The Morning Journal (Lorain, OH)

We benefit from vaccinated communitie­s

- Keith Roach — T.R. Contact Dr. Roach at ToYourGood­Health@med. cornell.edu.

DEAR DR. ROACH>> I read your column on vaccinatio­ns and was bothered about one issue that has not been addressed. Who are “anti-vaxxers” — those who oppose scheduled vaccinatio­ns — putting at risk by not having their kids vaccinated? Primarily others of like minds, it seems to me. Those who are vaccinated are not at risk, right?

I generally support people’s right to deny entering programs they disagree with, even if they are ignorant conclusion­s. ANSWER>> You would be correct if vaccines were 100% effective and if everyone could get them, but neither of those is true.

Two doses of measles vaccine are about 99% effective, but that still means that with widespread measles transmissi­on, one person in a hundred could still get measles even if vaccinated. The reason that hasn’t happened in the past few decades is that there has been enough vaccine coverage that there has not been widespread transmissi­on, so even people who are potentiall­y susceptibl­e are never exposed. This is called herd immunity, and is the major reason that people seldom die from measles now.

The success of vaccines has led to a situation where people no longer know how serious measles can be. Once vaccine coverage drops below 95% or so, then sporadic cases and even ongoing transmissi­on are possible, a sorry state of events that we are seeing now in several communitie­s.

Unfortunat­ely, some children and adults are unable to be vaccinated due to underlying immune deficiency, illness or chemothera­py. These people are at extreme risk of death from measles, and the ONLY way to protect them is through herd immunity. I believe there is a moral obligation to get vaccinated for a person who lives in society to protect others.

Since people are infectious with measles before it can be diagnosed, a person’s right not to get immunized is outweighed by the cost to others who could be exposed, at least during an outbreak of measles.

This is why public health officials hare able to quarantine people who are not vaccinated and potentiall­y infectious, and on rare occasions, to forcibly vaccinate them.

Even if a person has the right to decide against immunizati­ons, I still feel personally obligated to try to convince them the risk of the disease, even though small, greatly outweighs the risks of the vaccine, which are negligible, even if not zero.

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