still need to rant on occasion, but I don't regard the ranting as an effective tool).

  • neurolover says:

    "Vaccination has, however, been linked by some experts to autism or an increase in allergies among children."
    (from your Switzerland link: http://www.swissinfo.org/eng/front/detail/Swiss_need_booster_to_meet_measles_target.html?siteSect=105&sid=8010713&cKey=1184096521000)
    Aaargh.

  • Lab Lemming says:

    In the USA, are parents who don't vaccinate legally liable for the medical costs of kids who are infected by their negligence?
    People generally listen harder if you take their money away instead of just calling them names...

  • BugDoc says:

    The woo-nauts have all kinds of interesting ways to protect their children. I especially enjoy the invitation to chickenpox parties that go around our local parents' email network. These parents prefer to actually infect their children (and generally don't keep them home before showing symptoms, as far as I could tell from the discussion) rather than get them vaccinated. From the exchange of comments that ensued, it was pretty clear that many parents were making their decisions based on a very loose understanding of how vaccination works.

  • pelican says:

    LabLemming has got this right ... I suspect after the first few lawsuits, most antivax parents will see the personal risk-benefit ratio of vaccination differently and start vaccinating, particularly in wealthy areas like San Diego. For example, if someone's unvaccinated kid got measles and gave it to a six month old from a family that intended to vaccinate their baby and had vaccinated their older children .... I am not an attorney, so I don't have an opinion about whether such a lawsuit would succeed, but I am sufficiently familiar with litigiousness to suspect a suit for negligence could go forward and the costs of defending against it would be impressive, particularly if the infected infant sustained permanent disability.

  • _Arthur says:

    On the other blog, they repeated the recent Jenny McCarty meme: they're not against vaccines, but they're against "adjuvants" and toxins that are added to vaccines to make children sick.
    Aaaaargh.

  • Jim Lebeau says:

    I know I am taking the wrong side here, but those that do not vaccinate often have authority issues. They realized their science teacher was wrong (and he was, he said a kilometer was more than a mile, and that metric units were more accurate than english units.)
    Their church leaders just about admitted to being wrong. Ronald Reagan was not as forthcoming as he might have been.
    They don't believe George Bush, and they don't believe YOU!
    And the more you try to look like an authority, (imagine trying to look like George Bush) the less these people will believe you.
    Tough shitsky.

  • Luna_the_cat says:

    Are you aware that it the measles are (entirely predictably) spreading now?
    http://www.upi.com/NewsTrack/Top_News/2008/02/12/measles_break_out_in_san_diego/2321/
    --victims include and 11-month-old now, too.

  • Luna_the_cat says:

    Doh! I just now cought your update. Of course you were aware.

  • Justa Tech says:

    Chickenpox parties? Please, please tell me that's not true. Will someone please tell those parents that by letting their kids get chickenpox they are also setting them up for the possibility of shingles? My boyfriend's father nearly lost his eye to shingles. Or maybe we should just remind people that chickenpox is *herpes*! That might change the way they think about these 'parties'.
    And really, if you gave a 4-year-old the choice of "a little poke" or "be miserably itchy for a week", well, what would you chose?

  • DrugMonkey says:

    those that do not vaccinate often have authority issues. ...
    And the more you try to look like an authority, (imagine trying to look like George Bush) the less these people will believe you.

    I really don't give a crap if they believe me. Those that drive under the influence of "a couple a beers" and under the influence of "a few hits" also have authority issues. we don't mollycoddle them, we enact laws with penalties.

  • Calli Arcale says:

    I had chickenpox when I was a kid. I was miserably itchy for a week. One of my friends, however, was more than miserable. She got pox in her throat and on the insides of her eyelids. And some get it much worse. Some die. The odds of dying from chickenpox (or even shingles later on) are much greater with "conventional" exposure than with the varicella vaccine. It's idiotic for a decently-informed person to pick the chickenpox party over the vaccine. I so wish they'd had a varicella vaccine when I was younger. (I got the disease from a couple of quarantined kids that I was babysitting over the summer. I had had chickenpox as an infant, but alas, obviously had not developed immunity.)
    One of my dear relatives had shingles a few years ago. She was out of work for quite a while due to the neurological damage she endured. She also developed Beall's Palsy, which still hasn't recovered. (Beall's Palsy is paralysis on one side of the face. Effects range from mildly annoying to severely disfiguring, and can impede vision, speech, and eating.)

