I need some facts.
September 6, 2009 6:56 PM Subscribe
I am on the board of my son's nursery school. I found out today that on Wednesday we are being asked to vote on whether or not to allow a child to attend who has only been partially vaccinated due to religious reasons. I need some information to back up my vote. Please read on.
The nursery school is private and church-based, in the U.S. Our public schools allow for religious and medical exemption from vaccinations, but our preschool dictates that all children should be fully vaxed. I am planning to vote against allowing the child in, as I believe that making an exception is a) a liability for the school and the board, and b) a risk to my children and the children of others, including siblings of the students. I admit that both risks are small, but they are real risks, and in my eyes, the benefit to allowing the child to attend the school (goodwill? tuition money?) is outweighed by these risks.
I appear to be the only dissenter on the board. I have been asked to come to the meeting on Wednesday with facts in hand to support my position. I know that unvaxed children put themselves and other unvaxed kids at great risk for infection, particularly preschool aged children and younger, but *what is the risk to children who ARE vaccinated*? Can anyone provide statistics for me? My understanding is that vaccines are not 100% foolproof, and that sometimes vaccines don't "take", or that despite vaccination, some children's immunity is still not 100% by a certain age.
Anything you can provide, with references or citations if possible, would be greatly appreciated. Thanks for reading this. :)
The nursery school is private and church-based, in the U.S. Our public schools allow for religious and medical exemption from vaccinations, but our preschool dictates that all children should be fully vaxed. I am planning to vote against allowing the child in, as I believe that making an exception is a) a liability for the school and the board, and b) a risk to my children and the children of others, including siblings of the students. I admit that both risks are small, but they are real risks, and in my eyes, the benefit to allowing the child to attend the school (goodwill? tuition money?) is outweighed by these risks.
I appear to be the only dissenter on the board. I have been asked to come to the meeting on Wednesday with facts in hand to support my position. I know that unvaxed children put themselves and other unvaxed kids at great risk for infection, particularly preschool aged children and younger, but *what is the risk to children who ARE vaccinated*? Can anyone provide statistics for me? My understanding is that vaccines are not 100% foolproof, and that sometimes vaccines don't "take", or that despite vaccination, some children's immunity is still not 100% by a certain age.
Anything you can provide, with references or citations if possible, would be greatly appreciated. Thanks for reading this. :)
From this link
"Vaccines are very effective, but there is a small failure rate," said Dr. Rob Schechter, chief of immunization at the state Department of Public Health. "When the whole population is highly immunized, the few vulnerable children are protected by the immunity of the community. But when there is a high rate of exemptions, diseases can spread even to people who are immunized."
Outbreaks also tend to affect those who are particularly vulnerable to disease: newborn babies, the elderly and those whose immune systems have been weakened by cancer or other diseases, Dr. Schechter said.
So, you have to consider not just the other children in the classroom, who will all be immunized, but any infant siblings who may visit the classroom, Grandma, a friend or relative with immune-issues, etc. Again, small risks, but they are there.
posted by roomthreeseventeen at 7:15 PM on September 6, 2009
"Vaccines are very effective, but there is a small failure rate," said Dr. Rob Schechter, chief of immunization at the state Department of Public Health. "When the whole population is highly immunized, the few vulnerable children are protected by the immunity of the community. But when there is a high rate of exemptions, diseases can spread even to people who are immunized."
Outbreaks also tend to affect those who are particularly vulnerable to disease: newborn babies, the elderly and those whose immune systems have been weakened by cancer or other diseases, Dr. Schechter said.
So, you have to consider not just the other children in the classroom, who will all be immunized, but any infant siblings who may visit the classroom, Grandma, a friend or relative with immune-issues, etc. Again, small risks, but they are there.
posted by roomthreeseventeen at 7:15 PM on September 6, 2009
Not all children can receive vaccines (some are too young and some have legitimate medical reasons). Vaccines work in part on the principle of herd immunity--vaccinated people protect the vaccinated and each other by reducing the total incidence of the disease. Even if all the other kids are vaccinated, an unvaccinated child could spread a disease to younger siblings who are too young to receive certain vaccines, to people who cannot receive certain vaccines for medical reasons, and yes, to those for whom vaccines are ineffective. This article and its on vaccine effectiveness and its accompanying citations might be of use to you.
The argument is basically that the unvaccinated kids are essentially "freeloading" by receiving the herd immunity benefits from the vaccinated kids while not contributing to everyone else's well-being. In terms of arguments for you, the "little sibling" case is probably most persuasive: the unvaccinated child poses an especially large risk to children who are too young to receive certain vaccines themselves.
I am curious about these religious reasons you cite, as well as what "partially vaccinated" means. There's a big difference between a child who didn't receive a flu shot and one who isn't vaccinated against, say, polio. If the religious reasons involve the whole "aborted" stem cell lines issue, perhaps as a church-based school your church leadership may be able to weigh in on the issue somewhat (after all, most church schools seem to be down with the whole vaccination thing even if they are rabidly anti-abortion...). If the religious reasons are more of a vague, ill-defined way of saying "I prefer not to," that's a different story. Certainly, people are entitled to whatever religious beliefs they like, but only as far as it doesn't significantly hurt others. If there isn't a real religious basis behind this, I would definitely be inclined to vote against it as a church school ought to consider religion to be more than a convenient excuse for not following the rules.
posted by zachlipton at 7:17 PM on September 6, 2009
The argument is basically that the unvaccinated kids are essentially "freeloading" by receiving the herd immunity benefits from the vaccinated kids while not contributing to everyone else's well-being. In terms of arguments for you, the "little sibling" case is probably most persuasive: the unvaccinated child poses an especially large risk to children who are too young to receive certain vaccines themselves.
I am curious about these religious reasons you cite, as well as what "partially vaccinated" means. There's a big difference between a child who didn't receive a flu shot and one who isn't vaccinated against, say, polio. If the religious reasons involve the whole "aborted" stem cell lines issue, perhaps as a church-based school your church leadership may be able to weigh in on the issue somewhat (after all, most church schools seem to be down with the whole vaccination thing even if they are rabidly anti-abortion...). If the religious reasons are more of a vague, ill-defined way of saying "I prefer not to," that's a different story. Certainly, people are entitled to whatever religious beliefs they like, but only as far as it doesn't significantly hurt others. If there isn't a real religious basis behind this, I would definitely be inclined to vote against it as a church school ought to consider religion to be more than a convenient excuse for not following the rules.
posted by zachlipton at 7:17 PM on September 6, 2009
I personally would call around to different pediatricians and see what they have to say on the subject.
