How Childhood Vaccinations Help Protect Everyone

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We're talking wellness at MemorialCare Health System. It's time for our weekly dose of wellness. Here's Deborah Howell.

Deborah Howell
And welcome to our show, this is your weekly dose of wellness, I'm Deborah Howell, and today our guest is Dr. Marnie Baker, a pediatrician with MemorialCare Medical Group in Irvine, whose practice emphasizes prevention by focusing on the benefits of nutrition and injury avoidance. Dr. Baker and I will discuss the concept of herd immunity and why our most vulnerable children rely on us the most and really, how childhood vaccinations help protect everyone. Welcome, Dr. Baker.

Marnie Baker, MD, MPH
Thank you for having me.

Deborah Howell
Oh, it's our pleasure. Believe me. Can you please tell us a little bit about the state of childhood vaccinations in California?

Marnie Baker, MD, MPH
Well, it's a little bit concerning because despite the fact that we have widespread availability to free vaccinations all over our state, we have been seeing an increasing trend of parents that are declining vaccination for their kids. And you can see this, in fact, from looking at the number of personal belief exemptions. And that is a form that parents fill out in order to have their child enter kindergarten in public schools.

Deborah Howell
Mm-Hmm.

Marnie Baker, MD, MPH
And with the decline vaccination based on their personal beliefs, this form needs to be filled out. And we have found that the number of children entering public schools on these personal belief exemption have doubled since about 2007.

Deborah Howell
Wow. So one out of how many children are exempt or choose to fill out the form?

Marnie Baker, MD, MPH
Interestingly, if you look on the, for example, the California Department of Public Health website, you can actually look up your own school because there's a huge variation. Some of the schools are still maintaining 99% vaccination rates.

Deborah Howell
Mm-Hmm.

Marnie Baker, MD, MPH
Unfortunately, some of the schools have as high as a 15 or 20% personal belief exemption rate, meaning that 15 to 20% of those kids are entering either unvaccinated or under-vaccinated.

Deborah Howell
So two or three out of ten kids not vaccinated. Why do you think parents are not vaccinating their children?

Marnie Baker, MD, MPH
Well, that's a complicated answer, and I think my answer would depend on if I'm answering as a physician or a parent myself, as a parent, I certainly understand that there's been a lot of fear placed on the vaccines from a lot of media coverage and media attention that has gone to the questioning the safety of the vaccines.

Deborah Howell
Mm-Hmm.

Marnie Baker, MD, MPH
As a physician, I, of course, feel that there's been overwhelming scientific evidence proving the safety of vaccines. So as a physician, it's sort of difficult for me to understand why a parent would decline vaccinations. But again, as a parent, understanding that we all want to do the best thing for our kids and when we haven't even seen these diseases that are threatening our children because so many of these diseases have been eliminated. And then there's this fear has been placed into us questioning the safety of the vaccines. And I think that that's why some parents have made the decision to decline the vaccine.

Deborah Howell
I see, I understand that's got to be tough for you to try to play a dual role there as a physician and as a parent when people come to you. What do you tell them?

Marnie Baker, MD, MPH
I try to review the the facts, of course. Again, as a physician, knowing that there's an overwhelming amount of scientific evidence proving the safety of the vaccines and multiple studies that have shown that, you know, vaccines are not associated with autism or some of the other concerns that have been raised giving parents resources to to look up information for themselves and then helping them understand, as we have seen that as the vaccination rates decline, their child will be at risk for these vaccine preventable diseases.

Deborah Howell
That was my next question what has happened as a result of parents not vaccinating their children in schools in particular?

Marnie Baker, MD, MPH
Well, unfortunately, in the state of California, in the last year, we have seen a measles outbreak. In fact, two measles outbreaks. The initial outbreak was in the spring of 2014, and we are currently undergoing a measles outbreak right now, and we've also had an alarming increase in the number of pertussis cases or whooping cough. So we're currently in a pertussis epidemic in the state of California also, and again, these outbreaks have been clearly linked to the declining vaccination rates.

Deborah Howell
Can you explain a bit more about herd immunity?

