Commentary

In a San Diego pediatrician's office in 2008, Megan Campbell and her 10-month-old son were in the waiting room with an unvaccinated 7-year-old.

She didn't know the boy wasn't vaccinated. She also didn't know he had measles.

Within days, her infant was in the hospital fighting for his life, infected with the measles the unvaccinated child had brought back from a trip to Switzerland.

The 2008 San Diego measles outbreak was triggered by a pocket of parents who believed the MMR vaccine (measles, mumps, rubella) was worse than the diseases it prevents.

Eleven people were infected, and 48 children too young to be vaccinated had to be quarantined. Campbell's son recovered, but barely.

I wish this were an isolated incident.

With news that seven local children have been diagnosed with measles, several of them unvaccinated because of parental fears, it has become clear that the medical and public health establishment has failed to counteract certain claims of vaccine danger that have about as much veracity as Sasquatch sightings.

It is the very success of the public health system in nearly eradicating what were once terrifying childhood diseases that makes the job so difficult now.

It's time for the medical community, public health authorities, legislators and -- perhaps most important -- the overwhelming majority of parents who, like me, choose to vaccinate their children to stop being Minnesota Nice.

Despite the fact that science tried and failed to find a link between vaccines and autism, the percentage of unvaccinated Minnesota children continues to rise.

The minuscule amounts of aluminum in vaccines, which some parents cite as a reason for not vaccinating their children, is a fraction of the amount of aluminum we ingest in self-rising flour.

An infant ingests seven times more aluminum in the first six months of breast-feeding than is present in the entire recommended course of childhood vaccines.

But this isn't about science. If it were, nearly everyone would be vaccinated.

This is about fear, and truth rarely trumps fear. The decision not to vaccinate has been made too easy.

Because the risk of potentially disabling illness and even death seems, for many parents, uncompelling, it may be time to try other tactics.

There is currently no real repercussion besides this risk for parents who, out of fear, choose not to vaccinate. I am proposing some.

1. Higher insurance premiums for the nonvaccinated.

Parents who choose not to vaccinate for "philosophical reasons" are typically the middle- to upper-middle class individuals most likely to have private insurance (last week's measles outbreak in the Somali community bucked this trend).

Insurance companies know which of their clients vaccinate. They often mail a reminder to those who have missed a scheduled vaccine.

They need to see unvaccinated children for what they are -- higher-risk clients. Just as with a diabetic refusing to take medication, the risk of illness skyrockets when preventive health measures are refused, resulting in higher costs for the insurer.

After all, the cost of a measles outbreak affects the bottom line of not just the insurance carrier associated with the unvaccinated child, but also the insurer of individuals too young to have received vaccinations who were infected by that unvaccinated child -- like Megan Campbell's son.

2. Make it easier for day-care providers and preschools to refuse admission to the unvaccinated.

State law requires that parents produce a vaccination record before enrolling children in school or day care. But it would be a mistake to take comfort in this law, because all one needs to do to free oneself from the obligation is to walk down to the local notary and sign the "conscientious objection" opt-out line.

It's time to allow child-care facilities to protect their students by making vaccination 100 percent mandatory. Many of us leave our children in environments in which other children may not be vaccinated, and that is a risk many of us are no longer willing to take, especially if we have an infant at home too young to be vaccinated.

3. Institute sincerity testing in Minnesota.

In New York state, parents who want to opt out of vaccines for religious reasons (there is no conscientious-objection exemption, so many parents claim religious exemptions) are required to do a little more legwork than heading down to the notary.

They must undergo sincerity testing before a religious waiver is granted. This testing determines that the parents' claimed belief is genuinely religious in nature. These typically consist of questionnaires, affidavits and, occasionally, more-detailed questions.

Instituting sincerity testing may cut down on the more casual nonvaccinators, who have been infected by blogs, Jenny McCarthy and the other usual suspects.

4. Remove the conscientious-objection opt-out from Minnesota law.

Eliminating this loophole in our immunization statute, 121A.15, would go a long way to ensuring that outbreaks caused by unvaccinated children would return to the history books, where they belong.

Because this statute makes it so easy to refuse to vaccinate our children, yet allows us to participate in the community with no restrictions, we have a serious measles outbreak that doctors believe is only going to get worse.

And with the Minnesota Department of Health suggesting that all children in Hennepin County get their MMR boosters now instead of at age 4, this outbreak is going to touch you whether your child has been vaccinated or not.

Ashley Shelby is an author, journalist, and mother living in the Twin Cities.