Also, I know you asked for the risks and facts regarding children who are vaccinated - but I would also put a lot of emphasis on younger siblings and others in the community who have not yet been vaccinated (infants, those with certain medical conditions). I never thought anything about kids who didn't get vaccinated until I started thinking about infants that aren't old enough for certain vaccinations. Then I started to get scared. I felt like at that point my children's health was out of my hands and put into hands of strangers who decided not to vaccinate their own children. Personally, I'd focus on that a lot, because there might not be much out there on the risks to children who ARE vaccinated (but maybe there is - I dunno)
I have three children and it really ticks me off when I see obviously ill children still attending school when they should be home recuperating and staying the heck away from my kids. And it ticks me off so much because not only are my school-age children going to get ill - so is my little toddler who doesn't go to school. Whatever is catching at school is most definitely going to passed on to MY ENTIRE HOUSEHOLD. I would be honestly concerned especially if I had an infant at home. The same applies to those who have not been vaccinated - that they might come down with whatever they should have been vaccinated for - and then they pass the germs on to schoolmates (who are vaccinated) who then come home and pass those germs on to a not-yet vaccinated infant
posted by Sassyfras at 7:19 PM on September 6, 2009 [6 favorites]
Also, I know you asked for the risks and facts regarding children who are vaccinated - but I would also put a lot of emphasis on younger siblings and others in the community who have not yet been vaccinated (infants, those with certain medical conditions). I never thought anything about kids who didn't get vaccinated until I started thinking about infants that aren't old enough for certain vaccinations. Then I started to get scared. I felt like at that point my children's health was out of my hands and put into hands of strangers who decided not to vaccinate their own children. Personally, I'd focus on that a lot, because there might not be much out there on the risks to children who ARE vaccinated (but maybe there is - I dunno)
I have three children and it really ticks me off when I see obviously ill children still attending school when they should be home recuperating and staying the heck away from my kids. And it ticks me off so much because not only are my school-age children going to get ill - so is my little toddler who doesn't go to school. Whatever is catching at school is most definitely going to passed on to MY ENTIRE HOUSEHOLD. I would be honestly concerned especially if I had an infant at home. The same applies to those who have not been vaccinated - that they might come down with whatever they should have been vaccinated for - and then they pass the germs on to schoolmates (who are vaccinated) who then come home and pass those germs on to a not-yet vaccinated infant
posted by Sassyfras at 7:19 PM on September 6, 2009 [6 favorites]
I would vote against on moral and ethical grounds--not necessarily medical. The bottom line is that the non-vaccinated child rides on the backs of all those children and parents who do use vaccinations. What ever risk there is in vaccination, and I firmly believe in is minuscule, is absorbed by those who are vaccinated so other parents can avoid vaccination. The children who are vaccinated also permit the non vaccinated to avoid the cost of vaccination, the complications of serious communicable diseases and the inconvenience of caring for sick children. To me it ranks right up there with refusing to pay taxes but wanting outstanding public services paid by others.
posted by rmhsinc at 7:23 PM on September 6, 2009 [10 favorites]
posted by rmhsinc at 7:23 PM on September 6, 2009 [10 favorites]
Try the Vaccine Information Statements from the CDC. Its general info on vaccines might also be of use.
posted by MonkeyToes at 7:25 PM on September 6, 2009 [2 favorites]
posted by MonkeyToes at 7:25 PM on September 6, 2009 [2 favorites]
The benefit of vaccination is not at the level of an individual. The benefit is at the level of the population (or in your instance, the school). No vaccination is 100% effective in 100% of individuals. So the true value of vaccinations is herd immunity. Everyone is safer from disease is everyone is vaccinated.
If you have a rule at your institution, people should be required to follow it. If others on the board do not believe that is the case perhaps you should push for bylaw changes.
posted by i_am_a_Jedi at 7:28 PM on September 6, 2009
If you have a rule at your institution, people should be required to follow it. If others on the board do not believe that is the case perhaps you should push for bylaw changes.
posted by i_am_a_Jedi at 7:28 PM on September 6, 2009
I completely understand your hesitation, and given what previous answers have said about vaccines not providing complete immunity, I don't know that I would vote to let this child in, either.
That said, to answer your sort-of question about what the benefits would be of admitting this student, I see two: First, presuming that this family's religious views are different from those of other people at the school (which is implied in the question), this student adds to the diversity of the school which gives your child a more diverse environment in which to grow and learn. The second benefit is equity: if you bar this student you are essentially (via disparate impact) discriminating on the basis of religion.
Finally, one more thing: should it become clear in the course of this meeting that you are going to lose and the only one to vote to bar the student, I would strongly consider voting to admit the student. If you're going to lose regardless, this child will be your child's classmate and the parents will be people you likely interact with. You don't want to start that relationship with them thinking you're the person who never wanted them there (though I understand it's nothing personal on your part). Better to let everyone think you've been persuaded and keep the peace.
Like I said, I in no way mean to imply that I think you're wrong to have serious concerns here. You may want to google disease-in-question + Waldorf. Waldorf schools encourage parents not to vaccinate and I bet there's some at least anecdotal data about the effects on the vaccinated population.
posted by If only I had a penguin... at 7:31 PM on September 6, 2009 [1 favorite]
That said, to answer your sort-of question about what the benefits would be of admitting this student, I see two: First, presuming that this family's religious views are different from those of other people at the school (which is implied in the question), this student adds to the diversity of the school which gives your child a more diverse environment in which to grow and learn. The second benefit is equity: if you bar this student you are essentially (via disparate impact) discriminating on the basis of religion.
Finally, one more thing: should it become clear in the course of this meeting that you are going to lose and the only one to vote to bar the student, I would strongly consider voting to admit the student. If you're going to lose regardless, this child will be your child's classmate and the parents will be people you likely interact with. You don't want to start that relationship with them thinking you're the person who never wanted them there (though I understand it's nothing personal on your part). Better to let everyone think you've been persuaded and keep the peace.
