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Nine Pints – Rose George

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Nine Pints

A Journey Through the Money, Medicine, and Mysteries of Blood

Rose George

Genre: Life Sciences

Price: $14.99

Publish Date: October 23, 2018

Publisher: Henry Holt and Co.

Seller: Macmillan


An eye-opening exploration of blood, the lifegiving substance with the power of taboo, the value of diamonds and the promise of breakthrough science Blood carries life, yet the sight of it makes people faint. It is a waste product and a commodity pricier than oil. It can save lives and transmit deadly infections. Each one of us has roughly nine pints of it, yet many don’t even know their own blood type. And for all its ubiquitousness, the few tablespoons of blood discharged by 800 million women are still regarded as taboo: menstruation is perhaps the single most demonized biological event. Rose George, author of The Big Necessity , is renowned for her intrepid work on topics that are invisible but vitally important. In Nine Pints , she takes us from ancient practices of bloodletting to the breakthough of the "liquid biopsy," which promises to diagnose cancer and other diseases with a simple blood test. She introduces Janet Vaughan, who set up the world’s first system of mass blood donation during the Blitz, and Arunachalam Muruganantham, known as “Menstrual Man” for his work on sanitary pads for developing countries. She probes the lucrative business of plasma transfusions, in which the US is known as the “OPEC of plasma.” And she looks to the future, as researchers seek to bring synthetic blood to a hospital near you. Spanning science and politics, stories and global epidemics, Nine Pints reveals our life's blood in an entirely new light.

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Nine Pints – Rose George

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This Superbug Is Resistant to All Antibiotics—and Has Killed Its First American Victim

Mother Jones

For a while now, the specter of “pan-resistant” pathogens—superbugs so super that they can withstand all available antibiotics—have haunted US and global public health authorities. This week, we got news of one showing up in the United States.

An elderly Nevada woman died in September after being infected by a strain of Klebsiella pneumoniae that was “resistant to all available antimicrobial drugs,” the Centers for Disease Control and Prevention revealed in a Friday note.

For Americans, the good news is that she probably didn’t contract her fatal infection here. She had been on an “extended trip” to India, CDC reports, where she had been hospitalized several times for a broken femur (thigh bone). Since she had a history of foreign hospitalizations, the US hospital in Nevada where she died sent a sample of Enterobacteriaceae for extensive CDC testing, as the CDC recommends in such cases. The result: The bug showed resistance to no fewer than 26 antibiotics. The fact that other patients admitted to the Nevada hospital tested negative for the same strain suggests the patient picked it up in India.

But that should be cold comfort. Bacteria don’t respect borders—they travel rapidly, not just in people and products, but also in wild birds. As Sarah Zhang recently put it in The Atlantic:

Over and over, scientists have identified genes conferring resistance to a class of antibiotics, only to find the gene had circled the globe. Another recent example is ndm-1, a gene found in 2009 that confers resistance to class of antibiotics called carbapenems. “It’s very rare to catch something at the very beginning,” says Alexander Kallen, a medical epidemiologist with the Centers for Disease Control and Prevention. Looking for resistance is a constant game of catch-up. You don’t notice anything until there is something to notice; by the time there is something to notice, something bad has already happened.

Too often, though, media reports about antibiotic resistance neglect to mention a key driver: modern meat production. The unraveling of antibiotics as a tool to fight infections is intimately related to the way we have raised animals for decades, dosing them with antibiotics to make animals gain weight faster and avoid infections despite in tight, unsanitary conditions. Overuse in human medicine also drives the problem, but nearly 80 percent of the antibiotics used in the United States flow into livestock farms.

The CDC, the World Health Organization, the UK government, and other public health authorities warn that overuse of drugs in meat farming are a key generator of antibiotic-resistant pathogens, which cause 90,000 US deaths annually, while also racking up $55 billion in costs and causing 8 million additional days that people spend in the hospital, according to the National Institute of Allergy and Infectious Diseases.

