🔒Anti-vaccination movement puts CT docs in educator role

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Connecticut's vaccination rates are among the highest in the country, but local doctors are still concerned about what they see as an increasing wariness and distrust by parents and patients of shots aimed at preventing various diseases like measles, mumps and rubella.

Last school year, parents of 689 Connecticut kindergartners signed waivers to exempt their children from required vaccinations based on religious beliefs, according to government data.

Those exemptions represented 1.7 percent of the kindergarten population. The number of exemptions has climbed steadily in recent years, up 46 percent since 2011-2012, even as the number of kindergarteners in the state has fallen.

There could be several reasons for the uptick. Some doctors suspect cost or lack of knowledge could be a deterrent to sticking to the recommended vaccine schedule.

But they also think some parents of young children are putting too much stock in discredited or inaccurate information that has come out in recent years about some vaccines' ill effects.

“It can be frustrating trying to explain the benefits of vaccines with a parent who is convinced that an article on the internet — or even Facebook — goes against years of excellent science and the best public health intentions,” said Dr. Marc Ramirez, a pediatrician with Starling Physicians in New Britain.

The potential consequences are serious. Reported cases of preventable contagious illnesses like measles and whooping cough, once thought to be virtually eradicated, have increased across the country in recent years.

Ramirez sees that as a setback to the important goal of preventing disease in the broader population.

“Great gains have been made in eliminating and reducing the spread of deadly diseases, yet some of these diseases are coming back due to vaccine refusal,” Ramirez said.

Though mostly on the fringes, the anti-vaccine movement, and general distrust of vaccines, is very much alive.

While vaccines can cause various side effects — redness and swelling most commonly, according to the Centers for Disease Control —  some celebrities have lent their voice to more fringe claims. One of the most prominent is that vaccines can cause autism; medical scientists say there is no such link.

President Donald Trump made news early this year when he met with Robert F. Kennedy Jr., who has alleged that the federal government covered up a discovered link between a vaccine ingredient and autism. Scientists say studies have found no evidence of any such link.

“This link between autism and the [measles, mumps, rubella] vaccine has been disproven, yet some people still distrust this information,” Ramirez said.

Distrust in vaccines crosses socioeconomic lines. In fact, a 2011 study by Public Health Reports found that families of unvaccinated children are more likely to be wealthier and more educated than average.

Dr. Nicholas Bennett, medical director of the Division of Pediatric Infectious Diseases and Immunology at Connecticut Children's Medical Center, said he has seen anecdotal evidence of that finding. People who aren't doctors, after all, may have a hard time parsing through competing claims and complicated medical studies.

“They read just enough to be worried and not enough to be re-assured,” Bennett said. “It's not that they are stupid.”

Going beyond the many conspiracy theories, one common argument against mandatory vaccines for school children is that they are a violation of First Amendment rights. Some say parents should be able to make medical decisions for their own children and that recent upticks in measles and other illnesses have been overblown.

Doctors counter that more unvaccinated children increases the chances of a disease outbreak.

Elissa Diamond-Fields is a Stamford chiropractor and director of outreach and education for Health Freedom Action Connecticut, a group that advocates for the rights of parents to decide whether or not their children should be vaccinated.

She has testified against several vaccine-related state bills in the past several years, including a 2015 law that requires parents to submit notarized exemption forms annually instead of once, as well as a bill that died earlier this year that would have made school-by-school vaccination data public record.

“Our stance is that vaccine decisions belong between people and their health providers, and should never be forced or coerced by legislative actions,” Diamond-Fields said.

While vaccine skeptics are likely to remain, they are in the minority, and both Bennett and Ramirez say they don't run into a great deal of disagreement from parents.

“We see a smattering of cases where I work,” Bennett said. “They have concerns about the ingredients in the vaccines. A lot of these concerns aren't truly legitimate concerns. People have jumped on some of these ingredients as a reason not to get vaccines.”

When he does encounter a reluctant parent, he says he takes time to hear their concerns so he can formulate the best response.

“We need to figure out how to talk too them so their worries are addressed,” Bennett said.

Ramirez agrees.

“From a personal standpoint, I try to understand why a defiant parent may refuse vaccines and give them the correct information regarding any questions they may have,” Ramirez said.

Ramirez said some pediatricians decline to accept patients who refuse vaccines because they don't want the risk of having them in their waiting rooms.

“The consequences of not vaccinating can put the child at risk of some serious diseases, severe illness and even death,” Ramirez said, adding that he has experienced cases where vaccine refusal led to a significant illness that required hospitalization.

“I have had a couple infants contract whooping cough (pertussis),” he said.

The state requires non-exempt kindergarteners to have four doses of the so-called dTaP vaccine, which prevents whooping cough.

Bennett, too, has seen instances where patients got sick because they weren't immunized.

“The risk of the disease is so much more than the risk of getting vaccinated,” he said.

While challenges remain, public health still appears to be winning the day and medical science continues to create vaccines that are helping people. The first approved vaccine for Rotavirus — a contagious virus that affects young children most severely with fever, vomiting and diarrhea — emerged in the past decade.

The vaccine has resulted in a dramatic drop in hospitalization rates related to the illness.

“Huge public health victory,” Ramirez said.