A Growing Number of Concerned Families Exempt Children from Required Shots

As more parents refuse vaccines for their kids, health officials worry.

As more parents refuse vaccines for their kids, health officials worry.
HOC Health: Immunity Gap
Credit: Corbis

Late last year, Jessie Griffiths took a notarized document into the rural New Hampshire school her three-year-old son Cole attends, stating that, because of religious objections, he was not up-to-date on his vaccines. Later she admitted, "This is not actually the truth."

Cole had suffered a series of seizures days after receiving his measles, mumps, and rubella vaccines that alarmed Griffiths enough for her to stop all future vaccinations. She could have sought a medical note from her son's doctor, but she decided it would be easier just to take the religious exemption that every state except Mississippi and West Virginia allows -- often with no questions asked.

Across the country, a small but growing number of parents are doing the same thing. A 2006 survey from the Journal of the American Medical Association found that the number of parents exempting their children from some or all of their state's required vaccines, for any stated reason, grew by 6 percent per year between 1991 and 2004. All anecdotal evidence suggests their ranks have continued to grow since then.

Certain religious groups, such as the Amish, often choose not to vaccinate, and other people, like Griffiths's son, suffer serious side effects. But health officials believe that many of the parents opting out today are doing so out of fear that the vaccines may contribute to other conditions such as autism, a link long suspected but repeatedly refuted in scientific research.

It's easy to overlook these thousands of parents who opt out of vaccinations for hepatitis A and B, polio, chicken pox, whooping cough, and other illnesses among the millions who vaccinate right on schedule. Indeed, overall immunization coverage has risen steadily across the United States for many years.

But Lance Rodewald, who directs the Immunization Services Division at the federal Centers for Disease Control and Prevention (CDC), says he suspects there are already areas within the country where large numbers of parents taking exemptions have caused compliance to fall below 90 percent, a level generally considered a good measure of "herd immunity." Abstention is especially high in the Western states.

Sandy Cano, school nurse at John Muir Elementary School, in Santa Monica, California, estimates that, because of a high proportion of what she calls "free-to-be-me parents" in the school district, 5 percent or more of the children at her school have not received all their mandated vaccinations (all of them claiming religious exemption). "We try to reassure parents, but parents do their own research," Cano says. "School nurses are always worried."

Worried for good reason, says Rodewald. If parents who opt out of vaccines assume they are putting no one but their own child at risk, the reality is more complex. All vaccines have some small failure rate, meaning certain children who have been immunized against something like measles are still at risk -- a risk that only rises if they are going to school with other potential carriers.

"If a vaccine is 95 percent effective, and you have a lunchroom full of 300 kids, that means fifteen of them are susceptible, even if they have all been vaccinated," says Rodewald. An increasingly mobile society also means more people are traveling to and from developing nations, and the risk rises even more. A 2005 measles outbreak in Indiana began when one young girl who had not been immunized caught the measles during a trip to an orphanage in Romania. About thirty people in the community eventually came down with measles.

"I'm concerned when even one kid isn't vaccinated," says Cindy Lovell, school nurse at Midvale Elementary School, in Madison, Wisconsin. Having read much of the scientific research, Lovell remains convinced the benefits vaccines provide to the public health outweigh any risks.

But more and more parents who are skeptical of that research are turning to groups such as the National Vaccine Information Center, in Vienna, Virginia, which continues to explore possible hazards of vaccines and educates people to make their own decisions. The group's cofounder, Barbara Loe Fisher, argues that our concerns must go beyond the good of the "herd."

"I believe you cannot separate individual health from public health," she says. "We are at a point where one in five children is learning disabled. We cannot say our public health is being served."

Andrea Orr is a freelance writer in San Francisco.

This article originally published on 5/27/2008

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Comments (17)

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administrator, Clifton, NJ (not verified)

Educating children with learning disabilities

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Educating children with learning disabilities cost you and me and every public school district in the US millions of dollars each year. I am an administrator in a public school district and know that educating ONE learning disabled child with autism can cost a district ( which means your tax dollars) up to $60,000 to $75,000 a year! Increasing taxes and the continual financial strain that this puts on you and your family, is a matter of public "health" and public concern.

