Parents Still Fear Vaccinations

Wall Street Journal

The number of parents in Greater New York asking authorities to exempt their children from school immunization requirements is steadily rising, despite assurances from scientists and public-health officials that childhood vaccines are safe and essential to stopping the spread of infectious diseases.

Parents can ask schools in New York, New Jersey and Connecticut to excuse their children from the vaccination requirements for medical and religious reasons. Exemption rates on religious grounds—which are usually granted with little or no questioning—have risen sharply in each of the states over the past several years, according to data supplied by state health departments.

New Jersey has seen the biggest rise. The number of its religious exemptions has grown eightfold since the 2005-06 school year, with the tally at 3,865 students this school year. New York state granted religious exemptions to 3,615 students in 2008, more than double the rate from 1999, according to the latest figures available. In Connecticut, the number of students entering school with a religious exemption rose last year to 455, up from 248 in 1999. As a percentage of all students, those with religious exemptions remain tiny—below 1%—in each state.

While many people question the safety of vaccines, experts say there’s no reason to consider the shots harmful. Indeed, the experts say it is the refusal to immunize that risks children’s health and the health of babies too young to be fully immunized. Studies have found the chance of unvaccinated children getting measles, for instance, is 22 to 35 times the rate of vaccinated children, the New England Journal of Medicine reported last year.

For that reason, public-health officials expressed alarm at the numbers, however small, of vaccine exemptions. “These diseases haven’t gone away. They are just a plane ride away, and unvaccinated kids can present a danger not only to themselves but to other kids in the school,” said Dr. Guthrie Birkhead, New York state’s deputy commissioner for public health.

Yet, some parents fear the medicine more than the disease. Jennifer Crews, a Wharton-trained business consultant, said she began researching vaccine safety years ago, at the prompting of her chiropractor. Meantime in 2007, she moved to Ocean Grove, N.J., from Jersey City for the cleaner beach air. By the time her son was born in 2008, she decided it wouldn’t be safe to expose his immune system to the “heavy metals” in the shots and the multiple doses given at one sitting.

“Do I worry my son could contract swine flu and die? Yes,” said Ms. Crews, 40 years old. But she and her husband don’t want to take the risk that her child could develop a disease like autism or end up with “cancer and die.”

At momsupport.org discussions around New York City, new mothers talk through the issue as regularly as they compare breast to bottle feeding, says Jessica Shapley, the licensed social worker who runs the support groups.

Physicians at Tribeca Pediatrics regularly counsel bankers, lawyers and filmmakers about the benefits of vaccination.

“I have doctors and nurses who want to be cautious,” said Dr. Michel Cohen, founder of the practice, which has offices in Brooklyn and Manhattan. In New York City, the number of exemptions granted for religious reasons doubled between the 2008-09 and 2004-05 school years, to 350, according to the latest data.

Immunization is one of the first important medical issues facing parents. Doctors urge that newborns receive a hepatitis B vaccination shortly after birth. The pediatrician visits that follow are marked by a stream of more recommended shots. All told, the Centers for Disease Control and Prevention recommends 10 different vaccines be given a total of 29 times to children up to 6 years old. In addition, CDC recommends children get a yearly flu shot. States decide which vaccines to require, though they usually follow the CDC’s recommendations.

Authorities say safety concerns are not only misplaced but potentially harmful. For example, in February, a British medical journal retracted a notorious 1998 paper linking the measles-mumps-rubella vaccine to autism. And since 2001, nearly all child vaccines haven’t contained a mercury-based preservative that vaccine skeptics also frequently cite.

Vaccines aren’t always 100% effective, specialists acknowledge. A few have been recalled or are the subject of warnings. And as with any medicine, vaccines carry the risk of side effects. Most common are mild responses, such as a low-grade fever or redness where the shot was given. Rare but more serious are allergic reactions. A few studies have shown an association between flu vaccines and a potentially paralyzing condition called Guillain-Barre syndrome, though many studies have not.

Still vaccine specialists say clinical trials and monitoring for side effects have proven the safety of vaccines.

“Every time you have a missed opportunity to vaccinate a child, what you are doing is putting them at risk of acquiring that infection. There is good evidence that the child’s immune system can handle the vaccinations, and there are no” side effects from the multiple doses, said Dr. Jane Zucker, an immunization official at New York City’s health department. For this reason, she encourages parents to follow the recommended timetable for child immunizations.

Anxious parents such as Kelly Smith still decide to spread out vaccinations over additional office visits, rather than having their children receive multiple doses at one time.

Ms. Smith, a former human resources official at an investment bank, decided to delay the Hepatitis B vaccine normally given at birth until her son was four months. She also spaced out his other immunizations every two or three weeks. She was concerned about the chemical composition of vaccines and the impact of multiple doses given at one sitting after reading medical journal articles, materials from the American Academy of Pediatrics and other sources.

“We have to live within the rules of society, but at the same time, we do have to do well by our children,” said Ms. Smith, 35, who lives in Midtown.