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This Superbug Is Resistant to All Antibiotics—and Has Killed Its First American Victim

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6 ways the Rio Olympics are failing on sustainability

Game of groans

6 ways the Rio Olympics are failing on sustainability

By on Aug 5, 2016Share

Brazil wooed the International Olympic Committee with promises of sustainability when it made its bid in 2009 for Rio to host the games, but it hasn’t followed through on those pledges. From waters teeming with pathogens to transportation troubles, the Rio Olympics are looking like a hot mess. Of course, lots of past Olympics looked disastrous just before they kicked off too.

1. There’s something in the water

Athletes have been advised to keep their mouths closed when swimming or sailing, as Olympic waters have been found to have virus levels 1.7 million times higher that what would be considered worrisome in the U.S. Rio constructed barriers to keep trash out of the main areas where events are being held, but that won’t stop the sewage and pathogens from floating in (though they might stop body parts from washing ashore).

2. A transportation nightmare

Rio’s traffic is so bad (it’s the fourth most congested city in the world) that members of the International Olympic Committee are already regretting the decision to hold the games there. A $3 billion subway extension was massively delayed and has just barely opened. And earlier this year, a new bike path constructed for the games collapsed, raising safety concerns.

3. Scary diseases

Even though Zika infection rates are slowing down because it’s winter in Brazil, there are plenty of diseases and illnesses to worry about, including dengue fever, rotavirus, norovirus, and hepatitis A. Oh, and as if that’s not already enough, drug-resistant superbacteria.

4. Injustice to residents

An estimated 77,000 people have been evicted from their homes to make way for infrastructure for the games, and entire neighborhoods have been bulldozed.

5. Clashes with critters

The controversial Olympics golf course was built in a sensitive coastal area, and environmentalists say it destroyed habitat and harmed native plants and animals, including endangered species. But it didn’t drive all the animals away: The golf course is still teeming with wildlife like capybaras, sloths, boa constrictors, and miniature crocodiles, so organizers have hired five handlers to keep potentially dangerous critters away from players during game time.

6. Shoddy construction

The Olympics require a vast amount of construction in a short amount of time, and that’s led to buildings that aren’t up to code. Haphazard construction has already caused gas leaks, a small fire, and plumbing mishaps in the Olympic Village. Conditions have prompted some athletes to stay in hotels or luxury cruise ships instead.

Most Brazilians think the 2016 Olympics will do more harm than good. Judging by what we’ve seen so far, the average Brazilian citizen just might be smarter than the Olympic organizers.

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6 ways the Rio Olympics are failing on sustainability

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Thanks, climate change, for all the extra mosquito bites — oh, and the Zika

This bites

Thanks, climate change, for all the extra mosquito bites — oh, and the Zika

By on Jul 28, 2016Share

If rising sea levels, worsening wildfires, and butt sweat weren’t enough to worry about, climate change is also responsible for another problem: more mosquitoes, and more of the diseases they bring with them.

Researchers from Climate Central analyzed the length of mosquito seasons in cities around the country, and what they found is Not Good — at least for humans (the mosquitoes are doing just fine). Improving conditions for mosquitoes, the researchers found, have increased the number of mosquito days in cities like Baltimore and Durham, North Carolina, by nearly 40 per year since the 1980s. More than 20 major cities now have ideal conditions for mosquitoes for at least 200 days each year. That’s over half the year to contend with mosquitoes! Over half! And, nationwide, 76 percent of major cities have seen increases in mosquito season over the past 36 years.

As mosquitoes thrive, so do mosquito-borne viruses like Zika. Already, the Centers for Disease Control and Prevention has confirmed more than 1,400 cases of Zika in travelers returning to the U.S. from abroad. But even if you don’t have plans to travel, that doesn’t mean you’re in the clear: When infected travelers are bit by mosquitoes here, they can then spread the virus at home.

So stock up on mosquito nets, folks. We might all be needing them soon.

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Thanks, climate change, for all the extra mosquito bites — oh, and the Zika

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How the Fight Against Zika Is Playing Out Across Brazil Right Now

Mother Jones

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Brazil is in crisis. Earlier this month, President Dilma Rousseff was ousted from office after a series of scandals led to impeachment proceedings. Newly installed opposition leaders are facing a series of corruption charges of their own. And the Zika virus, first detected in Brazil in April 2015, continues to stymie public health officials concerned about the upcoming Summer Olympics in Rio de Janeiro.