Like I said, I in no way mean to imply that I think you're wrong to have serious concerns here. You may want to google disease-in-question + Waldorf. Waldorf schools encourage parents not to vaccinate and I bet there's some at least anecdotal data about the effects on the vaccinated population.
posted by If only I had a penguin... at 7:31 PM on September 6, 2009 [1 favorite]
In terms of your own children, if you're particularly concerned, blood tests can be done to ensure that they've received immunity from their vaccinations. I was recently checked to ensure that my Hepatitis A and B vaccinations had been effective - if this child is admitted, you can have your children checked.
Second, instead of some facts, why not play for them this recent segment from This American Life. The theme for the week was "Ruining it for the Rest of Us," and details what happened in a community when one unvaccinated child got the measles. It's certain to scare the bejesus out of the board.
posted by awesomebrad at 7:37 PM on September 6, 2009 [11 favorites]
Second, instead of some facts, why not play for them this recent segment from This American Life. The theme for the week was "Ruining it for the Rest of Us," and details what happened in a community when one unvaccinated child got the measles. It's certain to scare the bejesus out of the board.
posted by awesomebrad at 7:37 PM on September 6, 2009 [11 favorites]
Beyond health and safety reasons, there's also the point that your school has a rule. If if the board is willing to break the rule, they open the door to breaking it again. And while one unvaccinated child can take advantage of "herd immunity," two sick children will just pass back and forth. You have a system in place, and it was put there for a reason.
Moreover, kids are incubators. They have snotty noses, they cough all over everything, and they don't wash their hands. They bring whatever illness they pick up at daycare, nursery school, kindergarten, back to their homes, where they can pass bugs they may be vaccinated against to their unvaccinated infant siblings (who can't yet be vaccinated) and parents who may not have been vaccinated for some of the childhood diseases which have only recently had vaccines available (e.g. Chicken pox). Normal diseases for children can be lethal in adults who have not had them and are not vaccinated for them (measles, mumps, and again, chicken pox). Also, vaccines weaken over time, and most adults don't continue boosters for their MMR shots; notably, mumps can cause infertility in adults.
In truth, your risk is indeed low, but compared to a risk of zero, what level of risk are you willing to accept for yourself and your kids?
posted by honeybee413 at 7:41 PM on September 6, 2009 [4 favorites]
Moreover, kids are incubators. They have snotty noses, they cough all over everything, and they don't wash their hands. They bring whatever illness they pick up at daycare, nursery school, kindergarten, back to their homes, where they can pass bugs they may be vaccinated against to their unvaccinated infant siblings (who can't yet be vaccinated) and parents who may not have been vaccinated for some of the childhood diseases which have only recently had vaccines available (e.g. Chicken pox). Normal diseases for children can be lethal in adults who have not had them and are not vaccinated for them (measles, mumps, and again, chicken pox). Also, vaccines weaken over time, and most adults don't continue boosters for their MMR shots; notably, mumps can cause infertility in adults.
In truth, your risk is indeed low, but compared to a risk of zero, what level of risk are you willing to accept for yourself and your kids?
posted by honeybee413 at 7:41 PM on September 6, 2009 [4 favorites]
Which vax has the kid not had? That would matter a lot to me. Polio is different than varicella.
posted by mattbucher at 7:42 PM on September 6, 2009
posted by mattbucher at 7:42 PM on September 6, 2009
From JAMA:
Individual and Community Risks of Measles and Pertussis Associated With Personal Exemptions to Immunization
Daniel R. Feikin, MD, MSPH; Dennis C. Lezotte, PhD; Richard F. Hamman, MD, DrPH; Daniel A. Salmon, MPH; Robert T. Chen, MD, MA; Richard E. Hoffman, MD, MPH
JAMA. 2000;284:3145-3150.
"Results Exemptors were 22.2 times (95% confidence interval [CI], 15.9-31.1) more likely to acquire measles and 5.9 times (95% CI, 4.2-8.2) more likely to acquire pertussis than vaccinated children. After adjusting for confounders, the frequency of exemptors in a county was associated with the incidence rate of measles (relative risk [RR], 1.6; 95% CI, 1.0-2.4) and pertussis (RR, 1.9; 95% CI, 1.7-2.1) in vaccinated children. Schools with pertussis outbreaks had more exemptors (mean, 4.3% of students) than schools without outbreaks (1.5% of students; P = .001). At least 11% of vaccinated children in measles outbreaks acquired infection through contact with an exemptor.
Conclusions The risk of measles and pertussis is elevated in personal exemptors. Public health personnel should recognize the potential effect of exemptors in outbreaks in their communities, and parents should be made aware of the risks involved in not vaccinating their children."
posted by MonkeyToes at 7:42 PM on September 6, 2009 [5 favorites]
Individual and Community Risks of Measles and Pertussis Associated With Personal Exemptions to Immunization
Daniel R. Feikin, MD, MSPH; Dennis C. Lezotte, PhD; Richard F. Hamman, MD, DrPH; Daniel A. Salmon, MPH; Robert T. Chen, MD, MA; Richard E. Hoffman, MD, MPH
JAMA. 2000;284:3145-3150.
"Results Exemptors were 22.2 times (95% confidence interval [CI], 15.9-31.1) more likely to acquire measles and 5.9 times (95% CI, 4.2-8.2) more likely to acquire pertussis than vaccinated children. After adjusting for confounders, the frequency of exemptors in a county was associated with the incidence rate of measles (relative risk [RR], 1.6; 95% CI, 1.0-2.4) and pertussis (RR, 1.9; 95% CI, 1.7-2.1) in vaccinated children. Schools with pertussis outbreaks had more exemptors (mean, 4.3% of students) than schools without outbreaks (1.5% of students; P = .001). At least 11% of vaccinated children in measles outbreaks acquired infection through contact with an exemptor.
Conclusions The risk of measles and pertussis is elevated in personal exemptors. Public health personnel should recognize the potential effect of exemptors in outbreaks in their communities, and parents should be made aware of the risks involved in not vaccinating their children."
posted by MonkeyToes at 7:42 PM on September 6, 2009 [5 favorites]
Response by poster: In case it wasn't clear, barring any persuasive arguments from the other board members, I am planning to vote against allowing the child to attend.
I have no idea what beliefs the family has that require "religious exemption", nor do I know which vaccines the child has and has not had. I have asked the board president, but he hasn't provided that info yet. I'd be surprised if he asked, to be quite honest. Maybe it's the stem-cell thing, maybe it's simply a personal issue they have with vaccinating (alleged link to autism) and they're using religion as the excuse because it's commonly accepted. A friend who hasn't vaccinated her children says she uses religion as a reason to the kids' school, even though it has nothing to do with it.
