Today's lesson: "Alternative" Virginia school closes after half of its students infected with pertussis. All of them were unvaccinated.

One of the most painful chapters to write in The Panic Virus was the story of Danielle and Ralph Romaguera, whose infant daughter, Brie, died of a pertussis infection when she was less than two months old. (In January, I recorded a Vanity Fair podcast with that chapter of the book.) Whooping cough is a scary, scary disease — as the Romagueras, or the parents of any of the ten infants who died of pertussis last year in California, can attest. (Nine of those children were under six months old, which is the age at which a child following the CDC-recommended vaccine schedule would be fully vaccinated.)

Brie Romaguera’s death is a tragic example of the reality that when parents choose not to vaccinate, they are not making a “purely personal” decision — they are making one that has the potential to affect everyone their children come in contact with. Infectious diseases are, by definition, transmitted through the environment — which usually means from one person to another. If an unvaccinated child shows up at a pediatrician’s office with a nasty cough that ends up being pertussis, that child is putting the life of every infant who happens to be in the office for a wellness appointment that day at risk.

This week, there is an example in Virginia of the ways in which a concentrated number of deliberately unvaccinated children can effect (or infect, depending on your perspective) the health of an entire region: Earlier today, The Roanoke Times reported that the Blue Mountain School, an “alternative” private school in Floyd County, had to shut down for a full week after twenty-three of its forty-five students came down with pertussis. According to the Times, every single one of those children was unvaccinated. The school’s administrator, Shelly Emmett, was quoted as saying, “Many of the families and staff at our school understand that some people choose not to vaccinate their children. We’re not requiring that they do.”

Emmett seems to be saying that the school’s administrators have decided they are exempt from Virginia law, which requires schools and day care centers to have documented proof that children have been vaccinated. (There are religious exemptions available in Virginia, as there are in 48 out of 50 states; Emmett’s quote implies that some, but not all, of the school’s unvaccinated students obtained such an exemption.)

I fear we’re going to be reading similar stories in the months and years to come. After a 2008 measles outbreak in California — which, incidentally, was started after a non-vaccinated patient of self-proclaimed vaccine and autism expert “Dr. Bob” Sears came back from a European vacation with the virus — a Los Angeles Times investigation identified two hundred Southern California schools where outbreaks are more likely “in large part because of parents choosing not to immunize. … Most are schools in affluent areas.” I wrote about the ’08 outbreak in my book; when I went back and re-read that section this morning, I was struck by the parallels to the current situation in Virginia:

One of those schools is the Ocean Charter School in Del Rey, California, where an entire century’s worth of medical advances have effectively been thrown out the window: Since the 2007-2008 school year, between forty and sixty percent of incoming kindergarteners have been exempted from vaccines. Administrators told the Times those figures were no surprise, because the school’s “nontraditional curriculum” attracted “well-educated parents who tend to be skeptical of mainstream beliefs.” “They question traditional knowledge,” the school’s assistant director said, “and feel empowered to make their own decisions for their families, not deferring to traditional wisdom.”

Indeed: Traditional wisdom holds that vaccine-preventable diseases like whooping cough, measles, and Hib are dangerous and potentially deadly. This week, the students at the Blue Mountain School get to learn those lessons in basic virology first-hand.

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37 Responses to Today's lesson: "Alternative" Virginia school closes after half of its students infected with pertussis. All of them were unvaccinated.

  1. RL says:

    How does a child get vaccinated for pertussis if they are under 2 months old? I did not think this was possible, Seth! The fact that the child you reference was under 2 months and unvaccinated shouldn’t and doesn’t add up!

    • Seth Mnookin says:

      I’m not sure what doesn’t add up: Infants who are two young to be vaccinated are precisely the ones at risk of catching a vaccine-preventable disease. Unlike the deliberately unvaccinated children at the Blue Mountain School, Brie Romaguera didn’t have a choice. Every child at Blue Mountain who has been infected poses an incredible danger to infants too young to be fully vaccinated.

    • Craig says:

      RT, Crowd Immunity.

