Why are parents opting out?

This article, by Lawrence Solomon, first appeared in the Huffington Post

Vaccine refusals are reaching epidemic proportions in many communities in the U.S., with large numbers of parents defying public health authorities by obtaining official government exemptions for their children. In California, the majority of children in dozens of schools obtained exemptions — in some cases, 60 per cent, 70 per cent, 80 per cent or more of the children in this way escape the legal requirement to be vaccinated against childhood diseases such as measles, mumps and chickenpox.

“We’re definitely concerned,” said Dr. James Watt, chief of California’s division of communicable disease control, in light of a report last month showing the vaccine opt-out rate has doubled over the last seven years, as measured by children enrolled in kindergarten. “We’ve been increasing our analysis of the data to try to understand what’s happening with that trend.”

The parents who are balking at having their children vaccinated are overwhelmingly well educated and affluent. For example, in the San Francisco Bay area’s prosperous Marin County (median family income $90,000), the opt-out rate is three to four times that of less-well-off neighboring Bay counties. The individual California schools logging the highest op-out rates cater to liberal communities within Los Angeles County: The City School in Lake Balboa (88 per cent opt-outs) and Maple Village Waldorf School in Long Beach (87 per cent opt-outs). Opt-out rates are especially high in private schools.

In contrast, less affluent schools have much lower opt-out rates, particularly in down-market areas where unemployment is high and family life can be challenging. In California’s Yuba County, where the median income is well below the state average, parents fall in line when it comes to vaccinating their children — most Yuba County schools have either a 1 per cent or 0 per cent opt-out rate.

State-wide, the average opt-out rate remains low — despite the doubling, it barely exceeds 3 per cent. But public health officials are worried because the parents creating the opt-out trend tend to be opinion-leaders, raising the possibility that the doubling trend will snowball and threaten the full-vaccination goals of the public health officials. In other states, too, the parents leading the anti-vaccination trend are formidable: According to a survey in Pediatrics, unvaccinated children have a mother who is at least 30 years old, has at least one college degree and whose household has an annual income of at least $75,000.

Why do parents opt out? The Pediatrics study indicated the parents are almost 10 times as likely to be concerned about the safety of vaccines as parents who vaccinate their children. Other studies and anecdotal reports note that these educated parents, who tend to be professionals in their own right, are less likely to defer to government authorities, more likely to have a physician who is skeptical of vaccinations and more likely to research the pros and cons of vaccinations prior to agreeing to having their own child vaccinated.

Safety aside, many parents believe the advertised benefits of vaccines to be overhyped, and can point to credible sources to back up their view. The Mayo Clinic’s Vaccine Research Group, one of the world’s largest in the field, views today’s measles vaccine as a failure that needs to be rethought and replaced. According to Dr. Gregory Poland, a Professor of Medicine and the head of the group, because the vaccine has a high failure rate and wanes in effectiveness even when it takes, “this leads to a paradoxical situation whereby measles in highly immunized societies occurs primarily among those previously immunized.” As described in his 2012 paper, “The re-emergence of measles in developed countries,” dozens of outbreaks in North America and Europe have occurred over the last decade.

Likewise, there is reason to doubt the efficacy of the vaccine for mumps, which also has failed to prevent outbreaks. Last month, a possible explanation for its failure emerged when a U.S. District judge threw out attempts by Merck, the vaccine’s monopoly manufacturer, to dismiss two suits alleging that Merck falsified test data to show the vaccine to be effective. The extensive claims of misconduct in the suits, found plausible by the judge, rely largely on two Merck scientists who have since become whistleblowers. According to the scientists, Merck marketed its vaccine although it expected outbreaks to occur and, as predicted, they did — mumps epidemics occurred in 2006 in a highly vaccinated population and again in 2009-2010.

Other vaccines that public health authorities tout also can have iffy records, as many motivated parents are discovering by researching the adverse effects children sometimes experience following vaccination. Through word of mouth and through social media, the number of opt-out parents then climbs in communities across the country, leading to the rising rates now seen.

Lawrence Solomon is a columnist with Canada’s National Post and is research director of Consumer Policy Institute.

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For previous columns by Lawrence Solomon on vaccines, see here.