Thanks for both the links to articles as well as the idea to focus on vulnerable visitors to the school (younger siblings, those unvaxed for medical reasons, etc).
I share the frustration with those who choose not to vaccinate. I try to keep an open mind, and I think I believe it's a good thing for parents to have a choice to vax or not, but ...it's a sticky wicket.
And to If Only..., I agree that diversity would be welcome here. I wouldn't be opposed to a family with different beliefs attending the school. In fact, my family's beliefs (I'm a non-religious reformed Catholic, and my husband is an atheist) don't really fit in at the school either, although I don't think anyone there has figured that out yet ;)
posted by missuswayne at 7:44 PM on September 6, 2009
I have no idea what beliefs the family has that require "religious exemption", nor do I know which vaccines the child has and has not had. I have asked the board president, but he hasn't provided that info yet. I'd be surprised if he asked, to be quite honest. Maybe it's the stem-cell thing, maybe it's simply a personal issue they have with vaccinating (alleged link to autism) and they're using religion as the excuse because it's commonly accepted. A friend who hasn't vaccinated her children says she uses religion as a reason to the kids' school, even though it has nothing to do with it.
Thanks for both the links to articles as well as the idea to focus on vulnerable visitors to the school (younger siblings, those unvaxed for medical reasons, etc).
I share the frustration with those who choose not to vaccinate. I try to keep an open mind, and I think I believe it's a good thing for parents to have a choice to vax or not, but ...it's a sticky wicket.
And to If Only..., I agree that diversity would be welcome here. I wouldn't be opposed to a family with different beliefs attending the school. In fact, my family's beliefs (I'm a non-religious reformed Catholic, and my husband is an atheist) don't really fit in at the school either, although I don't think anyone there has figured that out yet ;)
posted by missuswayne at 7:44 PM on September 6, 2009
As a parent of a child with autism, but perhaps more importantly just as a citizen, I find it HIGHLY offensive when people start basing their actions and choices about vaccination on scientifically illiterate theories about vaccination causing autism.
I don't want to get too high up on a soapbox, but there really is scientific and civilizational consensus that vaccination is a good thing. Individual choice is also a good thing, but there is no license that gives the unvaccinated anything like a moral right to attend your school.
A friend of mine was exposed to measles (the parents of the measly kid had unconventional views about vaccination) while she was pregnant with her first child. The result was that her baby was born with severe and irreparable disabilities due to measles exposure in the womb.
posted by Mr. Justice at 8:01 PM on September 6, 2009 [33 favorites]
I don't want to get too high up on a soapbox, but there really is scientific and civilizational consensus that vaccination is a good thing. Individual choice is also a good thing, but there is no license that gives the unvaccinated anything like a moral right to attend your school.
A friend of mine was exposed to measles (the parents of the measly kid had unconventional views about vaccination) while she was pregnant with her first child. The result was that her baby was born with severe and irreparable disabilities due to measles exposure in the womb.
posted by Mr. Justice at 8:01 PM on September 6, 2009 [33 favorites]
The segment that awesomebrad linked to is great. Really, that's just perfect.
posted by Sassyfras at 8:04 PM on September 6, 2009
posted by Sassyfras at 8:04 PM on September 6, 2009
if you bar this student you are essentially (via disparate impact) discriminating on the basis of religion.
Um, no. Religion is in no way the basis for the considered "discrimination" (loaded word is loaded). Health concerns are, 100%.
posted by Aquaman at 8:04 PM on September 6, 2009 [1 favorite]
Um, no. Religion is in no way the basis for the considered "discrimination" (loaded word is loaded). Health concerns are, 100%.
posted by Aquaman at 8:04 PM on September 6, 2009 [1 favorite]
if you bar this student you are essentially (via disparate impact) discriminating on the basis of religion.
Um, no. Religion is in no way the basis for the considered "discrimination" (loaded word is loaded). Health concerns are, 100%.
Actually, as a religious institution, they are ALLOWED to discriminate on the basis of religion. No really. They are.
posted by ValkoSipuliSuola at 8:12 PM on September 6, 2009 [2 favorites]
Um, no. Religion is in no way the basis for the considered "discrimination" (loaded word is loaded). Health concerns are, 100%.
Actually, as a religious institution, they are ALLOWED to discriminate on the basis of religion. No really. They are.
posted by ValkoSipuliSuola at 8:12 PM on September 6, 2009 [2 favorites]
In addition to my very real health concerns, I'd worry that it potentially puts the school in a difficult position: Health privacy laws probably forbid you from informing other parents that the new child lacks the vaccinations. On the other hand, if it leads to someone getting ill where it can be plausibly traced to the new child, you might be open to a claim from some parent who argues that they relied on the stated policy. Does the school have an attorney who can weigh in on that and on any potential discrimination claims should you refuse admission (though that's unlilkely if you're a religious institution yourselves) ?
posted by tyllwin at 8:19 PM on September 6, 2009 [2 favorites]
posted by tyllwin at 8:19 PM on September 6, 2009 [2 favorites]
Finally, one more thing: should it become clear in the course of this meeting that you are going to lose and the only one to vote to bar the student, I would strongly consider voting to admit the student.
This is not how voting works. A board member who goes along with the crowd instead of voting her conscience is doing herself and the board a disservice and is unfit for the position.
posted by fritley at 8:25 PM on September 6, 2009 [20 favorites]
This is not how voting works. A board member who goes along with the crowd instead of voting her conscience is doing herself and the board a disservice and is unfit for the position.
posted by fritley at 8:25 PM on September 6, 2009 [20 favorites]
Suppose there is a small risk to vaccinating a child. Every parent with children currently enrolled in the school has already assumed that risk, to protect not only their own child, but also the other children and the population at large. Every other parent has assumed that risk.
An unvaccinated child would have a smaller chance of contracting a disease because all the other parents have already assumed whatever (small) risks there are from not vaccinating. By admitting the child anyway, you'd be, in a way, endorsing or at least allowing that choice, and making it that little bit much more likely that other parents would be able to make the same choice not to vaccinate their children.
More parents not vaccinating their children means more likelihood of a disease outbreak.