    • Brian says:

      Agreed. As a parent of three, I know that vaccinations are given on schedules. The first vaccination for pertussis is given at 2 months. If the infant died before she was 2 months, the parents’ decision does not factor into why she died. I understand the author is trying to use her case to support his viewpoint, but he should use a better example. I believe that vaccinations have a greater benefit than any risks, so all of my children have been vaccinated.

      • Ken says:

        Brian, I believe you are missing the point. The parents that choose to NOT have vaccinations are the problem. By NOT getting vaccinations, you run a risk of spreading the contagious disease. (ie. The 1-2 month old) This isn’t personal choice that only affects their children.

      • Poobah says:

        I assume that the person that infected the two month old was unvaccinated.

      • Nathan says:

        Brian,

        That’s precisely the point. When large groups of people refuse to vaccinate their children because of skewed beliefs regarding the dangers and efficacy of vaccines, the population loses “herd immunity”, and they are selfishly putting many others at risk who are unable to be vaccinated (like the 2 month old in the article). The two-month old who isn’t yet vaccinated isn’t going to contract the disease in the first place if an adequate percentage of the population is vaccinated, preventing the disease’s spread. Not being vaccinated is a selfish decision that can and does have dire consequences for the others in your community — that’s kinda the point of the article.

  2. Chris says:

    “This week, the students at the Blue Mountain School get to learn those lessons in basic virology first-hand.”

    Well, technically bacteriology! Though epidemiology or immunology might also be appropriate.

    You are showing your virus bias by being a guest on This Week in Virology. Though Dr. Racaniello has expanded the podcasts to include “This Week in Microbiology”, in addition to “This Week in Parasitism.” (fortunately, they are all posted in his blog: http://www.virology.ws ).

  3. SRH says:

    Brilliant article Seth. This really brings home just how important herd immunity is. How “RL” doesn’t understand this is a bit beyond me. The logic is horridly simple.

  4. Has anyone directly asked the parents why they didn’t get their kids vaccinated? In light of what happened, I would be curious to hear how many changed their opinions or still justify their utter stupidity.

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  6. Liz Ditz says:

    Possibly more than you want to know: Blue Mountain School is “Waldorf influenced”. It was at one time and may be now listed in a US directory of Waldorf schools.

    Waldorf and vaccine refusal:

    http://www.openwaldorf.com/health.html

    Immunization
    Waldorf’s official position on immunization is that there is no official Waldorf position on immunization. Instead, Waldorf says that immunization should be informed by medical professionals, and ultimately parents should decide whether or not to immunize their own children.

    Typically Waldorf schools do not encourage parents to immunize their children against the following diseases.

    * Hepatitis B
    * Diphtheria, Tetanus, Pertussis
    * Tetanus and Diphtheria
    * Haemophilus influenzae Type b
    * Inactivated Polio
    * Measles, Mumps, Rubella
    * Varicella
    * Pneumococcal Conjugate Vaccine (PCV)

    Strong Anti-Immunization Preference
    While there may not be an official position on immunization at Waldorf, there does seem to be a strong cultural anti-immunization preference among thought-leaders in the Waldorf community. This preference can be traced back to Steiner himself, who believed that immunization interferes with karmic development and the cycles of reincarnation.

    ===
    Waldorf schools, both private and public (“Waldorf charters”) have had outbreaks of vaccine-preventable disease.

  7. Goddessmother says:

    The children in the mentioned school will be immune to the whooping cough virus for the rest of their lives unlike all the vaccinated children that contracted whooping cough in my area several years ago, they may never be immune to the disease and could continue to infect others each time they are exposed because the vaccine was not good enough.

    That poor baby that died before she was two months old was not diagnosed properly and in time to save her life, and they overloaded her with medications. Please see the information at the bottom of the enclosed link. (Which attempts to use doctor incompetence as a reason to push early vaccinations)

    http://www.vaccinateyourbaby.org/why/victims.cfm

    • Chris says:

      Goddessmother:

      The children in the mentioned school will be immune to the whooping cough virus for the rest of their lives unlike all the vaccinated children that contracted whooping cough in my area several years ago,

      False. That bacterial infection only confers immunity between five and twenty years. Just like strep infections, it does not confer permanent immunity (I know from experience having had kids get repeated strep infections because the one “healthy one” was asymptomatic and kept reinfecting his siblings).

