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Published on November 20, 2017

The most important medical advancement for kids

The most important medical advancement for kids

Pediatrician Kira Grant Edwards, DO, calls the vaccination of children “the single most important medical advancement that we have made in saving children’s lives.”

The practice protects them against a whole host of diseases, from the measles to polio, which she knows firsthand.

“Growing up, there was a neighbor of mine who had a child who died of complications of chickenpox,” she said.

The push is now on by health officials for those who have not had a flu shot yet this year to do so, since the risk of contracting and spreading the flu remains.

The CDC recommends an annual flu shot for everyone older than 6 months, especially those at high risk of being harmed by the virus. These include young children, pregnant women, people older than 65 and those with certain chronic problems, such as heart or lung disease, asthma and diabetes.

[RELATED: Flu season is here and it could be a nasty one]

Vaccines not only protect the vaccinated person, but help keep whole communities safe, said Dr. Edwards.

Cape Cod parents lag below the state average in getting their children immunized, even though state law mandates all schoolchildren, from pre-school through high school, be immunized against several diseases. And the main reason apparently is fear that vaccines may cause autism – a fear that experts say is scientifically unfounded, according to Sean Palfrey, MD, co-director of the Massachusetts Immunization Initiative of the state chapter of the American Academy of Pediatrics.

Parents may seek exemptions from the state vaccination requirement for medical or religious reasons.

It is the religious exemptions that have been rising. According to state Department of Public Health figures for the kindergarten 2014-2015 school year, medical exemptions for Barnstable County amounted to 0.6 percent, but religious exemptions totaled 2.6 percent. For the state, medical exemptions averaged 0.3 percent, and religious exemptions, 1.1 percent.

The county’s kindergarten medical exemption rate dipped slightly in the 2015-2016 school year to 0.5 percent, but religious exemptions rose to 2.9 percent, according to a DPH survey.

An August letter to Massachusetts public school principals requesting information for last year’s kindergarten immunization survey stated that “personal belief exemptions for vaccination put people at risk.” It was signed by the heads of the state Department of Elementary and Secondary Education, Mitchell D. Chester, and the DPH’s Immunization Program, Pejman Talebian.

According to Palfry, parents claim religious objections to immunization out of fear the measles-mumps-rubella vaccine may cause autism. “They abuse that by saying, ‘This is my religion’ when it’s really their belief,” he said.

“We know the vaccines aren’t the cause of autism,” Palfrey said.

Letting unvaccinated children attend school is “most difficult,” said Dr. Palfrey, as it puts at risk a child with HIV, cancer or other condition that has suppressed their immune system.

Nauset Schools Policy

Nauset Public Schools has an immunization policy that states that philosophical exemptions are not allowed by law in Massachusetts, even if signed by a physician.

“It may seem obvious, but the problem with religious exemptions is that they don’t immunize,” said Ann Caretti, Nauset’s director of student services. “If a student does become exposed to a certain condition or illness, and that results in the student being excluded from school – that could happen again and again.”

The supposed link between autism and vaccines, particularly the MMR (mumps, measles and rubella) vaccine, resulted from an article published in 1998 in the British medical journal Lancet. But, according to the U.S. Centers for Disease Control and Prevention, the lead author of the study, Dr. Andrew Wakefield, was found guilty of professional misconduct in 2010 and lost his license to practice medicine in the United Kingdom. Also, 10 of the 13 authors of the study have since dropped their support of the article.

Numerous large studies in the United States and other nations have since found no evidence of a link between vaccines and autism, yet the rumor continues to be repeated by celebrities, and in various health advice and parenting websites.

Dr. Edwards said she has had some success with convincing reluctant parents to immunize their children, but some remain adamant in their opposition, and are unmoved by arguments that they may be endangering their community. This is unfortunate, she said, since introduction of a disease-causing virus to a community may only be a plane ride away. She noted the public health scare several years ago when an unvaccinated child on Martha’s Vineyard was initially diagnosed with measles, but later found not to be infected with the virus.

The initial concern was not misplaced. According to the Centers for Disease Control, in the decade before 1963, when a measles vaccine became available, most children under 15 contracted the disease. It then annually caused 48,000 hospitalizations, 4,000 cases of encephalitis (swelling of the brain) and 400 to 500 deaths.

“Physicians are simply trying to protect as many people as they can from potentially very serious diseases,” Dr. Palfrey said. “Vaccines not only protect the child or adult vaccinated but all those around them, their whole communities. Get high enough immunization rates and we can create effective herd immunity. Achieve high enough herd immunity everywhere and we can drive the pathogen extinct, as we have done with smallpox.”