Should Unvaccinated Children Be Banned from School During An Outbreak?

Curated by Claudia Shannon / Research Scientist / ishonest

Parents of high school students at an eastern Michigan high school have been issued a stark order.

If your children aren’t vaccinated, they aren’t allowed to return to school until they’ve gotten their shots.

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Following a chickenpox outbreak at Marysville High School, the St. Clair County Health Department identified 37 students who couldn’t prove they’d been inoculated.

In a letter to parents, health department officials said the affected students won’t be allowed to attend school until they’ve proven that their chickenpox shots are up to date.

“The health department is facing some hard decisions in this case,” Dr. Michael Grosso, chief medical officer and chair of pediatrics at Northwell Health’s Huntington Hospital in Huntington, New York, told ishonest.

“Chickenpox, also called varicella, becomes contagious before the rash appears and remains so until all lesions have crusted,” Grosso explained. “The incubation period is up to three weeks. Of course, administering vaccine to the unimmunized is helpful, but protection takes several weeks.”

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While chickenpox was once seen as a benign rite of passage, the vaccine means it’s no longer necessary to suffer through the itchy — and sometimes dangerous — ailment.

“Though most often an uncomplicated, if uncomfortable, viral infection, varicella can attack the liver and brain, cause serious secondary infections, and occasionally lead to death,” said Grosso.

An emerging trend

The story out of Michigan is just one aspect of the anti-vaccination trend that’s taken root in recent years.

Amid the country’s biggest measles outbreak since 1992, health officials in Wisconsin are holding their breath as an estimated 50,000 schoolchildren have waivers that make them vaccine-exempt.

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A measles outbreak at schools in upstate New York prompted a new state law ending religious exemptions for vaccinations, closing the kind of loophole that exists at Wisconsin schools.

In California, the state with some of the strictest vaccination laws in the country, Governor Gavin Newsom recently signed a bill giving the state power to reject certain exemptions.

The anti-vaccination movement was spawned by a since-debunked 1998 paper by discredited former doctor Andrew Wakefield that claimed a link between vaccines and autism. It’s been energized by claims from celebrities such as Jenny McCarthy.

Whether a vaccination opponent makes their decision because they believe vaccines carry unwanted side effects or they’re just skeptical of government intervention, the end result is the same.

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There are more unvaccinated people, a situation that allows diseases to make a comeback.

Dr. Matthew C. Washam, director of epidemiology at Nationwide Children’s Hospital in Columbus, Ohio, told ishonest this is a cause for concern.

“Overall vaccination rates in the United States continue to lag behind those of many other countries in the world,” he explained. “There are also some communities within the U.S. which have vaccination rates much lower than the national average. Disease outbreaks can occur in these communities due to lack of herd immunity.”

Why herd immunity is important

When you get vaccinated, the shot will protect you from various ailments.

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The vaccination also protects other people. And if those people also get their shots, their actions will protect you even further.

That’s the premise behind a form of protection known as herd immunity.

“Herd immunity occurs when a large percentage of people in a community or population are vaccinated against a disease,” explained Washam. “If one person becomes infected, it is unlikely that he or she will infect another person in the community. Without ongoing person-to-person spread of infection, an outbreak is prevented.”

The flip side to this is that in areas where a large percentage of people aren’t vaccinated, outbreaks are possible.

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This is already happening on a widespread basis with measles and in more isolated cases such as the chickenpox outbreak in Michigan.

How to curb an outbreak

Legislating mandatory vaccinations is one step that can be taken to curb future outbreaks.

When an outbreak is already occurring, health officials have few options other than keeping unvaccinated people away from others.

“During an outbreak of a vaccine-preventable disease within a community, persons who are not vaccinated are both at risk of becoming infected themselves as well as continuing to spread the infection to others,” said Washam. “Health departments must act for the safety of all the members of a community during an outbreak, and at times that requires minimizing contact of non-immune persons with large group settings.”

To those who can’t shake their skepticism over vaccines, Washam emphasizes that vaccines are safe and effective. He suggests speaking to a healthcare professional.

“There is a lot of both information and misinformation about vaccines for parents to try to understand,” he said. “I recommend that parents discuss their questions and concerns about vaccinations with their child’s primary care clinician. Vaccines are safe and effective, and they’re the best way to prevent many severe infections.”

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