The Risks of Vaccine Refusal

The truth about skipping immunizations

E-news_Oct 2012_vaccinations

In 2008, a 7-year-old intentionally unvaccinated San Diego boy returned from a trip to Switzerland with an unwelcome—and undetected—carry-on.


Unknowingly exposed to and infected with measles, the boy returned to school and community activities. By the time his symptoms had been correctly diagnosed, he had exposed an additional 839 people to the highly contagious virus. Eleven of those—all unvaccinated—developed the disease, including one infant who was too young to have been immunized. The infant required hospitalization.


This local outbreak, subsequently written up and published in Pediatrics, offers a real-world case study of the consequences of intentional under-vaccination.


Now a new study in the New England Journal of Medicine confirms that rates of intentional non-vaccination are rising.


“We’ve seen an increase in vaccine refusal across the board,” says Nicole Gorton, MD, a pediatrician at Scripps Coastal Medical Center. “There is, unfortunately, a lot of inaccurate information floating around out there, including studies about vaccines and autism that have been thoroughly debunked and withdrawn. And there are some groups that are dedicated to spreading distrust of modern medicine. But the fact remains, it is infinitely more risky to refuse childhood vaccinations than to have them administered—for the child and for the whole community.”


The American Academy of Pediatrics agrees, writing in an official policy statement on parental refusal: “It is ironic that the remarkable success of vaccine programs has resulted in a situation in which most parents have no memory of the devastating effects of illnesses such as poliomyelitis, measles, and other vaccine-preventable diseases, making it more difficult for them to appreciate the benefits of immunization.”

Whooping cough making a comeback

In July, 2012, the U.S. Centers for Disease Control & Prevention (CDC) reported a 1,300 percent increase in pertussis (whooping cough) cases in the state of Washington, which has the highest reported rate of vaccine refusal (6.2 percent) in the nation. More than 2,500 cases had been reported by mid-year—a rate unseen since 1942. The Seattle Times reported two infant deaths attributed to the outbreak.


“The problem with vaccine refusal is that you don’t just put your own child’s health at risk. You put the entire community at risk, especially babies too young or people too sick to be immunized themselves,” says Dr. Gorton. “Vaccinations work because they create herd immunity. When a large majority of people are vaccinated—more than 95 percent—viruses and bacteria aren’t caught and spread as rapidly or as widely. But when too many people refuse or delay immunizations, we lose ‘herd immunity’ very quickly and diseases re-emerge.”


Globally, vaccination has completely eradicated two devastating diseases: Rinderpest (cattle plague) in large mammals, and smallpox in humans. Polio—which once infected tens of thousands per year—has also been reduced dramatically, with fewer than one hundred cases reported each year.

Signs and symptoms

Dr. Gorton advises vigilance and rapid response if an unvaccinated person of any age develops symptoms that could be caused by a communicable disease. “Complications of these diseases can be serious—even life-threatening—in the very young or very old,” she says. If a vaccine-preventable disease is suspected, a trip to the doctor for testing is indicated to help prevent additional exposures and a wider outbreak.


  • Fever and rash
    If an unvaccinated person comes down with this combination, it could be measles acquired through contact with another unvaccinated person.
  • Persistent cough, especially in spasms
    Whooping cough presents itself and lingers for weeks, even months.
  • A cold with high fever
    This could indicate an infection called HiB, which can cause meningitis—a dangerous swelling of the brain.

Learn more

Visit the CDC’s website to find a wealth of information and tools about communicable vaccine-preventable illnesses, including recommended vaccination schedules.