More Families Are Shunning Inoculations

The New York Times | March 2, 2008
By Fran Silverman

AS states move to require more vaccines for school-age children, an increasing number of parents are saying no to some of the inoculations. They are seeking exemptions from the state in growing numbers, citing religious reasons or saying that they believe the vaccines will do more harm than good.

This fall state lawmakers in New Jersey approved a requirement for flu and pneumonia shots for preschoolers, and two other shots — one for meningitis, and a booster against tetanus, diphtheria and pertussis for sixth graders. Connecticut health officials are considering requiring the diphtheria, pertussis and tetanus booster, and a chicken pox and mumps booster for school-age children and a flu and Hepatitis A shot for children entering preschools. In January, New York started requiring a pneumonia vaccine for preschool children in day care and the DPT booster shot for sixth graders and is considering requiring flu shots for preschoolers in day care.

“With the sheer number of vaccinations recommended there is more of a backlash, more parents with questions,” said Mick Bolduc, epidemiologist for the Connecticut Department of Health’s immunization program.

The resistance of some parents persists despite the overwhelming consensus among scientists and health officials that vaccines are essential for public health and that they do not cause conditions like autism. 

Last week, in fact, an advisory panel for the Centers for Disease Control and Prevention said that all children ages 6 months to 18 years should receive an annual influenza shot. Flu has been widespread in almost all states this year.

Currently, flu shots are recommended for children from 6 months to about 5 years.

A pediatrician, Leo Distefano, of West Hartford, Conn., who is a member of the state’s chapter of the American Academy of Pediatrics, said women were asking about vaccines before they even gave birth. “In almost every prenatal visit, it’s brought up,” he said. “There’s more and more of a consumer mentality. People are really cautious about just sticking with the routine schedule.”

Katherine Silvan, 37, a hospice minister and social worker from Stamford, Conn., refused vaccines for her infant son at the hospital shortly after she gave birth last year, out of concern for his health. “I’m not trying to be extreme and say no vaccines,” she said. “I appreciate that we don’t have polio in this country because of the vaccines. But it should be our personal choice.”

New York, New Jersey and Connecticut allow for medical and religious exemptions, but the requirements for such exemptions differ in each state. In New York, individual school districts decide on exemptions, and how vigorously school officials question parents varies. In Connecticut and New Jersey, residents need only fill out a form for religious waivers. In all three states, medical exemptions require notes from doctors. 

Some parents say that either exemption can be hard to obtain regardless of state regulations. Lawmakers in New York and New Jersey have introduced legislation to add a “conscientious objector” exemption to give parents more alternatives if they want to opt out of vaccines for their children. Nineteen states already have such laws.

Less than one percent of school-age children in each state have exemptions from vaccines, but the numbers are going up. In Connecticut, 904 preschool and school-age children had either religious or medical exemptions in 2006, up from 845 in 2005. 

In New York 3,006 students entering pre-K, kindergarten and grades one through 12 received religious exemptions and 971 medical exemptions, which is almost double the percent of the school-age population with exemptions in 1999. In New Jersey in 2006, 1,474 children received waivers for religious reasons and 449 for medical, from 242 religious and 485 medical waivers in 1990.

SOME of the resistance to vaccines comes from parents who believe there is a link between a vaccine preservative called thimerosal and autism despite scientific studies that have failed to show any causal link between the two. The studies have been conducted by major health organizations like the Centers for Disease Control, the Food and Drug Administration, the Institute of Medicine and the World Health Organization.

A study published in November by the Centers for Disease Control showed that death rates for 13 diseases that can be prevented by childhood vaccinations are at an all-time low in the United States, showing the value of a regular program of vaccinations to the public good, doctors from the center said.

“We realize parents are going to have concerns, and rightly so,” Mr. Bolduc from Connecticut’s health department said. “But we feel very strongly in following the national recommended schedule. The risks from vaccines are outweighed by the benefits.”

Nevertheless, some parents say they want to make their own decisions for their children.

Jaime Polatsek, of Trumbull, Conn., stopped allowing vaccinations for both her children after autism was diagnosed in her daughter, Sophie, at age 4. Ms. Polatsek said she was always uncomfortable with the inoculations and had insisted the pediatrician spread out the shots. She said she wasn’t aware when her children were infants that she could seek a religious or medical waiver.

“They give you sheets at the pediatrician’s office about the vaccines, but they don’t tell you that you can choose not to vaccinate,” Ms. Polatsek said. “I had to learn through other people about the exemptions.”

Rita M. Palma, of Bayport, N.Y., sought a religious exemption from vaccines for her three sons but was turned down after a hearing with school officials. She said she had become increasingly uncomfortable with the vaccines the boys were getting.

“About two years ago I hit a wall with it,” she said. “I said I was going to listen to my inner voice. The whole vaccination process is based on fear of getting diseases but I would rather put my faith in God to heal diseases.”

After submitting a written request for a religious waiver, she was questioned at a two-hour hearing by the lawyer for the Bayport-Bluepoint School District and turned down last February by the school board. The New York Civil Liberties Union is now pursuing her case.

“It is unbelievably traumatic to have your religious convictions questioned,” Mrs. Palma said. “For schools to be in the religious sincerity business is just outrageous.”

Sue Collins, co-founder of the New Jersey Alliance for Informed Choice in Vaccination, said parents often face a variety of roadblocks when seeking vaccine exemptions in the state.

“We see schools decline letters, or tell parents that clergy must write letters,” she said. “Parents are being harassed and being asked to do things above and beyond the law.”

Assemblywoman Charlotte Vandervalk, a Republican from Bergen County, who introduced a conscientious exemption bill for vaccines, said parents shouldn’t have the burden of proving a religious or medical reason to refuse vaccines.

“This is America; you don’t force it on everybody,” Ms. Vandervalk said.