The Decline of Vaccination Rates and its Implications for Rare Disease Patients

According to a story from PLOS Medicine, most people will probably tell you that the anti-vaccine movement in the United States is a total failure. While the vast majority of children in the country are still getting the vaccines that they need to gain immunity from infectious disease, the anti-vaccine movement’s paranoia and conspiracy theory-fueled campaign of propaganda has left some lasting impact.

Currently, there are eighteen states that allow for non-medical exemptions (NMEs) for standard childhood vaccination regimens. This means that parents can choose to opt out of having their child vaccinated for reasons as vague as “philosophical beliefs.” Some of the states that allow these exemptions include Oregon, Texas, and Pennsylvania. Since 2009, the number of parents choosing NME for their children has begun to increase. These exemptions are particularly concentrated in major metropolitan areas, which make these places vulnerable to possible outbreaks of disease that could be prevented by vaccine.

Studies has shown that rates of infection for rubella, mumps, and measles increase in areas with higher rates of NMEs. What does this mean for rare disease patients?

To put it simply: nothing good. An unvaccinated child is 35 times more likely to be infected with measles. Many rare diseases can weaken a patient’s immune system or otherwise compromise the ability of an individual to resist infectious disease.

One of the significant benefits of practically universal vaccination is herd immunity. This means that, if almost everyone in a given group of people has been vaccinated for an infectious disease, then even a small number of people who are not vaccinated in that group are still effectively safe from the disease because everyone around them is immune.

In some rare diseases, the immune system can be compromised to the point that it can be unsafe for the child to be vaccinated with any vaccines that use live pathogens. These rare disease patients have a valid medical reason to not get the vaccine and must rely on herd immunity in order to avoid infection.

In areas with a significant number of NMEs, the herd immunity effect is eroded and weakened. When a parent chooses NME for their child, they are not just endangering that child, but potentially others as well, including rare disease patients with weakened immune systems. For these patients, an infection can be a life and death struggle.

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