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Posted at 07:00 AM ET, 02/24/2012

Measles outbreak after Super Bowl ignites vaccine debate

The controversy over vaccinating children — or really, not vaccinating children — has spread (literally) into to the mainstream. It seems there’s been a minor outbreak of measles linked to the Super Bowl.

Indiana health officials have confirmed 14 cases since the game, according to PBS. The officials suspect that the cases are linked to two individuals who had measles and had visited Super Bowl village before the game.
This could have been the scene of disaster. (Getty Images)

The most disturbing element of the mini outbreak is the potential for might have been. Measles has an incubation period of more than a week, so hundreds of thousands of fans might have been exposed. If the measles vaccine were not as widely used as it is now, this story would not be on a parenting blog. It would be front and center on every news outlet in the country.

In fact, the reason there was an outbreak at all was apparently because of the small but persistent group of people who refuse to vaccinate their children. According to the official quoted by PBS, 13 of those who have been diagnosed with measles in Indiana have said they had previously declined the measles, mumps and rubella vaccine.

Just as this news broke, a related debate has arisen about just how far doctors should go in confronting people who refuse vaccines.

By now, it’s been well publicized that some parents have safety concerns about certain vaccines, particularly the triple combination known as the MMR. These concerns are rooted in the debunked claims that the vaccines might be responsible for the rise in autism. Despite repeated testing and reassurances from public health officials, the number of parents resisting vaccines continues to rise.

The latest figures from the journal Pediatrics show that as many as ten percent of parents do not follow vaccination guidelines. That’s lead to outbreaks of both measles and pertussis, also known as whooping cough, across the country. Last year, for instance, California saw a major outbreak of whooping cough. Virginia, also last year, saw a rash of whooping cough cases that officials linked to several students, from one private school, who had not been vaccinated.

From a public health perspective, the decision to decline vaccinations is more than an individual choice. It’s one that’s dangerous for the child and the greater general public, especially the most vulnerable populations, such as younger children who are not yet old enough for vaccinations.

What recourse does the medical community have?

Public schools mandate vaccinations, but most states, including Maryland and Virginia allow parents to opt-out of vaccinations for religious beliefs and/or health concerns. (The District does not.)

Some lawmakers are actually siding with misguided parents on this front. USA Today reported last week that seven states are considering comprehensive opt-out laws.

Doctors are going the other way. Increasingly, surveys are finding that more and more doctors are refusing to treat patients who decline vaccinations.

A Wall Street Journal report last week cited several different surveys that revealed almost a third of doctors in Connecticut and a fifth of doctors in the Midwest dismiss patients who decline vaccinations.

One leading pediatrician told the Journal “There’s more noise among pediatricians, more people willing to argue that it’s OK to [dismiss patients] versus 10 years ago.”

It’s unclear if the trend is changing any minds. (Several reports on vaccine skeptic blogs called those doctors “brainwashed.”) It’s also unclear if refusing patients is the best answer.

Does it hold parents more accountable or does it endanger vulnerable children? The American Academy of Pediatrics recommends that doctors urge parents who refuse vaccines to reconsider and, if they don’t, continue to work with them.

Which approach, from a public health standpoint, is more ethical? If dismissing patients isn’t the answer, what is the best way to encourage universal vaccinations?

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By  |  07:00 AM ET, 02/24/2012

Tags:  Healthcare, Ethics

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