It Takes More Than a Deadly Outbreak to Improve Vaccination Rates

One of the creepiest things about the anti-vaccination movement is how it hedges. It doesn't deny the possibility of deadly new outbreaks—though by and large its bet is against them—but the movement's rhetoric is tailored in such a way as to shift the blame for those outbreaks away from the anti-vax crowd and back onto the makers of the very vaccines that prevent outbreaks. How shrewd.

The following quote comes courtesy of Jenny McCarthy in a 2009 Time magazine interview:

I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it’s their f*cking fault that the diseases are coming back. They’re making a product that’s sh*t. If you give us a safe vaccine, we’ll use it. It shouldn’t be polio versus autism.

So it's not about vaccines, it's about these vaccines. Vaccines are way cool, but Big Pharma is poisoning our children. The admission there that the anti-vax movement is actually likely to kill some people also might help explain the results of a study being presented today at the Pediatric Academic Societies' annual meeting describing the relationship between the outbreak of a deadly disease and vaccination rates pertaining to that disease, or rather, the apparent lack of one.

And there have been many outbreaks, of course, of diseases that not too long ago were thought of in historical terms. We might imagine an outbreak as the best advertisement imaginable for a vaccine but the new study, conducted by a team at the University of Washington, found that it might take more than actual death and illness to turn the tide back. The study focused on the administration of the classic diphtheria, tetanus, and pertussis vaccine (DTaP) among children within a variety of different age groups in Washington state before and after the outbreak of pertussis, otherwise known as whooping cough.

The outbreak occurred between the fall of 2011 and the end of 2012, targeting mostly infants. Pertussis is a brutal and highly visible bacterial infection characterized by an uncontrollable sort of super-cough that makes it difficult for the afflicted to breathe. The "whoop" is the sound a person with the cough tends to make as they labor to pull air into their junked-up lungs. The coughing can be so severe that broken ribs, hemorrhages, and hernias are not uncommon results. It's even possible to cough so violently as to tear open the vertebral artery that supplies blood to the brain.

Among hospitalized patients, the mortality rate is around two percent, with the critical factor being the administration of antibiotics (another touted would-be cause of autism, by the by). The Washington epidemic saw over 3,000 cases but, fortunately, no fatalities. Worth noting is that the state leads the nation for unvaccinated children, with opt-out rates ranging from an average of six percent all the way up to 20 percent in one county.

"Vaccination rates in the U.S. are still below public health goals," Dr. Elizabeth Wolf, the study's lead researcher, said in a press release. "We don't fully understand what improves vaccine acceptance. This study found no significant increase in vaccination coverage statewide during the 2011-2012 pertussis epidemic. This finding may challenge the assumption that vaccine acceptance uniformly increases when risk of disease is high."

Wolf also noted that the epidemic was highly publicized, leaving virtually no chance the results are just a matter of parents not hearing about it. She's also (scientifically) circumspect about the precise reasons behind her team's findings. "We don’t know if parents’ fear of adverse events still outweighed the fear of disease even in the face of the epidemic," Wolf told me on Monday. "DTaP, the current vaccine against whooping cough, is a relatively well-established vaccine with very few side effects, but it is possible that parents may have had generalized concerns about vaccine safety."