Dr. Jack Ross
President of the CT Infectious Disease Society
Journal Courier, March 2, 2021
I fear the Social Contract is Being Lost in the Vaccine Debate
Last week, I testified before the Public Health Committee, on behalf of the Connecticut Infectious Diseases Society, in support of critical bills that will strengthen our state’s vaccine policy by improving the medical exemption process and by eliminating the non- medical exemption.
As infectious disease physicians, we have witnessed tremendous advances in the field of infection prevention and the incredible development of life-saving vaccinations.
Unfortunately, we have also provided care to patients who have suffered from vaccine- preventable illnesses, resulting in lifelong debilitating consequences and in some cases even death.
It is these cases that stay with us and give me the greatest pause as I consider some of the testimony heard throughout the hearing before the Public Health Committee.
I was left feeling that the social contract has been lost as speaker after speaker focused on their own needs and entitlements rather than the concerns of our most vulnerable populations and of their neighbors.
You see, we have witnessed the devastating impacts of measles in patients who have suffered neurological injury and even infertility because of the mumps infection. We have cared for patients who have died from influenza, meningitis, whooping cough and tetanus-all vaccine-preventable diseases. That is the heart-breaking point, they didn’t have to die because we have safe, effective vaccines against these deadly infections.
The success of these vaccines relies on herd immunity, the resistance to the spread of an infectious disease in a society. Failure to reach herd immunity due to unvaccinated individuals leads to sustained disease transmission, long-term health consequences and unnecessary deaths.
What we heard this week was the breakdown in the social contract where individual needs seemingly take precedence over the needs of the community. Our most vulnerable-those patients with HIV, on immunosuppressing drugs for autoimmune or rheumatologic disorders or inflammatory bowel disease, those receiving chemotherapy for cancer, transplant patients, the elderly, newborns—these patients are at significant risk of serious infection or death when our herd immunity breaks down.
In Connecticut, we have seen clusters of mumps infections on the UCONN campus- infections that could have led to an outbreak without protective vaccine rates in the community. Without the social contract, and with the increase in non-medical exemptions, our state becomes more vulnerable to the outbreaks experienced in New York and even California. States that removed non-medical exemptions following their
own outbreaks-but after the damage was done.
During the hearing, we heard from New Yorkers who left their state and came to Connecticut to maintain their exemptions further exacerbating the problem here. With the rising rates of religious exemptions among kindergarten students throughout Connecticut-MAKE NO MISTAKE-we are in danger of developing large enough pockets of unvaccinated children to sustain transmission of these infections in our state.
Illnesses that further strain a health care system already at risk from the pandemic. Keep in mind that scientific literature demonstrates that measles has a secondary attack rate of 90%. What does that mean? One infected child who comes into close contact with 10 people who are non-immune will infect 9 of those people (say a cancer patient, someone on immunosuppressing medications, a newborn, an elderly person).
Clearly, this demonstrates how quickly measles can spread in an unvaccinated community and why we are so concerned.
If we have learned anything from the current crisis, it is the need to be proactive, to plan, to use everything in our power to protect our communities, to make the difficult decisions-to strengthen the social contract-putting the community above the individual.
If we are to avoid another crisis, we must enact legislation to remove non-medical exemptions and ensure we protect our communities from vaccine-preventable diseases. Vaccination complacency is not an option.
Vaccination complacency is not an option.