If it's the case the vaccine isn't 100% effective in all cases, that means that even vaccinated children -- again, those of parents who took that small risk and also inconvenience -- would be at a very slightly higher risk of infection. Even if the vaccine is 100% effective in those who receive it, it will affect the school and the people in it to have such a sick classmate.
posted by amtho at 8:46 PM on September 6, 2009
An unvaccinated child would have a smaller chance of contracting a disease because all the other parents have already assumed whatever (small) risks there are from not vaccinating. By admitting the child anyway, you'd be, in a way, endorsing or at least allowing that choice, and making it that little bit much more likely that other parents would be able to make the same choice not to vaccinate their children.
More parents not vaccinating their children means more likelihood of a disease outbreak.
If it's the case the vaccine isn't 100% effective in all cases, that means that even vaccinated children -- again, those of parents who took that small risk and also inconvenience -- would be at a very slightly higher risk of infection. Even if the vaccine is 100% effective in those who receive it, it will affect the school and the people in it to have such a sick classmate.
posted by amtho at 8:46 PM on September 6, 2009
My husband contracted the mumps when he was six. Minor illness? Not for him. He got meningoencephalitis as a result. It nearly killed him. He lived to make a full recovery and had no complications as an adult, but he had to learn to walk and talk all over again. If you could prevent it, why wouldn't you? My cousin contracted polio. My brother got hepatitis. These diseases were common a generation ago. Chicken pox never leaves your system: shingles is a very nasty complication that occurs decades after the initial infection.
Yes, the chance of serious consequences from one un-vaccinated child is slight, but it's not zero. People who flout the vaccination laws are saying they don't care about the health and welfare of everyone else. You should ask each of the other board members if they are willing to take personal responsibility if something happens to anyone as a result of their allowing this child in the school.
posted by clarkstonian at 9:22 PM on September 6, 2009 [3 favorites]
Yes, the chance of serious consequences from one un-vaccinated child is slight, but it's not zero. People who flout the vaccination laws are saying they don't care about the health and welfare of everyone else. You should ask each of the other board members if they are willing to take personal responsibility if something happens to anyone as a result of their allowing this child in the school.
posted by clarkstonian at 9:22 PM on September 6, 2009 [3 favorites]
Before you vote, please just ask yourself this one question: If the child were unable to receive a certain vax due to health reasons rather than religious ones, would I still be voting the same way?
posted by anastasiav at 10:03 PM on September 6, 2009 [2 favorites]
posted by anastasiav at 10:03 PM on September 6, 2009 [2 favorites]
Anastasiav, that is what herd immunity is for - people who can't get the vaccine for health reasons. People who don't vaccinate their kids are putting herd immunity at risk. There's a big difference between not wanting to vaccinate and not being able to vaccinate.
posted by IndigoRain at 10:17 PM on September 6, 2009 [10 favorites]
posted by IndigoRain at 10:17 PM on September 6, 2009 [10 favorites]
Thanks for [...] the idea to focus on vulnerable visitors to the school (younger siblings, those unvaxed for medical reasons, etc).
I'm not certain how long the various pathogens can survive on things like dirty hands or lunchboxes or backpacks or clothes, but you might want to look into whether a vaccinated kid could bring the germs home to infect the elderly grandma or the mom who's getting chemo for breast cancer or the baby sibling, too. It's easy to say that vulnerable family members shouldn't visit the school if the unvaccinated child attends, but much harder to say that they should never see their kid who might have been exposed.
posted by vytae at 10:46 PM on September 6, 2009 [1 favorite]
I'm not certain how long the various pathogens can survive on things like dirty hands or lunchboxes or backpacks or clothes, but you might want to look into whether a vaccinated kid could bring the germs home to infect the elderly grandma or the mom who's getting chemo for breast cancer or the baby sibling, too. It's easy to say that vulnerable family members shouldn't visit the school if the unvaccinated child attends, but much harder to say that they should never see their kid who might have been exposed.
posted by vytae at 10:46 PM on September 6, 2009 [1 favorite]
How strongly do you feel about this?
I spent a couple years on a preschool board and my argument in the same situation would follow the herd immunity, vulnerable younger siblings, pregnant women (of which there are ugually a LOT at coop schools) and then follow all of that up with one simple statement.
"If we vote to admit a child explicitly against the rules with which our other families entrusted their children to us, I will be pulling my children from the school to preserve their own health and my conscious."
posted by Edubya at 11:04 PM on September 6, 2009 [1 favorite]
I spent a couple years on a preschool board and my argument in the same situation would follow the herd immunity, vulnerable younger siblings, pregnant women (of which there are ugually a LOT at coop schools) and then follow all of that up with one simple statement.
"If we vote to admit a child explicitly against the rules with which our other families entrusted their children to us, I will be pulling my children from the school to preserve their own health and my conscious."
posted by Edubya at 11:04 PM on September 6, 2009 [1 favorite]
The argument could be made that, if this family takes health risks for this non-vaccinating-religion they're pretty passionate about their beliefs. Passionate enough that they might go to church meetings, summer camps etc with likeminded non-vaccinating parents. Places, in other words, that could be breeding grounds for these diseases.
So, assuming herd immunity will keep this child uninfected might not be a safe assumption.
I can't cite any statistics or scientific studies actually demonstrating this has happened, though.
posted by Mike1024 at 12:33 AM on September 7, 2009 [1 favorite]
So, assuming herd immunity will keep this child uninfected might not be a safe assumption.
I can't cite any statistics or scientific studies actually demonstrating this has happened, though.
posted by Mike1024 at 12:33 AM on September 7, 2009 [1 favorite]
I would find out more about the "religious reasons" the parents are leaning on. Are they Christian Scientists? They're nuts, and every few years we have a court case in New England related to Christian Scientist parents who killed their kid by denying the child access to antibiotics. However, they're consistent and have been forgoing life-saving medical procedures for generations out of a deep-seated conviction that medicine is wrong. If the parents are Christian Scientists or a similar sect, I'd consider admitting them even though I'm an atheist with religious tolerance issues. Because they're earnest and have enough other problems.
