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Opinion: Approach Toward Childhood Vaccinations Should Be Reevaluated

In an era where scientific advancements have transformed health care and eradicated once-deadly diseases, the resurfacing of vaccine-preventable illnesses raises alarming concerns about public health. As we witness statewide outbreaks in cases of the once-eradicated measles, we must reevaluate our approach toward childhood vaccinations.

According to the World Health Organization, childhood vaccines continue to be the most effective public health intervention in human history, saving between 3.5 million to 5 million lives each year. Vaccines, through their ability to stimulate the immune system, have prevented the spread of infectious diseases. Despite the proven success of vaccines, a growing number of parents are choosing not to vaccinate their children.

Measles, a highly contagious and potentially deadly viral infection, serves as an upsetting reminder of the consequences of vaccine hesitancy. Declared eliminated from the United States in 2000, measles has made a comeback in recent years. The reasons include skepticism about vaccine safety, the spread of misinformation via social media and the blissful dissociative reality of forgetting how contagious and deadly measles is to human beings.

Mandating childhood vaccines is not a novel concept. In fact, the United States already requires vaccinations including polio, mumps, rubella and diphtheria as a prerequisite for school entry. Exemptions for religious or philosophical reasons in some states have created pockets of vulnerability.

The economic and educational burden of preventable diseases caused by outbreaks, as we have all learned firsthand, is overwhelming. Our already damaged education system saw even harsher setbacks from COVID-19, and those problems will become exponentially worse should vaccines be withheld from children. Disease outbreaks disrupt school routines, leading to missed days and causing educational and developmental delays. With vaccine mandates, we can create a more stable learning environment, promote academic success and ensure that our future leaders can succeed.

Critics argue that mandating vaccines dismisses personal autonomy and parental rights. The reality is that there is a price for freedom, and public health must take priority. The government already places restrictions on individual freedoms, like seat belt laws or the cessation of smoking in public places. Similarly, a parent has the freedom to homeschool their child should they choose to not vaccinate their child.

Mandating childhood vaccines is a necessary step toward safeguarding the well-being of our communities. The term "herd immunity" has become a household phrase due in part to the COVID-19 pandemic. It emphasizes the importance of maintaining high vaccination rates to protect those who cannot be vaccinated. By ensuring widespread immunity, we create a shield that prevents the spread of infectious diseases and protects the most vulnerable members of our society.

To address these lapses in immunity, we need to address the root cause of vaccine hesitancy. Misinformation, propagated through various channels, has played a significant role in causing public mistrust in vaccines. Comprehensive, evidenced-based, and collaborative public health campaigns; education; and transparent communication from healthcare professionals are essential to counteract myths and provide accurate information about vaccine safety and efficacy. Mandating vaccines should also be accompanied by efforts to improve access to vaccination services. Lack of health care access can contribute to lower vaccination rates in underserved communities. In Connecticut, Chapter 169 Section 10-204a notes that any parent or guardian unable to provide a required vaccination due to cost will be paid for by the town. By addressing these disparities, we can ensure that all children, regardless of their socio-economic background, have equal access to better health outcomes.

In conclusion, the reappearance of measles and the trend toward vaccine hesitancy demands a motivated response. Mandating childhood vaccines is not only a practical solution to protect the health of our children but also an investment in the well-being, productivity and stability of our society. It is time to prioritize the health of our communities and safeguard our future through the power of mandatory childhood vaccinations.

Is it time to amend Chapter 169 sec. 10-204a and mandate childhood vaccines? What you can do to make a statement on this public health matter: If you are a parent looking for a CT vaccine provider, please visit https://www.Datawrapper.De/_/R0OUx/ or call 860-509-7929. If you feel motivated about mandating vaccines, join the CT Immunization Coalition, which is dedicated to promoting vaccinations through the community. As always, you can contact your local health representatives or the state Department of Public Health to express your concerns.

Peyton Teske is a lifelong Connecticut native and has been a registered nurse since 2020. She is currently in the AGACNP program at UConn.

Maine Reaches A Milestone For School-required Vaccinations

The state's K-12 schools reached 'herd immunity' – when at least 95% of a population is vaccinated – for the first time since 2011, health officials said Tuesday.

