Fort Worth, Texas,
10:50 AM

Why your choice not to vaccinate impacts my child too

The Doc Smitty and why high immunization rates happen in clusters

Vaccination is important to me. This should not shock you.

Articles and news reports about infectious diseases and their impact on our children keep me up at night. Tonight, it’s not an article about an outbreak of disease that has me up typing away at 11:30 on the night before I come home from vacation.

Tonight, at least in the United States, there’s no large ongoing outbreak.

Tonight, my concern isn’t so much about those parents who choose not to vaccinate. I’ve been down that road before.

Tonight, I’m concerned about parents who are choosing to vaccinate their child, but then also choose (often unknowingly) to send them to a school where the low vaccination rates put even their fully vaccinated child at risk.

We know that families who choose not to vaccinate tend to cluster in geographic regions because studies have shown this. I have proposed the theory before that perhaps clusters of unvaccinated children in our area might be more based on ideology (faith-based or otherwise).

Why does this matter?

Herd immunity.

Keeping vaccination rates relatively high (somewhere around 90 percent) actually helps protect all children (vaccinated or not) from diseases. In addition, when outbreaks occur (which is much more likely when herd immunity breaks down), even children who are vaccinated become at risk for contracting disease due to the number of possible exposures. (If you are about to say, “If your child is vaccinated, why do you care if mine is?” read the post above.)

NBC 5 Investigates released a really enlightening (frightening) report this week on vaccination rates in local school districts. They highlighted the growing number of vaccine exemptions in three public school districts (Frisco, Plano and Lewisville).

At first glance it may not seem that concerning. If you look at an individual school or district, the percentage of vaccinated children in those districts is still really high.

My bigger concern, and what keeps me up at night, is in the schools where unvaccinated children, for some reason, are clustered together.

Take a look at what’s happening in our area:

  • 30 schools in the DFW area have vaccination rates below 96 percent.
  • 5 schools in the DFW area have vaccination rates below 90 percent.
  • The highest unvaccinated rate in our area is around 13 percent. The highest in the state is near 50 percent.

Why does it matter?

If you read the names of the schools that fall into the categories above, you’ll see a trend. They are private schools. They are schools that have a high likelihood of having people go overseas for mission trips or other opportunities.

Traveling to countries where diseases are more common increases the likelihood of bringing a disease back to school. Waiting at school are their unvaccinated friends and their vaccinated friends who could even be at risk as the number of cases rise. Outbreaks are possible.

Do you think this is far-fetched?

The Tarrant County measles outbreak from 2013 basically had all the characteristics that I am describing. A large group of unvaccinated people, grouped together based on their faith that contracted measles from a visitor who brought measles into the United States after traveling overseas.

What can you do?

  • Get the best start to protection by vaccinating your child.
  • Be aware of the vaccination percentages of your child’s school, your church and your social community.
  • Be especially cautious when your child’s unvaccinated contacts return from overseas travel. If they are sick, stay away.

Get to know Justin Smith, M.D.

Justin Smith, M.D., is a pediatrician in Trophy Club  and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. Dr. Smith is an experienced keynote speaker for a variety of topics including pediatric/parenting topics, healthcare social media and physician leadership. If you are interested in having Dr. Smith present to your conference or meeting, please contact him at

He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.





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