So far, the new government’s approach toward Zika has been questionable, at best: The new health minister, Ricardo Barros, is an engineer with no previous experience in health administration. And while Barros listed the fight to eradicate the Aedes aegypti mosquito as one of his top priorities when he took over, he’s got his work cut out for himself: Zika has infected 120,161 Brazilians in 2016, with another 1,434 confirmed cases of microcephaly since October (up from around 150 per year).

But how has Zika affected the lives of average Brazilians? Here are some unexpected ways the virus is impacting people on the ground.

There’s no privacy when it comes to Zika: As part of the government’s Aedes aegypti eradication plan, federal health agents have been going door to door to inspect backyards and educate the public. Ever since Rousseff signed a new rule into law in January, these agents have been allowed to force their way into public and private buildings—including people’s homes—to search for mosquito breeding sites if no one answers the door after two separate visits. If necessary, the police can be called upon to help gain entrance.

There’s been a rush on bug repellent: Last November, right after the government announced that the increase of microcephaly cases in northeastern Brazil was probably related to Zika, many Brazilians—especially pregnant women—rushed to drugstores to buy mosquito repellent. But not just any repellent: Experts in the field started to recommend a specific brand, Exposis, which is the only one in Brazil made with Icaridin, an ingredient said to guarantee up to 10 hours of protection.

According to Paulo Castejón Guerra Vieira, general-director of Osler of Brazil—the lab that produces Exposis—the company had prepared for dengue and chikungunya epidemics but was surprised by the Zika explosion. The resulting shortage led to a repellent black market, with Exposis selling for more than double its already-expensive original price of $16 a bottle. Pregnant women started to stock it. Production increased 30-fold to meet demand. “I had people calling here saying that they were afraid their babies would be born with microcephaly and we should work it out,” Guerra says. “We did everything we could to increase production.” They were finally able to meet demand four months later, in March.

Introducing species-killing, multicolored GM mosquitoes: Millions of genetically modified mosquitoes have been released as part of research projects to reduce mosquito populations across the country. In the most recent test, transgenic mosquitoes helped cause an 82 percent reduction in larvae in a neighborhood in the city of Piracicaba, located the state of São Paulo. (The GM mosquito produced by the company Oxitec has an alteration that prevents offspring from developing.) Two cities in the state of Bahia have seen similar results with transgenic mosquitoes.

In the last few months, residents of Piracicaba have been surprised and a little frightened to find pink, blue, and yellow mosquitoes flying through their homes. These GM insects were actually dyed with powdered paint so the researchers could better control their survival in the wild.

Courtesy Oxitec

In vitro fertilization just got even more complicated: There have been countless reports of couples delaying pregnancy because of the risk of microcephaly. But what about those considering in vitro fertilization? According to new rules, they must first take Zika tests.

The exams started to be mandatory in April, following a resolution by the Brazilian equivalent of the US Food and Drug Administration, and it is now a requirement for the couple and for sperm and egg donors. According to geneticist Ciro Martinhago, who runs a São Paulo laboratory specializing in reproductive genetics, many couples who had gone through fertilization procedures at the end of last year decided to postpone the embryo transfer until the beginning of Brazil’s winter, when there are fewer mosquitoes.

Martinhago’s laboratory was the first in Brazil to offer a molecular test to detect Zika in semen, and he even got requests from men who weren’t going through in vitro but wanted to make sure they weren’t putting their sexual partners in risk. According to a preliminary data published in the journal Emerging Infectious Diseases, the virus could be detected in semen up to 62 days after the first symptoms. On May 10, the Brazilian Ministry of Health recommended the use of condoms to prevent sexual transmission of Zika, especially among pregnant women.

Poor Brazilians are more affected by microcephaly, and officials aren’t sure why: Microcephaly, the most severe condition so far associated with Zika, seems to be impacting the poor more intensely. According to data released by the Secretary of Social Development, Children, and Youth of Pernambuco, one of the first states affected by the microcephaly outbreak, 69 percent of the 1,947 reported cases through the beginning of May came in families living in extreme poverty.

