In the Journals: Pertussis Outbreak and Religious Exemptions

On August 30, 2013, the Florida Department of Health was notified of a case of laboratory-confirmed pertussis in a child attending a charter school in a faith healing community in Columbia County (Mattias J, Dusek C, Pritchard PS, et al. Notes from the Field: Outbreak of Pertussis in a School and Religious Community Averse to Health Care Vaccinations—Columbia County, Florida, 2013. MMWR Morb Mortal Wkly Rep. 2014 Aug 1;63(30):655.). The school contained 316 students from pre-kindergarten through 8th grade. Immunization rates were woeful. Only 15 percent of kindergarten students were immunized against pertussis; 5 percent of 7th graders were immunized.

A few days after the first child was sickened by pertussis, his sibling became ill. Then, on Sept. 3, two additional children from the school were confirmed to have pertussis by polymerase-chain reaction. On Sept. 12, the health department declared a communicable disease emergency. Thirty-eight children were subsequently excluded from school. Eventually, 94 children and 16 teachers were infected with pertussis. Fourteen cases, including three in infants, occurred in household contacts.

The outbreak extended into the community; 109 cases were identified. Although the health department offered pertussis vaccine to members of the community at no charge, only five people chose to be vaccinated. Despite the presence of a massive pertussis outbreak, community members continued to eschew medical care in favor of their beliefs.

In a more rational world, this would not be permitted. The United States Supreme Court has made it very clear that while people can martyr themselves to their religion, they should not be allowed to martyr their children to their religion (Prince v. Commonwealth of Massachusetts, 321 U.S. 158.) Also, again in a more rational world, the state would not consider it the inalienable right of any United States citizen to catch and transmit a potentially fatal infection. Someday we may evolve to disallowing people to put their children in harm’s way in the name of their faith. Sadly, we’re not there yet.