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There was an extremely troubling article in today’s New Jersey Trenton Times that indicated that a New Jersey’s childhood vaccination rates ranked 42nd in 2009—45^th in 2008—in the nation. The ranking were based on annual vaccination statistic compiled by the Centers for Disease Control in Atlanta, GA.

The lead-in paragraph to the article elegantly captured the irony of the dubious statistic:

“One of the most affluent (and most populous states) states in the country, home to more than a few giants in the pharmaceutical industry also has one of the lowest rates of immunizing babies and toddlers in the nation.”

New Jersey’s vaccination rates among infants and toddlers for childhood diseases— mumps, measles, diphtheria, Pertussis (whooping cough), hepatitis B and rubella—was roughly 64 percent in 2009. This was significantly lower than the national average of 71 percent and the lowest in the Northeast. For example, in Pennsylvania and New York, two of the states bordering New Jersey, the vaccination rates in 2009 were 72 and 71 present respectively.

The reasons given for the low rate are plausible but, in most cases, incomprehensible from an infectious diseases and public health perspectives. It has been postulated that low-income and immigrant communities lack health insurance and access to medical information about mandatory childhood vaccination regimens. While it is facile to blame low income and immigrant populations for New Jersey's  egregiously low vaccination rate, the problem may actually lie with more affluent and educated NJ citizens who have medical insurance (help to pay the salaries of medical billing workers) and understand the public health implications of mandatory childhood immunizations. 

According to the article, parents and even some health care professionals are backing away from mandatory vaccination because they “don’t like seeing kids cry” after sometimes receiving up to four vaccinations during a single office visit! Say what????? I accompanied my three children for most of their childhood immunizations, and while some tears may have been shed, they recovered quickly and are now protected against a variety of potentially life-threatening diseases.  Apparently, some parents and health care professionals are willing to jeopardize the public health of a nation because the “shots hurt.” To that I say; get over it—like it or not, life can be painful and no matter how hard you may try you cannot shield your kids from it!

The fallacious and recently publicly discredited link between childhood vaccination and autism, coupled with the growing public distrust of the pharmaceutical companies that manufacture the vaccines may be more plausible explanations for New Jersey’s declining immunization rates in NJ. This suggests that vaccine manufacturers and public health officials ought to work closely together to be educate the American public about the benefits and potential risks associated with childhood vaccination.

Finally, as some of you may know, many states like New Jersey have religious exemptions that allow children to skip mandatory childhood immunizations. Interestingly and troublingly these children are allowed to attend public schools despite the fact that they haven’t been vaccinated. Again, I say what??? Increasingly, these unvaccinated students have been implicated as the reservoirs for the pertussis outbreaks that are currently ravaging school aged children and older adults throughout the US. It is my belief that children who fail to receive the appropriate immunizations because of religious reason should not be allowed to attend public school. This is because, unlike many of the low income and immigrant families who may be unaware or cannot afford to immunize their children because they lack health insurance, many of the folks claiming religious exemptions have health insurance and are living above the poverty level. Consequently, if these parents choose to not immunize their children (and fail to meet mandated public health requirements for entry into public schools), then they ought to be financially responsible for their child’s education.

Paradoxically, the plummeting vaccination rates in New Jersey and elsewhere are being driven by a small but extremely vocal segment of the American public. Unfortunately, this anti-vaccine sentiment in America is unlikely to abate until an increasing number of children begin to die from easily preventable childhood diseases. As far as I am concerned, the benefits of childhood vaccines far outweigh their risks and help to maintain the public health of all Americans.

Until next time...

Good Luck and Good Job Hunting!!!!!!!!!

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I regularly watch Real Time with Bill Maher and generally agree with many of the political views and ideas that he espouses. In fact, I am a fan! However, his rant two weeks ago about the H1N1 vaccines, and vaccination in general, showed me that while politically astute and incisive he has absolutely no understanding about science and modern medicine (see video below). Making matters worst, his guest, former conservative senator Bill Frist, a surgeon by training, was ill prepared to correct and refute some of Maher’s outrageous assertions regarding the differences between the two currently available H1N1 vaccines and the basic principles of vaccinology.