While low-income populations are more likely to be exposed to the mosquitoes, scientists are already looking at other factors that might be increasing their microcephaly risk—specifically, poor nutrition and exposure to previous infections.

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How the Fight Against Zika Is Playing Out Across Brazil Right Now

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As W.H.O. Declares Zika a Global Health Emergency, a Look at the World’s Failed Mosquito Policies

Areas stricken in Zika virus outbreak were once free of the mosquito that carries this and other dangerous diseases. Continue reading:   As W.H.O. Declares Zika a Global Health Emergency, a Look at the World’s Failed Mosquito Policies ; ; ;

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As W.H.O. Declares Zika a Global Health Emergency, a Look at the World’s Failed Mosquito Policies

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The HPV Vaccine Prevents Cancer. So Why Aren’t Most Teens Getting It?

Mother Jones

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According to latest National Immunization Survey, released by the Centers for Disease Control and Prevention Thursday, around 60 percent of teenage girls and 78 percent of teenage boys haven’t received all three of the recommended doses of the human papillomavirus (HPV) vaccine, which helps prevent reproductive cancers and genital warts caused by the virus.

Administered through three shots over a six month period, the vaccine protects against the most common types of the highly contagious virus, which is spread through sexual contact. Health officials recommend that adolescents receive the shots between the ages of 11 and 12 to boost the chances for immunity prior to any sexual activity, but the survey showed that 40 percent of girls and 60 percent of boys ages 13 to 17 hadn’t received even the first dose.

HPV is the most common sexually transmitted disease—most people will contract one of the 40 strains at some point in their lives. Seventy-nine million people in the United States have HPV, and an additional 14 million people are infected annually. Many people don’t even know they have the virus, and it often goes away on its own.

But not everyone is so lucky: One in every 100 will develop genital warts and 23,000 are diagnosed with HPV-caused cancers each year. According to the CDC, the vaccine prevents almost all pre-cancers and warts caused by the virus in both males and females. Since the first HPV vaccine was developed in 2006, the vaccine has helped reduce HPV infections among teenage girls by 56 percent—even with vaccination rates as low as they are.

Still, many parents are deciding to pass. A study published in Pediatrics in 2013 showed that the reasons most cited included unwarranted fears about vaccine safety and disbelief that their kids would be sexually active. Despite it’s proven safety and effectiveness, the vaccine has become a politically divisive issue. In 2011, Texas Governor Rick Perry was the first in the country to order a mandate, sparking outrage from the religious right. During a 2011 debate, Michele Bachmann claimed that the vaccine was “very dangerous” and caused “mental retardation,” and Rick Santorum called vaccine mandates, “just wrong.”

HPV vaccine uptake has not kept pace with that of other adolescent vaccines and has stalled in the past few years. In 2012, only about one-third of 13- to 17-year-old girls received all three recommended doses. These levels fall considerably short of the U.S. Department of Health and Human Services Healthy People 2020 goal of having 80 percent of 13- to 15-year-old girls fully vaccinated against HPV. Immunization rates for U.S. boys are even lower than for girls. Less than 7 percent of boys ages 13 to 17 completed the series in 2012. This low rate is in large part because the ACIP recommendation for routine vaccination of boys was not made until 2011. However, it is even lower than what was observed for girls in 2007—the first year following the recommendation for females—suggesting that concerted efforts are needed to promote HPV vaccination of males. – See more at: http://deainfo.nci.nih.gov/advisory/pcp/annualReports/HPV/ExecutiveSummary.htm#sthash.R6gsTr6L.dpuf

The National Cancer Institute has called for an “urgency of action” in closing vaccination gaps , citing that current vaccine rates are falling short of the US Department of Health and Human Services Goal for 80 percent coverage among 13 to 15 year old girls by 2020.

Though the focus is more often on girls, men are at also risk for HPV-caused cancers, including throat cancer, which may soon replace cervical cancer as the most common caused by the virus.

The survey did show there had been big gains in some parts of the country—Illinois, Montana, North Carolina and Utah all averaged increases of roughly 20 percent—which health officials say is an encouraging sign.