Posted April 23

Updated April 23

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Maine has reached "herd immunity" for school-required vaccination coverage for the first time since 2011, driven by a law that went into effect in 2021 that eliminated philosophical and religious exemptions for students attending K-12 schools.

Herd immunity is achieved when at least 95% of a population is immunized against infectious diseases.

"Maine has become a leader in childhood vaccination," Dr. Puthiery Va, director of the Maine Center for Disease Control and Prevention, said in a statement Tuesday. "It couldn't come at a better time, as the United States has already seen more measles cases in the first three months of 2024 than in all of 2023. This alarming trend highlights the importance of childhood vaccinations, which reduce the risk that Maine's youngest residents could face from these harmful and potentially fatal diseases."

The U.S. CDC is reporting 125 cases of measles in 17 states (none in Maine) so far in 2024.

State lawmakers and the Mills administration prioritized improving Maine's vaccination rates after years of high rates of religious and philosophical opt-outs left the state vulnerable to outbreaks of infectious diseases.

Lawmakers passed the bill in 2019, and it survived a people's veto attempt that would have overturned the law before it was implemented. The new vaccine law went into effect in the 2021-22 school year.

Since then, as families have complied with the new requirements, vaccination coverage in schools has improved, plummeting from 4.5% opting out in 2020-21 – the last year before the law was implemented – to 0.8% in 2022-23 and 0.9% in 2023-24.

Medical exemptions are still permitted under the law, but religious and philosophic exemptions are no longer allowed.

Meanwhile, the percentage of students getting their first shots for diseases covered by school vaccination requirements – including measles, mumps and rubella, pertussis, polio and others – surpassed 95% for the first time since 2011, the Maine CDC said.

Herd immunity is the scientific term for when vaccination coverage among a population is so comprehensive that infectious diseases have few opportunities to gain a foothold. Public health experts say herd immunity is important in preventing highly contagious diseases from spreading in populations.

"Achieving herd immunity among schoolchildren represents a pivotal success for Maine," Jeanne Lambrew, commissioner of the Maine Department of Health and Human Services, said in a statement.

The percentage of students immunized against specific diseases can differ from the overall vaccination rate for several reasons, primarily because of missing vaccination records. Even if a parent has their child vaccinated, the child will be listed as unvaccinated if the school doesn't have the vaccination record to turn over to the state CDC.

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The Bombastic 19th-century Anti-vaxxer Who Fueled Montreal's Smallpox Epidemic

This article was originally featured on MIT Press Reader.

This article is excerpted from Sabrina Sholts's book "The Human Disease: How We Create Pandemics, from Our Bodies to Our Beliefs."

"VACCINATE! VACCINATE!! VACCINATE!!! THERE'S MONEY IN IT!!! TWENTY THOUSAND VICTIMS!!! Will be Vaccinated within the next ten days in this City under the present ALARM!!! That will put $10,000 into the pockets of the Medical Profession." In case all the exclamation points and capitalized letters didn't do the trick, Alexander Milton Ross embellished his poster with a large drawing of a police officer restraining a mother while Death vaccinated her child. It was terrifying, no doubt. For extra emphasis, the police officer held a piece of paper that read "Vaccination for the Jenner-ation of Disease," a reference to the English physician Edward Jenner, who developed and promoted vaccination.

In 1885, Canada had no greater adversary of smallpox vaccination than Ross, an Anglo-Canadian physician and naturalist whose medical training was informed by the sanitary movement of the 19th century. Opposed to the germ theory emerging in Europe (that same year, Louis Pasteur's rabies vaccine was announced to the world), Ross believed that smallpox was a filth disease and its only antidote was cleanliness. And though it's true that smallpox could spread through soiled fabrics used by smallpox patients (such as bedding and clothing), its primary route of transmission was virus-laden respiratory droplets. The real danger thus lay in close and prolonged contact with smallpox patients, independent of how clean the setting was.

