Ask any public health official and they will tell you that disease eradication through immunization is one of the greatest population-level health achievements in modern history. Deadly diseases like small pox, polio and diphtheria — which at one time killed thousands of people in the United States — are largely considered a thing of the past. Measles was also declared eliminated in 2000, all thanks to a vaccine.
In the last several years however, vaccine-preventable diseases have seen a resurgence in the U.S. In 2015, for example, more than 125 people came down with measles in California after an 11-year-old carrying the disease visited the Disneyland Resort in Anaheim.
Of those infected, 67% were intentionally unvaccinated because of personal beliefs and 12 were babies younger than 6 months, who were too young (the CDC recommends that the MMR vaccine, which prevent measles, be administered between 12–18 months).
With 1,241 reported measles cases this year the U.S. has seen the largest jump since 2000, possibly reversing our status as having eliminated the disease. This resurgence has alarmed public health officials and spurred a series of federal and state actions further cracking down on unnecessary exemptions that could put the public at risk.
New York State has seen the highest number of measles cases, largely due to parents within the Orthodox Jewish community seeking religious exemptions, prompting lawmakers in that state to ban such exemptions this past June.
California also has seen a resurgence, and lawmakers here have passed several measures to address the issue. In response to the Disneyland Resort measles outbreak, State Senator Richard Pan (D-Sacramento), who previously served as a pediatrician, championed Senate Bill (SB) 277, which eliminated personal and religious exemptions. And this year, Senator Pan authored SB 276, and a companion measure, SB 714, that adds a layer of state oversight in medical exemptions, and mandates state health officials to monitor schools that have less than a 95% vaccination rate.
Why is this happening? There are varied reasons why children go unvaccinated.
For some families, it’s an access problem. One study showed higher rates of vaccines for children whose parents were allowed Paid Family Leave. Still others are without health insurance and cannot afford the cost. Some populations are too vulnerable to receive vaccines, such as infants, the elderly and those with special medical conditions; and some, as in the case of Orthodox Jews, hold religious beliefs that prevent certain types of medical treatment.
There is a growing cohort of families using the personal exemptions –– a provision in some state laws that allows parents to exempt their children from the school vaccine requirement if it contradicts parental beliefs beyond those considered religious or spiritual. This group is considered “vaccine hesitant” or “anti-vaxx,” believing, despite significant scientific research to the contrary, that vaccines are harmful for their children.
When California eliminated the personal belief exemption in 2015, many of the anti-vaxx families sought medical exemptions for their children — and the number has grown three-fold since 2015. Dr. Bob Sears, based in Capistrano Beach, is one of the very few pediatricians supportive of the anti-vaxx movement, and is currently under investigation for falsifying medical exemptions.
Recently, a vocal group of anti-vaxx parents protested for several days at the California State Capitol prior to the passage of SB 277 and SB 714, bringing into sharp relief the intense fear and resolve that these parents feel. The group likened themselves to people of color during the Civil Rights Movement and sang “We Shall Overcome.” The protest reached a fever pitch when a protester threw blood on legislators in session, causing the session to shut down.
As the intersection of politics, vaccinations and public health continues to heat up, we have compiled a library of recent articles to help our readers understand and navigate the science as well as the politics involved in eradicating infectious diseases, with a focus on California.
We hope you find this compilation helpful in understanding the issue and the ways in which elected officials are acting to protect the public.
Editor’s Note: First 5 LA follows the CDC guidelines and evidence-based practices in support of vaccines.