Marnie Baker, MD, MPH
Yes, absolutely. So herd immunity is a concept where the majority of a population that is vaccinated will protect those very small number of children that are not able to be vaccinated. So for example, in the case of measles is about 95% of the population is vaccinated against measles. Then if there are a few children, less than 5% that are not vaccinated. That immunity of the herd or the majority will actually prevent the spread of the disease. But if, for example, the threshold of the immunity drops and less than a certain percentage of the kids are vaccinated, it allows the disease to spread more rapidly and then those children that cannot be vaccinated will be susceptible and exposed to the disease.

Deborah Howell
It's almost the opposite of survival of the fittest. The herd mentality. The herd.

Marnie Baker, MD, MPH
Yes, absolutely. I think that that's a great, great analogy.

Deborah Howell
What kind of child would not be able to have a vaccination for measles, for example?

Marnie Baker, MD, MPH
So measles is one of those vaccines that is a live virus vaccine. Again it is live and it's called attenuated. So it's been modified so that even getting this live virus vaccine, it gives you immune protection but does not make you sick. But there are cases where children and certain people in the population cannot receive this vaccine because it is a live virus. So, for example, pregnant women may not cannot receive a live virus vaccine.

Deborah Howell
Mm-Hmm.

Marnie Baker, MD, MPH
Children that have cancer that are undergoing chemotherapy and their immune systems are suppressed. They can't receive the measles vaccine. Also, children that have had an organ transplant, such as a heart, liver or lung transplant, and they're taking medications to suppress their immune system. They cannot receive the measles vaccine. So again, the concept of herd immunity shows us that those small percentage of children that can't be vaccinated really do rely on the rest of the population vaccinating their children in order to protect the other.

Deborah Howell
So you're not only protecting your child, you're potentially protecting every child in your child's class.

Marnie Baker, MD, MPH
Absolutely. And that's why it it's such an important public health issue, because again, it really is about about doing the right thing for not only your own child, but doing the right thing for the community, for all of our children.

Deborah Howell
I think this is a new concept for for many people.

Marnie Baker, MD, MPH
Yes, and I think again, because during this time where we've seen an increase in anti-vaccination, I think that parents understood that they were just making an individual decision for their child. And it wasn't until we've seen the increase in pertussis and measles in California that it really does bring to light that this is this is a community issue. This is not an individual parent choice. This is really an important thing to protect the safety of all of our children.

Deborah Howell
Right. It's sort of a wonderful tribal thing when you get right down to it, absolutely all taking care of each other, it takes a village. That's right. Dr. Baker, in your opinion, can we stop the current measles outbreak?

Marnie Baker, MD, MPH
Absolutely. We can actually stop this outbreak now as soon as we get those vaccination rates. There's still plenty of time to vaccinate your child, even if there was an exposure. If the measles vaccine is given within a few days of the exposure, it likely can offer some protection. If we get all of those parents that have, you know, put off or declined measles vaccine for whatever, whatever their personal belief, then if they go and get their children vaccinated and we can push that percentage past the threshold needed, we absolutely can stop the outbreak and prevent further spread of this disease.

Deborah Howell
And the same goes for pertussis.

Marnie Baker, MD, MPH
Yes, pertussis is a little bit more complicated because immunity against the pertussis vaccine does does sort of decline with age and the pertussis vaccine. Although it is protective, it doesn't have quite the level of protection of measles vaccine. So again, I think the pertussis outbreak will be a little bit trickier to handle. But again, the bottom line being that getting all the kids vaccinated is definitely the first step towards eliminating these diseases. All right. And I think pretty much all the doctors I know would agree with you.

Deborah Howell
And of course, if you have questions, go to your physician, ask the question and you know, what is what is the percentage of doctors that would probably say yes, absolutely get the vaccination?

Marnie Baker, MD, MPH
Oh, I would say that that, you know, a physician trained in in vaccines and medical science more than, you know, 99.5% of physicians are going to advocate for vaccinating their patients and their own children.

Deborah Howell
Thank you so much. Dr. Marnie Baker, wonderful pediatrician. I know you've got our kids on your mind and in your hearts, and we thank you so much for your good work.

Marnie Baker, MD, MPH
Thank you very much.

Deborah Howell
It's been a pleasure having you on the show today to talk to us about the importance of vaccinations. To learn more or to listen to a podcast of the show, please visit MemorialCare.org I'm Deborah Howell. Join us again next time as we explore another weekly dose of wellness and have yourself a fantastic day. Take care of your kids.