      That is why boosters for tetanus and diphtheria were needed every ten years. Now pertussis vaccines need to boosters, even though someone had the disease.

  8. Chris says:

    There’s another way of looking at this. The anti-vaccination folks are volunteering their children to be active participants in an epidemiological study of the spread of preventable diseases, and the development of resistant populations through the culling of susceptible individuals.

  9. Charles Lemos says:

    When I read “alternative” I assumed it was some sort of religious school especially given that it is located in SW Virginia but quite the contrary, Blue Mountain touts itself as a “progressive” institution. Why are we going backwards?

  10. Kris says:

    According to the CDC 2010 vaccination schedule this is the recommendation for the DTaP vaccine (diphtheria, tetanus, pertussis or whooping cough) for children:
    2 months DTaP plus Rotavirus (RV), Hib, Pneumococcal (PCV), & Polio
    4 months DTaP plus Rotavirus, Hib, PCV & Polio
    6 months DTaP plus Rotavirus, Hib, PCV & Polio
    15-18 months DTaP plus Hib, PCV, Polio
    4-5 years DTaP plus Polio, MMR booster, Varicella,

    11-12 years Tdap

    Source: Vaccine Epidemic Habakus ,L, Holland M. 2011 Skyhorse Publishing

    In the book The Vaccine Book by Dr Bob Sears there is no single vaccine for just the pertussis component. In the U.S you have to get the diphtheria and the tetanus as well for infants. There is a shot just for tetanus and a combo shot for diphtheria and tetanus but this is for older children in their teens or for adults who will be traveling abroad.
    Sanofi Pasteur makes two brands Daptacel & Tripedia and GlaxoSmithKline makes Infanrix.
    The ingredients include aluminum, formaldehyde, Polysorbate 80, 2-phenoxyethanol and mercury (Tripedia) along with the three germ and toxoid components which are cultured in cow tissue extract.
    Daptacel does not use cow extract.
    Some of the most serious reactions to the DTaP include Guillain Barre syndrome, brain damage, encephalopathy and other nerve dysfunction which according to the book maybe due to the tetanus toxoid component. Other reported reactions to the DTaP vaccine are as follows: lymph node swelling, heart inflammation, extensive and serious swelling of the injected limb, diabetes, seizures, bruising throughout the body, bleeding disorders, severe allergic reactions, skin infections.
    According to the CDC 2010 schedule by the time a child is six he/she will be receiving 50 doses of 14 vaccines. This in my opinion is an outrage to inject so much into an infant starting at birth with the Hepatitis B vaccine.
    We also need to remember that vaccines contain human tissue and DNA fragments (currently in 23 vaccines). This came out recently from senior scientist Helen Ratajczak who published her findings in the Journal of Immunotoxicology. Human DNA injected to humans affect the neurons in our brain causing long term inflammation which “doesn’t stop it continues through the life of that individual”says Ratajczak. This is what happens to the brains of children who are diagnosed with “autism”. What is autism but long term inflammation of the brain. MMR vaccine contains human DNA and rates in autism appeared to spike when DNA was introduced in the making of the MMR vaccine. In 1995 another spike in autism occurred when chicken pox vaccine was grown in human fetal tissue.
    Bordatella pertussis bacteria is the bacterium which causes pertussis. The latest outbreaks could also be caused by another bordatella bacteria called parapertussis. So the question is is whooping cough now being caused by a mutated version of the bordatella bacterium? Currently there is no vaccine for this strain and many say the more we mass vaccinate the more virulent strains will arise.

    • Papamonkie says:

      As a new parent, the total vaccine schedule horrified me…so much so that my study of medicine (I’m in a Master program currently) led me to set my own schedule to immunize my two children. When I look at their genetic siblings (cousins), my children seem to have fewer long-term health issues (allergic reactions, trips to the ER, general wellness). Much as the previous commentor has posted, it is foolish to believe the the human systems can withstand the assault of human-created bacteria/virii as well as the completely synthetic/toxic additives (mercury in any form, aluminum, polysorbitol, etc) at a stage where the cells are rapidly dividing and genetic transcription errors can be magnified.

