An Associated Press article (no link) reports that 131 cases, so far, of measles in 2008 is worrying doctors, and a conclusion of the article seems to be that because homeschooled children do not go to school, there is no requirement for them to be vaccinated.  Because no requirement forces vaccination, their parents leave them untreated.  What is left out is that most childhood vaccinations are given to children long before they are of school age.

The article muddles the concern about unvaccinated children with homeschooled children as disease vectors.  The logical mistake is that it isn’t the lack of a requirement for homeschooled children to be vaccinated that is causing the outbreaks, but that the parents who invoke a religious or medical exemption choose to homeschool.

I can understand the concern about discrete groups of individuals passing the disease amongst themselves, but I don’t think it is reasonable to tie the outbreaks to homeschooled children, rather than to children whose parents have chosen not to vaccinate them.

The 2008 report from the Center for Disease Control identifies some of the children as being homeschooled.

Update: Measles — United States, January–July 2008

Washington

All of the 19 cases were linked epidemiologically, and all but one occurred in children and adolescents aged 9 months to 18 years. The 19 cases included 16 in school-aged children, among whom 11 were home schooled.

…

Illinois

The remaining 29 cases were in persons aged 8 months–17 years, including 25 (83%) school-aged children, all of whom were home schooled and not subject to school-entry vaccination requirements. 

Of the 131 known people who contracted measles, 11 children in Washington, and 25 in Illinois were homeschooled.   That does make an unfortunate sum of 36 children who were homeschooled, and they were discrete groups, but what about the other 95 people?  Who were they?  Did they also have religious or medical objections?

Fifty-five of the people between the ages of 5 and 19 contracted measles.   I’m assuming this is the age range containing the people identified as homeschooled. Thirty-six were homeschooled, so given a lack of other identifiers, that means that 19 were in some form of school.  Were these people Americans who had been abroad or were they visitors from another country?  This chart shows that the number of ‘imported measles’ was low.

It may be that the 36 homeschooled children were all unvaccinated, but from the information provided, we can’t tell. 

The CDC points out that parents of schooled children can claim an exemption, as is allowed in “most” states.  The next report from 1985 has the religious exemption underlined, so this situation has been in place for many years.

Measles in a Population with Religious Exemption to Vaccination — Colorado

While most state school immunization laws allow exemptions on the basis of religious convictions, the data presented here illustrate the necessity of excluding persons with religious exemptions (as well as other unvaccinated individuals) from school and other environments in epidemic settings where contact with other susceptibles may occur. This serves both to protect their own health and to minimize transmission in the community.

Underlining that homeschooled children are not subject to vaccination requirements means nothing, because, given the availability of a religious and medical exemptions, people who use schools are also able to avoid vaccination.  And as for quarantine purposes, homeschooled children would not be attending school, although the “other environments” would need to be avoided.

Disease control is important, but thirty-six individuals among a population of an estimated million-plus children who are homeschooled is not an extravagant percentage.  Still, homeschooling parents whose children are not vaccinated may want to exercise caution if their children express a wish to travel outside the United States, and to take care if they know of another unvaccinated child who has traveled abroad.  These diseases are catching.

In any case, homeschooling is not the cause of the choice to not vaccinate.   That cause, in the noted cases, is an objection to vaccination.  

• Not all families who claim a religious exemption homeschool. 
• Not all families who homeschool are of a religion that objects to vaccination. 
• Not all exemptions are religious.

Implementing legislation that all homeschooled children be vaccinated, which seems to be what is hinted at, won’t change anything if the exemptions, both medical and religious, remain in place.

Aug 22 2008 in News-Commentary valerie 2 Comments »