As a child, science teacher Walt Werner contracted the measles. As an adult, Werner developed non-Hodgkins lymphoma and took a five-month medical leave last year to undergo treatment, which included chemotherapy and a stem cell transplant.
During Werner’s chemotherapy treatment, doctors targeted cancer cells, which, because of the type of cancer Werner had, meant intentionally killing his immune system. Werner then received a stem cell transplant that would rebuild his weakened system.
“In essence, I’ve had a reborn immune system,” Werner said. “So all my childhood immune responses have been kind of lost.”
Regaining his immune responses, which include his immunity to the measles, will not be as simple as just getting vaccinated again. Depending on the type of cancer and treatment, patients may have to wait from six months to a year or longer after finishing treatment to start getting vaccinated again. Because of the recent outbreak of measles, Werner recently emailed his oncologist asking if it is safe for him to get the MMR vaccine, which protects against measles, mumps and rubella.
In early January, multiple cases of measles were reported as originating at California’s Disneyland. Within a month, the few cases grew into an outbreak, with now more than 100 people diagnosed with measles in the United States, 92 percent of whom were linked to the Disneyland cases. This resurgence of a disease that had been declared officially eliminated from the United States in 2000 has sparked a national debate over the use of vaccinations and the possibility of new legal requirements.
A central point in this debate has been the theory of herd immunity, a type of immunity that works when a large portion of the population has been vaccinated and protects individuals who cannot get vaccinated themselves. These individuals include infants, the elderly, people born with immune deficiency disorders and people who become immunocompromised due to a disease or medical treatment, like Werner.
California state law requires children to get certain vaccinations, including MMR, in order to attend school. However, students can be exempted due to religious belief, in which case parents must sign an affidavit, or due to personal belief, which requires a doctor’s note.
Although no one in the Harvard-Westlake community has contracted the measles, Santa Monica High School’s child-care center, less than 20 miles away from the Coldwater campus, was shut down for four days last week after an infant too young to be immunized was diagnosed with the disease. A freshman baseball coach there was also diagnosed with the measles.
In the Santa Monica-Malibu Unified School District, the rate of vaccine waivers for kindergartners is 11.5 percent, compared to the statewide rate of 2.5 percent.
At Harvard-Westlake, two to three percent of students have opted out of vaccinations due to religious or personal beliefs, Assistant to the Head of Upper School Michelle Bracken said. Bracken handles the collection of the California School Immunization Records at the beginning of each year.
Harvard-Westlake does not require employees to turn over immunization records or to get certain vaccines. The only requirement is that each employee takes a tuberculosis test every four years, Director of Health Benefits Nicole Ryan said.
The school offers employees the flu vaccine, the hepatitis A series, the hepatitis B series, the Tdap vaccine (for tetanus, diphtheria and pertussis, better known as whooping cough) and the shingles vaccine for employees over 60 for free at the employee health fair every fall. Before 2010, the school offered the vaccine for tetanus and diphtheria (Td), and not pertussis. In 2010, some students at the middle school contracted whooping cough, so the school switched Td for Tdap.
As a result of the recent outbreak, Ryan has begun looking into ways to bring the MMR vaccine to campus for employees who need it.
Adults born before 1957 are considered immune because most children contracted the disease during that time. But many adults may not know whether or not they have been immunized. There are tests that can determine whether or not someone has the antibodies to fight a disease, but it is also safe to get the vaccination a second time just in case, Ryan said.
Sandee Teruya, an Athletic Trainer and the Community Health Officer at Harvard-Westlake, stays in close contact with the Centers for Disease Control and Prevention and the California Department of Public Health in order to monitor outbreak situations such as this one, she said.
By working with infectious disease experts, Harvard-Westlake has a protocol in place if someone within the community were to contract the measles or any other highly contagious disease.
“The most important thing is to be aware,” Teruya said. “Have a protocol in place to isolate people who are infected, communicate with the rest of the community, that’s the most important thing to stop the spread. Also make sure people know that the vaccines are safe.”
