Nonmedical exemptions for vaccines have been on the rise over the past few years. They allow parents to bypass vaccination requirements for their children, based on religious or philosophical beliefs. These exemptions are often referred to as NMEs. A recent report published by the Public Library of Science Journal of Medicine, or PLOS Medicine, analyzed trends in the 18 states that permitted NMEs, from 2009 to 2017. Texas is one of them.
Dr. Peter J. Hotez is the dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston and coauthor of the PLOS Medicine report. His team divided the states they studied into two groups: states that have rural counties with large numbers of children not receiving vaccinations, and states with urban hotspots.
“In terms of the rural counties – we found a number of them in Idaho, for instance – with a very high percentage of kids not getting vaccinated and that was a real concern,” he says, “As well as in Washington state, it tended to be more western states than eastern states,” he says.
Four cities in Texas had more than 400 children get NMEs for vaccines. They are: Austin, Fort Worth, Houston and Plano. Hotez says that number only includes kindergarteners.
“In Texas, we have – by some estimates – more than 300,000 kids who are homeschooled, and we have no idea what percentage of those kids are being exempted on vaccinations” he says.
Hotez guesses there is some sort of sociological or religious explanation that accounts for these nonmedical exemptions. He and his team are conducting a follow-up study that looks at the level of education and affluence of parents whose children are being exempted from vaccinations.
“It’s looking tentatively that we’re seeing parents who are pretty well-educated and relatively well-off financially,” he says, “Where I often like to say ‘educated enough to do a Google search’ – maybe not so educated enough to know to distinguish the anti-vaccine websites from the pro-vaccine websites.”
With so many parents getting NMEs for their children, the big question is what that means for herd immunity.
“We’ve got now schools – and some schools in Texas where 20, 30, even 40 percent of kids are not getting vaccinated – and that’s a recipe for breakthrough childhood infections that would ordinarily be prevented through vaccines.”
Often the first childhood disease Hotez sees in his patients is measles, because it’s so highly transmittable. Measles outbreaks have occurred in California and, more recently, in Minnesota.
“The problem is not only among those kids who are not getting vaccinated – but any time that there’s a sibling or a friend of a sibling that’s under 12 months of age – those kids are not old enough to receive their measles vaccine,” he says, “What you worry about are outbreaks occurring among infants living in that community are not yet old enough to receive the measles vaccine.”
Written by Amber Chavez.
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