A Look Behind Low Vaccination Rates in Chicago-area Schools

Dr. Bartlett practicing what she preaches, with 2-year-old son Will while he gets a hepatitis A vaccination.

Dr. Bartlett practicing what she preaches, with 2-year-old son Will while he gets the hepatitis A vaccine.

Last week NBC 5 Chicago ran an investigative report on the surprisingly low vaccination rates of children in Chicago-area schools. After reviewing data from the Illinois State Board of Education, they found 369 schools across the Chicago area where more than 10 percent–and as many as 76 percent–of students are not vaccinated for one or more serious illnesses.

Despite decades of evidence that vaccines are safe and effective, some parents still refuse to vaccinate their children out of the mistaken belief that they are harmful or unnecessary. NBC investigative reporter Tammy Leitner spoke to Allison Bartlett, MD, Associate Medical Director of the Infection Control Program at the University of Chicago Medicine Comer Children’s Hospital, about why vaccines are necessary, and the danger posed by increasing numbers of unvaccinated children in schools. You can see Dr. Bartlett in the video version of the story. What follows is a lightly edited version of their complete conversation:

Allison Bartlett, MD, MS

Why should children be vaccinated?

We have a lot of vaccines that are available that were developed over the years to combat the most common and most serious illnesses in childhood. We often don’t think about those illnesses today, because no one I know has ever seen a child with measles or polio, so we don’t think it’s a really big deal. But when we think back historically about how devastating these illnesses were, we’re so fortunate today to have these vaccines available to help keep our kids safe.

Are vaccines foolproof?

Unfortunately they’re not foolproof. When someone gets a vaccination, we know that maybe 95 percent of the time it works just as we want. But there is a chance that, for some reason, the vaccine isn’t being as effective in a certain person. We’ve learned that the hard way with the chicken pox vaccine. When it first came out we gave every child a dose of the chicken pox vaccine, and then we saw that after several years there were a certain number of kids that were still getting the chicken pox infection. It looked like maybe 10 or 20 percent of kids, even though they got the vaccine, were still getting chicken pox and it didn’t look like the vaccine worked. So what we do now is give everyone a second dose, and once we made that recommendation we’re seeing a lot less chicken pox. That’s much better for our kids.

How important is it for every child to be vaccinated?

It’s critical that every child who can be vaccinated, should be vaccinated. There are some important exceptions in kids who shouldn’t be vaccinated: children with cancer whose immune systems aren’t working, children who are born with immune system problems, and some young infants that just aren’t old enough to be vaccinated. So it’s our duty for everyone else to be vaccinated to protect the people who really truly cannot be vaccinated.

One of the reasons that we’ve been so successful at eradicating some of these diseases is that we have something called herd immunity. This basically means that even though not every vaccine is 100 percent effective, and we know that 100 percent of people can’t be vaccinated, as long as the overwhelming majority of people are vaccinated and respond to the vaccine, the community is kept safe.

We know that the law requires people to be vaccinated, but there are exemptions. How does this play a role?

There are two different kinds of exemptions. There’s the medical exemption, so children who are too young and people with immune system issues that make it unsafe for them to get the vaccine. But then there’s another population that has a religious or philosophical reason why they don’t want their children to be vaccinated, and that is a potential population of concern. We know that the more people in a group that are not vaccinated, the higher the chance of everyone in that group getting a vaccine-preventable disease.

One of the concerns we have with people with philosophical or religious concerns about immunizations is that often they tend to be in community with each other. So whereas the whole city might have a 90 percent immunization rate, in this certain population the immunization rate may be 50 percent, or 40 percent or 30 percent. When that happens, that population is at a much higher risk of getting a vaccine-preventable disease. An example of that is the measles outbreak happening right now in New York City. All it take is one person who comes in and has the measles. If they’re surrounded by unvaccinated people, those unvaccinated people are at risk of getting the infection, as opposed to one unvaccinated person in a whole school of vaccinated people, where that would be enough to protect the whole school against the epidemic.

Do you think parents are under the false sense of security that if their child is vaccinated and going to school, they’re fine?

It’s a concern I have that when parents who believe in immunization, who have their kids fully immunized, it’s an expectation that all the other parents of all the other children feel the same way. I can’t control whether my child is in that 5 percent where for some reason the vaccine didn’t work for them, but I did my duty to the community, to society, to keep my child as safe as they could be, and to keep your child safe. So it’s unfair when my expectation is that I’m doing this to take care of my child and my child’s school, that there are other people in the school who don’t feel the same way about their duty to keep everybody else safe.

Does it surprise you to know that the number of unvaccinated kids in schools is so high, or do you think this is a trend we’re going to keep seeing increase?

I think a little bit of both. Unfortunately there is a lot of publicity in the media with celebrities regarding immunizations. I think we’re just going to see this struggle continue. It’s very disappointing to me, and unfortunately not very surprising, that the rates are lower than the 80 or 90 percent we would like to see.

Is there an end in sight?

I really don’t know how to get out of the trouble we’re in. The constant stream of celebrities who are promoting their opinions about vaccines—and all of the scientific evidence is not supportive of that—but that doesn’t seem to make a difference. It’s not an intellectual decision that parents are making. It’s very much an emotional decision. No one likes to see their kids get a shot. It’s not fun, they cry and it hurts. And it’s kind of scary if you don’t understand the science behind why this is important. But I think that’s really where your relationship with your physician and your health care provider comes in, to know that these are very safe. They have been used for years and years, and I don’t want us to go back to having measles outbreaks killing kids and pregnant women having stillborn babies because of chicken pox because we dedicated that vaccines weren’t important.

You mentioned the measles outbreak right now in New York City, and last year here we had an outbreak of whooping cough. Is this the direction we’re heading? Are we at a very scary crossroads right now?

I’m glad we’re getting all the press about these outbreaks. It’s true, it only takes one person to travel to a country where vaccination rates aren’t so high and bring it back here, or in the case of whooping cough it’s already here. We know that vaccines aren’t perfect against preventing illness, but if you get whooping cough and you’ve been vaccinated, you get much less sick than if you weren’t vaccinated. The same thing is true for chicken pox, the same thing is true for flu. We’re not going to be able to prevent 100 percent of the cases of whooping cough, but if we can keep adolescents and adults from getting very sick with it, if we can keep young infants from getting sick and dying with it, that’s worth our effort to work on vaccination rates for everybody.

Email NBC 5’s Tammy Leitner about this and other story ideas, or contact her on Twitter and Facebook.

About Matt Wood (531 Articles)
Matt Wood is a senior science writer and manager of communications at the University of Chicago Medicine & Biological Sciences Division.
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