With measles cases surging, why are vaccination rates dropping?

Measles made an alarming comeback this year, and many argue that parents against vaccines are part of the problem

ORANGE COUNTY, Calif. — Holly Blumhardt and her husband, Shannon, are part of a growing minority here in well-heeled Orange County and other affluent areas across the county: They did not vaccinate their children.

She said that decision is part of a larger philosophy.

“I think that we are very aware, from the foods that we eat, like being more organic, non-GMO,” she told “America Tonight.” “We just want to have the healthiest family that we can.” 

Holly and Shannon Blumhardt
Holly and Shannon Blumhardt chose not to vaccinate their three children, Grace, Ava and Adele, believing that would be better for their health. Instead of vaccinations, they rely on holistic regimens, including chiropractic adjustments.
America Tonight

Vaccine opponents are a tiny minority of the population. Less than 1 percent of all children don’t receive any vaccines, according to the Centers for Disease Control and Prevention. But in California, the percentage of kids with up-to-date vaccinations has been dropping since 2008.

The trend is especially pronounced in Orange County, where the proportion of kindergartners with their full shots fell from 92.9 percent in 2003 to 89.3 in 2012, and particularly in the county's wealthy beachfront communities. The county is also battling the state’s largest measles outbreak in recent memory: 22 cases.

In the late 1950s, measles infected more than half a million Americans a year and killed roughly 450. But since 2000, when the infectious disease was considered eliminated, measles cases have hovered around 60 a year. 

Last year, that number rose to 189. According to an analysis by the CDC, 82 percent of the cases between January and August were among unvaccinated people.

In just the first four and a half months of this year, the CDC tallied 216 cases across 18 states. Measles — the world’s greatest vaccine-preventable killer of children — is having a mighty comeback across the U.S., and public health experts argue that a growing anti-vaccine movement is responsible.

Questioning vaccines

Blumhardt started researching vaccines back when she was a high-flying lieutenant in the U.S. Air Force and was required to get several shots before she deployed. She said she found studies linking vaccines to conditions like asthma and attention deficit disorder, and read that some contained aborted fetal tissue and DNA from animals and insects.

Holly Blumhardt
In her 20s, Holly Blumhardt spent three years in the U.S. Air Force, but her military career ended when she refused to have the required vaccinations.
America Tonight

According to the CDC, fetal tissue and insect cells have been used to grow viruses for vaccines, but none of that tissue has ever actually been in the vaccines themselves. Nevertheless, Blumhardt declined to take them. The decision ended her military career. 

“I think ultimately the body is a self-healing organism,” said Blumhardt, adding that if no parents vaccinated, “we would be a lot healthier.” 

That resistance to vaccines as “foreign” material and preference for more “natural” health care is a common refrain among parents who choose not to vaccinate. Some are skeptical that vaccines are actually effective, while others say the number of vaccines children receive today “overloads” the immune system.

These views are amplified in like-minded online communities, where distrust of the government and big pharma runs high and stories of infants purportedly harmed by vaccines are widely shared.

Fanning the flames of the so-called vaccine war are Hollywood celebrities who have publicized their decisions not to vaccinate — including reality TV star Kristin Cavallariactress Alicia Silverstone and, most famously, the former Playboy playmate Jenny McCarthy. 

When McCarthy’s son Evan was diagnosed with autism a few weeks after receiving a series of vaccines, including the mumps, measles and rubella (MMR) shot, McCarthy found a community of parents online who also suspected a troubling association between the MMR vaccine and autism. She's been an outspoken activist on the subject ever since, first alleging a direct link between autism and the MMR vaccine, and more recently arguing that she's "not anti-vaccine," just wary of a "one size fits all philosophy of the recommended vaccine schedule."

The movement traces its roots to a 1998 paper in the British medical journal The Lancet, which linked autism and the MMR vaccine. It has since been retracted and its author, Dr. Andrew Wakefield, had his medical license revoked. Since then, numerous comprehensive studies have found no link between vaccines and autism, including one published earlier this month that studied 1.3 million children. Still, the number of parents questioning vaccines continues to grow.

Around 90 percent of children receive the MMR vaccine, but a 2013 Public Policy Polling survey on conspiracy theories found that 20 percent of Americans believed there is a link between childhood vaccines and autism, and a further 34 percent weren’t sure.

My baby vs. the public good

At the heart of the battle over vaccines is the fact that there are rare — but real — risks. According to the CDC, one in 20 people who receive the MMR vaccine will get a mild rash; one in 30,000 is vulnerable to a bleeding disorder; one in a million has a serious allergic reaction. 

