Friday, December 03, 2004

Unvaccinated in Massachusetts

I got a call from the school nurse at my son's preschool yesterday who called to tell me that I need to keep P out of school because he is unvaccinated and there has been a case of chickenpox at school.

It turns out the Massachusetts has a regulation that requires anyone who is susceptible to chickenpox to be excluded from work or school for day 10-21 after exposure. My son has supposedly been exposed (someone in another class at preschool has it) and as he is unvaccinated I've been told I need to keep him home. Here's the regulation: http://www.mass.gov/dph/cdc/epii/ch...arexclusion.htm

I find this regulation to be discriminatory and punitive. The CDC estimates that the varicella vaccination is at most 85% effective. Some studies (such as one where infection at a New Hampshire preschool was followed) have found the effectiveness of the vaccine to be as low as 40%. Therefore, even a vaccinated child who is exposed to chickenpox may contract it and be contagious. Obviously, vaccinated children who have been exposed to chickenpox are not excluded from school for the contagious period. Students from the infected child’s class, whether vaccinated or not, are far more likely to contract chickenpox than my son, whose exposure was slight to nonexistent. Furthermore, the varicella vaccination is a live vaccine, and around 7% of people vaccinated develop a rash and may be contagious (there are documented cases of recently vaccinated individuals infecting others). Newly vaccinated children are also not excluded from school, despite their possibly contagious condition. My son is less likely to infect anyone with chickenpox than a child in the same class as the infected child or a child who has been recently vaccinated.

I spoke with an epidemiologist at the Department of Public Health and despite intending to calling only to get information, couldn't prevent myself from starting a debate. Of course, our views are so divergent that we could not agree on anything -- like I thought I could change her mind?! However, one of my arguments was that vaccinated people can pass on chickenpox too, and they aren't excluded from school. Her response was that they were at least trying not to pass it on. To which I concluded -- "See that's where it's punitive." I don't think I should be punished (or more precisely that my son should be punished) for drawing my own conclusions from the vaccine debate and deciding not to vaccinate. I'm certainly aware of the other point of view, that claims that I am endangering public health, and I don't agree with it. And I'm unwilling to expose my healthy children to the risks of vaccination.

I spent the evening writing a letter to the school nurse and trying to find out about legal resources.

At any rate, it has turned out that there was no chickenpox at preschool -- the child turned out just to have some spot, so my stress and my letters were for nothing -- except to prepare me for the next time. In the meantime, I'm looking to expose my preschooler to chickenpox!

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