The rise of the anti-vaccination movement has shown that even affluent and well-educated parents can be dolts, and that school and public health officials can be inexcusably complacent. The Disneyland measles outbreak may finally give all these parties a much-needed jolt of reality.
As of Wednesday, according to my colleagues Rosanna Xia and Rong-Gong Lin II, the latest California-centered measles outbreak numbered 67 confirmed cases in nine California counties, four other states and Mexico. For a first-world country, an outbreak on this scale is shameful.
Of those cases, 42 have been linked directly to visits in December to Disneyland or Disney's California Adventure park, and some others to park visits this month. Of those whose vaccination status is known, 28 were unvaccinated. At Disneyland itself, five employees have come down with measles. Those who came in contact with them are being screened for their vaccination status.
The silver lining in this public health crisis is that it apparently has awakened public officials to the consequence of indulging parents who refuse to have their children vaccinated for measles. The awarding of "personal belief" exemptions from vaccination requirements has been out of control for years. Reputable medical experts have warned that the vaccination rates of schoolchildren have been falling below safe levels. Now their warnings have been validated in the worst way possible.
Public health officials are finally taking a hard line. Orange County authorities have ordered two dozen students out of Huntington Beach High School because they couldn't produce proof of vaccination. That happened after a measles-infected student came to class. Officials say the same steps will be taken at other schools if a measles case shows up.
Orange County is a hotbed of ill-informed vaccine opposition. The L.A. Times reports that in the Huntington Beach City School District, more than 8% of kindergarten children have been exempted from vaccination on personal belief waivers in two out of seven elementary schools, including one where the non-vaccination rate has reached 11%. The 8% mark is the point at which a community's "herd immunity" from a disease begins to disappear, allowing outbreaks to occur.
Nor is that the worst. A Times analysis last year found that the non-vaccination rate was 14.8% at Santa Monica-Malibu Unified. Statewide, the rate was 3.1%.
None of this is because vaccines are too expensive or unavailable. It's because anti-vaccination ignorance finds a ready haven in rich and educated communities whose residents have an excessive faith in their ability to be more expert than the expert. In some of these places, such as Santa Monica-Malibu and Northern California's Marin County, the anti-vaccination position is worn as a badge of sophisticated nonconformity. It's not; it's stupidity masquerading as cleverness. These parents endanger not only their own children, but those of their neighbors.
The state deserves a large measure of blame. Personal belief exemptions from required vaccinations are handed out virtually on request. The state Department of Public Health requires only an affidavit from the parent or guardian attesting to his or her personal beliefs, accompanied by a form to be signed by a doctor, osteopath, nurse practitioner, physician's assistant or naturopathic doctor.
Obtaining the required professional signature can't be that difficult, since there are plenty of mountebanks in the state willing to abet for profit this threat to public health. The question is why any of them is able to retain a professional license. That's an issue for the Medical Board of California, which doesn't seem to have taken it publicly in hand. We've asked the board for a clarification of its policy, if it has one; we'll update if we hear back.
Plainly the state's policy is far too lax, given the well-established safety of the required vaccines and the dangers of allowing children to go without them. The measles outbreak points to the right policy: a child who isn't vaccinated should not be in school unless there's a very, very good reason for not having his or her shots. A documented medical reaction is a good reason. Affiliation with a religious organization that prohibits treatment by medical personnel is a marginally good reason; such denominations are in a distinct minority. "Personal belief" is not a good reason. It's vague, unenforceable and a danger to innocent people. Far too often it provides cover for casual ignorance, and it should be outlawed.