Dr. Matt Zahn
Dr. Matt Zahn is a pediatric infectious disease specialist who is frustrated that some parents are relying on unscientific sources over rigorous studies and guidelines from the CDC. "Not all information is created equal," he said.
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Parents are asked to accept those risks not only to keep their children safe, but also to protect the community from diseases that are now largely invisible in this country. Americans haven’t witnessed mass epidemics of measles, polio or whooping cough for decades. But public health officials warn that these infections could easily hop over on a plane, and spread among the unvaccinated and the small percentage for whom the vaccine didn't work. 

“I think people have to realize that when your child is not getting vaccinated, your child is still generally safe against measles,” said Dr. Matt Zahn, the Orange County Health Care Agency's medical director for epidemiology. “They’re hitching a ride on the protection that all of those children in that school are getting to keep them from being sick.”

One Orange County pediatrician is less concerned. Dr. Bob Sears, author of the best-selling “The Vaccine Book,” said half of his young patients aren’t vaccinated. He’s one of a handful of doctors whose warnings about vaccination risks have found a large national audience. 

"Most parents don’t consider the public health benefit when they’re making decisions for their individual child,” he said. “Should they consider those issues? Yes. Do I fault them for not considering those issues? Not so much. I don’t hold that against them.”  

People are entitled to different opinions. They’re not entitled to different sets of facts.

Dr. Matt Zahn

By not considering those issues, though, public health officials say parents can put whole communities at risk. Officials have traced a recent 111-person surge of measles in Ohio to Amish missionaries who brought the disease back from the Philippines, which is now in the throes of a major outbreak. The Amish traditionally have low vaccination rates.

Dr. Bob Sears
Dr. Bob Sears believes in the value of vaccines but is a leading defender of parents' right to choose. His position on vaccines and autism and “alternative vaccine schedule” have made him controversial in the pediatric community.
America Tonight

Sears said he wants parents to vaccinate their children, but he’s sympathetic to their concerns. His goal is to offer parents choices, and he’s developed an alternative vaccination schedule that spaces shots further apart — in violation of the guidelines approved by the CDC and the American Academy of Pediatrics. 

Sears, too, believes vaccines can cause autism.

“My statement I like to make on vaccines and autism is that vaccines don't cause autism, except when they do," he told “America Tonight.”

He also said parents shouldn’t be overly concerned about measles because “the vast majority of cases pass without any long-term harm.”

The Orange County Health Care Agency’s Zahn is particularly concerned about that line of thinking. He points out that seven of the 22 victims in Orange County ended up in the hospital, and that statistically 1 in 1,000 will die

“The science is really solid behind the notion that getting vaccinated, at 1 and 4 years of age, with your MMR is the safest, smartest thing to do,” said Zahn. “People are entitled to different opinions. They’re not entitled to different sets of facts.”

Philosophically exempt

Still, a growing number of parents are opting out of required school immunizations. All 50 states require schoolchildren to be vaccinated, with exemptions for medical reasons and, in 48 states, for religious reasons, too. But now 19 states, including California, allow parents to file “philosophical exemptions.”

According to a 2012 Emory University study, vaccination opt-out rates are 2.5 times higher in states with personal belief exemptions compared with states that allow only religious ones. But there's a difference depending on how easy it is to apply. In states where parents simply have to sign a form, rates of nonmedical exemptions are 2.3 times higher than in states where there's another step to the process. 

In January, California passed a law requiring that parents get a pediatrician’s signature on an exemption form, indicating that they’ve been informed of the benefits of vaccines. Sears said he’s been signing hundreds.

“They’re very easy to sign,” he said. “I just feel that it does slightly infringe on people’s rights to make medical decisions.”

Measles outbreak
Martha Figueroa watched her little sister die of the measles as a child.
America Tonight

To combat falling vaccination rates, Orange County has launched educational outreach programs. “America Tonight” visited a preschool in Anaheim, the center of the county’s outbreak, where “school readiness nurses” were explaining to a group of mothers that some parents had decided not to immunize their kids, and there was now an outbreak of measles. 

Martha Figueroa, one of the mothers, said she had vaccinated her children and was particularly worried about the measles outbreak because, at the age of 7, she had seen her 2-year-old sister die of the disease.  

“It affects me a lot,” she said, “because I remember watching how she suffered.”

Zahn said it’s possible the current outbreak could change some parents’ minds about vaccines, or at least serve as a reminder of the pain these infectious diseases can bring.

“Events like this, of measles, clusters and outbreaks, change minds, change people’s perceptions,” said Zahn. “The beauty and the importance is we have a way to keep yourself and your child safe. Go get vaccinated.”

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