More parents opting out of vaccinating their children
Cole Kestler is distracted by his mother, Jourdan Kestler of Mt. Lebanon, as medical assistant Kelly Kidwell, right, gives the toddler a vaccination at the Pediatric Alliance office in Bridgeville.
Cole Kestler, 21 months, wasn’t happy about receiving a vaccination last week at Pediatric Alliance in Bridgeville. Pediatricians are concerned about a nationwide trend of parents opting out of vaccinating their children.
Vaccines are generally regarded as one of the greatest medical advances in modern times.
Many of the diseases that killed or severely disabled children a few generations ago were reduced or eradicated by vaccines.
But diseases like whooping cough, measles and mumps are making a comeback in some parts of the country as parents opt out of vaccinations for their children, according to the National Public Health Information Coalition.
Immunization requirements for public schools are determined by individual states, and Pennsylvania is one of 19 states to exempt school-aged children from required vaccines based on parents’ philosophical beliefs. All states, except for West Virginia and Mississippi, allow religious exemptions. Just last year, the Pennsylvania legislature made philosophical beliefs a separate category from religion.
Nationwide, there is a rise in exemption rates, which reflects some parents’ belief that the vaccines are more dangerous than the diseases they prevent and could be linked to a rise in autism. However, according to the Pennsylvania Department of Health, there has not been a significant fluctuation in recent years in the number of children who are getting vaccinated.
In 2013-14, Washington County school districts reported 14 medical exemptions, 24 religious exemptions and 43 philosophical exemptions among kindergarten and seventh-grade students to the state Department of Health, while Greene County reported five medical, three religious and eight philosophical exemptions. The department does not break down the number of exemptions by school district.
Of the total number of public school kindergartners in Washington County, fewer than 1 percent have philosophical exemptions, fewer than 0.55 percent have religious exemptions, and just 0.2 percent have medical exemptions. In Greene County, there were no religious exemptions reported among kindergartners, while 1.2 percent had philosophical exemptions and 1 percent had medical exemptions.
All those numbers are below the statewide average, according to the Department of Health. Still area pediatricians are concerned about parents opting out of vaccinations for their children.
“A lot of that has to do with what people find on the Internet. They get a lot of misinformation from Googling, and just because something’s on the Internet does not mean it’s accurate,” said Dr. Mary Maher, a pediatrician with Cornerstone Care Pediatric Alliance in Washington. “At Cornerstone, we have very few parents who opt out of vaccines. In the office, we really promote the vaccines and give parents literature about the importance of having children vaccinated.”
While pediatricians are concerned about unvaccinated children catching a disease, they also worry that the numbers of vaccinated children will fall below herd immunity, the level at which enough people are vaccinated so that an isolated case of an infectious disease will not develop into an outbreak. Diphtheria, for example, requires 85 percent of people to be vaccinated to reach herd immunity, but pertussis and measles require a 94 percent vaccination rate for herd immunity.
“If you choose not to get the (measles-mumps-rubella) for your child, for example, and there was a measles outbreak, if you go to the playground, you’re exposing your child and everyone else on the playground, too. You’re putting other children and anyone unable to get vaccinations because of health issues at risk, as well as your own child,” said Maher.
Pennsylvania is one of two states that allow for an eight-month provisional period from the time school begins for parents to get their children’s immunizations up to date.
Scott Martin, superintendent of Bentworth School District, said the district has denied students admission to school because they have not turned in an exemption or vaccination records.
“It’s become more of an issue in the past two years, and we’ve been sending home reminders for parents to turn in their forms and we keep sending them deadline dates. It’s real important for those kiddos who are exempt,” said Martin. “It’s important for us to know who has their vaccinations and who doesn’t because, depending on a student’s medical issue, something like chicken pox can be life-threatening.”
At Bentworth, 19 of the district’s 1,200 students have exemptions.
Dr. Edward Ketyer, a pediatrician at Pediatric Alliance in Peters Township, said it’s socially irresponsible for parents not to vaccinate their children.
“There has been an increase in parents opting out in certain pockets of the country, like southern California, but I think the vast majority of parents nowadays understand the importance of vaccines and respect science enough to know vaccines are safe and effective,” said Ketyer. “I’m sorry, but there’s no excuse for not getting vaccinated to protect your children, yourself and the rest of us. I’d say it’s safer to get a vaccine than to put your kid in a car seat and drive to my office.”
Risks for outbreaks have been increasing in the United States, especially for measles, which the U.S. Centers for Disease Control and Prevention says is at a 20-year high.
Before the measles vaccination program started in 1963, measles would infect about 4 million people each year, killing about 500, according to statistics from the Children’s Hospital of Philadelphia’s Vaccine Education Center, provided by Ketyer.
Each year, polio paralyzed 10,000 children, Hib (haemophilus influenza type b) caused meningitis in 15,000 children, leaving many with permanent brain damage, and pertussis (whooping cough) killed thousands of infants.
“These diseases will come back if we don’t get children vaccinated. A lot of younger practitioners have never seen these diseases. I’ve never seen a case of measles,” said Maher. “When vaccines first came out, people were excited that they could get rid of these diseases. Nowadays, it’s easier to consider not vaccinating if you haven’t seen someone with a case of measles or pertussis, because you don’t know what happens when someone develops it. You haven’t seen the effects.”
But despite medical evidence, not everyone is convinced vaccinations are safe.
Parental concern about vaccinations increased following a 1998 study by a British physician, Andrew Wakefield, which linked vaccines to autism. His paper was discredited, but uncertainty remains for some parents.
Pam Perry of Canonsburg is the mother of three sons, and her oldest two, who are in their 20s, have autism.
When her third son, Evan, was born, she and her husband decided to have him vaccinated on an altered schedule starting at the age of 3 – a decision her pediatrician did not support, so Perry took him to another doctor.
“We weren’t against (vaccines), but we thought there was something we could do differently than we did for Blake and Justin. I don’t know if that’s what caused (autism), but it’s always made me wonder. Blake was born a month premature, and that wasn’t taken into consideration when they gave him his vaccinations.
“Then we started reading some of the ingredients in the vaccinations and we read something about how you shouldn’t give a vaccination to kids who are allergic to eggs,” said Perry, who recalled two occasions when Blake touched egg whites and had a reaction. “Who knows what caused it, it could be the environment, it could be anything, but how do you know these babies have a strong enough immune system to tolerate all of these things that are injected into their little bodies?”
Louise Francis, a Pennsylvania leader of the Vaccination Liberation group, is opposed to all vaccinations.
“I think they’re neither safe nor effective, and while some studies show limited effectiveness, any limited effectiveness is far outweighed by adverse reactions,” said Francis, an actuary who volunteers her time to talk with parents who are considering foregoing vaccinations.
Responses like Francis’ frustrate doctors like Ketyer, who said he realizes no amount of evidence he presents will sway anti-vaccers’ beliefs.
Ketyer also said it’s important for adults to keep up on immunizations throughout their lives because immunity from childhood diseases can wear off and they become at risk for other vaccine-preventable diseases.
Maher said she tells parents she has three children who have all been vaccinated, and she would not give them anything that would harm them.
“The benefits definitely outweigh the risks and everyone should have their vaccines,” she said.
Ketyer agrees.
“I think vaccines really are the miracle of 20th-century medicine, and along with antibiotics and better sanitation they are why we’re living up into our 80s,” he said. “Polio, measles, meningitis, these things were real 20 years ago. Kids were dying and survivors were having permanent problems. This is something we can put in the history books.”