I do not understand the decision not to vaccinate one’s children under the best of circumstances.

Even when the community in which a family is living is healthy and the surrounding herd immunity is robust, the evidence in favor of protecting one’s kids is weighted so heavily in favor of immunization that opting out is nothing short of baffling to me. The best I can do is chalk it up to a fear that medical science is powerless to allay, and accept that even my best arguments fall short for some people.

But you’d think that perhaps the unfounded and inchoate fear of vague harm from vaccines might be overcome by a more imminent fear of actual disease.

After all, with outbreaks of vaccine-preventable illness cropping up all over the place, even famous vaccination opponents are trying to toss their past statements against the practice down the memory hole.

It stands to reason that, were some illness spreading within a family’s local area, surely they would err on the side of protecting their own children from it if an effective preventive measure were available. If whooping cough were knocking at parents’ doors, wouldn’t that be enough to sway them toward vaccinating their kids against it?

The answer, as it happens, is no.

According to a study presented this week at the annual meeting of the Pediatric Academic Societies, vaccine rates in Washington state did not increase despite an epidemic of pertussis (whooping cough) there. That epidemic sickened thousandsof individuals from October 2011 through December 2012. Over a similar span of time the Centers for Disease Control received reports of 20 pertussis-related deaths nationwide, the majority of which were in infants.

What didn’t happen in Washington during that span of time was more people choosing to vaccinate their kids against pertussis. The study’s authors had hypothesized that the threat of a potentially fatal disease nearby would lead hesitant parents to have their children immunized, and were surprised to discover no change in statewide immunization rates.

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