Sharp rise in parents saying no to vaccines

08/26/01
WENDY Y. LAWTON
The number of Oregon children missing one or more vaccinations because of religious reasons
increased sharply during the last school year.
For nearly a decade, the percentage of children with religious exemptions for immunizations
hovered around 1 percent, according to the Oregon Health Division. This spring, the figure
jumped from 1.4 percent to 2.7 percent. That's at least 3,600 kids.
But many families aren't finding faith. They're joining the anti-vaccination movement. Convinced
that shots are dangerous, unnecessary or unhealthy, a small but passionate group of parents is
using a broadly worded state rule to opt out of shots required for school and day-care attendance.
The choice is legal. Under Oregon's exemption rule, religion is defined as "any system of beliefs,
practices or ethical values." Some parents do believe immunizations go against God's will. But a
church letter isn't required. Parents simply sign a state health form. No questions asked.
Hank Collins, the health director in Jackson County, put it plainly: "That rule is so big, you could
drive a truck through it."
Jackson County has one of the most persistently high exemption rates in the state. Ashland, in
particular, is a hot spot. County figures show that an estimated 12 percent of Ashland children
have religious exemptions for shots. At one preschool, the number of kids exempted runs as high
as 34 percent.
Public health officials and pediatricians are taking notice. A health department draft plan for
Jackson County calls for everything from focus groups to immunization fairs. Fearing disease
outbreaks in the county and other places, advocates this fall will launch a statewide vaccine
education campaign.
"Vaccines aren't perfect," said Dr. Mary Brown, a Bend pediatrician. "But the risks of adverse
reactions are far less than the risks from the diseases themselves. I've treated children over the
years who had seizures and hearing loss from haemophilus influenzae. My brother had polio."
But many parents -- and young doctors -- have never seen polio, measles or other illnesses that
largely have been wiped out by vaccines.
They do, however, hear stories about kids who've had fevers, speech problems or other side
effects after getting shots. Or they've read claims that vaccines cause autism, asthma, diabetes,
brain damage.
"I'm not ready," said Victoria Johnson, a Medford mother, "to play that Russian roulette."
Fear and uncertainty aren't the only reasons Johnson and other parents opt out of shots. These
families, on the whole, say they are health conscious. They breast-feed, buy organic, forbid junk
food.

So the idea of injecting children with live or dead viruses, often mixed with chemicals such as
formaldehyde, goes against their parenting principles. It also goes against their belief in the
body's ability to protect and heal itself.
Take John Schmidt. The Silverton chiropractor has never vaccinated his six children, including
two grown sons who contracted whooping cough as children. Schmidt said the boys nearly died.
"But today they're healthy," he said. "Statistically, I was better off with my decision."
Distrust grows Slapping themselves with labels ranging from pro-life Republican to environmentminded Democrat, these anti-vaccine parents don't like being told what to do. They distrust drug
companies and federal regulators. They do their homework. And the more they read, the more
they question.
The Internet offers plenty of fodder.
Some online information is true. Shots can cause fevers and, in rare cases, severe reactions
such as seizures. Thimerosal, a preservative containing mercury that recently was phased out of
vaccines, is under fire in Oregon courts and under study by the National Institutes of Health.
But other postings are not proved. Controlled research studies have not clinched a connection
between vaccines and disorders such as autism.
Yet some possibilities are packaged as certainties.
There's no doubt, for example, that the number of children diagnosed with autism is increasing. At
the same time, the number of shots in Oregon required to enter kindergarten has gone from 10 in
1997 to 15 today. Some families believe there's a connection.
Or parents have heard of -- or seen -- children falling ill after getting a shot. Was the vaccine the
culprit?
There is always a chance, said Dr. Paul Cieslak, manager of the Health Division's communicable
disease unit. But Cieslak said the environment, genes and general health also could be to blame.
"Too many people are making cause-effect associations that can't be supported," Cieslak said.
"The science isn't there."
No absolute proof Science, however, is at a disadvantage in the brewing vaccine battle.
The Internet, where many safety claims crop up, is quick and cheap. Research, which tests such
claims, is slow and expensive. Science can't give some parents what they're really after:
irrefutable proof that shots aren't to blame for elusive and incurable conditions such as autism.
The research is reassuring, said Dr. Robert Chen, chief of vaccine safety and development
activity at the federal Centers for Disease Control and Prevention. But it is always evolving.
"We don't use absolutes in science," Chen said. "We can't, because we're not God."
Improvements in vaccine study and surveillance are under way. The CDC will spend $1.7 million
this year to start a national network of research centers that will train doctors to better spot and
treat adverse reactions and investigate what role biology and genetics may play.

Barbara Loe Fisher, head of the National Vaccine Information Center, a watchdog group, said
such an individualized study will go a long way toward addressing parents' concerns.
"For too long, we've focused on a one-size-fits-all approach," Fisher said. "But let's start looking
at why some children don't handle vaccines. If you don't look for the answers, you won't find
them."
Focus on today Public health officials aren't focusing on the future. They're worried about now.
Unvaccinated children weaken what's known as "herd immunity," a community's ability to ward off
infectious disease when enough people are protected. Dips in preschool vaccination rates, for
example, helped fuel a national measles epidemic between 1989 and 1991 that sickened 55,622
people, sent 11,251 to hospitals and killed 125 children and adults.
In Oregon, the viral infection gained its foothold in Jackson County. Dozens of cases were
recorded, and hundreds of young people were sent home from schools. In Kennewick, Wash.,
two women died.
When outbreaks occur, kids who haven't been immunized are at much greater risk of getting sick.
A study published in December in the Journal of American Medical Association showed that
exempted kids were 22 times more likely to contract measles and six times more likely to get
whooping cough than peers who had shots.
But outbreaks aren't common, said Nancy Church, manager of infection control at Providence St.
Vincent Medical Center in Portland. And parents hear more about vaccine problems than they do
about the diseases they prevent. Church said it's time for a reality check.
"Parents need to hear both sides of the issue," she said. "We need to get all the facts on the
table."
That's why the Oregon Partnership to Immunize Children, the pro-shot coalition Church leads, will
bring a CDC physician to Medford and Portland to speak in October. Health care providers will
learn about the anti-vaccine movement and how to answer parents' questions with proven data.
At the meetings, and in the coming months, the coalition will distribute dozens of vaccine
education guides. A video, "Vaccines: Separating Fact from Fear," will be sent to private doctors
offices and public clinics.
The materials are unabashedly pro-vaccine. But the groups that created them don't take drug
company money; that's a deliberate decision made to gain credibility with skeptics.
A handful of anti-vaccine advocates will continue their own campaign to change Oregon's
immunization law. A bill to allow parents to opt out of shots for philosophical reasons died in the
Legislature this year. Bob Snee, a Portland parent and attorney, plans to reintroduce the idea in
2003.
"If you decide to vaccinate, that's your choice," Snee said. "But parents who make another
decision should have a choice, too." You can reach Wendy Lawton at 503-294-5019 or by e-mail
at wendylawton@news.oregonian.com.