      In Chinese Medicine, we are taught that for a healthy life one must live in moderation. I believe that we can apply this concept to both ancient and modern medical practices. At this stage, I do not believe anyone questions the validity and social responsibilities of vaccinations, but I believe that we must choose intelligently how those vaccinations are applied and at what rate.

      • Mokele says:

        If your Master’s program hasn’t taught you that anecdote is not data, you need to go to a better school.

      • Heliantus says:

        “When I look at their genetic siblings (cousins)”

        Err, are you really attending a medical school? Cousins are not really genetic siblings. Likely closer than the guy next door, but not necessarily by much more.

        We all have 2 sets of 23 chromosomes (including the odd XX or XY pair), and only one of each pair will be given by a parent to his/her child. Thus, two brothers or sisters could share between 100% of their genetic bagage (by chance, they all got the same chromosomes from you and your spouse), all the way down to 0% (by chance, they didn’t have a single chromosome in common).
        Not exactly 0%, actually. They will always share the same mitochondrial DNA. Cousins may not: this DNA is strictly passed on by the mother (except in some very rare cases), so children from your wife and children from your wife’s sister will have the same mitochondrial DNA, but not other combinations.

        For cousins, the best is 50% of similar DNA material, unless you and your brother (assuming your cousins are from your brother) are true twins who married twin sisters: even if you and your brother (or sister) share 100 % of similar DNA, obviously, when you marry, your spouses will bring new and different DNA, and give half of it to your children.

        You are comparing children with at least 50% genetic difference, which is huge.
        OK, a lot of genes are more often seen in the population than others, so your spouses can actually share a lot of DNA with you. But it still left a lot of unknown differences.

        And then there is the lifestyle question. Obviously, you and your sibling at least disagree on vaccination, you may have other lifestyle differences. Different places of living, to start with. Which have a big role for environmental stuff like allergies.

        That’s why genetic studies often compare identical twins and non-identical siblings. Same lifestyle, but genetic similarities (twins) and genetic differences (other siblings).

      • Nomen Nescio says:

        if your childrens’ legal cousins are their genetic siblings, methinks your family tree doesn’t branch enough… either way, get those kids immunized. it isn’t just about them, it’s about the kids they have contact with and hence might infect, too.

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  12. SpeakingUp says:

    So how many of these families that had non-vaccination children had autism, allergies, or immune disorders? I’d surmise they they have LOWER rates of those. Now that we have a study group of non-vaccinated children, lets do some real comparing. Lets see both the GOOD and the BAD results.

    I have 3 children. 1 vaccinated who has Asberger’s and a host of allergies including nut allergies.
    2 children who are non-vaccinated and have NO allergies and NO autism.

    So they might get whooping cough and are out sick for a few weeks. They’ll get better. None of those children at that school had fatalities.

    Ask yourself, would you rather have a chance of having LIFELONG autism or allergies, or the possibility of getting one of those illnesses?

    Why do you think nut allergies have soared???

    The only true scientific testing is comparing large groups of vaccinated and non-vaccinated. Take the non-vaccinated Amish and their near ZERO autism rates. Dare to compare.

    • axiomaticsandwich says:

      First:

      You’re wrong about the Amish on two counts: First, the Amish are not a fully unvaccinated community. They have no religious opposition to vaccination. Second: Their rate of autism is not “near ZERO.” It is closer to 1:250. (source:http://imfar.confex.com/imfar/2010/webprogram/Paper7336.html)

      Further, The Amish are very poor group to use for vaccination study. Their lifestyle, eating habits, and environmental exposures are radically different from the average American. The Amish demonstrate a markedly low rate of ADS, but to immediately conclude that it is due to vaccination is foolish. There are a myriad of myriad of other issues potentially involved.

      Second: Your anecdotal evidence is irrelevant. I am vaccinated, I have no allergies and no autism. I have a cousin who is not vaccinated, and he autism and allergies. Does this mean anything? No, it means nothing. It’s a tiny study group and not relevant.

      However: There is a lot of real, non-crackpot science that disproves the Autism-Vaccine link. Not vaccinating your children recklessly endangers the rest of the population.

