As the start of school approaches, many parents are making sure their child’s vaccinations are up to date. But others are opting out of vaccinations, a practice that’s on the rise statewide.
There are several reasons exemptions for vaccinations have grown. Among them are fear of the perceived health risks of vaccines and school staff overwhelmed with forms — all of which poses a health risk, officials say.
“Our rates are increasing regularly for a long time,” said Michele Roberts with the state department of health. “We’re one of the highest states in the country with our exemption rates.”
Roberts is the health promotion manager for the state’s immunization program.
In 2002-03, 3.8 percent of parents statewide signed forms to exempt their child from vaccines the state requires to attend school. This past year, the number climbed to 5.2 percent. This year in Snohomish County, 6.4 percent of parents opted out. In King County, it was 5 percent, up from 2.7 percent in 1997-98.
“There have definitely been more outbreaks,” said Roberts. “I don’t know if it’s caused by (increased exemptions), but the majority (of cases) have been in unvaccinated children.”
This year, there were 19 cases of measles in Grant County and about 70 cases of whooping cough in San Juan County, mostly among children and adolescents. Chicken pox broke out in various school districts. In April, 150 children were hit by a chicken pox outbreak at Jefferson Elementary in Spokane. Snohomish County saw 10 cases of whooping cough as of June.
“Higher exemption rates intuitively mean children are not protected and there is a greater risk of outbreak for diseases,” said Rita Mell, clinic manager with the Snohomish County Health District.
There are several reasons for opting out of vaccines. The state allows three kinds of exemptions: medical, religious and philosophical. Most exemptions are philosophical, Roberts said.
To get the exemption, parents sign a form. The state doesn’t collect data on why parents opt out. Underfunded schools and harried school staff have added to “convenience exemptions,” which are on the rise, Roberts said.
“It’s a lot of work for the schools they are not funded to do,” she said.
Schools have lost nurses, and sometimes the school secretary is responsible for forms.
“When sitting in front of a parent trying to enroll and they have 20 papers that they need to do to get the kid enrolled…” Roberts said. And sometimes parents don’t want the headache, so just sign the exemption line, she said.
Others are afraid of possible health affects of the vaccines.
Stories of a possible link between vaccines and autism are well-known. Internet searches turn up studies where babies die during vaccine trials, for example. Though these things scare some parents, health officials insist that science has confirmed safety of vaccinations.
There’s conclusive data on the safety of vaccines, Roberts said.
“There’s a ton of misinformation and bad press,” she said. “For the most part immunizations are much safer and the rates of side effects much lower than other types if pharmaceuticals.”
Thus far, no research proves a link between vaccines and autism or chronic illness.
A study in 1998 by a Scottish researcher, Andrew Wakefield, involved 12 children and reported a link between the two. But the study was shown to be without scientific merit by the U.K. Medical Research Council immediately after it came out.
Still, lack of scientific proof for a direct causal link isn’t enough for many parents who would rather not take the risk.
“To parents who fear that vaccines are dangerous, I would emphasize that the diseases that vaccines prevent are known to be dangerous,” said Gary Goldbaum, health officer and director of the Snohomish Health District. “Children still die of vaccine preventable illnesses.”
To reach out to jittery parents, the Web site of Public Health Seattle and King County has a list of horror stories on its Web site. Parents can read about the child who died of chickenpox and the mother in Snohomish County who caught whooping cough a week before the birth of her second child.
The site also outlines the known risks of vaccines. For example, the MMR vaccine, which vaccinates against mumps, can cause severe allergic reaction in less than 1 in 1 million. However, the death rate with mumps is 1 in 3,000 to 1 in 10,000.
“We don’t at all question the fact that parents have questions or concerns to things they’re hearing or finding on the Internet,” Roberts said. “We just really want to make sure parents have the right information to make an informed decision that’s right for their child.”
There’s a lot of information out there, she said.
“It’s overwhelming for parents,” she said.
New this year
There are some new state vaccination requirements this year:
• Sixth- and seventh-graders must get the tetanus, diphtheria and pertussis (Tdap) vaccine, a booster shot that protects against whooping cough (pertussis).
Last year the shot was required for sixth-graders. This year, seventh grade was added. More grade levels will be added each year until students through 12th grade are required to get the shot.
• Children who start kindergarten this year require a second vaccination against chicken pox (varicella), to be administered three months after the first dose.
Parents must supply medical documentation, for example a blood test that verifies immunity. The requirement also applies to children entering child care or pre-school.
Children in first, second and sixth grade can get by with one dose of the vaccine or a parent’s statement that they have had chicken pox.
Two doses are recommended for older children and adults who haven’t had the virus, but not yet required. Next year, all first-graders must have the two doses or documentation they’ve had the disease. One grade level will be phased in each year. By 2020, all students through 12th grade will need two varicella shots or documentation.
Where to get vaccinated
These local public clinics do vaccinations:
• Snohomish Health District South County Clinic
6101 200th Ave. SW, Lynnwood
425-775-3522
• Snohomish Health District Main Clinic
3020 Rucker Ave, Suite 108, Everett
425-339-5220
• Northshore Public Health Center
10808 NE 145th St., Bothell
206-296-9816
• Downtown Public Health Center.
2124 Fourth Ave., Seattle
206-296-4755
For more information in Snohomish County, see www.snohd.org or call 425-339-5220.
For more information in King County, see www.metrokc.gov/health/immunization/school.htm or call 206-296-4949.
On the rise
The percent of parents who exempt their children from vaccines has grown. The state requires a number of vaccinations for children to be able to attend school. Here are the numbers by school year for parents of kindergarten through 12th grade students who exempted their students:
2002-03: 3.8 percent
2003-04: 3.9 percent
2004-05: 4.3 percent
2005-06: 4.7 percent
2006-07: 6 percent
2007-08: 5.2 percent
In 2007-08, 6.4 percent of Snohomish County parents signed exemptions, as did 5 percent of parents in King County.
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