See also 'Answers to questions about common vaccine concerns'
BYU nursing professor Beth Luthy said her life’s darkest moments came when she was a 19-year-old first-time mother and her infant son Michael desperately needed a liver transplant to survive. After putting Michael on the liver transplant waiting list, Luthy could do nothing but wait.
“As a parent, to feel completely helpless ... There was nothing I could do for him,” Luthy said.
Michael was fortunate enough to receive a liver transplant when he was a year old, but the transplant didn't eliminate his health problems. He took what his mother called “elephant doses” of immunosuppressant medications so his body wouldn’t reject his new liver, making him extremely susceptible to disease and unable to receive his immunizations.
“I was really concerned and thought, ‘Well, but what if he catches chickenpox? What if he catches all of these different diseases?’” Luthy said. “And the transplant team would tell me, ‘That would be bad. That would be life threatening to him.’”
Sure enough, it was. In the first years of his life, Michael almost died after catching rotavirus, chickenpox, RSV and whooping cough. Luthy said the only way to protect Michael was through 'herd immunity,' which is reached when enough people are vaccinated in the community that the most vulnerable are protected despite not being immunized.
“Unfortunately, there was no herd immunity where we lived at the time,” Luthy said. “He caught four vaccine-preventable diseases that we almost lost him over, and he caught it in the community which I had hoped would help protect him.”
Luthy's experience with Michael not only motivated her to study nursing but also to become a passionate advocate for immunizations and immunization education.
“If people just understood that here's my fragile and vulnerable little baby who needs them to get vaccinated to help protect and save his life, certainly people would do that. That only makes sense to me,” Luthy said. But, 'I found out through a very long and hard road that not everyone shares that same sense of community responsibility.”
Michael’s story has a happy ending — 30 years later, he has a family of his own. But his mother has not slowed her efforts to actively fight the anti-vaccination movement. She’s dedicated her nursing career to promoting vaccinations, advocating for immunization education in legislation and involving herself in the Utah County Immunization Coalition.
Luthy and other medical and public health professionals are concerned about the consequences of the vaccine opposition movement that is growing in Utah and across the world. In fact, the World Health Organization listed vaccine hesitancy as one of 2019’s top 10 threats to global health.
Despite several studies affirming the safety of vaccines — including a study released in early March refuting a link between the measles, mumps and rubella vaccination and autism — an increasing number of parents are hesitant to vaccinate their children. This expanding movement raises notable public health concerns.
What are vaccine exemptions?
Utah is one of 17 states that allows philosophical or personal exemptions from laws that require students to get vaccinated to attend school, according to the National Conference of State Legislatures.
Immunize Utah Program Manager Rich Lakin said the majority of parents exempt their children from getting vaccinated for personal reasons, as opposed to religious or medical reasons. Lakin said the state’s immunization exemptions have steadily increased over the past few years, increasing half a percent from 2017 to 2018.
“Any increase is not good,” Lakin said. “If you look at the trend, if people aren't going to vaccinate, then you're going to see these diseases come back.”
A June 2018 study by PLOS Medicine named both Provo and Salt Lake City as hotspots for vaccine non-medical exemptions alongside 13 other U.S. cities, including Seattle, Washington, and Austin, Texas. In addition to metropolitan hotspots, the study adds that smaller counties in Idaho, Wisconsin and Utah stand out for their high vaccine exemption rates.
“Our concern is that the rising (non-medical vaccine exemptions) linked to the anti-vaccine movement in the U.S. will stimulate other countries to follow a similar path,” the study concludes. “In such a case, we could experience massive epidemics of childhood infections that may threaten achievement of United Nations' global goals.”
BYU nursing professor Lacey Eden, a colleague of Luthy’s, worked with vulnerable newborns as a nurse in the neonatal intensive care unit.
“It just lit this fire under me,” Eden said. “We need to do more to make sure that people understand that immunizations are actually an ethical responsibility because they are safe. We know they are safe, so it's our responsibility to get them so that we can protect those who are medically vulnerable.”
Eden felt startled after reading a news article in 2015 about the low vaccination rates at her child’s school. Around the same time, she attended a pediatric nurse practitioner conference where she learned about education modules implemented in Washington for parents who choose not to vaccinate their children.
“I just thought that would be a great thing to implement here,” Eden said. “When I came back (to Utah), I just started meeting with people who have a stake in this issue.”
After years of work, Eden’s idea became a reality with the passage of HB308 during the 2017 legislative session. The law required the Department of Health to create an online education module parents now must complete before they can exempt their children from vaccinations.
Eden said the focus of the module is to inform parents who choose not to vaccinate their children about their responsibilities to keep diseases from spreading.
“It kind of goes through all of the different immunization-preventable diseases and what the signs and symptoms are so parents will be able to recognize that and keep their children home in the first place, rather than sending them to school and spreading this communicable disease,” Eden said.
The law also removes the fee for vaccine exemptions and allows Utah parents to complete vaccination exemptions online. According to Utah County Health Department public information officer Aislynn Tolman-Hill, before HB308 passed, parents were required to complete the exemptions in person at their local health department. She called that aspect of the law discouraging because it has made the exemption process easier.
The impact of vaccinations
The Centers for Disease Control and Prevention reported 465 confirmed cases of measles in 19 states from Jan. 1 to April 4. Seven outbreaks have been reported in 2019.
Lakin expressed concerns that such outbreaks affect a community's most vulnerable people — including those with a comprised immune system, newborn babies and pregnant mothers — more than anyone else.
“I know a lot of parents are basically saying, ‘If you're not vaccinated, don't come around my baby,’ and that's the best way to do it, really,' Lakin said.
Eden voiced similar concerns. She said she believes getting vaccinated is an ethical responsibility shared by the community.
“It's not just about yourself. It's not just about your own children,' Eden said. 'It's about protecting everyone and those who are vulnerable among us, like the infants who aren't fully immunized yet, and can get severely ill from diseases.”
Eden said many parents genuinely believe vaccines can be dangerous, but emphasized the significant amount of research that has proved vaccines' safety. According to the CDC, data shows the current U.S. vaccine supply is the safest in history.
A study from Annals of Internal Medicine 'strongly supports' that there is no link between autism and the MMR vaccine, a commonly-cited fear about the vaccine. Also, the MMR vaccine is not associated with increased febrile seizures among 4- to 6-year-olds, according to a study by the American Academy of Pediatrics.
A study from the Journal of the American Medical Association found no significant correlation between vaccine antigens and the risk of infectious diseases not targeted by vaccines, rejecting the idea that vaccines stunt a child's immune system.
More studies on the safety and side effects of vaccines can be found on the CDC's website.
Luthy, who has dedicated her life to researching vaccinations and published several academic papers on the topic, said there’s a spiritual aspect to her understanding of vaccinations. She disagrees with those who argue vaccines are unnatural and not what God intended, especially as she ponders mothers of the 18th and 19th centuries who lost their children to diseases.
“Can you imagine some mother with no resources in her little cabin with the baby, praying her heart out for some sort of cure? Well, guess what. (God) gave it to us,” Luthy said. “All those prayers have been answered. … I see (God) giving us this knowledge and this capability as an answer to so many prayers of so many mothers who have lost so much.'