Fatal Exemption

The recent pertussis outbreak at New Trier--I wondered why here? In an area where good health care is a given, there has to be another explanation.

Saturday's WSJ had a story on a newly released study in the Journal of the American Medical Association. It's gotten little attention, but offers a possible explanation---lots of parents who obtained philosophical exemptions?

And 20 states have philosophical exemptions. In some states these exemptions are easy to obtain by simply signing your name to a form; and in others they're much harder, requiring notarization, annual renewal, a signature from a local health official, or a personally written letter from a parent.

The JAMA study examined the relationship between vaccine exemptions and rates of disease. The authors found that between 1991 and 2004 the percentage of children whose parents had chosen to exempt them from vaccines increased by 6% per year, resulting in a 2.5-fold increase. This increase occurred almost solely in states where philosophical exemptions were easy to obtain. Worse, states with easy-to-obtain philosophical exemptions had twice as many children suffering from pertussis -- a disease that causes inflammation of the windpipe and breathing tubes, pneumonia and, in about 20 infants every year, death -- than states with hard-to-obtain philosophical exemptions.

Illinois must be loose enough, given the outbreak at New Trier. A check yields this-no philosophical objection allowed in Illinois, only religious:

Section 665.510 Objection of Parent or Legal Guardian

Parent or legal guardian of a student may object to health examinations, immunizations, vision and hearing screening tests, and dental health examination for their children on religious grounds. If a religious objection is made, a written and signed statement from the parent or legal guardian detailing such objections must be presented to the local school authority. The objection must set forth the specific religious belief which conflicts with the examination, immunization or other medical intervention. The religious objection may be personal and need not be directed by the tenets of an established religious organization. General philosophical or moral reluctance to allow physical examinations, immunizations, vision and hearing screening, and dental examinations will not provide a sufficient basis for an exception to statutory requirements.

According to the article, measles is another one to worry about. And given the number of kids who have allergies, and can't be vaccinated, parents' decisions affect more than their own child's health. Something to weigh. Because an exemption could prove fatal. At New Trier the outbreak was largely contained to the high school and did not spread to young families.