When an unvaccinated child in Dr. Daniel Levy's practice came down with whooping cough this year, the Owings Mills pediatrician made a decision: He would no longer see patients whose parents refused to have them immunized against that disease or others, such as measles and meningitis.
The risks posed to his other patients were too great, Levy reasoned. And he felt he couldn't give adequate care to children whose parents rejected some of his most basic advice: That routine childhood vaccines are safe and are the key to preventing diseases that used to kill many before they could reach adulthood.
A new study out today in the journal Pediatrics shows that children who are not vaccinated are 23 times more likely to contract whooping cough - also known as pertussis - than those who have received all of their shots. Lead author Jason M. Glanz, an investigator at the Kaiser Permanente Colorado Institute for Health Research, said he and his colleagues found that, while 1 in 500 vaccinated children came down with pertussis, about 1 in 20 children who were not vaccinated got the disease.
That confirms Levy's fears. "We don't have a large refusal rate in Maryland, but it's something we're really concerned about," he said. "We're going to start seeing the return of diseases we had almost gotten rid of."
Pertussis, which is caused by bacteria, makes children cough uncontrollably. With the cough so hard and so persistent, children often can't catch their breath and they make a "whooping" sound when they attempt to breathe in. Pneumonia or seizures can also develop. There were 64 confirmed cases of pertussis in Maryland last year, including an outbreak of multiple cases in a school and another in a hospital, according to the state health department. That was up from 43 the year before.
A measles outbreak was reported last month in Rockville, with four cases linked to unvaccinated people. Last year, the number of cases of measles in the United States rose to its highest level in a decade.
"The ones who are refusing vaccines are often the epicenters of the outbreaks," said Dr. Daniel Salmon, a vaccine safety specialist with the National Vaccine Program Office at the U.S. Department of Health and Human Services.
