Linn County must stand firm on proven public health protections

In Linn County, the health of our community is something we safeguard deliberately with evidence-based research. However, following the pandemic, the public has questions and doubts about health messages from governmental entities, even when those messages are backed by research. We understand many people have questions, but we wish to reiterate that there are two instruments to prevent disease and preserve health: immunizations and community water fluoridation.

Vaccines protect lives and prevent avoidable suffering

Vaccines have been among the most successful public health tools in history. They work by teaching the immune system to recognize and fight disease without requiring a person, especially a child, to endure the illness itself. Relying on natural immunity alone means accepting the risks of hospitalizations, long-term complications, and, in some cases, death.

In Linn County, the vast majority of K-12 students meet vaccination requirements, with over 93% of school-aged children submitting up-to-date immunization certificates in the 2022—23 school year, and nearly 95% of children in licensed child care centers compliant with routine vaccine requirements. However, the proportion of students with missing or invalid certificates has increased over time, this weakens the community protection vaccination coverage offers.

Across Iowa, vaccination coverage for young children has hovered around 70—71%, with room for improvement to reach targets which help stop disease spread.

When immunization rates fall, we see resurgence of vaccine-preventable illnesses elsewhere in the country — like measles and whooping cough. Measles, for example, is highly contagious; two doses of the MMR vaccine are about 97% effective in preventing it. When coverage decreases below the thresholds needed for community protection, diseases we once controlled can return.

Vaccines:

In recent years, Iowa has seen increases in whooping cough activity, a reminder that pertussis circulates when immunity gaps widen. State public health officials emphasize that vaccination remains the most effective prevention.

Water fluoridation is a proven public health measure

Water fluoridation is one of the most cost-effective approaches to prevent tooth decay, reducing decay by roughly 25% across a person’s lifetime. Poor dental health is associated with an increase in morbidity and mortality later in life.

In Iowa, nearly 89% of residents have access to fluoridated drinking water, with many communities recognized for excellent consistency in fluoride levels by the CDC. This built-in preventive measure benefits all ages and is particularly important for children and families with limited access to dental care.

Tooth decay is not merely a “dental problem.” When untreated, it can lead to pain, infections, missed school days, costly emergency care, and contribute to broader chronic health issues like difficulty eating, poorer glycemic control in people with diabetes, and other complications.

Unfortunately, some Iowa communities, including the city of Ely in Linn County, have discontinued fluoridation in recent years, decisions made without broad public discussion.

At the recommended level of 0.7 mg/L, fluoridation is safe and supported by major scientific and medical bodies including the CDC, WHO, American Dental Association, and American Academy of Pediatrics.

Evidence based research must guide public health policy

We recognize many people feel fatigued after the pandemic and face genuine uncertainty when confronted with conflicting information. Those feelings are understandable. But public health policy should respond to both a community’s values as well as research and scientific fact.

When proposals arise to weaken immunization requirements or discontinue fluoridation, the guiding question must be: will this policy change hurt or harm me? Will this policy change hurt or harm my children? And the answer to those questions should be guided by nothing less than the truth. Truth, by the way, that has been earned over centuries, with each new generation of scientists building on the knowledge of the last. The truth is fluoridation prevents tooth decay, which can lead to a host of other issues. The truth is vaccination saves lives, plain and simple. If a policy change flies in the face of those truths, then it is our responsibility as local public health leaders to advocate for the residents of the Linn County.

A call to protect what works

We live here. Our families drink from the same water systems. Our children attend the same schools. The people we serve are our neighbors, friends, and co-workers.

We urge residents to seek information from credible medical and public health sources, and we call on local and state policymakers to uphold two protections that have been proven to work:

These tools are effective and affordable. Protecting them is about responsibility and care for our community. The health of Linn County depends on our willingness to defend both.

By Dustin Arnold, DO, is chair of the Linn County Board of Health. Pramod Dwivedi, DrPH, Health is Director of Linn County Public Health.