“The large increases in these diverse parts of the country show us it is possible to do much better at protecting our nation’s youth from cancers caused by HPV infections,” Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunization and Respiratory Diseases, said in a statement released with the report. “We are missing crucial opportunities to protect the next generation from cancers caused by HPV.”

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The HPV Vaccine Prevents Cancer. So Why Aren’t Most Teens Getting It?

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Scientists Can Predict Your City’s Obesity Rate by Analyzing Its Sewage

Mother Jones

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If someone were to ask you what distinguishes skinny cities with from fat ones, you might think of the prevalence of fast food joints, the average length of automobile commutes, or the relative abundance of parks and jogging trails. But there’s also another, more underground factor: their sewage.

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Are Happy Gut Bacteria Key to Weight Loss?


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Poop Therapy: More Than You Probably Wanted to Know About Fecal Transplants


Can Antibiotics Make You Fat?


Antibiotics As Key to Curing Starvation


Why You Shouldn’t Take Antibiotics for a Sinus Infection

Researchers with the University of Wisconsin-Milwaukee collected raw sewage samples from the intakes of municipal wastewater treatment plants in 71 cities around the country. Their results, published last month in mBio, the American Society for Microbiology’s open-access journal, showed that the microbial content of that sewage predicted each city’s relative obesity with 81 to 89 percent accuracy.

The finding actually isn’t all that surprising, says lead author Ryan Newton, a visiting professor at UW’s School of Freshwater Sciences. Other studies have shown that bacterial imbalances in your intestines can lead to metabolic syndrome, obesity, and diabetes. Newton’s study, however, is the first to demonstrate that those microbial differences also play out across entire populations, even after our poop gets flushed, mixed together, and sent through miles of pipes.

The UW study was enabled by computing advances have allowed scientists to rapidly sequence microbial populations and look for patterns in the results. Other researchers are using similar techniques to look for correlations between gut bacteria and a wide range of health conditions.

Newton isn’t the only scientist who sees sewage as a promising place for data dives. The Massachusetts Institute of Technology’s Underworlds project, which began in January, will study sewage for the presence of viruses such as influenza and polio; bacterial pathogens that cause cholera typhoid fever, and other diseases; and biochemical molecules ranging from antibiotics to illegal drugs like cocaine and methamphetamine. Scientists hope the resulting data could help predict epidemics and track other public health trends within particular neighborhoods.

As scientists gain a better understanding of the interplay between microbes and human health, they may eventually be able to look at municipal sewage to figure out which communities would be the best to target with public health campaigns designed to, say, get people to eat less sugar or more vegetables.

And just as important, sequencing sewage could eliminate the thorny problem of doing public health surveys. Unlike people, your poop can’t lie about what you had to eat.

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Scientists Can Predict Your City’s Obesity Rate by Analyzing Its Sewage

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Do You Live in a State With Low Vaccination Rates?

Mother Jones

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Measles is making a comeback: The extremely contagious and potentially deadly disease was eliminated in the US in 2000, thanks to a highly effective vaccine and laws requiring kids to be vaccinated before starting school. But in recent years, it has become easier for parents to opt out—and vaccination rates are slipping. The Centers for Disease Control and Prevention reported a major spike in cases in 2014, and 2015 might be even worse—in just over a month, there have been 102 cases (and counting) reported across 14 states, mostly connected to December’s Disneyland outbreak.

As we reported yesterday, Anne Schuchat, an assistant surgeon general and the director of the CDC’s National Center for Immunization and Respiratory Diseases, stressed that measles could get “a foothold in the United States and become endemic again,” if people don’t get vaccinated.

Overall, national vaccination rates seem high: The median rate of coverage for the measles, mumps, and rubella (MMR) vaccine, administered to most before entry into kindergarten, was 94.7 percent for the 2013-2014 school year. But, as Schuchat points out, the rate is lower in communities where unvaccinated families tend to cluster. In some areas, low rates might have more to do with access to clinics than with beliefs about vaccinations.

“The national estimates hide what’s going on state to state. The state estimates hide what’s going on community to community. And within communities there may be pockets,” said Schuchat. “It’s one thing if you have a year where a number of people are not vaccinating, but year after year in terms of the kids that are exempting, you do start to accumulate.”

Note: This second map has been revised.

