Parents here are more scared of gluten than they are of smallpox. Narrator are personal choices putting the Public Health at risk . 70 cases of the measles. At least 145 in 14 states. Narrator tonight on frontline, the latest chapter in the bitter vaccine war. Frontline is made possible by contributions to your pbs station from viewers like you. Thank you. And by the corporation for public broadcasting. Major support for frontline is provided by the john d. And catherine t. Macarthur foundation, committed to building a more just, verdant and peaceful world. More information is available at macfound. Org. Additional support is provided by the Park Foundation dedicated to heightening Public Awareness of critical issues. The ford foundation, working with visionaries on the front lines of social change worldwide. At fordfoundation. Org. The wyncote foundation. And by the frontline journalism fund, with major support from jon and jo ann hagler. What a cute little face. Aw. Here we come its a girl shes beautiful. Whats her name . Rachel. Narrator a new life begins. Congratulations. Thank you. Narrator out of her mothers womb, Rachel Murphy is now surrounded by a new world filled with countless germs. Modern medicine will do what it can to protect her. Just a tiny little stick. Narrator barely an hour old, rachel gets her first shot against hepatitis b. This is the first of up to 35 inoculations she will get in the next six years of her life to fight 14 diseases. Rachel. Its okay, princess. Narrator Public Health doctors celebrate vaccines as one of medicines shining achievements. Theyve increased our lifespan by 30 years. Hib would cause 20,000 to 25 ,000 cases a year. Gone. I mean, polio would paralyze you know, tens of thousands of children every year. Gone. I mean, diphtheria was t he most common killer of teenagers in the 1920s. Gone. I mean, you know, vaccines. The benefit of vaccines is clear. Well, theres now 16 diseases that are prev entable by vaccination for children. 14 of those are diseases that we vaccinate infants and Young Children for, and two of them are diseases that we vaccinate adolescents. From my point of view, being able to prevent 16 diseases by vaccination is a really good thing. Shame on you shame on you narrator but this Public Health miracle has been losing ground. Since we first reported on the vaccine war in 2010, more parents across america have decided not to fully vaccinate their children. Like all wars, this one has casualties. Health officials suspect someone who was at the Disneyland Resort in middecember had the measles and thats how the disease spread. The Measles Outbreak that began at disneyland in december has now spread to more than 90 people in the u. S. Narrator december 2014, the u. S. Experienced a major Measles Outbreak, a disease that had been eliminated from this country 15 years ago. This has gotta be so frustrating for Public Health officials. Now its spread to over 100 infections, to different states around the country. Because of that, its something thats gotten a lot of attention. Narrator seth mnookin is a Science Writer at mit who has reported extensively on the vaccine debate. A Single Person infected with this disease can have implications that are going to go on for months. Because it is the most infectious microbe known to humankind, the efforts to contain it, the efforts to track down everyone that the infected person has come in contact with are just incredibly, incredibly expensive. Narrator the cdc tracks outbreaks of Infectious Diseases around the country from its center in atlanta. Over the last 15 years theyve detected pockets of diseases like whooping cough and measles. The cdc uses forensic techniques to dissect in fine detail how dangerous pathogens can spread. They analyzed one such event, a Measles Outbreak that struck an undervaccinated area of san diego in 2008. Like most Measles Outbreaks, it came from abroad. It began when an infected sevenyearold returned from a Family Vacation in switzerland on january 15. The child gave measles to two siblings, and collectively, they infected classmates at the San Diego CooperativeCharter School in linda vista. A visit to the childrens clinic of la jolla spread the infection to four others. One of these, an infant, flew on a plane to hawaii, where she was intercepted and quarantined. The other 250 passengers had to be contacted and tracked. Dr. Wilma wooten is san diego countys Public Health officer. This entire process resulted in exposur es of almost 1,000 individuals, 90 with no proof of immunization, 73 were quarantined, 12 additional actual cases of measles in san diego. Narrator Public Health officials determined that what allowed measles to enter the community was that kids were not being immunized because their parents were getting around Public School immunization rules by using personal belief exemptions allowed in states like california. School principals have found themselves caught on the front lines. The fact is that some families choose not to immunize their children. And then there are f amilies who have children who are particularly medically sensitive, and theyre in jeopardy because they could get sick from unimmunized children. So its a very emoti onal issue on both sides. Narrator across america, the cdc has discovered certain communities with a Large Population of parents who either do not vaccinate their children or pick and choose which vaccines to permit and how they are scheduled. One such place is ashland, oregon. Youre walking . Yeah, well, what am i going to do with a baby. Scooter . This is our neighborhood and we love it because we can walk everywhere. Ashland is a very safe town compared to almost every place else in america. Narrator its a college town, the home of an annual Shakespeare Festival, where a welloff, educated population has easy access to alternative medicines, an