Deadly Choices: How the Anti-Vaccine Movement Threatens Us All (33 page)

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Authors: Paul A. Offit M.D.

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Yarkin knows that her efforts could alienate friends. “I’m okay with being in a controversy. It’s okay with me if people disagree and back away from me. It’s something that I’ve had to really work through. But I don’t think I’ll lose any real friends over it. And I won’t be insulted or hurt if people don’t do what I want them to do.” In the end, she remains optimistic: “I feel I have a chance to really change the course of events.”
 
Yarkin’s outspokenness is fueled by the fear of what might happen if children in her community remain unvaccinated. More typically, parent activism is fueled by events that have already affected their children. Such is the case with the mother of Julieanna Flint of Waconia, Minnesota.
In January 2008, when Julieanna was fifteen months old, she had an episode of vomiting and slight fever. Her mother, Brendalee, thought little of it. The next morning Julieanna’s temperature rose. So Brendalee took her daughter to Heidi Wuerger, her family doctor. “It sounds like flu,” she was told. “Give her Tylenol.” Brendalee took her daughter home, gave her plenty of liquids, and washed her with a cool, damp washcloth. But the fever didn’t go away. As the day wore on, Julieanna refused to eat or drink.
The next day, she woke up screaming with a temperature of 104 degrees. “She couldn’t say ‘Help me,’ but her eyes were begging me to do something,” recalled Brendalee, who rushed her to the emergency room at Ridgeview Medical Center, where doctors performed a spinal tap. But instead of the fluid being clear (as it should be), it was cloudy; and instead of containing no white blood cells (cells the body uses to fight infection), it contained 145,000. “Your daughter is seriously ill,” Dr. Wuerger told Brendalee. “We need to transport her to Children’s [Hospital in Minneapolis], now!”
At Children’s Hospital, doctors gave Julieanna antibiotics to treat her bacterial meningitis. Her fever decreased. But the next day Julieanna had a seizure, the first of many. That same day, the cause of her meningitis was revealed: Hib. At that point, a Hib vaccine had been available for twenty years, and Julieanna had received every dose of it. Yet she still suffered the disease. Later, doctors figured out why: Julieanna had an inability to make antibodies. So, even though she’d gotten the vaccine, she’d never developed an immune response to it.
Julieanna worsened. During an MRI scan, doctors found a massive collection of pus surrounding her brain. “We’re doing everything we can to save your daughter’s life,” a doctor told Brendalee. “I still remember walking her to the surgery room and giving her to the doctor,” recalled Brendalee. “I didn’t know if I would see her again.” Brendalee called a priest to administer last rites. “Through this holy anointing may the Lord in his love and mercy help you with the grace of the Holy Spirit,” said the priest, marking Julieanna’s forehead with oil in the shape of a cross. “May the Lord who frees you from sin save you and raise you up.”
Julieanna slowly began to recover. As a result of her meningitis, she had to relearn how to swallow, crawl, walk, and talk. “It was like having a newborn again,” recalled Flint. “I would rub her throat for swallowing and rub her cheeks for chewing. She couldn’t crawl. She could scream and that was about it.” But she was alive. Although Brendalee didn’t know it, the percentage of children in Minnesota whose parents had refused to give them Hib vaccine had increased sixfold during the previous few years. Because Julieanna couldn’t make antibodies, she was particularly vulnerable.
Brendalee and Julieanna Flint, December 16, 2009. (Courtesy of Andy King.)
In April 2009, Brendalee and Julieanna Flint traveled to Washington, D.C., to speak to congressional staffers about the importance of vaccines. “Parents need to understand that when they choose not to vaccinate, they are making a decision for other people’s children as well,” said Brendalee. “Someone else chose Julieanna’s path. It doesn’t seem fair that someone like Jenny McCarthy can reach so many people while my little girl has no voice.”
 