However, there's a growing segment of people who claim religious deferments based on reasoning that goes like this: "I don't want to do this, and if I cynically claim 'religious convictions' then no one will dare call me on it." Those people need to be confronted and told to go to hell so they'll cut it out.
posted by Mayor Curley at 2:33 AM on September 7, 2009 [2 favorites]
However, there's a growing segment of people who claim religious deferments based on reasoning that goes like this: "I don't want to do this, and if I cynically claim 'religious convictions' then no one will dare call me on it." Those people need to be confronted and told to go to hell so they'll cut it out.
posted by Mayor Curley at 2:33 AM on September 7, 2009 [2 favorites]
If the school has an explicit policy requiring vaccinations, and parents generally know of that policy, then those parents are assuming that all the other kids in the school are vaccinated.
Arguably small medical risks aside, if you were to admit this kid against policy then you'd have (IMO) a moral and ethical obligation to send a letter to every other family explaining that the school has chosen to admit an unvaccinated child.
Which I suspect the board wouldn't be too eager to do.
posted by jon1270 at 2:43 AM on September 7, 2009 [2 favorites]
Arguably small medical risks aside, if you were to admit this kid against policy then you'd have (IMO) a moral and ethical obligation to send a letter to every other family explaining that the school has chosen to admit an unvaccinated child.
Which I suspect the board wouldn't be too eager to do.
posted by jon1270 at 2:43 AM on September 7, 2009 [2 favorites]
Health privacy laws probably forbid you from informing other parents that the new child lacks the vaccinations.
State laws, of course, vary from state to state, but this is not true about the federal HIPAA laws, which apply only to health care providers and certain related entities.
posted by yclipse at 3:46 AM on September 7, 2009
State laws, of course, vary from state to state, but this is not true about the federal HIPAA laws, which apply only to health care providers and certain related entities.
posted by yclipse at 3:46 AM on September 7, 2009
Can you claim that it is against your religion to pay tuition? I don't see how this is different. "I just don't wanna" isn't a good enough of an excuse to not do something. Even worse is "I just don't wanna because my sky-Dad said so."
As to the difference between this and a health concern, seriously. In one case, the child will be harmed by the vaccine. In the other case, the child will not be harmed by the vaccine. In both cases, the threat to the population of students of possible infection goes up, however marginally. If the threat to the child is greater than the threat to the population, then that child is not expected to receive a vaccine.
missuswayne, I think you are completely in the right on moral and ethical grounds to vote against this student. As you stated, the school has rules and guidelines. Making an exception for this student will lead to more headaches. Either amend the rules or stick to them. If the parent is so adamant that his or her child not be vaccinated, then they can send their child to another school or homeschool them. The only reason you should allow this student is if there is the possibility of a catastrophic lawsuit looming. If that is the case, then your school should hire a lawyer and amend the wording so that in the future you will be able to deny admission to those you choose. Indeed, my read of the situation is that if you make an exception for this one student, you would in fact simply be opening yourself up for more and more lawsuits down the line - ie, "you let that student in against your stated rules, why won't you let my child in??"
posted by billysumday at 5:52 AM on September 7, 2009 [2 favorites]
As to the difference between this and a health concern, seriously. In one case, the child will be harmed by the vaccine. In the other case, the child will not be harmed by the vaccine. In both cases, the threat to the population of students of possible infection goes up, however marginally. If the threat to the child is greater than the threat to the population, then that child is not expected to receive a vaccine.
missuswayne, I think you are completely in the right on moral and ethical grounds to vote against this student. As you stated, the school has rules and guidelines. Making an exception for this student will lead to more headaches. Either amend the rules or stick to them. If the parent is so adamant that his or her child not be vaccinated, then they can send their child to another school or homeschool them. The only reason you should allow this student is if there is the possibility of a catastrophic lawsuit looming. If that is the case, then your school should hire a lawyer and amend the wording so that in the future you will be able to deny admission to those you choose. Indeed, my read of the situation is that if you make an exception for this one student, you would in fact simply be opening yourself up for more and more lawsuits down the line - ie, "you let that student in against your stated rules, why won't you let my child in??"
posted by billysumday at 5:52 AM on September 7, 2009 [2 favorites]
This Scripps article on the risks of unvaccinated children in schools is accessible, persuasive, and short enough that the other board members might actually read it.
And yclipse has it right: a private, church-based nursery school is not going to be covered under HIPAA health privacy regulations (or FERPA regulations, for that matter). If the school board does admit an unvaccinated child, they will have to consider whether they have an obligation to inform the parents of all the other children, who complied with the school's policy and have the reasonable expectation that other families will be required to do so as well.
posted by timeo danaos at 7:17 AM on September 7, 2009
And yclipse has it right: a private, church-based nursery school is not going to be covered under HIPAA health privacy regulations (or FERPA regulations, for that matter). If the school board does admit an unvaccinated child, they will have to consider whether they have an obligation to inform the parents of all the other children, who complied with the school's policy and have the reasonable expectation that other families will be required to do so as well.
posted by timeo danaos at 7:17 AM on September 7, 2009
Also, if this child IS permitted to enter the school, I would insist that a letter/phone call to each parent already registered there be sent out, so that everyone can be informed. That may cause parents to pull their kids out of the classroom, which may have a financial impact on your school.
posted by roomthreeseventeen at 7:37 AM on September 7, 2009 [1 favorite]
posted by roomthreeseventeen at 7:37 AM on September 7, 2009 [1 favorite]
Immunized children are not exempt form getting sick; they are a lot less likely to get whatever they've been immunized against. One study of varicella (chickenpox) vax failure states that "Universal immunization of young children with 1 dose of varicella vaccine was recommended in the United States in 1995, and it has significantly decreased the incidence of chickenpox. Outbreaks of varicella, however, are reported among vaccinated children. Although vaccine effectiveness has usually been ~85%, rates as low as 44% have been observed. "
In other words: The risk of a vaxed kid contracting chickenpox from an unvaxed kid is not zero.
I would ask a pediatrician if a vaxed kid could then be a subclinical (asymptomatic) carrier of illnesses contracted from the unvaxed kid.
Breaking the rule to allow an unvaxed child into a vaxed setting is knowingly setting the stage for infection. The family made the choice not to have the immunization and refusal of admittance is a consequence of that choice. They knew it when they first said no.
posted by MonkeyToes at 7:43 AM on September 7, 2009 [1 favorite]
In other words: The risk of a vaxed kid contracting chickenpox from an unvaxed kid is not zero.
I would ask a pediatrician if a vaxed kid could then be a subclinical (asymptomatic) carrier of illnesses contracted from the unvaxed kid.