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Do You Live in a State With Low Vaccination Rates?

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More States Are Letting Parents Refuse to Vaccinate Their Kids

Mother Jones

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In 2000, the Centers for Disease Control and Prevention declared that measles had been eliminated in the United States. Now it’s making a comeback, in large part due to parents who refuse to vaccinate their children.

This year’s outbreak—more than 100 cases reported across 14 states—follows a dramatic rise in measles cases in 2014—644 cases across 27 states. In light of the the potentially deadly disease’s return, public health officials are expressing concern about rising vaccine exemption rates. Citing the risks of not vaccinating, Anne Schuchat, an assistant surgeon general and the director of the CDC’s National Center for Immunization and Respiratory Diseases, stressed that measles could get “a foothold in the United States and become endemic again.”

More stories on vaccines and outbreaks:


Vaccines Work. These 8 Charts Prove It.


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How Many People Arenâ&#128;&#153;t Vaccinating Their Kids in Your State?


Measles Cases in the US Are at a 20-Year High. Thanks, Anti-Vaxxers.


This PBS Special Makes the Most Powerful Argument for Vaccines Yet


Mickey Mouse Still Stricken With Measles, Thanks to the Anti-Vaxxers


If You Distrust Vaccines, You’re More Likely to Think NASA Faked the Moon Landings

Every state requires children to get the measles, mumps, and rubella (MMR) vaccine before they enter kindergarten. (The vaccine is usually administered in two doses after a child’s first birthday.) All states offer medical exemptions for kids with allergies, cancer, or compromised immune systems. Most offer religious exemptions as well. And now a growing number of states—20 as of this year—permit personal belief exemptions (PBEs) that allow parents to not to vaccinate for reasons of philosophy or conscience.

Nonmedical vaccine exemptions—the rules that allow parents to opt their kids out of required vaccines based on beliefs—are on the rise. Over the past four school years, there’s been a 37 percent increase in exemptions filed. Between the the 2010-2011 and 2011-2012 school years, the rate of of exemptions for incoming kindergartners jumped 30 percent. The CDC reports that 85 percent of people who go unvaccinated do so for personal or religious beliefs.

According to a 2012 study led by Saad Omer, a professor of global health and epidemiology at Emory University, allowing PBEs leads to fewer kids getting vaccinated. Opt-out rates in states with PBEs are more than double those in states with religious exemptions alone. These vaccination gaps result in higher rates of diseases like measles and whooping cough, especially in states where PBEs are easily obtained.

“We do know that states that have philosophical exemptions tend to have not only high rates of exemption but also high rates of disease,” Omer says. But some states grant exemptions more readily than others. In states such as Colorado, a parent’s signature is all that is required. But in states like Arkansas, parents must first establish why they are seeking an exemption or receive counseling from a health care provider. “We have found that the more difficult the requirements are, the lower the rate of exemption and the lower the rate of disease,” Omer says.

Looking at data from 1991 to 2005, Omer’s team found that states with easy exemption procedures had whooping cough rates up to 90 percent higher than states that made it more difficult to get exemptions.

Last year, nationwide vaccination coverage was at about 95 percent, and the median national rate of children with PBEs was 1.7 percent. That might not seem so bad. Yet because unvaccinated kids are often clustered together, one transmission of a highly contagious disease like measles can put many people at risk and set off a series of outbreaks like those happening now.

These “clusters of vaccine refusal” put two groups at risk, Omer explains. First are people who are not vaccinated, which may include infants and children with compromised immune systems. The other is people who have gotten their shots but did not get immunity—something that affects about 1 in 10 vaccine recipients, even with the most effective vaccines. “Even when it is a good vaccine and someone has done the right thing and gotten their kid vaccinated there is still a chance that they will be unprotected. So, their risk not only depends on their own vaccination status—but also what is happening around them.”

As Schuchat noted earlier this week, “The national estimates hide what’s going on state to state. The state estimates hide what’s going on community to community. And within communities there may be pockets. It’s one thing if you have a year where a number of people are not vaccinating, but year after year in terms of the kids that are exempting, you do start to accumulate.”

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More States Are Letting Parents Refuse to Vaccinate Their Kids

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