The protocol would require any diagnosed students to stay at home until they can be confirmed disease-free. Any students who may have been exposed and students who are not vaccinated would be placed on a watch list and would not be allowed to come to school.
Teruya emphasized the highly contagious nature of measles. According to the World Health Organization, the disease is airborne, and is spread when an infected person breathes, coughs or sneezes. It is also possible to catch measles by entering a room an infected person has been in up to two hours after that person has left. In addition, those infected may be contagious before they start showing symptoms themselves.
Werner said that he must be very careful about staying healthy. When he notices a student sniffling or coughing, he tends to be more cautious, he said.
Werner believes that any argument against vaccines is not based in fact.
“I don’t think there’s controversy [surrounding vaccines],” he said. “I think it’s misinformation. People will lose historical perspective on how many people died of measles and chicken pox and mumps and all these kinds of diseases.”
Although Werner does believe the science behind herd immunity, he also acknowledges people’s religious reasoning for not getting vaccinated.
“I think it’s a fine line,” he said. “Because in the constitution we do have this thing about religious freedom, on the other hand where do you start to separate the wackos from true religions?”
Werner is not especially worried about contracting the measles because he is not around young children very often, he said.
Jack* is a student and Christian Scientist who has never received a vaccination. Christian Scientists generally do not turn to medicine first. Instead, they use spiritual methods of healing, though they are not opposed to Western medicine.
“The Bible basically says that every person on earth is a child of God, and therefore as a child of God they’re a reflection of God, and since God is never sick or dying or anything like that, it wouldn’t make any sense for people, as his reflection, to be sick,” Jack said.
Jack’s parents have practiced Christian Science for their whole lives, and Jack has only been to a hospital a handful of times. The last time he can remember is when he broke his collarbone skiing in seventh grade, he said.
Though Jack believes that modern medicine, including vaccinations, can be very useful to non-Christian Scientists, he does not believe he is more vulnerable than vaccinated people to diseases such as the measles.
“I’ve never had to miss school for more than a day or two, or gotten anything major or anything like that, so I consider myself to be just as susceptible as anyone else who may or may not have had a vaccine,” he said. “I don’t think of myself as any more at risk than anyone else.”
However, according to the CDC, people who are not vaccinated and are exposed to the measles have more than a 90 percent chance of contracting the disease themselves.
When asked if he ever feels guilty about possibly lessening the effectiveness of herd immunity, Jack said that he does sometimes question whether or not Christian Science is correct in all aspects.
“I do feel like on some level, I feel kind of conflicted because I feel like for people who do have weakened immune systems from diseases or things like that, I think those are the people who I’d be more concerned about than anything,” he said. “But then again, I’ve never carried anything like [the measles]. So I would say generally no, but sometimes kind of philosophically I feel maybe it’s inconsiderate on a level, but I don’t necessarily feel guilty.”
Science teacher Wendy Van Norden strongly believes that all people should be required to get vaccinations, regardless of religious or personal beliefs. Van Norden’s nephew was born with agammaglobulinemia, an immune disorder that involves a low production of the protective immune system proteins immunoglobulins. This means that her nephew cannot be immunized and must rely on herd immunity. Van Norden’s sister founded the Immune Deficiency Foundation.
“I’m furious that people would make a choice that would endanger the lives of people around them,” she said. “Not only are there people who can’t be immunized, but a very small percentage of people who have been immunized don’t know that it didn’t take. So you have to rely on everyone else being a good citizen.”
In the wake of the recent outbreak, a group of California state senators have introduced legislation that would abolish the exemption from vaccines for parents’ personal beliefs. Van Norden believes that all states should follow the examples of Mississippi and West Virginia, the only two states that do not allow exemptions for personal or religious beliefs. While the other 48 states offer exemption for religious beliefs, California is one of only 19 that allows exemptions for personal belief.
Of 474 students polled, 74 percent agree with Van Norden in that they believe students should be required to get vaccinations, regardless of religious or personal beliefs, while 26 percent believe that they should not.
“I can’t imagine any state having good enough justification to endanger their citizens by letting people with non-scientific views ruin the herd immunity,” Van Norden said.
*Names have been changed