Breaking the rule to allow an unvaxed child into a vaxed setting is knowingly setting the stage for infection. The family made the choice not to have the immunization and refusal of admittance is a consequence of that choice. They knew it when they first said no.
posted by MonkeyToes at 7:43 AM on September 7, 2009 [1 favorite]
I have been asked to come to the meeting on Wednesday with facts in hand to support my position.
A lot of people here have given you very good advice about the relevant facts. But having the facts on your side, as you know, is only one part (and sometimes not at all a part) of winning an argument - just look at the insane birthers & deathers spewing their nonsense today.
I think you need to consider other appeals as well, including an appeal to authority and an appeal to emotion. If you go in alone, then no matter how much your fellow board members respect you, you're still just someone with a bunch of printouts from the Internet.
So, if the board would allow it, and if it would be feasible for you, I'd suggest trying to bring along a pediatrician or epidiomologist. In other words, you need your own "expert witness." This person can explain the medical concepts and recite statistics in a way which will be harder to assail, and he or she can also hopefully share some stories about the real-world consequences of failing to get vaccinated.
Obviously time is short. But do you have any friends who are doctors who could spare half an hour? Or maybe your own children's pediatrician would be willing to help out?
posted by Conrad Cornelius o'Donald o'Dell at 9:44 AM on September 7, 2009
A lot of people here have given you very good advice about the relevant facts. But having the facts on your side, as you know, is only one part (and sometimes not at all a part) of winning an argument - just look at the insane birthers & deathers spewing their nonsense today.
I think you need to consider other appeals as well, including an appeal to authority and an appeal to emotion. If you go in alone, then no matter how much your fellow board members respect you, you're still just someone with a bunch of printouts from the Internet.
So, if the board would allow it, and if it would be feasible for you, I'd suggest trying to bring along a pediatrician or epidiomologist. In other words, you need your own "expert witness." This person can explain the medical concepts and recite statistics in a way which will be harder to assail, and he or she can also hopefully share some stories about the real-world consequences of failing to get vaccinated.
Obviously time is short. But do you have any friends who are doctors who could spare half an hour? Or maybe your own children's pediatrician would be willing to help out?
posted by Conrad Cornelius o'Donald o'Dell at 9:44 AM on September 7, 2009
Response by poster: Wow, so many good comments and sources of information. Thanks for all that!
Conrad, funny you should mention it, I do have a lot of printouts from the internet. :) I'm going to call around tomorrow to my children's pediatrician, and also the infectious diseases department at Children's Hospital of Philadelphia (I'm in PA). Of course today's a holiday, so I have about a day and a half to get some recommendations, but we'll see what happens.
I still don't know which vaccinations the child has had -- as several of you have mentioned, the difference between not getting the flu vax vs not getting the polio vax is significant.
And I'm not sure the rest of the board has realized that they're going to have to send a letter/make a phonecall to every family at the school if they decide to let the child attend. I suspect that will make them think twice, as that will probably open up the can of worms even more than it already is.
posted by missuswayne at 10:57 AM on September 7, 2009
Conrad, funny you should mention it, I do have a lot of printouts from the internet. :) I'm going to call around tomorrow to my children's pediatrician, and also the infectious diseases department at Children's Hospital of Philadelphia (I'm in PA). Of course today's a holiday, so I have about a day and a half to get some recommendations, but we'll see what happens.
I still don't know which vaccinations the child has had -- as several of you have mentioned, the difference between not getting the flu vax vs not getting the polio vax is significant.
And I'm not sure the rest of the board has realized that they're going to have to send a letter/make a phonecall to every family at the school if they decide to let the child attend. I suspect that will make them think twice, as that will probably open up the can of worms even more than it already is.
posted by missuswayne at 10:57 AM on September 7, 2009
Lots of good info above, so I won't repeat it. But I'd like to emphasize the part about the risks for infant siblings and add in a warning for pregnant mothers. Sometimes women find out that their vaccinations weren't quite up to snuff -- or perhaps there was some medical reason they couldn't be vaccinated or maybe they didn't know the status of their vaccines until they became pregnant. Varicella, rubella, pertussis and other diseases can be devastating for pregnant women or their unborn children.
posted by acoutu at 1:13 PM on September 7, 2009
posted by acoutu at 1:13 PM on September 7, 2009
...A friend who hasn't vaccinated her children....
Doesn't seem like anyone else caught this, so maybe it won't come up at the meeting, but if you are already exposing your kids to non-vaxed kids, you may not have a strong leg to stand on for prohibiting others from joining your school. Just a thought.
posted by CathyG at 5:02 PM on September 7, 2009
Doesn't seem like anyone else caught this, so maybe it won't come up at the meeting, but if you are already exposing your kids to non-vaxed kids, you may not have a strong leg to stand on for prohibiting others from joining your school. Just a thought.
posted by CathyG at 5:02 PM on September 7, 2009
Response by poster: CathyG - she's an old friend from before we had kids and she lives in another state. Our kids have never met, and it's unlikely they will now that I know she doesn't vaccinate (I just found out very recently).
posted by missuswayne at 5:17 PM on September 7, 2009
posted by missuswayne at 5:17 PM on September 7, 2009
I could certainly rant on and on about parents that don't vaccinate/immunize their children because they 'don't believe in it' (whatever that is supposed to mean), but I won't...
That said, the risk that this child brings the population attending your school is (in my opinion) pretty close to nil. There's herd immunity for one, and it sounds like the other students have been following the routine vaccination schedule. So in the highly unlikely event that this unvaccinated child did fall ill by one of these (thankfully uncommon these days) maladies, to whom would it spread?
To me it sounds like you're about to punish the child for the poor decisions of his/her parents.
posted by sero_venientibus_ossa at 6:35 PM on September 7, 2009
That said, the risk that this child brings the population attending your school is (in my opinion) pretty close to nil. There's herd immunity for one, and it sounds like the other students have been following the routine vaccination schedule. So in the highly unlikely event that this unvaccinated child did fall ill by one of these (thankfully uncommon these days) maladies, to whom would it spread?
To me it sounds like you're about to punish the child for the poor decisions of his/her parents.
posted by sero_venientibus_ossa at 6:35 PM on September 7, 2009
One point that I haven't seen brought up is that this child may harbor or generate a breakthrough virus, that is a viral mutant that the vaccine does not provide protection against. While herd immunity is great in the short term, for many viruses it just puts selective pressure on the virus to evolve around the vaccine. We've seen this recently with the mumps outbreak we had in here in Kansas and it is one reason that the chickenpox vaccine does not give complete coverage.