organic food coop, and yoga centers. Go get him narrator Jennifer Margulis a writer with a ph. D. In english, is the mother of four children. When my daughter was born in 1999, the nurse bustled in with her tray and said, okay, its time for your hepatitis b vaccine. And i looked at my daughter and i looked at the nurse and i said, isnt hepatitis b a sexually transmitted disease . And i said, why am i supposed to vaccinate my newborn baby against a sexually transmitted disease . And the nurse got really mad. Narrator margulis went on to research and write about vaccines, and in 2009 published a long article about the vaccine debate in mothering magazine, a magazine promoting a natural lifestyle. Why are we giving children so many vaccines . They get four times the number of vaccines than i got when i was a child growing up in the 70s. As a parent, i would rather see my child get a natural illness and contract that the way that illnesses have been contracted for at least 200,000 years that homo sapiens have been around. Im not afraid of my children getting chicken pox. There are reasons that children get sick. Getting sick is not a bad thing. Narrator in common with many other ashland parents back in 2010, margulis had decided not to fully vaccinate her other children according to the officially recommended vaccine schedule. Ashland still has one of the lowest vaccination rates in the country. Because of exemptions, some 28 of ashlands kids are allowed to attend Public School lacking some or all of their required vaccinations. So were going to need today the dtap number five, your final polio. Narrator pediatrician dr. Donna bradshawwalters worries that these parents may unwittingly bring back diseases that havent been seen for decades. Say, ah. Ah. Good job. The possibility of an outbreak is real here in ashland. We are not living in a bubble, especially in this day and age of international travel. Our Shakespeare Festival draws people from all over the world and its just a matter of time before someone comes to here from another area who is unimmunized and who has the disease and brings that disease into our community. Narrator in fact, ashland experienced an outbreak of chicken pox in 2014. And given the low rate of vaccination here, the community is at constant risk of other highly infectious and potentially serious diseases like measles or whooping cough taking hold. There are many provaccine parents in ashland, like lorie anderson, whose son, evan, is fully vaccinated. Its an outbreak waiting to happen. And so i dont just care about my own child. My child may be well protected because of his vaccination. But i hate to see people get hurt, injured, die, have to be quarantined, isolated because of an outbreak that is preventable with a vaccine. All they have to do is sign an exemption and their kid is exempt from immunization before they go to school. I will try not to be angry. I hope it doesnt get contentious. It will, though. It will get contentious if theres an outbreak. If vaccinated children start to get breakthrough disease because of the high rate of unvaccinated children, it probably will get ugly. Narrator a vast Public Health infrastructure is committed to preventing such outbreaks the National Institutes of health, the food and drug administration, the centers for Disease Control and prevention, large vaccine manufacturers. The mainstream medical establishment sp eaks with one voice vaccines are a Public Health miracle far too valuable to put at risk. Emilio emini has spent his life making vaccines in americas pharmaceutical companies. He heads pfizers vaccine operation. People havent seen these diseases in a while, so people become complacent. They dont vaccinate. And what they wind up doing is putting their children and themselves in considerable risk of a severe disease and infection. Polio, even though people arent worried about it because they havent seen much of it, is still present in many parts of the world, and it can easily be introduced into a nonvaccinated population. And from what weve seen in other parts of the world, once its introduced, it will spread very rapidly and cause a lot of disease. The fear, my friends, is po lio. But soon, perhaps within a year, there may be a vaccine. Thanks for visiting with us. Hey, kids, how about saying goodbye, huh . Goodbye when i was a child and the big scare was polio, where you would see your friends playing ball outside with you, baseball and basketball, and all of a sudden get sick and be in bed, be in an iron lung, and then come out with a deformity, a serious limp, or a serious physical disability that is absolutely frozen in your mind as a very scary scenario. I think were compelled b y our own fears. And certainly my parents who, you know, who grew up in the 1920s and 30s and 40s, saw these infections. They saw what they could do. For them, vaccines was an easy sell. Narrator paul offit is a pediatrician and coinventor of a vaccine against rotavirus, a pathogen that causes serious fever, vomiting, and diarrhea. I grew up in the 1950s and 60s. I saw measles. I had measles. I had mumps. I had german measles. I mean, i knew what those diseases could do. I watched my friends also be sickened by those diseases. And so for me, vaccines was an easy sell. I think for people now, Young Mothers today not only dont see these diseases, they didnt even grow up with these diseases. So for them, vaccination becomes a matter of faith. Narrator but the faith of some parents has eroded. Offit, for example, is seen in some quarters not as a hero for inventing a successful vaccine but as a selfinterested entrepreneur whom skeptics have called dr. Profit. They all have this guy, paul offit. You guys know him . Boo and he is the poster child for the term biostitute. Narrator for such critics, the fact that vaccines have made offit rich is enough to discount what he