If there's one great truth of political debate, it's this: when noise trumps knowledge, someone's going to get hurt. That's been proven anew with Wednesday's report that vaccination rates for children with health insurance have been falling — due mostly to fears about the widely disproven link between vaccines and autism. If there was a glimmer of good — and surprising — news in the report it's that vaccination rates for kids on Medicaid are on the rise.
The evidence for a vaccine-autism link has always been more observational than scientific. A child gets vaccinated and soon after, autism symptoms emerge. The apparent cause-and-effect is understandable but erroneous — more a coincidence of the calendar and childhood developmental stages than anything else, as repeated and exhaustive studies have shown. But the fear has stuck and it's the kids themselves who are paying the price.
According to data reported by the National Committee for Quality Assurance (NCQA), a nonprofit group that evaluates health care protocols and policies and recommends improvements, the share of children with health insurance receiving the measles, mumps and rubella vaccine (MMR) fell from 93.5% in 2008 to 90.6% in 2009. For diphtheria, tetanus and whooping cough the drop was from 87.2% to 85.4%. For chicken pox it was 92% to 90.6%. The data came from an analysis of 1,000 health plans covering 118 million people.
In all of these cases, the fall-off in vaccinations is admittedly small — and the compliance rates remain admittedly high. But viruses are opportunistic things and it takes only a few holes in the immunity net for disease to slip through and range free. In 2003, leaders of a region in northern Nigeria halted polio vaccinations, claiming that the vaccines harbored HIV and could render girls sterile. Polio quickly spiked in the region, and by 2005, cases of the disease genetically consistent with a Nigerian strain had swept through 10 neighboring countries. In California, a recent outbreak of whooping cough has sickened 6,200 people and claimed the lives of 10 infants. (More on Time.com: Polio's Back. Why Now?)
What surprised some analysts in the NCQA study was the bump in vaccine rates among lower-income — and often less-educated — families on Medicaid. Typically it is more affluent parents who are the most vigilant about following preventive health measures and poorer families who see that as an unaffordable luxury. But public programs that provide vaccines at low or no cost have apparently helped change that.
Wealthier families, meantime, are getting too much of their health advice not from doctors and epidemiologists, but from talk shows, the blogosphere and the rumor mill, all of which are filled with vaccine scare stories. Making things worse is that the kind of folks spreading the tales are precisely the kind we find hardest to ignore.
"Very articulate, very good-looking movie stars or personalities ... are giving out information about how bad vaccines are," pediatrician Robert Frenck of the Cincinnati Children's Medical Center told the online health news service HealthDay. "Frumpy middle-aged doctors" find it awfully hard to compete with that.
But they have to try. Vaccines save lives; fear endangers them. It's a simple message parents need to keep hearing.
Saturday, November 6, 2010
From Time magazine:
Posted by BA Haller at 7:10 PM