Following the tragedy of September 11, 2001, there was a moment when we all stood still and looked at each other. No longer individuals, we were part of a whole. Personal interests were irrelevant. We were united in our grief. One.
Then the moment was gone, dissolved in a cloud of lawsuits, finger-pointing, partisanship, and blame. But, although fleeting, it had been there. And if we can recapture it—recapture the feeling that we are all in this together, all part of a large immunological cooperative—the growing tragedy of children dying from preventable infections can be avoided. We can do this. It’s in us: the better angels of our nature.
NOTES
 
Prologue
 
ix
Parents choose not to vaccinate their children:
G. L. Freed, S. J. Clark, A. T. Butchart, et al. “Parental Vaccine Safety Concerns in 2009,”
Pediatrics
125 (2010): 1-6; P. J. Smith, S. G. Humiston, Z. Zhao, et al., “Association Between Delayed or Refused Vaccination Doses and Timely Vaccination Coverage,” abstract presented at the Pediatric Academic Society’s annual meeting, Vancouver, British Columbia, May 4, 2010.
ix
Percentage of unvaccinated children has more than doubled:
S. B. Omer, W.K.Y. Pan, N. A. Halsey, et al., “Nonmedical Exemptions to School Immunization Requirements: Secular Trends and Association of State Policies with Pertussis Incidence,”
Journal of the American Medical Association
296 (2006): 1757-1763.
ix
Doctors refuse to see unvaccinated children:
E. A. Flanagan-Klygis, L. Sharp, and J. E. Frader, “Dismissing the Family Who Refuses Vaccines: A Study of Pediatrician Attitudes,”
Archives of Pediatric and Adolescent Medicine
159 (2005): 929-934.
Introduction
 