National response to vaccines
CNN: Amid measles outbreaks, Senate hearing to discuss how vaccines save lives
Just a week after a congressional hearing on the significant rise of measles cases in the United States, lawmakers are meeting again to discuss outbreaks of preventable diseases that seem to be sweeping the nation. (Howard, 3/5/19)
The Washington Post: To combat anti-vaxxers, U.S. needs a national campaign, top Washington state official says
The top official overseeing Washington state’s worst measles outbreak in two decades is calling on the federal government to launch a national campaign to counter anti-vaccine groups spreading false information. (Sun, 3/5/19)
Quartz: Journalists could change the way we think about vaccines in one powerful way
A topic so vulnerable to misinformation, fear and disinformation campaigns demands a different approach — one that considers highlighting the major health benefits of vaccines, instead of the momentary second of pain they cause. (Timsit, 4/29/19)
ABC News: New York bans non-medical exemption to vaccines amid ongoing measles outbreak
Gov. Andrew Cuomo signed the removal into law Thursday, noting that the Empire State is in the midst of the worst measles outbreak in more than a quarter of a century. (Keneally, 6/14/19)
Also featured in NBC News (6/13/19)
U.S. News and World Report: Vaccines for Kids and Adults
It’s important to talk with health care providers about immunization for children and adults. (Schroeder, 7/15/19)
Education Dive: Vaccine exemptions tightening in several states as measles outbreak grows
With 1,044 cases of measles reported in the United States since Jan. 1, several states have now either passed or are considering legislation reducing the exemptions that parents can use to avoid vaccines for their children. (Harper, 6/20/19)
Vaccine Hesitancy/Misinformation
NPR: Medical Anthropologist Explores ‘Vaccine Hesitancy’
Distrust of vaccines may be almost as contagious as measles, according to medical anthropologist Elisa Sobo. (Gordon, 2/13/19)
The Washington Post: Anti-vaxxers are spreading conspiracy theories on Facebook, and the company is struggling to stop them
On Facebook, in public pages and private groups with tens of thousands of members, false information about vaccines is rampant and tough to pin down. (Telford, 2/13/19)
NPR: Some anti-vaccination parents cite religious exemptions. Measles outbreaks could change that.
Nelson started her own group, South Carolina Parents for Vaccines. She began posting scientific articles online. (Olgin, 2/20/19)
NPR: Why Aren’t Parents Getting Their Children Vaccinated?
The U.S. went from measles-free in 2000 to the largest outbreak in 25 years. NPR’s David Greene talks to Jennifer Reich, author of Calling the Shots: Why Parents Reject Vaccines. (4/29/19)
CNN: Richer countries have less faith in vaccines, survey finds
People in high-income countries have the lowest confidence in vaccines, with about 20% of those in Europe either disagreeing or being unsure of whether vaccines are safe, according to a new global survey. (Hunt, 6/19/19)
Also featured in Reuters (Kelland, 6/18/19), VICE News (Marcin, 6/19/19), TIME (Ducharme, 6/19/19)
NPR: When It Comes To Vaccines And Autism, Why Is It Hard To Refute Misinformation?
For years scientists have said that there is no link between vaccines and autism. There are still many people who are reluctant to vaccinate. But one woman has changed her mind about vaccines. (Vedantam, 7/22/19)
ABC 7: Families requesting more vaccine exemptions in local schools despite recent measles outbreak
One hundred and seventy-six Los Angeles Unified School District schools reported that 5% of kindergarteners are not up to date on vaccines. And within LAUSD, 27% of kindergarteners had permanent exemptions. (Dador, 8/21/19)
California Vaccine Legislation
Los Angeles Times: Here’s what happened after California got rid of personal belief exemptions for childhood vaccines
Health authorities in California have more power to insist that a dog is vaccinated against rabies than to ensure that a child enrolled in public school is vaccinated against measles. (10/29/18)
CALMatters: California made it hard to avoid vaccinating kids. Medical waivers have tripled. Now what?
Three years after California stopped allowing families to easily opt out of childhood vaccines, the number of kids getting medical waivers has tripled — the result, critics say, of some doctors loosely issuing exemptions to help families get around the law. (Aguilera, 2/7/19)
The Sacramento Bee: 3 in 4 Californians back vaccines as state debates making it tougher to opt out
As lawmakers and vaccine skeptics battle in the Capitol corridors over a bill to restrict medical exemptions, a new poll shows that three fourths of Californians support mandatory vaccinations and nearly all believe the shots are safe. (Wiley, 6/5/19)
The Sacramento Bee: Does this vaccine bill go too far? Concerned families say they’ll leave California if it passes
After consulting with two physicians who both recommended brain scans, and a medical review of her family’s history and records, Sabino said she was shocked when a doctor said future vaccines could be “fatal.” (Wiley, 6/10/19)
California Healthline: A Proposal To Make It Harder For Kids To Skip Vaccines Gives Powerful Voices Pause
As California lawmakers attempt to tighten the rules on childhood vaccinations, they’re getting pushback from unexpected quarters: high-profile officials who support vaccines. (Barry-Jester, 6/14/19)
The Sacramento Bee: Amended vaccine bill faces next hearing
Today the Assembly Health Committee is scheduled to hear Senate Bill 276, the newly amended vaccine measure that’s kicked up controversy over the last three months. (Wiley, 6/20/19)
The Los Angeles Times: Anti-vaccine activist assaults California vaccine law author, police say
An anti-vaccine activist was cited on suspicion of assault by the Sacramento Police Department on Wednesday after he livestreamed a physical confrontation with state Sen. Richard Pan, author of legislation to restrict vaccine exemptions. (Gutierrez, 6/20/19)
EdSource: What schools and parents need to know about California’s vaccination law: a quick guide
Changes to California’s current vaccination law being considered in Sacramento would make it more difficult for parents to use medical exemptions to avoid immunizing their children before enrolling them in school.
