Many students do not realize that a bad case of measles can cause pneumonia, brain damage and death, or that complications from mumps can lead to pancreatitis, meningitis and hearing loss. Before vaccines became available, whooping cough caused thousands of deaths in the United States every year. By the year 2000, the Center for Disease Control had deemed that each of these illnesses had been eliminated, controlled or vaccine-preventable, yet in the last five years they have all infiltrated University of California (UC) campuses.
Most Americans living in the 21st century have never experienced the devastation that can result from measles, whooping cough and mumps. According to some experts, this lack of experience might be one reason why Americans are not prioritizing vaccinations and why vaccination rates in some parts of the country are declining. Dr. Thomas Ferguson, medical director of the UC Davis Student Health Center, wants to make sure vaccination rates at UC Davis remain high.
New vaccine requirements coming to UC Davis
Ferguson is one of several leaders of the UC Systemwide Immunization Policy Work Group, a committee dedicated to creating consistent vaccination and screening requirements across the UCs that would comply with those recommended by the California Department of Health (CDH) and the American College Health Association (ACHA). The committee hopes to implement these new requirements by Fall 2016.
UC Berkeley, UCLA and UC Davis will pilot the regulations determined appropriate by the committee as a soft mandate, meaning that students will be able to petition to waive the requirements in the cases of religious restrictions or medical cause.
While the only vaccination requirement for students entering UC Davis is compliance with the California state law which mandates hepatitis B inoculation for students under 18, the California Department of Public Health recommends that university students should be vaccinated for the measles, mumps, rubella, chickenpox, tetanus, diphtheria, pertussis (whooping cough), meningococcal meningitis and hepatitis B before coming to school.
Do students need vaccinations?
According to Ferguson, ensuring a high rate of immunizations on UC campuses is critical to the health and well-being of UC students. He said that there have been several incidences of the measles on various UC campuses in recent years, including one at UC Davis this past spring.
“At UC Davis we have had mumps,” Ferguson said. “We see chickenpox every year. We have had pertussis. Those are all preventable by vaccinations.”
In 2011, a mumps outbreak at UC Berkeley infected an estimated 29 students, and a deadly strain of meningitis infected at least four students at UC Santa Barbara (UCSB) during the 2013 school year. In response to both the Berkeley and UCSB outbreaks, campus health services implemented massive rapid vaccination plans to stop the spread of disease.
And although the flu may seem less threatening than some of these other infectious diseases, Ferguson would also like to encourage students to receive a vaccination for it as well.
“Flu can devastate a student’s quarter,” Ferguson said. “They just feel horrible for two to three days. If that’s right before finals, it can really hurt their academic performance. So this is the time of year to come on in for flu [vaccination], before the quarter gets going.”
Has UC Davis lost its “community immunity?”
Ingrid Chu is one of many students at UC Davis who will elect not to get a flu shot this year. Chu says that she has received the flu vaccine in the past and still caught the flu.
“I don’t see a huge benefit,” she said. “Whether you get it or not is just up to chance.”
However, Dr. Dean Blumberg, an associate professor of Pediatric Infectious Diseases at UC Davis and chief of the Division of Infectious Diseases at the UC Davis Children’s Hospital, has seen both healthy children and young adults die from complications of the flu and explained that students like Chu may be discrediting vaccines without fully understanding how vaccines work to confer protection. Blumberg said that vaccines should be thought of like seat belts in a car. According to Blumberg, they can never be 100 percent effective, but still do a very good job in protecting users from harm — and the true effectiveness of vaccines at protecting individuals comes from halting the spread of disease within a community.
“Ideally you’d have a high enough level of immunity in a population that if a disease got introduced there would be very limited transmission because more people are vaccinated and would be protected,” Blumberg said. “And for different diseases, that level of immunity varies. If the level drops below a certain point then you can have sustained transmission of the pathogen.”
When a community is above that level, according to Blumberg, it is said to have “herd immunity,” and even members who cannot be vaccinated because they are too young or sick are thought to be protected from the diseases by the immunity of the group.
“So for example, with measles, it’s believed that if you can vaccinate 95 percent of the population with a vaccine that’s about 95 percent effective, then you have over 90 percent of the people who are protected and immune,” Blumberg said. “And that level of immunity, considering the dynamics of transmission of measles, likely means that if measles is introduced you get very limited transmission. If you get decreased levels of vaccination – decreased levels of immunity – then you introduce measles into the community, you have sustained transmission.”
The flu vaccine might not be the only recommended immunization that students are opting out of. According to a health survey administered to UC Davis students by Student Health and Counseling Services, the student population at UC Davis might be well under the levels thought to confer “herd immunity.” Of the students surveyed, 78.6 percent reported receiving a vaccination against hepatitis B; 65.2 percent reported receiving the measles, mumps and rubella vaccine; and only 53.8 percent reported being vaccinated for meningococcal meningitis, an illness for which freshmen living in dorms are at highest risk and which caused Amy Purdy, a world champion paralympic snowboarder, to lose both her legs at 19, along with her kidney and spleen.
Although these rates may seem low, lower vaccination rates have been reported in some areas of the U.S. Blumberg said that while some U.S. schools report 100 percent vaccination rates among their students, other schools have rates lower than 50 percent.
Blumberg cites anti-establishment ideals, inconvenience and concerns about vaccine safety as reasons that individuals decline vaccines for their children and for themselves. One particular health concern promulgated by a study published by British researcher Andrew Wakefield in 1998 was that vaccines in young children might cause autism. However, Blumberg explained that it is no longer considered a valid concern by the scientific community.
“The original study that made the suggestion that vaccines cause autism — that’s since been discredited,” Blumberg said. “The person who made the study – the lead author – was found to have lied and lost [his] medical license. But it did create a lot of concern. Since then, there have been 10 very well-done studies with different methods involving millions of children and there is no scientific evidence that vaccines are associated with autism.”
UC Davis health officials take steps to make vaccine information available
One way that Blumberg has worked to combat lower vaccination rates among grade-school children was by helping to add a new clinic to the UC Davis Children’s Hospital this past January. The clinic provides information and counseling to parents considering declining vaccinations for their children.
The clinic was established in response to a new California law that requires parents who do not wish to vaccinate their children to have a documented conversation with a physician on the topic. Although the ultimate decision remains up to the parents, this dialogue ensures that parents have the most recent and accurate medical information to help them make their choice.
Additionally, to help students stay up-to-date on their vaccinations, the UC Davis Student Health Center is encouraging students to utilize a new tool on the UC Davis Health-e-Messaging website. The site now has a tracker that allows students and doctors to record their vaccinations online. This tracker currently allows doctors to advise students on their vaccination needs and can streamline screening for students working in health-related internships. In the future, Ferguson plans to use this system to document required vaccinations for incoming students. Students can ask their current and previous doctors to help them access their vaccination records and complete the tracker.
Ferguson said that it’s never too late to be vaccinated and encourages any students who may not be up-to-date on their immunizations to take advantage of resources at the Student Health Center in order to make informed decisions.
“Any student can come to discuss [the topic] if they want more information,” Ferguson said. “We’re experienced at that. We’re not going to judge you. We’re happy to talk with you about this. This is open.”