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Vaccine Refusal Increases Risk for Pertussis in Unvaccinated Children

Herd immunity did not protect children whose parents refused vaccination.

Parents often ask whether refusing immunizations really increases the risk for vaccine-preventable diseases in their children. To find out, investigators conducted a case-control study in 156 children (age range, 2 months to 18 years) with culture-proven pertussis and 595 randomly selected matched controls without pertussis who were enrolled in the Colorado Kaiser Permanente health plan between 1996 and 2007. Documentation of vaccine dates and refusal were obtained from chart review. Overall, 12.0% of cases were vaccine refusers, compared with 0.5% of controls.

Comment: The authors estimate that 11% of pertussis cases in the Colorado Kaiser Permanente pediatric population were attributable to vaccine refusal, although the percentage of children who were not vaccinated was extremely low. These results dispel the myth that herd immunity protects children whose parents refuse pertussis vaccine.

— Howard Bauchner, MD

Published in Journal Watch Pediatrics and Adolescent Medicine July 1, 2009

Citation(s):

Glanz JM et al. Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children. Pediatrics 2009 Jun; 123:1446.

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Reader Remarks:

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• morbidity of Pertussis
  Sheldon S Ball, Veterans Administration, 7 Jul 2009 8:08 AM EST
  What was the fate of those infected with Pertussis? How many deaths? How many hosptializations? How many endotracheal intubations?
• Herd immunity is not a myth!
  Louis M. Katz, Scott Co. Health Dept. (Iowa), 17 Jul 2009 3:09 PM EST
  The conclusion of the study includes the following: "(H)erd immunity does not seem to completely protect unvaccinated children from pertussis."... [more]