By Adriana Yarkin, Copy Editor
Vaccines: A trip to the doctor’s office, a poke in the arm. Done.
Diseases such as pertussis, Haemophilus influenzae and measles are not common fears in the U.S., and cases are rarely reported. However, prior to the development and widespread use of vaccines in the last half-century or so, these diseases killed thousands of citizens every year.
There are two mechanisms by which vaccines have been so effective. On an individual scale, the antibodies produced in response to a vaccination prevent contraction of a given disease in the future. On a wider scale, vaccination of the majority of individuals within a community effectively protects the community as a whole from the spread of disease.
Antibiotics, by comparison, do neither. You must first get sick in order for them to work, and they do not help to prevent others from getting sick.
School nurse Dr. Sarah Day talked about the importance of herd immunity, which is a high immunization rate met when a certain percentage of the population of a community is vaccinated. The herd immunity requirement threshold varies from vaccine to vaccine.
“There’s no vaccine that works 100 percent,” Day said. “It really depends on having a high level of protection, so you don’t get sick.”
Herd immunity, according to Day, is one of the most effective forms of protection for both individuals and communities.
It can be thought of like a forcefield — if you don’t have immunity to a disease, but most everyone around you does, then the disease won’t be able to work its way through the community, and you won’t get sick.
However, if some of the people that you interact with also do not have immunity, then they are invisible holes in your forcefield and you are more likely to be exposed to the given disease. If your vaccine didn’t give you full coverage, or if you did not receive a vaccine in the first place, you are at risk not only of getting sick, but also of transmitting the disease to other people.
Some people are more susceptible to diseases or cannot be vaccinated. Infants and elderly people are the most common examples, but some people have medical conditions that put them in this category as well. Herd immunity is key to protecting these people. Without it, diseases can reach those without a defense and spread throughout a community.
Vashon Island does not have herd immunity.
Only 74.1 percent of students at VHS have all of the required vaccines for their age, yet only 0.3 percent of students are medically exempt, according to Day.
Vashon has been a hotspot for so-called “anti-vaxxers,” as seen in the BBC investigative video piece, “Vashon Island: The place where many parents skip jabs.”
This is particularly worrying when you consider that many of the diseases that vaccines protect against are far from uncommon in other parts of the world. According to the Center for Disease Control (CDC), an outbreak could be “just a plane ride away.” One way to glimpse a possible future can be seen in what happened when a decrease in vaccinations took place in Japan between 1974 and 1979.
In 1974, 80 percent of Japanese children received the pertussis (whooping cough) vaccine. There were 393 cases throughout the country, and there was not a single pertussis-related death. By 1979, pertussis wasn’t considered much of a threat, and the vaccination rate of children had dropped to a mere 10 percent. That year, there was an outbreak during which 13,000 people contracted pertussis, and 41 people died.
As the rate of vaccinations subsequently increased, the number of reported cases dropped again.
According to the CDC, nearly every child in the U.S. contracted measles before the age of 15, and hundreds died of it every year prior to the development of the vaccine in 1963. Measles is more communicable than most other diseases — an infected person can sneeze in a room, and up to two hours later another person can enter the room and become infected.
Though it was considered nationally eradicated in 2000, measles has recently made a comeback as seen this past May and June in Minnesota. A surge of 79 cases cost the Minnesota Department of Health $900,000, according to Debra Berliner, who is an immunization specialist for Seattle and King County Public Health.
Measles infects nine out of 10 people who come into contact with a measles patient. Ninety six to 99 percent of a community must be vaccinated in order to achieve herd immunity and prevent an outbreak.
According to the data provided by Day from last year, eight percent of students at VHS were not vaccinated for the measles, mumps and rubella (MMR) vaccine, placing the school at a level below herd immunity.
“It takes just one person who’s been abroad to start an outbreak,” Berliner said. “In almost all outbreaks, measles is able to establish itself in the community because herd immunity levels hadn’t been reached.”
Washington state laws allow parents to “opt out” of vaccines for their children that are otherwise required, a practice more common on Vashon than many other places in the state. Parents have cited “personal reasons” as a reason for total exemption from vaccinations for 15.5 percent of VHS students.
One of the most prevalent claims made by people who choose not to vaccinate is that vaccines are linked to autism. According to the National Library of Medicine, the origin of this story comes from now discredited British doctor Andrew Wakefield.
In 1998, Wakefield published a paper linking the MMR vaccine to autism. Though it was later declared fraudulent, it received wide publicity and led to a sharp decrease in the number of people vaccinating — as well as a corresponding increase in instances of measles and mumps in the UK.
Additional studies took place which demonstrated zero correlation between vaccines and autism, and Wakefield was found to have had multiple conflicts of interest and to have manipulated his evidence.
According to Day, the decision of whether or not to vaccinate is usually made by parents, and not by students. Both Day and Berliner encourage conversation between students and their families.
“Clinicians often tell me how influential teen voices are in their families’ decision-making about vaccines,” Berliner said.
Day emphasizes that people of all ages, particularly those in high school, should concern themselves with this decision — in part because if there is an outbreak, not only are unvaccinated students much more susceptible to the disease, but they may also be required to stay home for a period of time in accordance with Washington state law. Additionally, some colleges and universities have “proof of immunization” requirements that must be met in order to attend.
Vaccines have allowed children and families to live in a world where diseases which have tormented past generations do not even feel like a reality, where a poke in the arm is an easy alternative to becoming sick, and where protecting yourself also means protecting your neighbors and your community as a whole.
“We’re getting better — we’re getting closer,” Day said. “Because we have such a small population, it would only take a few more people to be vaccinated to provide that level of immunity.”
