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It's MORNING EDITION from NPR News. Good morning. I'm Steve Inskeep.

Today in Your Health, a look at two behaviors that are very hard to change. In a moment, we'll hear about a new approach to helping people who collect way too much stuff. First, what happens when people refuse to vaccinate their kids? NPR's Richard Knox reports.

RICHARD KNOX: Not long after San Diego had a measles outbreak, a very similar storyline popped up in the TV drama "Private Practice." A kid gets sick with measles after a family trip to Switzerland. A doctor wants to vaccinate the kid's brother, Will, but the mom thinks vaccines cause autism.

(Soundbite of TV show, "Private Practice")

Unidentified Woman: Will's fine.

Mr. PAUL ADELSTEIN (As Dr. Cooper Freedman): So far, but he hasn't been vaccinated, and he's at risk to get this.

Unidentified Woman: It's the measles. When my parents were growing up, everyone got it.

Mr. ADELSTEIN (As Dr. Freedman): And hundreds of people died from it every year. The vaccine changed...

Unidentified Woman: Don't even think of suggesting...

Mr. ADELSTEIN (As Dr. Freedman): There's no proven link between vaccinations and autism.

Unidentified Woman: It's not just me. I have talked to dozens of parents.

KNOX: Karen Waters-Montijo has been in real life scenes like that. She's chief of immunization at the San Diego County health agency. She remembers two years ago, when a public health nurse called to report a measles case.

Ms. KAREN WATERS-MONTIJO (Chief of Immunization, San Diego County Health Agency): I just almost fell off my chair. The child had two siblings. This family wasn't vaccinated. And in fact, there were a lot of unvaccinated children at their school as well.

KNOX: That's trouble. There's no virus more contagious. Measles can spread very fast among the unvaccinated. It can kill, and it can cause permanent brain damage.

Just like on TV, San Diego's first patient was a kid who picked up the virus during a family trip to Switzerland. Doctors were slow to recognize that it was measles.

Ms. WATERS-MONTIJO: There's a good reason for that, is that we hardly ever see any measles cases. Most doctors have never seen a case.

KNOX: Health authorities kicked into gear, tracing everybody who came in contact with the child, and everybody in contact with them. That added up to 839 people. Among those, 73 families had unvaccinated children. Most of the children had parents who believed in vaccination, but the children were too young to get the shots. These parents were pretty unhappy when they were asked to keep their kids home for three weeks to avoid spreading the virus.

Ms. WATERS-MONTIJO: Kind of a range of emotions, sort of angry. You know, what do you mean, people don't get vaccinated? You know, why is this happening?

KNOX: In the end, only a dozen children got sick. No big deal, you might think, except it disrupted a lot of lives and it cost county taxpayers more than $10,000 per case to stop the virus.

Afterwards, Waters and her colleagues looked into who the vaccine refusers were. They're college-educated, well-off and believe a natural lifestyle -organic food, prolonged breastfeeding - is enough to keep their children safe. And they just don't believe it when government officials say vaccines don't cause autism.

Ms. WATERS-MONTIJO: Sure, it is wrapped up in their attitudes about government. I don't think they think I'm the enemy. I think they think I'm well-intended, but misinformed.

KNOX: Many communities have pockets of vaccine refusers. So we're likely to see more outbreaks. It's happening right now in Vancouver. Infected travelers brought measles from overseas during the Olympics, and it spread. Half the 16 cases so far are in a family of vaccine refusers.

U.S. officials are watching closely. Dr. Jane Seward, of the Centers for Disease Control and Prevention, says there are many vaccine refusers in neighboring Washington State.

Dr. JANE SEWARD (Centers for Disease Control and Prevention): And so if measles crossed the border there into those populations, there's potential for a sizable outbreak.

KNOX: Back in San Diego, Karen Waters is still trying to persuade skeptical parents to get their children vaccinated. She says refusers are not bad guys in this drama.

Ms. WATERS-MONTIJO: You know, these are very nice people. They care a lot about children, as I do. It's unfortunate that there's a group of people who are off on this track.

KNOX: So far, Waters hasn't changed many minds. She knows of a thousand families who've refused to get their kindergartners vaccinated. That's 100 more since that last San Diego measles outbreak.

Richard Knox, NPR News.

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