is saying. But offit, a prolific author makes no apologies. Im the coinventor of a rotavirus vaccine, a vaccine that i made in collaboration with merck, and its a vaccine which has caused a dramatic decrease in this country in hospitalization and has caused already a dramatic decrease in hospitalization and death in some countries in the developing world. Im enormously proud of that. I would argue that i have an expertise in rotaviruses and. But you also financially benefit from that vaccine. Itsits. I know this isnt going to sell. But it doesnt matter. It doesnt matter whether i financially have benefited or not. The only thing that mattered is, did the vaccine that we created at Childrens Hospital of philadelphia do what it was claimed to do . Has it prevented hospitalization and suffering and death . And the answer to that question is yes. Its a mistake that we have a vaccine against rotavirus, the vaccine that paul offit helped to develop. In the third world, maybe people are dying of rotavirus, but in this country, you have to do back flips to show a death toll of people from rotavirus. Well, one of the bitter ironies of vacci nation is it carries with it the problems of its own success. Narrator author and bioethicist Arthur Caplan is an expert on the ethical issues surrounding vaccines. Many parents are not thinking about the risk side of disease because they dont see those diseases. Theyve never seen any child rendered deaf by the mumps. Theyve never seen somebody whos had a case of polio. I had polio. I was in the hospital, paralyzed legs and neck, for about a year. So i know firsthand what the polio epidemic looked like. I was sort of at the last outbreak before the vaccines really came online and eliminated it. Narrator vaccinepreventable diseases like polio have become rare in the United States, so rare, in fact, that most younger doctors have never seen a case. baby crying and coughing this is one of the few places where you can see what vaccinepreventable diseases look like. This is a case of pertussis, also known as whooping cough. The audience is made up of paramedic students. She cant breathe, and thats horrifying for any patient of any age to discover that your airway has closed and you cant inhale. Narrator the teacher, dr. Cynthia cristofani, is a pediatric intensivist who treats children in need of critical care. She decided early in her career to document the rare cases of vaccinepreventable illness that turned up in her portland, oregon, icu. baby coughing she has used the footage to teach other medics how to recognize these diseases. Im old eno ugh to have seen most of the serious lifethreatening illnesses that are largely suppressed and some almost eradicated by the modern vaccines. This baby was a victim of rotavirus. Theres major fluid deficiency in this childs tissues. Actually kills over half a million humans annually, most of them elsewhere on the planet. The community recollection for these diseases has largely disappeared, and so the parents of younger kids who are of vaccine age are unlikely to have had any personal experience. And unless the grandparents or others can tell them what it was like and happen to have had knowledge of somebody who had a severe complication, its easy to imagine that these diseases are eradicated. Those spots are actually something probably none of you have ever seen. Theyre chicken pox. This patient had one of the commoner potentially lethal complications of chicken pox. He got strep sepsis from an infected lesion. This child came as close to dying of chicken pox as you can come without doing it. And so i encourage you to remember that chicken pox also can cause fatalities, even though most people used to think of it as a rite of passage in childhood and we all got it. You can do better than that. Theres a vaccine. This ones a scary one. This is haemophilus influenza type b meningitis. And he was actually the last patient i ever saw with this disease. I can tell you it was the scourge of pediatrics when i was in training because there was no vaccine. But beware. It could come back if people stop vaccinating. Narrator but critics have argued that while some vaccines may be lifesaving, the current vaccine schedule delivers just too many vaccines too quickly. Why are we giving children so many vaccines . Theres no more polio in the United States and theres no more diphtheria in the United States. And no one, no child, has contracted wild polio since 1979 in the United States. So when do we take polio off the vaccine schedule . When do we say, fantastic. The vaccine worked. We figured it out. We dont have a polio epidemic anymore. Lets stop vaccinating against polio. The number of antigens in the 14 vaccines, including their boosters which brings it up to somewhere in the 20s its literally a drop in the bucket to the antigens that an infant and a child get exposed to naturally even if they never got vaccinated with anything. Narrator officials like Anthony Fauci have struggled with how to convince parents that the benefits of vaccines far outweigh the risks. To say that there is no risk in any vaccine would not be truthful. What is the risk of injecting something into someones arm . The risk is that a certain proportion of people will get swelling and a little bit of pain, lasting from an hour to a day. That is a very acceptable risk. A very, very, very small percentage of people will get an allergic reaction. Namely, theres a component to the vaccine that they didnt realize that they were allergic to. And then theres a subset of a very, very, very, very s mall percentage of those who actually could get a serious reaction. But if you look at that, the risk of that is so minisculely small as to be completely outweighed by the benefit. Narrator the cdcs website tries to convey all these risks accurately, even when scientists are not sure the vaccines are, in fa