Figures reveal that more parents are opting out of school shots for their kids. In eight states now, more than one in 20 public school kindergarten children aren't getting all the vaccines required for attendance.
In an analysis by the Associated Press it was noted that more than half of states have seen at least a slight rise in the rate of exemptions over the past five years. States with the highest exemption rates are in the West and Upper Midwest.
According to Mary Selecky, secretary of health for Washington State, its “really gotten much worse.” In Washington State six per cent of public school parents have opted out. In some rural counties in northeast Washington, for example, vaccination exemption rates in recent years have been above 20 per cent and even as high as 50 per cent.
Rules for exemptions vary by state and can include medical, religious or - in some states - philosophical reasons. Reasons for skipping some school shots vary. Some parents are skeptical that vaccines are essential. Others fear vaccines carry their own risks. Some find it easier to check a box opting out than the effort to get the shots and required paperwork schools demand. Still others are ambivalent, believing in older vaccines but questioning newer shots against, say, chickenpox. Additionally many are flummoxed by the number of shots. By the time most children are six, they will have been stuck with a needle about two dozen times - with many of those shots given in infancy. The cumulative effect of all those shots has not been studied enough, some parents say.
Health officials have not identified an exemption threshold that would likely lead to outbreaks. But as they push for 100 per cent immunization, they worry when some states have exemption rates climbing over 5 per cent. The average state exemption rate has been estimated at less than half that.
The AP reviewers asked state health departments for kindergarten exemption rates for 2006-07 and 2010-11. The AP also looked at data states had previously reported to the federal government. (Most states don't have data for the current 2011-12 school year.)
Alaska had the highest exemption rate in 2010-11, at nearly 9 percent. Colorado's rate was 7 percent, Minnesota 6.5 percent, Vermont and Washington 6 percent, and Oregon, Michigan and Illinois were close behind. Mississippi was lowest, at essentially 0 percent.
“Vaccine refusers tend to cluster,” said Saad Omer, an Emory University epidemiologist who has done extensive research on the issue. While parents may think it does no harm to others if their kids skip some vaccines, they are in fact putting others at risk, health officials say. No vaccine is completely effective. If an outbreak begins in an unvaccinated group of children, a vaccinated child may still be at some risk of getting sick.
Studies have found communities with higher exemption rates sometimes are places where measles have suddenly re-emerged in outbreaks. Vaccinated kids are sometimes among the cases, or children too young to be vaccinated. Last year, California had more than 2,100 whooping cough cases, and 10 infants died. Only one had received a first dose of vaccine. “Your child's risk of getting disease depends on what your neighbors do,” said Omer.
Immunization expert Dr Lance Rodewald with the federal Centers for Disease Control and Prevention said, “Polio can come back. China was polio free for two decades, and just this year, they were infected from Pakistan, and there is a big outbreak of polio China now. The same could happen here,” He cited outbreaks of Hib, a disease that can lead to meningitis, among the Amish who don't consistently vaccinate their children. Russia had a huge diphtheria outbreak in the early to mid-1990s, he said, because vaccine coverage declined. “Measles is just visible, but it isn't the only concern,” Rodewald said.
“Every time we give them [parents] evidence (that vaccines are safe), they come back with a new hypothesis” for why vaccines could be dangerous, said Kacey Ernst, another University of Arizona researcher. The exemption increases have come during a time when the government has been raising its estimates of how many children have autism and related disorders. Some experts suggest that parents have listened intently to that message, with some believing the growing roster of recommended shots must somehow be related.
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