    • Grumpy says:

      @ SpeakingUp

      I’m not really writing this to you, as I’m sure that nothing I could possibly say would sway you. However, to those people that are capable of critical thinking, may I take this opportunity to rebut the points above:

      “So how many of these families that had non-vaccination children had autism, allergies, or immune disorders? I’d surmise they they have LOWER rates of those. Now that we have a study group of non-vaccinated children, lets do some real comparing. Lets see both the GOOD and the BAD results.”

      There are precisely zero credible studies that link autism and vaccination. The one study that originally ‘found’ a link was written by a fraud who was trying to make money as an expert witness for people suing vacine companies (http://en.wikipedia.org/wiki/Andrew_Wakefield).

      Allergies and immune disorders certainly do seem to be on the rise. However there is no correlation to the time of the introduction of vaccinations compared to the beginning of the upward trend in reports of increased immune disorders in any country.

      There does seem to be some interesting work being done in rates of allergies and immune disorders vs the timing of exposures to environmental triggers.

      “I have 3 children. 1 vaccinated who has Asberger’s and a host of allergies including nut allergies.
      2 children who are non-vaccinated and have NO allergies and NO autism.”

      Not having a child that has Asberger’s, I’m not going to comment on this apart from saying that anecdotal evidence such as this is useless. I have a child that has been vaccinated and doesn’t have allergies nor Asberger’s. Should my anecdote cancel yours? Obviously not. They have equal weight, both being essentially useless in discovering if there is a link between autism and vaccinations.

      “So they might get whooping cough and are out sick for a few weeks. They’ll get better. None of those children at that school had fatalities.”

      This line pisses me off. Did you read the post? Children who are not vaccinated by parental choice are giving these diseases to kids who can not be vaccinated and those kids are dying. So the kids that are at highest risk – those with childhood cancers, those under the age of 6 months, those that have compromised immune systems kids that can not be vaccinated – these are the kids that pay the price for the parents that are not capable of making informed decisions. Or worse, those like SpeakingUp, who peddle lies through stupidity, malice or greed.

      “Ask yourself, would you rather have a chance of having LIFELONG autism or allergies, or the possibility of getting one of those illnesses?”

      There is no link between vaccinations and autism nor allergies.

      “Why do you think nut allergies have soared???”

      Well that is an interesting question.

      An eminently easy to read article that SpeakingUp seems to have missed in his/her extensive research is: http://www.newyorker.com/reporting/2011/02/07/110207fa_fact_groopman

      There are many, many others as well. Google is your friend here, SpeakingUp.

      “The only true scientific testing is comparing large groups of vaccinated and non-vaccinated. Take the non-vaccinated Amish and their near ZERO autism rates. Dare to compare.”

      Finally something we can agree on. True scientific testing. For example here:

      Jefferson T, Price D, Demicheli V, Bianco E (2003). “Unintended events following immunization with MMR: a systematic review”. Vaccine 21 (25–26): 3954–60. doi:10.1016/S0264-410X(03)00271-8. PMID 12922131

      is a review of 120 studies trying to find a link between the MMR vaccine and outcomes such as autism and allergies. To precis: there’s no link.

      Oh and the so called non-vaccinated Amish? They do vaccinate at approximately the same rates as non-amish. Though they do appear to have slightly lower autism rates, as do several other populations with lower genetic variation.

      http://autism.about.com/b/2008/04/23/do-the-amish-vaccinate-indeed-they-do-and-their-autism-rates-may-be-lower.htm

      http://imfar.confex.com/imfar/2010/webprogram/Paper7336.html

      Cheers.

    • Nomen Nescio says:

      oy, what a load of drek. first off, vaccination does not cause autism or allergies; this has been established past reasonable doubt, and nobody but crackpots claims it does any longer. second, even if vaccination DID cause those things — autism and allergies do not kill kids anywhere near as often as diphteria, pertussis, and tetanus do.

      yes, i know raising an autistic kid must be hellish. but no, even if that HAD happened due to vaccination — which it didn’t — trust me, watching a kid cough their lungs up and die in misery is even worse still.

      there are mp3′s of pertussis coughing out there on the internet; there are pictures of infants locked in tetanus to where they balance on their heels and the back of their head. it’s gruesome stuff. go find it, watch, listen — and then go vaccinate your offspring.