  • BugDoc says:

    Chickenpox parties are all too real, and apparently becoming fashionable. These parties are like play dates, but with an added bonus! There are a lot of articles about this phenomenon, but I think this posting on Craig's List (under the "Childcare" section) says it all:
    chicken pox parties
    Date: 2008-01-22, 10:13AM CST
    I do not vaccinate our kids against the chicken pox virus. I am looking for others who have chicken pox, so we can have a party and introduce the virus while my kids are young.
    If this sounds crazy, you can do some research (one way is to Google "chicken pox parties", it is actually something that parents have done for years (even before the vaccine came out) to expose their children to the virus while they are young and it is still safe.
    If this interests, you, feel free to email me and I will put you on the "chicken pox parties" mailing list, and I will organize a party or play date as soon as I find someone who has a child or children with the virus.
    I am a responsible working mother and we keep a very nice clean house. Our kids are 5 and 1. We would also be excited to meet some more kids to play with!

  • Meaty Urologist says:

    As a child, I had chicken pox- which my mother proceeded to pass along to my siblings so we could all get it out of the way, whooping cough, and a particularly nasty case of mumps. Growing up, I was one of the last to receive standard smallpox vax and I'm the only one I know missing adenoids. As a result, I have a superhuman immune system but retarded sperm. I'm still not sure how that fits with natural selection...Oh, and the antivaxers are child abusers.

  • weing says:

    I wonder if suing ABC and the writers of the recent Eli Stone episode about vaccination causing autism would help.

  • Poodle Stomper says:

    Does anyone know if it has been determined whether the chicken pox vaccine actually prevents the virus from establishing latent reservoirs in the CNS or does it just prevent a person from being symptomatic?

  • DavidCT says:

    Any one who considers vaccine preventable diseases to be harmless should visit the following site maintained by Peter Bowditch :http://www.ratbags.com/rsoles/vaxliars/pictures.htm

  • Calli Arcale says:

    Poodle Stomper -- I don't know about that, but here's something that might be kinda related. I read a mass media article (eek, I know) about a study done of the varicella vaccine in nursing homes. When given to patients who had, as children, been exposed to chicken pox, there was a lower incidence of shingles and fewer symptoms in those who did get shingles.
    I understand there is also some evidence that the varicella vaccine might require booster shots, much like tetanus. Right now, I think it's only given once in childhood and that's it. (The nursing home study was an experimental use.)
    So there may even be a varicella vaccine in the future for those of us who have had chickenpox -- giving hope that we, too, might have the chance to escape shingles.

  • Poodle Stomper says:

    Calli,
    Thanks. I guess it would make sense that vaccinating previously infected adults could help supress shingles later on being that it is the same virus. I suppose we will have to wait and see if it prevents latent pools from occurring when the vaccinated generation gets older. I wonder if they will come out with a similar HSV vaccine soon. There's got to be a large market for that here in the US from all the valtrex commercials I keep seeing!

  • Heather says:

    I got chicken pox when I was 11, before there was a vaccine (I think, my parents were very good about getting me all of the necessary vaccinations). It was terrible, I had them in my throat, on my palms and the soles of my feet, under my eyes...everywhere. Anyone who would rather their child get chicken pox than the vaccine is a terrible, terrible person. Seriously.

