This week, a young child with measles arrived in Georgia from Kyrgyzstan via the Atlanta International Airport. According to press reports, it is the eleventh case of measles in Georgia since 2002. One measles case in our state is hardly a crisis, but it should cause us to reflect on the issues of the easy spread of communicable diseases, national immunization requirements, and political leadership.
According to a report in the Journal of Infectious Diseases, “Measles is the greatest vaccine-preventable killer of children in the world today and the eighth leading cause of death among persons of all ages worldwide.” The World Health Organization reports that there were 147,500 deaths from measles worldwide in 2013 — mostly children under 5 years of age. This number would have been far higher without an aggressive push for vaccinations between 2000 and 2013. It is estimated that the death toll would have been 15.6 million worldwide without immunization.
Despite these facts, the percentage of children being immunized in the United States has actually dropped over this same period of time to well below the optimum rate of 92 to 94% experts believe is necessary to eradicate the disease. When immunization rates were this high, the United States had no outbreaks of measles in 2000. In 2014, the U.S. had 644 reported cases of measles. In January of this year alone, we had 102 cases. How did this happen? Simple: Poor Leadership + Bad Science = A Confused Public.
Senator Rand Paul is not the only or the first American leader to provide poor leadership on this issue but since he is also a medical doctor, he is a good case in point. Last week, he came out in opposition to mandatory vaccinations arguing that he has heard of cases in which healthy children developed severe mental disorders after being immunized, and that since parents “own their children,” they should be free to decide whether to have their children immunized.
The fact that Senator Paul linked immunization to mental disorders is nothing less than quackery. The 1998 British study that linked immunization to autism has been shown to be not just a poor or sloppy study but a deliberate mischaracterization of the facts. The author was found to have purposefully distorted results to lead to a false conclusion that benefited his sponsors – trial lawyers seeking to sue pharmacy companies. As a result, the author, Dr. James Wakefield, was stripped of his medical license and the British Medical Journal labeled his study a fraud.
Rather than providing needed leadership, Senator Paul sought to give parents who refuse to immunize their children cover by arguing that the decision should be left solely up to the parents with no mandated requirements by the government. However, contrary to what the senator says, we do not “own” our children. Rather, parents are trustees of their children and there is an enormous difference between the two roles. An owner has every right to be stupid, careless, negligent, stubbornly wrongheaded, and even intentionally malicious toward what he owns. A parent as a trustee of a child’s welfare does not have these rights. A parent trustee has the duty to study and take all necessary steps to protect and promote his or her child’s best interest.
As the trustee of their children, parents should be given wide discretion on what is in their child’s best interest but there are limits. Immunization is one of those limits. We can end measles as a threat but only by universal immunization and – yes – that means a government mandate. No one is an island and the failure to immunize a child is a dereliction of parent’s trusteeship and endangers others in our society as well.
It is time for Senator Paul and other political figures, Republicans and Democrats, to step up and send a strong message on this issue. Immunization is not just a good idea for a parent to consider. It is a public health necessity to protect us all.