Bucking the Herd

Parents who refuse vaccination for their children may be putting entire communities at risk

Boulder, Colorado, a university town of 96,000, lies in a sequestered valley on the western edge of the Great Plains. Both geographically and culturally it is a place apart. Ralph Nader won more than 10 percent of Boulder's vote in the most recent presidential election. Natural-food groceries outnumber Safeways; chiropractors' offices line the main drag; and the city council recently declared that dog owners would henceforth be referred to as "dog guardians." A popular bumper sticker reads, WELCOME TO BOULDER, 20 SQUARE MILES SURROUNDED BY REALITY. Boulder is, in short, an experiment-oriented city.

From the archives:

"Schooling the Imagination" (September 1999)
Waldorf schools, which began in the esoteric mind of the Austrian philosopher Rudolph Steiner, have forged a unique blend of progressive and traditional teaching methods that seem to achieve impressive results—intellectual, social, even moral. By Todd Oppenheimer

A particularly interesting experiment, from a public-health perspective, has taken shape at the Shining Mountain Waldorf School, a campus of one-story wooden buildings set amid cottonwood and willow trees hard by the foothills of the Rockies. By their parents' choosing, nearly half of the 292 students at Shining Mountain have received only a few, and in some cases none, of the twenty-one childhood vaccinations mandated by Colorado state law in accordance with federal guidelines. The shunning of one of the vaccines, against diphtheria, tetanus, and pertussis, has resulted in a revival of whooping cough, the illness that occurs when colonies of the bacteria Bordetella pertussis attach to the lining of the upper respiratory passages, releasing toxins that cause inflammation and a spasmodic cough. The high-pitched whoop is a symptom heard mainly in younger children; it's the sound of a desperate attempt to breathe.

Shining Mountain exemplifies a growing movement in American life: the challenge to childhood vaccination. According to a survey published in the November 2000 issue of Pediatrics, one fourth of all parents are skeptical of some or all of the standard vaccines. Some states grant exemptions to the law so that parents can refuse vaccinations for their children. In Colorado parents who don't want their children vaccinated have only to sign a card stating as much. In Oregon the rate of religious exemptions—which are granted to all parents who choose not to have their children immunized for philosophical reasons—tripled, from 0.9 percent in the 1996- 1997 school year to 2.7 percent in 2001.

Those skeptical of vaccines have various reasons. Some believe that vaccines are responsible for otherwise unexplained increases in conditions such as autism, asthma, and multiple sclerosis. Others, including the conservative activist Phyllis Schlafly, see government attempts to track and enforce immunization as an intrusion on privacy. Still others—parents whose recollections of their own bouts of chickenpox or measles are bathed in nostalgia—argue that the elimination of traditional childhood illnesses is an attack on childhood itself. The parents at Shining Mountain are influenced by the philosophy of Rudolf Steiner, a turn-of-the-century Austrian philosopher who founded the Waldorf movement. Steiner (who was not a medical doctor) believed that children's spirits benefited from being tempered in the fires of a good inflammation.

The critics have concluded that the dangers of vaccination outweigh the risks of vaccine-preventable disease. Like all medical interventions, vaccination entails some risk, although the extent and gravity of potential side effects are matters of debate. For example, febrile seizures occur in roughly one in 10,000 children—perhaps 1,000 a year in the United States—who receive the current whooping-cough vaccine. Such seizures rarely, if ever, lead to permanent brain damage, however, and in any case febrile seizures are triggered just as easily by a run-of-the-mill infection as by a vaccine. Suspicions that mercury preservatives used in vaccines inflicted neurological damage on children are worrisome but unproved (mercury has largely been phased out of vaccines over the past three years).

To some extent vaccination is a victim of its own success. Owing to vaccination campaigns, smallpox no longer exists in man, and polio has been driven from the Western Hemisphere. Measles, diphtheria, and invasive hemophilus bacterial disease (such as meningitis) are rare in the United States, and even whooping cough is unusual enough that few parents consider it a threat. All these diseases, with the exception of smallpox, still infest various corners of the world, but in most of the United States even those who have not been vaccinated against them, or in whom the vaccine is not effective, are protected, because most of the people we meet have been vaccinated. Epidemiologists call this phenomenon "herd immunity": the more vaccinated sheep there are, the safer an unvaccinated one is. When vaccination rates drop, disease returns.

From the archives:

"Dead Souls" (January 1999)
A prominent demographer warns that the spread of tuberculosis and AIDS in Russia will soon make Western hand-wringing over the pace of Russian "economic reform" seem quaint. By Murray Feshbach

Precisely at what point herd immunity fails is difficult to calculate, but there is ample evidence that it does. Since the collapse of the Soviet public-health system diphtheria has returned to Russia with a vengeance, killing thousands. Sweden suspended vaccination against whooping cough from 1979 to 1996 while testing a new vaccine. In a study of the moratorium period that was published in 1993, Swedish physicians found that 60 percent of the country's children got whooping cough before they were ten. However, close medical monitoring kept the death rate from whooping cough at about one per year during that period.

Presented by

Arthur Allen lives in Washington, D.C., and is at work on a history of vaccination.

How to Cook Spaghetti Squash (and Why)

Cooking for yourself is one of the surest ways to eat well. Bestselling author Mark Bittman teaches James Hamblin the recipe that everyone is Googling.

Join the Discussion

After you comment, click Post. If you’re not already logged in you will be asked to log in or register.

blog comments powered by Disqus

Video

How to Cook Spaghetti Squash (and Why)

Cooking for yourself is one of the surest ways to eat well.

Video

Before Tinder, a Tree

Looking for your soulmate? Write a letter to the "Bridegroom's Oak" in Germany.

Video

The Health Benefits of Going Outside

People spend too much time indoors. One solution: ecotherapy.

Video

Where High Tech Meets the 1950s

Why did Green Bank, West Virginia, ban wireless signals? For science.

Video

Yes, Quidditch Is Real

How J.K. Rowling's magical sport spread from Hogwarts to college campuses

Video

Would You Live in a Treehouse?

A treehouse can be an ideal office space, vacation rental, and way of reconnecting with your youth.

More in Technology

More back issues, Sept 1995 to present.

Just In