But so too does immunization, at least in rare cases. Those who favor vaccinating children from diseases such as measles and mumps — and that’s most of the medical community — say exaggerated claims of the unintended consequences of vaccines are scaring parents from immunizing against a public health threat.
“If even one person is unvaccinated, we are all at risk,” Jose Rodriguez, a spokesman for the Columbus Public Health Department, told Reuters news service in late March.
Last week, Dayton Children’s Hospital reported two unconfirmed cases of the mumps — two Greene County boys ages 2 and 19 months — the first cases the hospital has seen in at least two decades.
In Clark County, at least six suspected or probable cases of mumps have been reported.
At least 353 mumps cases were linked to a community outbreak in Franklin, Delaware and Madison counties. Of those, 204 cases have been linked to an outbreak at Ohio State University. Local health officials are concerned the disease may be transported by OSU students returning home for the summer.
Last year, a spike in measles cases briefly drew national attention. From January to November 2013, there were 175 known cases of measles, almost triple the usual number. At the time, Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said the outbreak was a failure on many fronts.
“It’s not a failure of the vaccine,” Frieden said in a Dec. 5, briefing on the 50th anniversary of the measles vaccine. “It’s a failure to vaccinate. Around 90 percent of the people who have had measles in this country were not vaccinated either because they refused or were not vaccinated on time.”
Vaccination rates in Ohio have declined for virtually all childhood vaccines. Experts attribute the decrease, in part, to complacency. The diseases for which vaccinations are offered are no longer common.
Many, too, have forgotten how terrible some diseases were. Before the life-changing vaccine was discovered, polio would paralyze some 10,000 children each year, according to the Children’s Hospital of Philadelphia.
But some parents are choosing against vaccinating their child because of fear of what the vaccine might do.
Celebrities, such as actress Jenny McCarthy, whose comments suggesting that vaccines are linked to autism — which her son has — have helped fuel the debate.
“There are people who intentionally mislead about the vaccines,” said Dr. Ryan Simon, a pediatrician who practices for Dayton Children’s and Wright State Physicians. “I don’t necessarily want to point fingers at them, at the celebrities.”
Audra’s story
For many, the immunization debate is purely hypothetical.
But for the Ankeney family in Centerville, it is quite real.
On a Wednesday in June 2003, Tonya Ankeney’s 10-month-old daughter, Audra, received Hepatitis B and diphtheria-pertussis-tetanus vaccines. By Sunday, their daughter was having severe difficulties moving and breathing.
Soon, she was paralyzed and intubated, on life support, in Dayton Children’s Hospital.
“They actually didn’t expect us to take her home,” Ankeney said.
Physicians quizzed Ankeney on what had happened in the past few days with her daughter. They determined that damage to Audra’s spinal cord had not been caused by any external trauma.
Then, Ankeney recalled, “One doctor asked, ‘Has she had any vaccines?’”
“And I said, ‘Yes. She had her vaccines this past Wednesday.’”
OSU outbreak
The Columbus Public Health Department found that of the more than 200 OSU students who were infected with mumps only 3 percent were wholly unvaccinated, according to spokesman Jose Rodriguez. But any time there is a concentration of people who have received no vaccine doses, the likelihood for infection increases greatly, he said.
At OSU, health officials said 82 percent of the people with mumps were fully vaccinated and about 47 percent had received two doses of the mumps, measles and rubella vaccines. “We wish it would have been 100 percent” fully vaccinated, Rodriguez said, “you reduce your chances.”
While the vaccine is 80 to 90 percent effective, he said those odds are “not bad.”
Mumps isn’t merely an inconvenient disease. Columbus Public Health has also reported 11 cases of orchitis, or swollen testicles; two cases of oophoritis, or swollen ovaries; one case of deafness; and at least 10 people hospitalized in “severe pain,” Rodriguez said.
Mumps-infected students had to be isolated for five days, forced to miss school and work, he said. “Once you’re very contagious, you need to be isolated, must not come into contact with others,” Rodriguez said.
Measles still circulate in other parts of the world, noted Dr. Mary DiOrio, Ohio’s chief epidemiologist.
DiOrio echoed the CDC’s stance that the measles vaccine remains effective.
“The measles are highly contagious,” DiOrio said. “The vaccine is highly effective, though. So if individuals are vaccinated, we think it’s about 97 percent effective, if they get appropriately vaccinated. But we need to have high vaccination rates.”
“We’re only a plane ride away from bringing these diseases back to the United States,” she added.
Life forever altered
The risks of health-related problems from vaccines are statistically rare but acknowledged. The U.S. National Vaccine Injury Compensation Program was established in 1986 to pay patients who have been harmed by vaccines.
Three federal agencies — the U.S. Department of Health and Human Services, the U.S. Department of Justice and the U.S. Court of Federal Claims — have a role in the program and its compensation fund, which is paid by a tax imposed on the producers of vaccines. For example, trivalent influenza vaccine is taxed at 75 cents because it prevents one disease, while the measles-mumps-rubella vaccine, aimed at a trio of diseases, is taxed at $2.25, according to the Health Resources and Services Administration.
The program compensates individuals harmed by vaccines while continuing also to offer them as widely as possible, in the interest of achieving and maintaining a healthy, widely immunized population.
