Vaccines, measles and the retreat from common sense

Austin American-Statesman, February 10, 2015

When I began working as a staff nurse in neonatal intensive care in 1980 ... all the babies got their immunizations. No questions, no doubt, no hesitation. Boom.

This thing of American parents refusing to vaccinate their children makes about as much sense to me as countries that don’t educate their female children. Both are choices based on ideologies that defy reason; both can cause irreparable harm.

We all know by now of the measles outbreak of more than 100 cases since January including eight babies from a suburban Chicago daycare center who were too young to be vaccinated. How the (expletive) could this happen after measles was declared eliminated in the year 2000?

Truth is, I could see this coming. When I began working as a staff nurse in neonatal intensive care in 1980, all my co-workers got the flu shot every year. All the babies got their immunizations. No questions, no doubt, no hesitation. Boom.

The ax fell in 1998 when the British medical journal The Lancet published a study by Andrew Wakefield, who now lives in Austin. His study, which had only 12 study subjects, linked the measles, mumps and rubella vaccine with autism.

As we know by now, news of his study ricocheted around the world and use of the vaccine plummeted worldwide. An anti-vaccine movement was ushered in. The Lancet reassessed the scientific methods and financial conflicts of Wakefield and in 2010 retracted the study; his medical license was subsequently revoked. But the damage had been done.

In 2004, I had no trouble getting parents to immunize their children. According to Texas Department of State Health Services data, that year only 0.09 percent (just under 3,000 kids) of Texas’ overall school-age population had nonmedical exemptions to school immunization laws. But in the 2013-14 school year, that percentage jumped to 0.75 percent (more than 38,000 kids). That’s almost a 13-fold increase in 10 years, and that aligns with my experience in neonatal.

In 2009, three years before I retired from neonatal, Central Texas experienced a large pertussis outbreak, the first in 50 years. Pertussis in our hospital! With a shiver, we feared it was the canary in the coal mine. It was. About the same time, parents began to refuse to sign vaccine consents, and nurses even began questioning flu shots.

I’ll never forget a prescient 12-hour shift in the winter of 2009. I received report from a night-shift nurse who was wearing a mask because she had refused the flu vaccine. Rondah Kentch, a nurse with a limp from polio she contracted at age 4, and I cared that day for eight premature babies in our neonatal intensive care bay. All of them were adorable, nearing discharge and had unsigned immunization consents on the fronts of their charts.

With 65 years of neonatal nursing experience between us, Rondah and I could handle the babies. The tough part was obtaining consent from the parents to protect their children from communicable, deadly diseases. The poor, uneducated parents didn’t hesitate; they were grateful their children could receive the vaccine. It was the educated parents, those empowered with all of the information in the world at their fingertips, who balked. Scientific reasoning did no good. It was obvious at that point what the future held: a retreat from common sense.

But wait. The story gets better. Since I retired in 2012, the same ilk of parents who refuse vaccines is also refusing the vitamin K injection to prevent hemorrhagic disease and antimicrobial eye ointment to prevent blindness. I’m glad I’m not there to witness that.

Measles is awful. It makes you very sick. It can kill you. It can blind you. Pregnant women exposed to measles can miscarry or give birth to infants with deformities. Are pediatricians justified in closing their practices to children whose parents refuse to immunize? Absolutely. Are schools justified in requiring unvaccinated children to stay home for 21 days (the length of time between exposure and the beginning of the rash and fever) after an exposure? Of course.

What I don’t understand is … every baccalaureate degree requires passing basic science courses. Yet it’s the educated parents (and some health care workers) who are refusing vaccines. Immunization science is 65 years old and about as basic as evolution science. Resistance is especially odd coming from people with degrees that have the word “science” in the name.

Toni Inglis, MSN, RN CNS (retired), FAAN, a lifelong Austin resident and retired neonatal intensive care nurse and editor of NursingNews, writes a monthly opinion column for the Austin American-Statesman editorial page.