Vaccination, in Ross's mind, was poisonous. He wanted everyone to know it too. Besides papering the city of Montreal with antivaccination posters and pamphlets, writing letters to newspapers and professional journals, and founding a magazine called the Anti-Vaccinator, he formed the Canadian Anti-Vaccination League as part of an international antivaccination crusade. "Though Police and the Profession cry Vaccinate! Vaccinate!! Vaccinate!!! And people in thousands follow their blind leaders, — I still say, DON'T," Ross urged in a circular that he distributed throughout the city.

Ross believed that smallpox was a filth disease and its only antidote was cleanliness.

At the time, Montreal was struggling to fight off the largest epidemic of smallpox that it would ever face. For almost a century, smallpox vaccination had been widely used to prevent the disease, but many of the city's inhabitants had refused the procedure.

Some of the holdouts were surely persuaded by Ross and his English-only propaganda. But most of the unvaccinated population and therefore the bulk of the cases consisted of French Canadians. To convince them of the evils of vaccination, French Canadian physician Joseph Emery Coderre formed the first Canadian antivaccination society in Montreal and published numerous antivaccination pamphlets in French in the 1870s. His ardent antivaccination views fed the fervor of protesters who attacked the city council in 1875, halting efforts to enact mandatory smallpox vaccination in Montreal and leaving the city vulnerable to devastating disease 10 years later. When compulsory vaccination was attempted again in 1885, the riot was even bigger. Shortly thereafter, Coderre and colleagues created an antivaccination journal, L'Antivaccinateur canadien-français, the Francophone counterpart to Ross's magazine.

Antivaccination poster in 1885. Created by Alexander Milton Ross during the smallpox epidemic in Montreal, the text accuses medical doctors of profiting from smallpox vaccination and urges citizens to refuse it, while the image suggests that the smallpox vaccine is deadly. Source: Michael Bliss, "Plague: The Story of Smallpox in Montreal" (Toronto: HarperCollins, 1991).

The misinformation promoted by Ross, Coderre, and their contemporaries should be familiar to anyone with a social media account in the 21st century. First off, they downplayed the threat of the epidemic in Montreal. Francophone newspapers wrote little about it, except to dismiss the panic, while Ross stressed in one of his pamphlets, "CAUTION. Do not be alarmed by the smallpox." Simultaneously, they insisted that vaccination was the true danger. In the Anti-Vaccinator, Ross explained that vaccination didn't prevent smallpox and actually infected people with the smallpox virus, along with other equally lethal pathogens. Coderre likewise insisted that victims of vaccination were everywhere. His writings included pages of individuals whom he believed were sickened or killed by the vaccine, either from contracting smallpox or some other malady such as gangrene and syphilis.

And then, of course, they spouted conspiracy theories. Provaccination doctors were accused of profiting from the practice, as Ross broadcast in his poster. One French Canadian doctor, in an open letter to Coderre published by the medical journal L'Union Médicale du Canada in 1875, laid out the same charge. He also perceived another conspiracy among English physicians in particular, attributing their advocacy of the smallpox vaccine to nationalistic conflicts of interest given that English physician Jenner was associated with it. Coderre replied in agreement, affirming that English doctors and public vaccinators practiced vaccination par intérêt — purely out of self-interest. These beliefs were consistent with a general distrust of the Anglophone elite, whose vaccines were seen as both poisoning and punishing the French Canadian community, which mostly lived in overcrowded tenements in the poorest quarters of the city.

Their arguments are reminiscent of misinformation during subsequent epidemics and pandemics, all the way up to the present. It's also noteworthy that while Ross thought sanitation was the answer to smallpox, Francophone newspapers printed recipes for at-home remedies, such as buckwheat root or mixtures of zinc sulfate, digitalis, and sugar. (A cure was never found for smallpox before its eradication, and treatments generally consisted of cleaning the wounds and easing the pain of the ill.) These ideas are akin to the popularization in the United States of non-FDA-approved treatments for COVID-19, such as ivermectin (an antiparasitic agent used to treat patients with certain worm infections and head lice) and hydroxychloroquine (a medication used for malaria and autoimmune conditions such as lupus and rheumatoid arthritis), which many people learned about through the internet, social media, and celebrity testimonials. Despite early hopes, neither of them turned out to be effective for preventing or treating COVID-19. But without any specific treatments for COVID-19 until long into the pandemic, it's not surprising that some patients opted to take risks with these unproven remedies rather than heed public health warnings against them. Some physicians even participated in misinformation about the efficacy of these drugs and continued to prescribe them for COVID-19. And although many studies haven't observed that ivermectin and hydroxychloroquine cause serious adverse effects in COVID-19 patients, they can still be dangerous if the patients forgo evidence-based COVID-19 treatments or vaccination against SARS-CoV-2 as a result of using them, as editors at the Journal of the American Medical Association pointed out last year.

