Vaccine resisters attract attention from medical authorities

Medical authorities want to determine why certain populations shun vaccines

Register-Guard | Jan 10, 2009

By Anne Williams

Today in Ashland, a team of specialists under the auspices of the federal Centers for Disease Control is trying to figure out why so many parents there shun vaccines for their children, and what might change their minds.

Ashland caught the CDC’s attention because of its unusually high concentrations of under-vaccinated children — 28 percent of kindergartners, according to Jackson County records. It’s one of three communities around the country where the advisory team to the CDC’s Immunization Safety Office is holding public forums to gather feedback.

The CDC could easily pose the same questions in Eugene.

Records from Lane County public and private schools for 2007-08 reveal sizeable pockets of resistance in several Eugene schools, nearly all of them in the south end of town.

At the private Eugene Waldorf School on McLean Boulevard south of 28th Avenue, three of every four of its nearly 200 students lack one or more of the vaccines Oregon requires against 11 diseases. Their parents have filled out religious exemption forms, which allow them to skip vaccines due to “any system of beliefs, practices or ethical values” — with the understanding that the child might be excluded from school in the event of an outbreak.

Down the hill at The Village School, a public K-8 charter school with a similar enrollment, 58 percent of students are missing one or more vaccines; Next door at Ridgeline Montessori Public Charter School, 31 percent are. Among regular public schools, Family School, an alternative school on the Cesar Chavez Elementary campus, posts the highest exemption rate, at 54 percent.

Those compare to a Lane County average of 4.6 percent and a statewide average of just 2.8 percent as of 2007.

Such hot spots — generally any school with at least 100 students and an exemption rate of 10 percent or more — are troubling, said Betsy Meredith, nursing supervisor for communicable disease at Lane County Public Health, which provided the school-by-school data.

“This is a concern for us in public health, because it does mean that certain populations that are collected together in a school are vulnerable to these vaccine-preventable diseases,” she said. “One of the great worries, though, is they could expose someone who is in a much more vulnerable population, such as infants or the elderly or people with compromised immune systems.”

Parents cite a host of reasons for opting out of vaccines. Many worry about potential harm from metals and chemicals found in vaccines (the most-feared, mercury, was removed from most childhood vaccines after 2001), and some suspect a link between vaccines and autism. Many question how well the developing immune system of a young child can handle the onslaught of multiple vaccines.

Others say they want their children to develop immunity naturally; some even expose their children purposefully to chickenpox and other diseases considered relatively benign. Some are mistrustful of the establishment, citing ties between doctors and profit-driven pharmaceutical firms.

Though all vaccines carry a small risk of adverse side effects, Meredith said the science plainly comes down on the side of immunizing. A growing body of studies debunk any connection between vaccines and autism.

“The fear factor plays such a huge role, a disproportionate role,” she said.

Too many people, Meredith added, have lost sight of the risks of communicable diseases such as polio and measles — largely because vaccines have so effectively prevented widespread outbreaks and deaths in recent decades. But the risk from an under-immunized population, she said, remains “very, very significant.”

Those are the same messages Jimmy Unger, a pediatrician at PeaceHealth’s south Eugene clinic, delivers to his patients, but it doesn’t always resonate.

“I would think it’s about 10 percent that are either modifying the recommended schedule or not immunizing,” he said. “It’s my job to educate them about the science and refer them to what I consider good sources. I try to talk to them about the benefits to their child and the slight risks to their child, but I also try to educate them that this isn’t just about protecting their own child, but also about protecting the community. In an ideal world, a parent might want every child immunized except for their own — that way they get all the benefits and none of the risk. But that concept doesn’t really work.”

The schools with especially high concentrations of religious exemptions — 25 percent or more — share more than just geography: All attract families seeking an alternative to mainstream education. The Eugene Waldorf School, for example, takes a go-slow approach to teaching reading, emphasizing art, play, imagination, movement and music. At Family School, children learn in mixed-age classrooms and celebrate world cultures at the “Rainbow Conference.”

Two of the schools with high opt-out rates — HomeSource in west Eugene and Logos Academy in Springfield, with 23 percent and 22 percent exemption rates, respectively — are resource centers that serve home-schooled children.

It stands to reason that parents seeking educational alternatives might also take a nontraditional approach to medical matters.

“We are a school that is culturally creative and we attract people who have different, culturally creative values, if you will,” said Martha Collins, principal at The Village School, which follows most elements of the Waldorf model, inspired by the theories of philosopher Rudolf Steiner. “(Skipping vaccines) is certainly not something we proselytize or encourage — in fact, our primary responsibility is to make sure we do have all the paperwork.”

Marina Taylor, the Eugene Waldorf School’s public relations and enrollment coordinator, said many families there embrace alternative health care, “and quite a few of our parents are natural health care practitioners themselves.” Some are physicians, too, she noted, and she suspects they vaccinate.

Taylor said she believes Waldorf parents as a group are “very deliberate” in their health care choices, researching issues carefully on their own and weighing the evidence and individual circumstances.

Parents echo that — although at least one, Melanie Glock, said it took a crisis before she paid attention. When she had her second child, 7-year-old Maisie, she went ahead with the recommended vaccine series, just as she had with firstborn Julia, 8. Developing normally her first year, Maisie then had the measles/mumps/rubella and chickenpox shots.

“Within a month, she had lost almost all of her language — she just completely stopped talking,” Glock said. Soon thereafter, the girl seemed to retreat within herself, avoiding eye contact, eschewing play, engaging in repetitive behaviors.

Maisie was diagnosed with autism, and Glock — who said she researched every ingredient in the vaccines her daughter received — is convinced mercury and possibly other toxins played a key role.

“The autism movement has a really interesting expression — they say environment loads the gun and vaccines pull the trigger,” said Glock, who moved with her family from the Seattle area to Eugene last February.

Through diet change and extensive — and controversial — biomedical treatment aimed at detoxifying the body, Maisie recovered, her mother said, and though a bit quirky would not be diagnosed as autistic today.

With 3-year-old Tate, who attends the Waldorf preschool, Glock said there was no question about it: He would go without vaccines.

“I cut my foot open and I refused to even get a tetanus shot,” said Glock, who advises other parents as a volunteer with the autism advocacy group Generation Rescue, which urges caution on vaccines and espouses biomedical treatment.

Another Waldorf parent, Rebecca Emerson of Eugene, felt comfortable following the standard vaccine schedule with her two daughters, Lena, 6, and Laura, 3. No one in her family had ever had a bad reaction to a vaccine before, she said.

“From the beginning I was pretty confident about vaccines,” said Emerson, noting it’s a hot topic among Waldorf parents and she’s in a distinct minority. “I read the literature and kept myself really well-informed.”

Emerson understands the views of parents who choose otherwise, and doesn’t believe the research cited by the medical establishment necessarily tells the whole story. But as she sees it, “I feel like it’s also a service to the world to get vaccinated, if you can help prevent the spread of diseases.”

Taylor said there haven’t been widespread outbreaks of disease at the Waldorf School in recent memory, though chickenpox tends to pay a yearly visit and last year there were three cases of pertussis, or whooping cough.

Health officials acknowledge erasing vaccine skepticism is a tall order, but pledge to keep trying. To that end, Lane County Public Health this year will survey health-care providers and a sampling of parents who choose to skip shots, hoping to glean insight on how to persuade them otherwise.