Record: Matthew G. Johnson, Kristy K. Bradley, Susan Mendus, Laurence Burnsed, Rachel Clinton, and Tejpratap Tiwari, “Vaccine-Preventable Disease Among Homeschooled Children: Two Cases of Tetanus in Oklahoma” in Pediatrics 132 , no. 6 (December 2013): e1686-e1689. Available Here.
Summary: Johnson and colleagues begin by noting that rates of vaccination among homeschoolers are unknown because in many states they are not subject to the same school-entry vaccination requirements as are other schoolchildren. The authors then explain that tetanus has become extremely rare in the United States thanks to vaccinations. In the entire United States there were only 37 reported cases of tetanus in 2012. In Oklahoma there were only two. Both were homeschoolers, one of whom had never received a vaccination and the other of whom had not received the 10 year booster shot.
The first patient, a 17 year-old white male, after puncturing his foot on a rusty boat anchor, contracted tetanus and was admitted to the hospital in June of 2012. Ten days later, after several rounds of very powerful drugs, he was discharged in stable condition.
The second patient, an 8 year-old white male, after puncturing his foot on a rusty nail, contracted tetanus and was admitted to the hospital in October of 2012. This patient had a more severe case, which included respiratory failure requiring intubation and mechanical ventilation. He was in the intensive care unit for 18 days and was finally discharged from the hospital nearly two months after he had first been admitted.
After describing both cases the authors return to the issue of homeschoolers and vaccinations, noting that some states (notably North Carolina) require of homeschoolers the same vaccinations they require of students attending public and private schools. But most do not. While the authors would like to see changes in law, they recognize that “strong resistance exists nationwide for any attempt to regulate homeschooling.” (p. e1688) They recommend that in lieu of legal changes efforts should be made to work with primary care physicians, with church groups and homeschooling associations, and with extra-curricular organizations homeschoolers tend to frequent to spread the word about the importance of vaccination. They also recommend periodic vaccination clinics for homeschooling families.
Appraisal: Unfortunate situations like the two anecdotes described in this brief article occur quite frequently in the homeschooling community given the pervasive distrust many homeschoolers feel toward medical professionals and especially toward vaccinations. This article’s recommended policies are well-intentioned, but they do not take into consideration this incredulity toward medical authority. The anecdotes themselves, however, are to me the more effective motivator. It’s not lack of access in most cases that is leading large numbers of homeschooling parents to forgo vaccination for their children. It is conviction that vaccines have harmful side effects. But what parent wants her child hospitalized for two months because of a poor parental judgment call? My policy proposal would be to increase public awareness of the horrible, needless suffering brought upon some children by such decisions. This article, appearing as it does in an obscure medical journal, is not likely to raise public consciousness. What is needed is a large-scale social marketing campaign analogous to campaigns to alert citizens to the dangers of smoking or the virtues of breastfeeding.
Milton Gaither, Messiah College, author of Homeschool: An American History
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Tetanus shots can be administered up to 48 hours after an injury and still be effective in preventing tetanus. A better approach is to educate parents about this fact instead of pushing what many find to be unnecessary vaccinations.
Our doctor’s office doesn’t check vaccinations. Even if I want to be in compliance, he doesn’t do vaccines. I have to go elsewhere. That other place has no day-to-day interaction with us and won’t bother checking the vaccines I ask for against the ever-changing “recommendations.” (I might be missing all kinds of stuff and not know it.) So I think actually, the school nurse plays a vital role in coordinating that compliance IF the parents wish to do all the vaccines. It is very easy to miss a ten-year-booster when there are so many other shots to do.
School nurses are absolutely vital pieces of the public health puzzle. They seem to be pretty much the only people up-to-date on these things. I kept the “get your child these immunizations” card we got when we delivered in the hospital, and it’s already hopelessly out of date.
Then, too, on the flip side of that, I do think medical people OVERpush on some vaccines, and homeschoolers see through this and say no to the whole caboodle. That should stop. And I mean on the over-pushing.
I’ll give some examples. Start with chicken pox. Hardly anyone dies of it. Not needed. Why push homeschooling parents to get this shot? Especially given that contracting chicken pox at a later age (say, after these vaccines may wear off? They haven’t been around for 75 years and don’t have that track record, so they likely will wear off) is more dangerous. I’m sure I’m not alone in concluding that often, it’s not about what the kids really need, but what brings the most profit.
Which leads me to IPV. That’s exactly why they’re pushing that instead of the OPV, even though OPV is so much more effective. They say it’s because of the off chance of contracting polio. Yeah. One in two million or so. I’m really scared. If my kid is exposed to ACTUAL polio, I’d way rather he had *real* protection, thanks. But I don’t get that choice for my child. It’s only available to people in the third world because they don’t have money for the pharmaceutical companies there.
And yet still, I have a child who is allergic to eggs. The medical people refuse, absolutely refuse, to give the vaccine to my child. I assure you he is FAR more likely to die of H1N1 if he contracts it, than any mild reaction he’d have to the egg allergen. So I can’t get the shots I feel my child needs, but they have no problem pushing me to get useless crap like chicken pox shots. And the reason, again, is the money. It’s defensive medicine on the one hand, and profit on the other.
In short, there are tons of reasons rational, loving people say no to those shots. I could tell you that a “campaign” to “educate” me will likely backfire. I’m well-aware of the current literature, and no stick-figure pamphlet in any waiting room is gonna change my mind. I find it insulting to think upon. Better, would be to have medical folks back WAYYYY off on un-necessary shots, coordinate care better, and push only a few very necessary vaccinations. Most people are more than reasonable if you respect them and meet them halfway.
I’ve had all my shots (and extra, having travelled to live in Australia as a child) and I still got a medically documented case of the measles in college. These things are not foolproof. I still think they’re important, but I’m skeptical enough to know that someone profited from those shots I got, and they simply didn’t work.
How many of these shots simply don’t work, and we really don’t know? I don’t mean in a lab situation.