Cathy, Clifton, NJ (not verified)

The choice to vaccinate, or not

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An increase in adult whopping cough has nothing to do with children being vaccinated or not. Perhaps the fact that you got whopping cough proves that vaccines are not that effective. Perhaps lifesytle, poor diet and lack of exercise have more to do with an increase in adult illnesses than your speculation that you might have gotten pertussis from a child that was not immunized. Your correlation makes no logical sense; it is pure speculation. People have the inalienable right in this country to choose, be informed, and make their own decisions regarding their own body. I would never want to live in a world where we ever give up this right. I don't think you would want to either.

NC Teacher (not verified)

Response to SF teacher who contracted whooping cough

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Most studies show that adults catch and pass whooping cough from other ADULTS, not children. It is important for you have a booster to prevent passing it to fragile infants that you could come into contact or close proximity with.

Kelly L. Madison (not verified)

Thank you for your story!

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As President of the Meningitis Foundation of America, I want to thank you for your story "Immunity Gap: A Growing Number of Concerned Parents Exempt Children from Required Shots".

We also agree that this is becoming a dangerous trend and are working very hard to not let apathy or ignorance jeopardize our children's futures!

We certainly support parents having the right to make informed decisions. However, many of the parents we work with after a loss or devastating outcome from Meningitis, they often wish there could have been more they could have done to protect their loved ones.

Feel free to visit our website for more information about Meningitis: http://www.musa.org

Sincerely,
Kelly

Kelly L. Madison - President, Western Region
Meningitis Foundation of America

San Francisco Teacher (not verified)

Immunization for public health reasons

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(My use of a pseudonym will become obvious shortly.)

I had my immunizations as a child, and I have my tri-annual state-mandated screening for TB as a teacher. Yet, I walked around the last two months of the school year with pertussis -- WHOPPING COUGH -- that I most likely picked up from a child who wasn't immunized. Because I'm an adult who was immunized, it presented differently than it does in children, so I delayed going to the doctor. It's been four months under now, and I still can't shake the cough.

The worst part is I could have spread it at school -- to those other unimmunized students -- and to other adults whose immunity has lessened, as the childhood vaccine is not lifelong.

Evidently the incidence of adult whopping cough has risen so dramatically, that adult tetanus shots are now including pertussis again.

The nonimmunization of children is going to become a public health issue -- not just for children -- but for ADULTS.

David (not verified)

Vaccine Risks

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Parents must begin to take more responsibility for their own children's health. Doctors are in bed with the pharmaceutical industry. They don't read their own medical journals regarding the risks of vaccinations. The www.nvic.org site is an excellent place to start. Take that information and begin asking tough questions of your doctor.

A few years ago I was sitting on a plane to Washington D.C. and enjoyed a two hour conversation with a physician from France. I asked him how the practice of medicine in France is different from the U.S. He came back and said, "Oh, they are identical. We take great risks at the individual level to treat the masses." Remember, this is a physician telling me this.

For mothers who are expecting and plan to have their babies delivered at the hospital, consider this question:

1. If the mother's blood tests negative for Hepatitis B, how can my newborn contract Hep B? In other words, there is no reason to inject a newborn when the mother's blood tests negative. Last time I checked we don't have too many newborns who are using drugs or involved in illicit sex.

Here in Colorado I asked the head nurse in the maternity ward this question. She looked at me in disgust (think brainwashed by pharma) and said, "Your child won't be able to get into the seventh grade without it." I reminder her that in the State of Colorado that wasn't true and I hoped she wasn't sharing false information with other new parents. Then I asked her for a "medical" reason. She said, "We find that infants are more compliant in receiving the shot than teenagers."

Sounds like a medical dilbert cartoon but it's reality in most hospitals across the country.

Children in this country are dealing with chronic illness like we've never seen before. You'll find in the American Medical Association journal the link between a 2000% increase in childhood asthma and the MMR vaccination.

It's time for parents to pull their head out of the sand, quit treating doctors like deity, and become educated. Their children deserve better.

KayDee Caywood (not verified)

The discussion about vaccinations

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I have a concern with the final leap in a discussion regarding vaccinations and parents resisting having their children vaccinated to the high occurence of learning disabled in the population -- and this being related to public health.

There is no research that suggests that children who are not vaccinated have a higher risk of having a learning disability.

And please explain to me how having a learning disability is related to "public health".

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