San Francisco Chronicle: Parents block California’s effort to investigate ‘fake’ vaccine exemptions
California medical regulators have been flooded with complaints about doctors accused of writing improper vaccine exemptions for children, with at least 186 accusations filed in the last four years. (Gardiner, 8/12/19)
The Los Angeles Times: The hidden battle over California’s new vaccine law
Most everyone who heard Gov. Gavin Newsom’s words had the same reaction: He’s finally on board. (Gutierrez & Luna & Myers, 9/22/19)
Access
Fortune: More American Kids—Especially Those Without Private Health Insurance—Aren’t Getting Vaccines
American child vaccination rates have dipped, according to U.S. Centers for Disease Control and Prevention (CDC) reports on preschool-age children and kindergarten students. (Laursen, 10/12/18)
Also featured in USA Today (10/12/18), TIME (10/12/18)
Forbes: The Hidden Reason Behind Low Vaccination Rates In The U.S.
Despite the known success of vaccines in reducing morbidity and mortality, immunization rates remain relatively low across the U.S. in 2019, especially in the 19–35 month age range. (Fisher, 1/29/19)
WBEZ: Low-Income Kids In Illinois Get Access To Vaccines
In 2016 the Rauner administration made it harder for low-income kids to get vaccinated. Prior to the change, kids in the state’s Children’s Health Insurance Program, or CHIP, were able to receive free vaccines from the CDC. (White, 7/9/19)
Pediatricians
CNN: Pediatrician: How I partnered with parents who didn’t want to vaccinate
As a pediatrician, over the past few years, I have cared for families with different views on vaccinations. Most parents followed my recommendations to vaccinate and, with parent guilt on their faces, held down their children while we administered the vaccines. (Bracho-Sanchez, 2/9/19)
Los Angeles Times: Anti-vaccine activists have doctors ‘terrorized into silence’ with online harassment
Dr. Dana Corriel wrote on Facebook in September that the flu vaccine had arrived and encouraged patients to come to her office for a shot. Within hours, the post was flooded with thousands of comments from people opposed to vaccines. (Karlamangla, 3/18/19)
The Los Angeles Times: California doctor critical of vaccines is punished for exempting 2-year-old boy from all childhood immunizations
In a decision that could signal how California’s fierce vaccine debates will play out in the coming years, the Medical Board of California has ordered 35 months’ probation for Dr. Bob Sears, an Orange County pediatrician well-known for being sympathetic to parents opposed to vaccines. (6/29/18)
Also featured in The Hill (6/29/18)
Science Daily: Should doctors accept unvaccinated children as patients?
Four in 10 parents say they are very or somewhat likely to move their child to a different provider if their doctor sees families who refuse all childhood vaccines, according to a new national poll. (8/19/19)
Opinions
The New York Times: This Is the Truth About Vaccines
Deadly diseases that should be seen only in history books are showing up in our emergency rooms. (Giroir & Redfield & Adams, 3/6/19)
The New York Times Magazine: Can I Get My Anti-Vaxx Sister’s Kids Vaccinated?
I am the primary caregiver for my elderly mother, who has lupus and thus a compromised immune system. My sister has four young children, none of whom she has had vaccinated out of fear that vaccines cause autism. (Appiah, 5/14/19)
The New York Times (Opinion): Finding Compassion for ‘Vaccine-Hesitant’ Parents
They’re infuriating and dangerous. I try to remember they’re also the terrified victims of misinformation. (Ali, 3/7/19)