After establishing a link that the vaccine likely caused their daughter’s paralysis, the Ankeneys filed a federal complaint in 2007.
After the testimony of experts, the court awarded Audra Ankeney $742,000 through the federal program for her injury, a case of transverse myelitis that left her substantially paralyzed from the shoulders down, said her Cincinnati attorney, Nicholas Bunch.
The award allowed the family of five children to move from a home on Leo Street in Dayton to a Centerville ranch home, with all rooms on one floor, allowing relatively easier access for Audra.
So far in fiscal year 2014, which began on Oct. 1, the federal program has paid 154 awards totalling nearly $85.7 million to petitioners. Attorneys’ fees and costs payments that year amounted to nearly $4.9 million. The program has also dismissed 416 claims so far in the fiscal year.
Audra’s life is forever altered. Every six months, she goes to a Philadelphia hospital to have titanium rods placed in her spine to counter spinal curvature, her mother said. The 11-year-old will undergo that treatment until she stops growing.
“This goes all the way back to vaccines,” Ankeney said.
Ankeney understands that her position is regarded as a controversial one. She said she doesn’t care. She sees vaccines as inherently dangerous, and today she believes “her calling” is speaking out about what she sees as the risks of immunization.
“Until you watch a perfectly healthy child go from crawling and chewing to nothing, then you don’t understand,” Ankeney said.
Vaccines do work
A spokesman for the Health Resources and Services Administration, which helps administer the federal compensation program, noted how vaccines generally serve its purposes.
“Vaccines save lives by preventing disease in the people who receive them,” the spokesman said in an e-mailed. “Most people who get vaccines have no serious problems. However, vaccines, like any medicines, can rarely cause serious problems, such as severe allergic reactions. In those rare cases, the Vaccine Injury Compensation Program provides compensation to people found to be injured by certain vaccines.”
The federal government has an open source reporting system for tracking reactions to vaccines at vaers.hhs.gov. Anyone who experiences an adverse reaction — anything from a sore arm to a rash to hospitalization — can report the event at that website.
But the system relies on voluntary self-reporting, and that reporting may be based in some cases on a faulty understanding of pre-existing medical conditions or coincidental reactions, said Karie Youngdahl, project director for The History of Vaccines, an educational website created by The College of Physicians of Philadelphia, a nonprofit medical society.
More than 10 million vaccines per year are given to children less than a year old, usually between 2 and 6 months of age, according to the CDC and the Food and Drug Administration, which co-sponsor the VAERS reporting system. The two agencies hold that some children will experience “medical events” after a vaccination “by coincidence,” while some are caused by vaccines.
About 30,000 events are reported each year to the federal reporting system, according to the College of Physicians of Philadelphia. Between 10 percent and 15 percent of these reports describe serious medical events that result in hospitalization, life-threatening illness, disability — or death, the center says.
The system relies on reporting by physicians, nurses and parents. It is meant to serve as an early-warning system of “adverse events associated with vaccines.”
“The scientific and medical community was of the belief, and still is of the belief, that no matter that safe they make these vaccines, the law of unintended consequences comes into play,” Bunch said.
Medical concerns
For some, there are medical reasons to avoid vaccines.
Samantha Block, a Huber Heights resident who works at Wright-Patterson Air Force Base, is the mother of three young sons, one of whom has an immune deficiency, which she said prevents him from receiving many vaccines.
“I do not describe myself as anti-vaccine,” Block said in an e-mail. “I do not subscribe to many of the so-called conspiracy theories, but I do believe that vaccines are an imperfect attempt at addressing some diseases, vaccines have real risks, and that nothing in medicine should be applied to an entire population without individual risk/benefit analysis.”
Block said if an individual believes vaccines will benefit them and are worth the “very real” risks, then getting vaccinated is the correct course.
“But realize that vaccines are one of many ways to prevent and treat only a handful of illnesses,” she added. “They are not the only way, and for many people may not be the best way.”
Public health advocates understand that many parents decline vaccines based on what they believe is best for their child, DiOrio said.
“We appreciate that,” she said. “But we really want to help them understand that we believe the best way to help their child is through immunization.”
Ohio has had a slight increase in vaccine refusals among parents of infants and children, but the numbers are still low, DiOrio said.
Ohio Department of Health immunization rates vary by vaccine. As of 2012, 92.5 percent of Ohio children between 19 and 35 months old were covered for polio; 90.3 percent were covered for measles, mumps and rubella; 90.8 percent were covered for varicella or chickenpox; and 83 percent were covered for diphtheria, tetanus and pertussis.
Gayle Sewak , registered nurse at Clark County Combined Health District, said the district administered 11,600 vaccine doses last year. She said the most common reason vaccines are refused is “misinformation,” particularly from the Internet.
That’s when her job becomes one of establishing trust, overcoming fear, of persuading parents that vaccines are in their child’s best interest, she said.
“That’s what we do,” Sewak said.
Parents should trust physicians before illness strikes, Simon said.
“You trust me to take care of them (children) once they’re sick,” he said. “I don’t understand why that trust falls down or breaks down when the time comes to preventing them from getting sick.”
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