Vaccination in the U.S.: Public health debate turns political

The decision over whether to vaccinate young children in the United States has quickly turned from being a personal discussion to a heated, political debate.

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The decision over whether to vaccinate young children in the United States has quickly turned from being a personal discussion to a heated, political debate.

U.S. President Obama argued recently that vaccinating young children in the U.S. is a matter of public health, while his political opponents say that it is a personal matter in which the government should have no input.

But while the debate is heating up, numbers are growing; since the end of December 2014, there have been a total of 59 confirmed cases of measles in California alone – 42 of which were linked to an initial exposure in December at a Disney park in California, according to the California Department of Public Health.

The spread of measles in the United States has been dominating headlines in recent weeks, fueled by fears that the infection, which can be deadly in some cases, is rapidly spreading. The debate over the infection, however, is centered on whether vaccinating children in the United States is an issue in which lawmakers have jurisdiction.

In an interview this week, President Obama urged parents to vaccinate their children. "I understand that there are families that in some cases are concerned about the effect of vaccinations. The science is, you know, pretty indisputable. We've looked at this again and again. There is every reason to get vaccinated, but there aren't reasons to not," the president said.

Herd immunity

Some vaccines, such as the MMR (Measles, Mumps, Rubella), are required for children to be enrolled in U.S. public schools, unless they have an approved religious (or in some states, philosophical) exemption. Mandatory immunization requirements are the most efficient method of maintaining “herd immunity,” which occurs when a large percentage of a community has been immunized from a particular disease, in order to prevent the disease from spreading within the community. Children in the U.S. are still getting vaccinated, but public health officials fear that if an increasing number of vaccine exemptions are approved, herd immunities will be threatened. Herd immunity is not only an efficient method of preventing disease, but also cost effective, in that maintaining the health of a population will save the government, health care providers, and patients millions of dollars in medical expenses for treatment.

The licensing of the first measles vaccine in 1963 and widespread vaccination over the next several decades led to a complete eradication of the disease in the U.S. by 2000. However, the disease is now thought to be coming to the U.S. from infected/exposed patients abroad. The WHO (World Health Organization) reported there to be over 30 countries in Europe that saw an increase in measles in 2011 (particularly France at the time).

According to the CDC, measles are still common in parts of Europe, Asia and Africa. The fear, for U.S. officials, is that people may contract the disease abroad and bring it to the United States and spread it among non-vaccinated populations.

Developmental disorders

The most vocal critics have recently framed the debate against vaccinating their children under a main point: that vaccines lead to an increase in other developmental disorders in their children.

Recently, one of the most outspoken critics of the MMR vaccine has been celebrity television host, Jenny McCarthy, whose son is autistic. She claims that vaccines can cause children to develop autism. This claim was raised in the 1998 study by British researcher and surgeon, Dr. Andrew Wakefield, first published in The Lancet, which cited a link between the MMR vaccine and autism. His theory, though based on insufficient evidence, caused a widespread public health scare and anti-vaccine movement. In addition to scientists having proven that the MMR vaccine is safe, organizations such as Autism Speaks have assured the public that vaccines do not cause autism, and urged parents to vaccinate their children.

In 2010, The Lancet retracted the study and Wakefield lost his medical license. In addition to those critics, lately, some U.S. lawmakers that stand in opposition to President Obama, have said that vaccinating children should be a choice of the parents, not a mandate of the U.S. government.

The Obama administration has urged that vaccinating against measles is a matter of public health. The director of the CDC, Dr. Tom Frieden, wrote in an article this week that the United States is currently facing a measles outbreak—something it has not seen in around 50 years, when the measles vaccine was first used.

“Fifteen years ago measles transmission in the United States was declared over. But as this current outbreak shows, unvaccinated people can get measles while they are abroad and bring it to the United States. They can spread it to others and cause outbreaks,” Frieden said in the article.

California, which has now been put under the spotlight, due to the recent outbreak at the Disney park, enforced that vaccination is a choice of the parent. However, after recent scrutiny, California lawmakers are now proposing legislation that would bar parents from choosing to not vaccinate based on their personal beliefs.

"The high number of unvaccinated students is jeopardizing public health not only in schools but in the broader community. We need to take steps to keep our schools safe and our students healthy,” California Senator Ben Allen said in a written statement announcing the legislation he is co-sponsoring. If approved, California would become the 33rd state in the U.S. to mandate vaccinations.

Yasmeen Sami Alamiri is a Journalist with Al Arabiya News Channel. Nour Alamiri studies and researches the social and medical implications of public health campaigns on women and children in underserved communities.

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