I was also able to quickly find an article in the New England Journal of Medicine where ONE infected 17 year old returning from Romania was able to spread the virus to 34 people, 2 of which developed measles even though they were vaccinated, and cost $167,000 to contain. The article is Parker, et al. "Implications of a 2005 Measles Outbreak in Indiana for Sustained Elimination of Measles in the United States" NEJM, 2006, 355(5), 447-55 and if the abstract and conclusion is not enough for your case, I'd be more than happy to send you a full copy of the article.
posted by The Bishop of Turkey at 6:41 PM on September 7, 2009
I was also able to quickly find an article in the New England Journal of Medicine where ONE infected 17 year old returning from Romania was able to spread the virus to 34 people, 2 of which developed measles even though they were vaccinated, and cost $167,000 to contain. The article is Parker, et al. "Implications of a 2005 Measles Outbreak in Indiana for Sustained Elimination of Measles in the United States" NEJM, 2006, 355(5), 447-55 and if the abstract and conclusion is not enough for your case, I'd be more than happy to send you a full copy of the article.
posted by The Bishop of Turkey at 6:41 PM on September 7, 2009
Can you please post the results of your wednesday meeting here? Good luck!
posted by RobotNinja at 8:28 AM on September 8, 2009
posted by RobotNinja at 8:28 AM on September 8, 2009
Response by poster: I most definitely will keep you posted. Right now I'm trying to sort through all the info I've got here, and I just got off the phone with the county dept of health, who were very helpful. At some point I guess I have to pay some attention to my kids, too. ;)
I'll post back after the meeting tomorrow. Thanks again.
posted by missuswayne at 1:48 PM on September 8, 2009
I'll post back after the meeting tomorrow. Thanks again.
posted by missuswayne at 1:48 PM on September 8, 2009
Response by poster: Well, for those of you still checking this thread...the vote was supposed to be last night, but I got an email from the board prez requesting that the meeting be postponed until tonight. BUT he wanted to do a vote last night since he was supposed to get back to the child's parents by today. So he wanted us each to call him and let him know what our vote was. We haven't even sat down to discuss the issue and he wanted a vote via phone.
Anyway, long story long, I guess he changed his mind and we're voting tonight, although I'm not 100% sure because I can't get ahold of him.
Oh, and he forwarded to us the letter from the parents outlining their reasons for partially vaccinating. The child hasn't had her mumps or hep B vaccinations because they disagree with the CDC's vax schedule. In other words, it's not a religious exemption they're asking for, although that is what they called it originally, it's an "I'm not going to agree to your policy" exemption.
Stay tuned. :)
posted by missuswayne at 10:07 AM on September 10, 2009
Anyway, long story long, I guess he changed his mind and we're voting tonight, although I'm not 100% sure because I can't get ahold of him.
Oh, and he forwarded to us the letter from the parents outlining their reasons for partially vaccinating. The child hasn't had her mumps or hep B vaccinations because they disagree with the CDC's vax schedule. In other words, it's not a religious exemption they're asking for, although that is what they called it originally, it's an "I'm not going to agree to your policy" exemption.
Stay tuned. :)
posted by missuswayne at 10:07 AM on September 10, 2009
Response by poster: I was the only board member who voted to not let the child attend. And no one but me thinks that we should send a letter home notifying parents. No one else thinks it's unethical to not tell anyone, which stunned me. They think HIPAA applies to us, but I am fairly certain it only applies to healthcare providers and health insurance companies.
I have to figure out a) if there's some other privacy policy that we would be violating by notifying parents and b) how much more I want to push the issue.
Ugh. People suck!
posted by missuswayne at 7:08 AM on September 11, 2009
I have to figure out a) if there's some other privacy policy that we would be violating by notifying parents and b) how much more I want to push the issue.
Ugh. People suck!
posted by missuswayne at 7:08 AM on September 11, 2009
I'm sorry it went that way. I've been thinking a lot about the issue. Now that it appears that this child will be allowed to attend, I have to wonder if the parents of the child will notify other like-minded parents that your school allows non-vaccinated students. If the board allows that one child, why not another and another?
Best of luck with it all. As a parent, I would want to know about this change in rules. (My children go to a public school and I know there are exemptions to vaccinations - however, that was something I knew going into it all). Your parents assume that everyone's vaccinated because that's one of the rules. I'd think it only fair to let them know that that has now changed.
posted by Sassyfras at 9:45 AM on September 11, 2009
Best of luck with it all. As a parent, I would want to know about this change in rules. (My children go to a public school and I know there are exemptions to vaccinations - however, that was something I knew going into it all). Your parents assume that everyone's vaccinated because that's one of the rules. I'd think it only fair to let them know that that has now changed.
posted by Sassyfras at 9:45 AM on September 11, 2009
You are correct. It is completely unethical to not send a letter home to the families at the school. You have contracts with these people and they have a reasonable expectation that the school's end of that contract is being upheld. If the school has voted to act in violation of that contract, they are in potentially dark waters.
I'd be resigning from the board and leaving the school while loudly telling everyone why that is, but that's just me.
posted by Edubya at 11:37 AM on September 11, 2009 [3 favorites]
I'd be resigning from the board and leaving the school while loudly telling everyone why that is, but that's just me.
posted by Edubya at 11:37 AM on September 11, 2009 [3 favorites]
Response by poster: Yeah, I was actually considering resigning. This is such a drag -- I love my son's teacher this year, and I think he's going to have a really good experience so I don't want to pull him out. He knows his teacher, he knows his classmates, and he knows the school. Besides, pretty much any other school I put him in is going to have the same policy as far as medical and religious exemptions so there isn't much to gain with regards to that. I would just be making a point, and I have to weigh that with my son's school experience this year.
I really dislike how the board came to this decision though.
I might wrap up a few tasks I have to do this month and then submit my letter of resignation.
posted by missuswayne at 12:31 PM on September 11, 2009
I really dislike how the board came to this decision though.
I might wrap up a few tasks I have to do this month and then submit my letter of resignation.
posted by missuswayne at 12:31 PM on September 11, 2009
This thread is closed to new comments.
posted by fifilaru at 7:10 PM on September 6, 2009 [4 favorites]