    • NotAFanOfDeath says:

      “So they might get whooping cough and are out sick for a few weeks. They’ll get better.”

      I’m glad that you can apparently live with the entirely real possibility that your child, unvaccinated by your choice, will spread it to an infant who doesn’t have the opportunity to be vaccinated or the immune system to fight whooping cough and subsequently dies.

    • Chris says:

      Kim Stagliano did not vaccinate her youngest daughter, and yet that daughter is also autistic.

      There are many more out there who are not vaccinated and are autistic. If you search the LeftBrainRightBrain blog you will see several come out and explain to a Tony Bateson that they have autistic children who are not vaccinated (he still claims there aren’t any, and apparently wants them to come to his front door with all the medical records to prove it).

  13. Tim says:

    I can’t have many vaccinations due to being allergic to eggs. I got some childhood vaccines, but not all of them are available for people with egg allergies. I can tell you flat out that I’d like to have them. I can also say without hesitation that if I contracted some disease because some dimwit didn’t vaccinate their little rug rat I would sue the parents out of every last nickel they had.

    People who believe vaccines are somehow bad are like flat Earth advocates. Sure, plenty of people ran around and told each other the Earth was flat, but the fact is they were all wrong. So are these morons in a very similar manner. Just because they want to believe doesn’t make it true.

    • Mike says:

      Well, that would be an interesting case to read about. The problem (of suing the rugrat’s parents) would be to prove that it was that particular rugrat and not some other rugrat who was responsible. Still, it’s only a matter of time before someone tries this on, if they haven’t already.

  14. evodevo says:

    The plural of anecdote is NOT data.

  15. Nin says:

    You used the word “effect” when you should have used “affect”. Sorry for my pedanticism.

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  17. Samantha Murphy says:

    As a new parent to be, I have invested myself heavily in researching all sides of this debate.

    #1. No one has mentioned that the primary problem with the vaccines, despite recognizing they are necessary, is that NO research has been done on how much aluminum a 2 month old baby can handle. The closest we have come to researching this is to study how much aluminum a baby can handle when given an IV containing aluminum. The maximum they have discovered is 50 micrograms per day given over an extended period of time.

    The first DTaP shot, depending on which of the three manufacturers you choose, can contain up to 750 micrograms of aluminum PLUS you’re expected to give your 2 month old baby an additional 4-5 shots of other things that contribute to a weakening of their immune system, even if only temporarily. It’s not that we know it will harm the infant, it’s that we don’t know that it WON’T. Simply not good enough.

    #2. Parents need to keep their newborns at home and away from other children until they’ve at least had their first DTaP shot at 2 months old and preferably severely limit their contact with other kids and daycares until they’re 6 months old. Even adults who will be holding the newborn need to be given a titer to ensure they are immunized against Pertussis.

    #3. Why give an MMR immunization when a child is 12 months if they aren’t going to school or daycare yet? Autism is usually discovered shortly after a child turns one, so why not wait? Particularly when Measles, Mumps and Rubella are so rarely fatal.

    If you do choose not to immunize or to stretch out your immunizations, keep your children at home and out of daycare and schools.

    As a side note, I think it’s unfair to nail Dr. Sears to the wall when he presents merely a modified vaccination schedule that limits the amount of aluminum your child receives at one time. He stands behind most vaccines, but recommends more trips to the pediatrician to receive less shots at one time.

    The CDC recommends a Hep B shot when babies are first born at the hospital. Hep B is predominantly a sexually transmitted disease. Unless one of the parents has it, why not wait until the child is 12 or 13 years old to give this?

    Finally, newborn babies are automatically covered for a lot of diseases while they are being breastfed by the mother. Immunity from Diptheria and tetanus are both automatically transferred to the newborn from the mother, although as parents we aren’t given the option to only vaccinate our children for Pertussis. Why?

    I believe in vaccinating when necessary, but a lot of the vaccines on the CDC schedule are not only NOT necessary they are foolish.

    • Chris says:

      Finally, newborn babies are automatically covered for a lot of diseases while they are being breastfed by the mother. Immunity from Diptheria and tetanus are both automatically transferred to the newborn from the mother, although as parents we aren’t given the option to only vaccinate our children for Pertussis. Why?

      Cite?

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