The global health threat posed by the coronavirus again reinforces the critical need for effective public health policies, including and perhaps especially in the category of preventative care, as in the practice of vaccination.
Pharmaceutical companies are scrambling to develop methods of inoculating against the virus, and a vaccine would be expected to be in high demand, depending on the scope and impact of the virus’s worldwide proliferation. Yet, we continue to see evidence of persistent anti-vaccination attitudes, including examples of people moving to Utah and elsewhere from states where it is more difficult to acquire exemptions against laws requiring immunizations for school children.
While so-called “anti-vax” sentiment is generally focused on mandatory immunization policies, inoculating against measles or smallpox is, in principle, no different than protecting against influenza or any other virulent invader. Those who choose to resist immunization for whatever personal or ideological reasons do so at their own risk, and at the risk of their friends, neighbors and all with whom they come in contact.
Last year, 19 states reported measles outbreaks, resulting in the second-largest recurrence of the disease since it was virtually eliminated — by immunization — in 2000. Anti-vaccination attitudes are relatively prevalent in Utah, where research published in Plos Medicine in 2018 listed Salt Lake City and Provo as “hot spot metropolitan” areas due to their numbers of nonmedical exemptions from immunization applied for and granted.
This is important from an epidemiological perspective in that research shows that any levels of inoculation below 90% or 95% of the population opens a window for contagion — the result of failing to establish “herd immunity.”
Anti-immunization ideas are promulgated among groups sympathetic to the notion that mandatory vaccination rules deprive parents of the liberty of choice. Others fall into believing unsubstantiated theories about the harmful effects of immunization, like a discredited study that claimed a link between vaccination and autism. To that point, researchers at BYU documented how people who are directly exposed to the actual effect of diseases spread as a result of a lack of immunization tend to become less skeptical about vaccination.
Educating the public was integral to legislation passed in Utah in 2017, which requires parents applying for exemptions for their children to watch a 20-minute video about vaccine-preventable disease. However, there are anecdotal reports that parents in some cases disbelieved the content of the video, and the same law actually made it easier to apply for exemptions by creating an online application forum.
California, along with a handful of other states, has enacted legislation restricting or eliminating personal, philosophical or religious reasons for granting exemptions. It’s that law that has reportedly led people to relocate from California to states where laws, like in Utah, allow people to invoke nonmedical reasons for an exemption.
A tightening of Utah law may not be the preferred solution among policymakers, but efforts to better inform applicants for exemption of the very real risks they face could go far in reducing the number of exemptions sought, as the BYU research suggests.
It’s too soon to know the full impact of the coronavirus, but there is plenty of real-world data showing how life-threatening communicable diseases can ultimately be contained and even eradicated. To make that happen requires the cooperation of a properly informed public, not swayed by suppositions ungrounded in fact.