To be fair, smallpox vaccination was far from perfectly safe in the late 19th century. Even Jenner himself couldn't explain how his vaccine worked, and some methods (such as passing infectious material directly from the arm of a vaccinated person to an unvaccinated one) undoubtedly had the potential to introduce other infections. There were also some cases where children may have died as a result of faulty vaccine preparations. Furthermore, even if the vaccination was successful, it didn't guarantee complete or lifelong immunity. Antivaccinationists, though, were incorrect about the risks and effects of the vaccine. And their dishonesty, at least in the case of Ross, raised questions about their own motives.

One State Board of Health report called him "a monster in human form who desired that a most terrible disease should decimate his patrons, that he might grow fat on their putrid bodies."

Ross, the bombastic pamphleteer, was apparently a hypocrite at heart. In October 1885, while the smallpox epidemic was still raging in Montreal, he boarded a train to Toronto. As reported afterward by the Gazette, a medical inspector at the Ontario border asked Ross to show proof of recent smallpox vaccination, either in the form of a certificate or scar. It was a standard policy for travelers, but Ross tried his best to get out of it. Then when he couldn't produce a certificate, he reluctantly took off his coat, rolled off his sleeve, and revealed "three perfect vaccination marks" on his arm. One of them was relatively fresh, and the others were from infancy and childhood, according to Ross. The article about the incident offered little by way of commentary, except to note the long history of doctors who believed in the efficacy of vaccination but opposed the practice since they would lose a source of revenue if smallpox declined. (Similarly, during the COVID-19 pandemic, the Fox News channel was a top broadcaster of vaccine skepticism in the United States, even though nearly all of the corporation's employees were vaccinated.)

The news about Ross reached the United States, where it was met with outrage among the public health community. One State Board of Health report called him "a monster in human form who desired that a most terrible disease should decimate his patrons, that he might grow fat on their putrid bodies."

By the end of the smallpox epidemic in Montreal in 1886, more than 3,200 people had died from the disease. The city lost almost 2 percent of its total population in 1885 alone, and more than 3 percent of its French Canadian community. Most of them were children. There were numerous blunders that helped the disease spread, as historian Michael Bliss recounts in his book "Plague: How Smallpox Devastated Montreal," and the large population of unvaccinated children created by fear and ignorance was a major factor. Every one of the deaths could have been prevented, Bliss emphasizes. Unfortunately, it wasn't until the disease ran out of unvaccinated or otherwise vulnerable hosts that the epidemic finally waned.

Misinformation about diseases is a timeless human challenge. Some opinions offered about the antivaccination riot in Montreal, such as in a New York Times editorial in 1875, ring a bell 150 years later. With shock that anyone would harbor such an absurd preconception against vaccination, a triumph of modern medicine, the editorial lamented that "in spite of all our boasted progress, curious revelations of popular ignorance and superstition are constantly showing us how little progress has been made." But after laying blame on the fortune tellers in large cities, the quacks in medicine that flourished everywhere, and even the scientific research and scholarly writings that went above the heads of the public, there was still optimism: "When knowledge is more evenly distributed, there will be less of this fantastic and ignorant prejudice."

Evenly distributed knowledge? That sounds a lot like the internet to me.

Sabrina Sholts is the curator of biological anthropology at the Smithsonian's National Museum of Natural History, where she developed the major exhibit "Outbreak: Epidemics in a Connected World." She is the author of "The Human Disease," from which this article is excerpted.

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