Maher is quick to tell people that they are stupid when they don’t agree with his ideas or political views. And, he rightfully criticized George W. Bush for routinely making decisions about important issues based on “his gut feelings” rather than facts. Ironically, this is exactly what Bill Maher does when he talks to his guests about medicine and food. Maher, who may be a vegetarian and is clearly anti-traditional medicine,  is quick to point out that Westernized medicine and food production is profit driven and consequently, any information or advice offered by the US government is little more than a ploy to keep people sick and fat. In other words, don’t trust anything that the government tells you if you believe otherwise or you heard it from a celebrity. 

I suspect that science wasn’t Bill’s “cup of tea” (he frequently calls the tea baggers who don’t trust anything that the Obama administration tells them idiots and morons) and may have never taken anything he learned about science seriously. If he had, he might have learned how vaccines work and realized that modern vaccines (the first vaccines were produced in the 1780s) protect over 95% of people who receive them from devastating childhood diseases and even cervical cancer. Instead, he cites bogus and scientifically refuted claims about vaccine safety including mercury poisoning, links to autism and the miniscule possibility of developing Guerin-Barr Syndrome (which was first observed in large number of patients following vaccination with the 1976 Swine Flu vaccine). Shockingly, despite incontrovertible evidence to the contrary he continues to spew misinformation and flat-out wrong claims about vaccines. Ironically, his wrong-headed vaccine tirades are remarkably similar to those of the Birthers —people who refuse to believe that President Obama is an American despite incontrovertible evidence to the contrary—and racists who contend that Obama is a Muslim—two groups that he is quick to bash and dismiss as crazies and morons. In other words, Maher believes that he is right even though he is clearly misinformed or wrong!

Originally, I was going to write this post after Maher’s “Real Time” tirade about vaccines almost two weeks ago on Real Time. However, I relented but couldn’t help myself after reading an article in today’s Scientist Times about a pregnant woman who lost her second child after she contracted the flu. As many of you may know, pregnant women are very susceptible to influenza which could have serous consequences for the mother and baby. This is an exchange the woman had with a physical therapist with whom she was working to regain muscle control after being hospitalized (and near death) for almost 4 months:

“Have you ever read the labels?” she (the physical therapist asked). “They’re so full of toxins.”

Asked if she realized that a shot, had it existed in June, might have saved her client and her baby, she frowned and went back to her clipboard.

Are you kidding me—full of toxins? This is exactly what Maher was trying to imply during his anti-vaccine rant on Real Time. Unfortunately, millions of people listen to him and celebrities like Oprah, Dr. Phil and Maher and many believe (and blindly follow) their recommendations and advice. While this may not be a problem when talking about hair color, books to read or weight loss it is extremely troubling and dangerous when it comes to scientific and medical advice. The problem is that a vast majority of Americans are scientifically illiterate and are either incapable or unwilling to analyze and evaluate scientific or medical information on their own. This forces many people to rely on the Internet, government agencies and sometimes healthcare professionals to do their medical and scientific thinking for them. And when things go wrong, or not as advertised, they are quick to accuse the government or the healthcare industry of withholding information and engaging in nefarious conspiracies. This is exacerbated by the fact that science and medical reporting in the US is grossly inadequate, often wrong and frequently designed to be as sensationalistic as possible. Is it any wonder why the American public is often confused and misinformed about science and medicine?

My scientific training has taught me to analyze and evaluate all available data before I draw any conclusions on a topic. And, as an infectious disease expert I believe that childhood vaccines are unequivocally safe and effective. To that end, they have substantially reduced the morbidity and mortality associated with mumps, measles, diphtheria, whooping cough, pneumonia, tetanus, almost eradicated polio and eliminated smallpox from the planet. There is no doubt that there are risks associated with vaccination and that a small number of those vaccinated may experience some side effects or serious adverse events. But, the small risks associated with modern vaccines don’t outweigh the benefits and positive effects on billions of people who may have lost their lives if they hadn’t been developed in the first place. I wonder whether or not an anti-vaccine movement would exist today if smallpox and polio were still causing as much death, disfigurement and paralysis as they had prior to development of the smallpox and polio vaccines in the mid 20^th century.

In closing, as an American, I believe that everybody is entitled to their opinions and the right to freely express them. However, I implore Bill Maher get the FACTS right before summarily bashing a topic and making recommendations to the millions of people who watch Real Time and believe what he says. Otherwise, he is no smarter or better than the ignorant, close-minded, right wingers who he regularly trashes on his show.

Until next time...

Good Luck and Good Job Hunting!!!!!!!!!!

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