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How Low Vaccination Rates Can Endanger

Advocate for those with primary immunodeficiency diseases testifies in Washington.

Child receiving vaccination from doctor

As outbreaks of measles and mumps continue in the United States, experts and advocates are sounding the alarm about the threat to public health.

But what about the threat to people who are especially vulnerable because they have immune system problems? John Boyle, CEO of the Immune Deficiency Foundation, recently testified before a U.S. Senate health committee to inform lawmakers about the heightened risks for PI patients. Parents of children who have primary immunodeficiency (PI) are understandably fearful, he said.

“They’re afraid because they understand the science, the math and the history. They know the stakes: if people stop vaccinating and the safety net of ‘community immunity’ fails, their children will be among the first casualties,” said Boyle, who has the primary immunodeficiency disease, X-Linked Agammaglobulinemia, or XLA.

Kids who have PI regularly miss school because of cold viruses that present little threat to someone with a properly functioning immune system, he said. An infectious disease like measles poses an extreme threat. 

Already this year, health officials report that measles cases in the United States have broken records for 2019. About 400 people in the U.S. are infected, according to a recent report in USA TODAY. Mumps, another vaccine-preventable disease, also spiked in 2019 with about 100 confirmed or suspected cases on college campuses.

Measles cases are on the rise in other parts of the world as well, according to global health officials. Those outbreaks prompted the World Health Organization to list “vaccine hesitancy” among the top global threats to world health. Scott Gottlieb, who recently resigned his post as commissioner of the U.S. Food and Drug Administration, said improving vaccination rates had the most potential to quickly improve health in the country.

The leader of BIO, an organization that represents biotech companies and academic institutions, also recently spoke out about low vaccine rates. In an opinion piece for The Hill, BIO CEO Jim Greenwood, reminded readers how devastating measles was in the last century.

In the decade after the U.S. began tracking measles in 1912, it killed an average of 6,000 people per year,” Greenwood wrote. “Before the measles vaccine was introduced in 1963, about 3 to 4 million children were sickened with the disease each year, leading to 48,000 hospitalizations. And about 1,000 of those children suffered encephalitis, a dangerous swelling of the brain.”

The 2019 U.S. measles outbreak shines a spotlight on communities where parents opt out of preventive childhood vaccinations, a series of injections recommended by the American Academy of Pediatricians. After exhaustive studies, medical experts have concluded that the benefits of vaccination far outweigh the risks. A rumored link to autism also has been debunked.

People who have primary immunodeficiency diseases (actually a group of more than 350 rare, chronic disorders) depend on “herd immunity,” Boyle testified in March. Herd immunity means that when much of a community (the herd) is vaccinated, members are less likely to contract or spread the disease, protecting people who are at risk.

Because of their faulty immune systems, vaccines may be ineffective and, in some cases, not recommended for people who have PI, Boyle said.

“It is particularly important for family members of patients with T and B cell immunodeficiencies, such as Common Variable Immune Deficiency (or CVID), SCID, and XLA to receive all of the available standard immunizations in order to protect their family member with these types of PI,” he said.

This isn’t the first time the Immune Deficiency Foundation has highlighted this risk to the PI community. In a 2014 article about vaccine guidelines for PI patients, the IDF’s Medical Advisory Committee cited “the growing neglect of societal adherence to routine immunizations.”

Learn more about herd immunity.

See the AAP’s recommended vaccine schedule.