  • Interrobang says:

    I had rubella when I was a baby, too young to be vaccinated. I didn't have any ill effects, as far as anyone knows, but not everyone is so fortunate. I also somehow managed to get pertussis, despite having been vaccinated for it. (To whomever infected me with that, thanks a damn lot, you jerk.)
    That said, I'd get the varicella vaccine in a heartbeat if I thought it'd prevent me from getting shingles later on. I got chicken pox when I was five, and I remember being terribly sick (I had the bad respiratory infection as well as just the lesions) and itchy and miserable. My maternal grandfather went through six months of hell with shingles. My maternal grandmother went blind in one eye from shingles. My father managed to get treated rapidly (first 72h) for his shingles with a strong antiviral and only had to suffer for a few days with lesions in his mouth, of all places. My sister has been vaccinated for varicella and has also caught the disease twice; she's apparently quite susceptible. I've seen firsthand how nasty it can be.
    I'm really quite distressed at how this is spreading. I seem to recall a similar case with something infectious spreading amongst religious nuts near me (SW Ontario) a couple years ago. It's interesting how various forms of crankery (funnymentalist religion, anti-vax woo) seem to go together. Someone at The Panda's Thumb suggested calling such folks "syncretins," and I quite like the term...

  • Liz Ditz says:

    There was a pertussis outbreak at Palo Alto High School in the fall of 2006. While the outbreak seemed to arise more out of the natural waning of the effectiveness of the pertussis vaccine than vaccine non-uptake, the health risks are real.
    http://www.paloaltodailynews.com/article/2006-11-22-letters

    Dear Editor: I was a bit dismayed to read comments made by various students and parents at Palo Alto High School regarding the immunization program established to counteract the spread of an outbreak of whooping cough. Perhaps there needs to be more education at Paly on the real risks this disease causes for the very young. My daughter contracted pertussis at the age of two months (around the time of her first immunization for diphtheria, tetanus and pertussis) from her father and me. All three of us were misdiagnosed (most doctors today have not seen many cases of pertussis in their practices, unlike physicians of a few generations ago who practiced before the vaccine was developed). Pertussis is also easy to misdiagnose in its early stages. Once properly diagnosed, my daughter spent 11 days in pediatric intensive care with around-the-clock monitoring for episodes of apnea and cyanosis, 10 days in a regular pediatric ward followed by a three-week period during which she wore an apnea monitor at night. While pertussis may be something of a nonissue for adolescents and adults with the worst symptom being a severe and long-lasting cough, it is absolutely life-threatening for the very young. Students at Paly who may baby-sit young infants, or be exposed to them at home or in the community, or who may expose someone with young children at home should seek immunization.

    more:
    http://findarticles.com/p/articles/mi_qn4176/is_20061114/ai_n16845543
    http://voice.paly.net/view_story.php?id=4764
    I hope some clever reporter (or public health researcher) will calculate the total cost of the measles outbreak in San Diego.

  • Michelle says:

    All those infants...I remember the baby sister of one of my friend's dying of measles; and I'm not yet 50. Kids die from these diseases, maybe someone you know!

  • isles says:

    All of you wanting a shingles vaccine are in luck! http://www.immunize.org/catg.d/p4221.pdf It's really just a big dose of chickenpox vaccine, given later in life. Unfortunately it's not tremendously effective, but worth giving a try, I would think.
    Interestingly, you can get shingles whether you had natural chickenpox disease *or* varicella vaccine.
    As to the possibility of suing somebody who gave you measles, it would be beautiful, but I think a little too hard to prove causation. Maybe under just the right circumstances. I'm not sure how courts have treated cases like that in the past - there must be some regarding transmission of HIV.

  • Sara says:

    There's worse than chickenpox parties. On the big crunchy-alternamoms bulletin board, the response to the news about the measles outbreak is:
    1) Scorn: "Some of the cases are in Vaccinated Kids! See! Vaccination doesn't work! Measles was going away on its own, and the correlation with widespread vaccination is just a coincidence!! Germ theory is just another THEORY like EVOLUTION, and science is just a religion without a god!!
    2) Glee: They're trying to figure out how to get their kids to Measles Parties. They're talking about getting the parents of measles cases to ship them INFECTED BLANKETS. YOu know, like we gave the Native Americans, only without the smallpox. So THEY can get "natural" measles and enjoy the immunities, since measles is a harmless disease that the CDC tries to hype as a killer in order to push their Evil Vax Agenda (like the Gay Agenda, but with needles)
    They are so far from caring about quarantine or the time that a child might be contagious when they're out in public that... well, its certainly not funny.

Leave a Reply