xi
Robert Bazell:
NBC Nightly News
, February 17, 2009.
xi
Minnesota outbreak:
Centers for Disease Control and Prevention, “Invasive
Haemophilus Influenzae
Type B Disease in Five Young Children—Minnesota, 2008,”
Morbidity and Mortality Weekly Report
58 (2008): 1-3.
xi
Parent of child with Hib:
NBC Nightly News
, February 17, 2009.
xii
Hib outbreaks:
D. Sapatkin, “A Fatal Link in Vaccine Shortage,”
Philadelphia Inquirer
, April 1, 2009.
xii
Hib disease:
Centers for Disease Control and Prevention, “Invasive
Haemophilus Influenzae
Type B Disease in Five Young Children—Minnesota, 2008,”
Morbidity and Mortality Weekly Report
58 (2008): 1-3.
xii
Whooping cough before vaccine:
J. Cherry, P. Brunnel, and G. Golden, “Report of the Task Force on Pertussis and Pertussis Immunization,”
Pediatrics
81 (suppl.) (1988): 933-984.
xii
Whooping cough today:
Centers for Disease Control and Prevention, “Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines,”
Morbidity and Mortality Weekly Report
55 (2006): 1-42.
xii
Vashon Island:
K. Rietberg, C. DeBolt, N. Heimann, et al., “School Exemption Data and Geocoding as Tools for Assessing Relationships of Pertussis Clusters to High Immunization Exemption Rates,”
http://cdc.confex.com/cdc/nic2002/recordingredirect.cgi/id/1446
; “Public Health Skepticism,” November 30, 2002,
http://medpundit.blogspot.com/2002_11_24_medpundit_archive.html
.
xiii
Whooping cough symptoms:
K. M. Edwards and M. D. Decker, “Pertussis Vaccines,” in
Vaccines
, 5th ed., eds. S. A. Plotkin, W. A. Orenstein, and P. A. Offit (London: Elsevier/Saunders, 2008).
xiii
El Sobrante:
H. K. Lee, “Whooping Cough Outbreak Closes Private School in El Sobrante,”
http://sfgate.com/cgibin/article.cgi?f=/c/a/2008/05/10/BAN310JQVL
. DTL; “East Bay School Opens After Whooping Cough Outbreak,”
http://cbs5.com/local/whooping.cough.pertussis.2.722073.html
.
xiii
Rudolf Steiner:
R. Steiner,
Fundamentals of Anthroposophical Medicine
(Toronto: Mercury Press, 1986).
xiii
“Karmic development”:
Open
Waldorf.com
,
http://www.openwaldorf.com/health.html
.
xiii
Nationwide whooping cough outbreaks:
Centers for Disease Control and Prevention, “Pertussis Outbreak in an Amish Community—Kent County, Delaware, September 2004-February 2005,”
Morbidity and Mortality Weekly Report
55 (2006): 817-821; Illinois Department of Public Health, “Pertussis Outbreak Prompts Public Health Warning: At Least 69 Sickened in Four Chicago-Area Counties,”
http://www.idph.state.il.us/public.press04/6.18.04.htm
, June 18, 2004; Centers for Disease Control and Prevention, “Use of Mass Tdap Vaccination to Control an Outbreak of Pertussis in a High School—Cook County, Illinois, September 2006- January 2007,”
Morbidity and Mortality Weekly Report
57 (2008): 796- 799; Mississippi State Department of Health, “State Health Officials, CDC Studying Pertussis Outbreak in Mississippi,”
http://msdh.ms.gov/msdhsite/index.cfm/23,5373,279.html
, August 30, 2007; “Pertussis Outbreak Reaches 500 Cases Statewide,” Arizona Department of Health Services,
http://www.asdhs.gov/news/2005-all/pout.htm
; Centers for Disease Control and Prevention, “School-Associated Pertussis Outbreak—Yavapai County, Arizona, September 2002-February 2003,”
Journal of the American Medical Association
291 (2004): 1952-1954; “Pertussis Outbreak Points to the Importance of Vaccination,” Oregon Department of Human Services News Release,
http://www.oregon.gov/DHS/news/2008news/2008-0117.shtml
; Centers for Disease Control and Prevention, “Pertussis Outbreak—Vermont, 1996,”
Morbidity and Mortality Weekly Report
46 (1997): 822-826; “CDC Reported Highest Number of Whooping Cough Cases in Nearly Forty Years,”
http://www.medicalnewstoday.com/articles/15220.php
; Centers for Disease Control and Prevention, “Pertussis—United States, 1997-2000,”
Morbidity and Mortality Weekly Report
51 (2002): 73-76.
xiv
Delaware pertussis outbreak:
Centers for Disease Control and Prevention, “Pertussis Outbreak in an Amish Community—Kent County, Delaware, September 2004-February 2005,”
Morbidity and Mortality Weekly Report
55 (2006): 817-821.
xiv
Ashland, Oregon:
S. Robinson, A. Timmons, and L. Duncan, “School Exemptions and Disease Risk in Ashland, Oregon,”
http://www.co.jackson.or.us/files/school%20exemptions%20and%20disease%20risk%20-%20final.pdf
.
xiv
Indiana measles outbreak:
A. A. Parker, W. Staggs, G. H. Dayan, et al., “Implications of a 2005 Measles Outbreak in Indiana for Sustained Elimination of Measles in the United States,”
New England Journal of Medicine
355 (2006): 447-455; Centers for Disease Control and Prevention, “Import-Associated Measles Outbreak—Indiana, May-June 2005,”
Morbidity and Mortality Weekly Report
54 (2005): 1073-1075.
xv
Measles complications:
P. M. Strebel, M. J. Papania, G. H. Dayan, and N. A. Halsey, “Measles Vaccine,” in
Vaccines
, 5th ed., eds. S. A. Plotkin, W. A. Orenstein, and P. A. Offit (London: Elsevier/Saunders, 2008).
xv
CDC warnings:
Centers for Disease Control and Prevention, “Update: Measles—United States, January-July 2008,”
Morbidity and Mortality Weekly Report
57 (2008): 893-896.
xv
San Diego outbreak:
Centers for Disease Control and Prevention, “Outbreak of Measles—San Diego, California, January-February 2008,”
Morbidity and Mortality Weekly Report
57 (2008): 203-206; R. G. Lin II, “Rise in Measles Cases Worries Health Officials,”
Los Angeles Times
, May 2, 2008.
xv
California vaccination rates:
R. G. Lin II, “California Schools’ Risks Rise as Vaccinations Drop,”
Los Angeles Times
, March 29, 2009.
xvi
Nationwide measles outbreak, 2008:
Centers for Disease Control and Prevention, “Update: Measles—United States, January-July 2008,”
Morbidity and Mortality Weekly Report
57 (2008): 893-896.

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