Doug Thompson: Of mumps and liberty

Heed pre-vaccine risks to rights

There's a mumps outbreak in Northwest Arkansas. Vaccinated children get to keep going to school. Those who aren't vaccinated can go back to class as soon as they get vaccinated. Kids who get the disease can return soon after the illness runs its course.

Kids who don't get vaccinated or catch the disease have to stay out of school for 26 days -- after the last case of the mumps at his school. Such a prohibition could drag on for months.

Some parents who don't want their children vaccinated have protested to local lawmakers. Those unvaccinated children should be allowed to attend school, perhaps with precautions such as isolating them from other kids. That was the argument made at a Monday meeting of the state House and Senate Public Health committees.

I never thought I'd see the day when people asserted a "right" to have their kids quarantined at school.

Historically, quarantine involves isolation of people who are already sick or known to have been in contact with the sick. The word was invented long before vaccines existed. The practice largely disappeared after vaccines became widespread. Now quarantine, a blunt instrument of public health, appears poised to make a comeback.

The stigma that will attach itself to any group of kids who are isolated from the rest of a student body at a school should be considered here.

I'm no public health expert, but have to question the wisdom of putting the most vulnerable people, say, in the third grade all into the same classroom at a public school. That sounds like a good way to create a multi-patient outbreak from a single slip-up. I'll also mention in passing that parents had to agree to abide by the 26-day rule to get an exemption so their unvaccinated child could attend public school.

People I know who are anti-vaxxers include both relatives and good friends. I've heard some voluminous and passionate arguments against vaccines. I remain unconvinced for two reasons: I'm a history nerd who also used to have Hot Springs, Ark., in my "territory" as a reporter. The public health benefits of vaccines are both worldwide and undeniable. Hot Springs was a major resort for the relief of suffering brought on by various diseases. Vaccines and antibiotics put the bath houses out of business except for some touristy relics.

Almost all the arguments I've heard against vaccines concern individual health risks. As the size of the non-vaccinated population grows, debates on public health risks spring up. What I haven't heard yet are any debates on the civil rights aspect -- not about the right to reject vaccines, but the civil rights (or lack of them) of a body of people now paying a price because their families made that choice.

Pre-vaccine era laws about isolating people who are public health risks remain on the books. They are not always applied reasonably. Ask Kaci Hickox. She lives in Oregon, last I heard.

In an outstanding example of no good deed going unpunished, nurse Hickox went to Sierra Leone in West Africa in 2014 to help a nonprofit group fight the Ebola outbreak there. After flying back, she was held against her will in a tent at a Newark, N.J., airport for three days. She had to fight one legal battle there and another in her then-home state of Maine to avoid de facto imprisonment. This dragged on even after the incubation period for her possibly having the disease had long expired. She won, but still had to take her temperature twice a day and keep health officials informed about her movements for a while.

Even people Hickox knew were shunned in various and irrational ways. She wrote an article about the ordeal and the fallout. It's still available at: https://www.theguardian.com/commentisfree/2014/nov/17/stop-calling-me-ebola-nurse-kaci-hickox. Meanwhile, in Britain, a nurse from Scotland who volunteered in the same country in the same year did contract the disease. She just won the legal battles resulting from that -- in a ruling on Wednesday.

We have a large population of people who are vaccinated and are the children of vaccinated generations. Widespread, dangerous infectious diseases were never a fact of life for them. We also have a growing number who refuse vaccination for their kids. Those kids are becoming outsiders who pose a risk. Disease isn't the only risk they're running.

Commentary on 09/17/2016

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