12/09/2007
Blethen Maine Newspapers
An organic diet free of processed foods, chiropractic adjustments, plenty of exercise and rest are among the things Meg Pickering thinks her kids need for their health.
Immunizations don't make the list.
Neither of Pickering's two children -- 12-year-old Alex and 10-year-old Grace -- have been vaccinated against diseases like whooping cough, polio and measles. They are among a growing number of Maine children who have not had the vaccinations normally needed to enter school because their parents have sought an exemption for philosophical beliefs.
"Based on all the research we had done and continue to do, the risks, for me, far outweighed the perceived benefits," said Pickering, a 45-year-old chiropractor in a family practice in Scarborough.
Parents in Maine have the option of exempting their children from immunizations based on health, religious or philosophical grounds, but only philosophical exemptions have increased markedly in recent years.
Philosophical exemptions in Maine have more than doubled in five years, from 174 exemptions out of 14,209 kindergartners in the 2001-02 school year to 377 exemptions out of 13,838 kindergartners in the 2006-07 school year, according to data from the Maine Immunization Program.
Skepticism about the pharmaceutical industry, a desire to follow a holistic approach to health, concerns about possible side effects and feared links between vaccines and autism are among the factors behind philosophical exemptions.
Though the number of exempted children remains small relative to the overall population, the trend reflects a growing debate among parents and raises concerns with some public health officials.
HERD IMMUNITY
Health officials say they worry about children who are not immunized both because they are at greater risk of contracting diseases and because they can undermine "herd immunity," the disease protection afforded the general population when there is a high rate of immunity among its members.
Maine is having its first outbreak of mumps in at least 12 years. The state Center for Disease Control and Prevention has directed schools to send letters to parents of non-immunized children in kindergarten through 12th grade to inform them that their children will be prohibited from attending school for at least 18 days if there is an outbreak. The University of Southern Maine notified more than 1,300 students that they had to have mumps vaccinations by last Thursday to stay on campus.
As vaccines become available for more diseases, parents are asking more questions than they did five to 10 years ago, said Dr. Christopher Stenberg, director of the pediatric clinic and Maine Medical Center. Some of the questions have their roots in a feared connection between thimerosal -- a preservative containing mercury that is no longer used in routine childhood vaccines aside from some flu vaccines -- and autism.
"They're asking why, why is this vaccine necessary, what are the reasons," he said.
Sarah Levy, the owner of Ballard House, a birthing center in Portland, has also noticed more concern among parents.
"In the last three years, the question of whether to immunize or not has definitely increased, I'd say by double," Levy said. "And families are absolutely making more choices in that whole array between not immunizing and fully immunizing."
Rebecca Diaz said her decision to not immunize her 14-month-old daughter, Estella, or the daughter who's due in April was influenced in part by her work as a chiropractic assistant and her training as a massage therapist.
Another important influence was the experience of a friend who got polio after receiving a version of the polio vaccine that is no longer used in the United States.
"You never know if your child is going to react badly. And the medical people are like 'That's just the risk you have to take.' I'm not willing to take that kind of risk. My daughter's life is way too important," said Diaz, a 27-year-old resident of Bryant Pond.
Patience Deah of Portland, meanwhile, said she never had any doubts that she would get her infant daughter, Lyssi Faith Yekeh, immunized to protect her from serious diseases. Last week, the 3-month-old got four shots -- for polio, pneumococcal conjugate, Haemophilus influenzae type b, and diphtheria, tetanus and pertussis -- and an oral vaccine for rotavirus. The appointment was difficult -- Deah said she couldn't hold her daughter because it was upsetting to see her cry so hard during the shots.
Deah said it was the right thing to do. "If it wasn't good, they wouldn't give it to her," she said.
COLLECTING MORE DATA
Proponents of immunizations say that any vaccine can cause side effects, but most are minor. The combination vaccine for measles, mumps and rubella, for example, causes fever in about one of six people and a mild rash in about one of 20. A serious allergic reaction is estimated in less than one of a million doses. Long-term seizures, coma and brain damage are reported after vaccination more rarely, and the federal Centers for Disease Control and Prevention says it's unclear whether a link can be established.
Dr. Dora Anne Mills, director of the Maine Center for Disease Control and Prevention, said the Internet is driving misinformation about vaccines. She also believes vaccines, which she called the "crowning achievements of the 20th century" are victims of their own success. Some people don't see the need for them because they haven't seen previously dreaded diseases like polio, she said.
"The word 'polio' if you talk to someone over 70, they shudder with fear," she said. "You mention polio to a young adult, there's no blood pressure change."
It's unclear whether the increase in philosophical exemptions in Maine, which is one of 20 states that allow them, reflects a broader increase.
"I think it really varies by region, state and even within states," said Dr. Lance Rodewald, director of the Immunization Services Division for the federal Centers for Disease Control and Prevention.
"It tends to be in more localized areas. This is why we want to gather systematically obtained information so we can really get a close handle on the number of exemptions," he said.
Starting next year, data on exemptions will be monitored more closely because of concerns of eroding protection, he said.
SIDE EFFECTS WORRISOME
The jump in Maine from 159 philosophical exemptions in 2002-03 to 341 in the following school year can be explained in several ways, said Jiancheng Huang, director of the Maine Immunization Program. Fears about thimerosal were growing at the time and, in 2003, Maine started implementing its vaccination requirement for chicken pox, which some parents felt was less necessary than other immunizations, he said.
The state data do not show whether a child was exempted from a particular vaccine or from all of them.
Pickering, the chiropractor, began researching vaccinations in anticipation of having children and in response to questions from patients. The same concerns that make her shun food grown with pesticides cause her to worry about some vaccine ingredients, like formaldehyde, which is sometimes used as an antimicrobial and preservative. And the risks of serious side effects, for her, outweigh the benefits touted by the medical establishment.
"Most of the diseases they vaccinate for are not life-threatening: measles, mumps and chicken pox," she said. "If they go untreated, absolutely, but they're very treatable."
While she has decided personally against immunizing her children, Pickering said, she doesn't push her perspective. For 14 years, she and her chiropractic practice partner have been giving informational talks about immunizations to help inform people.
"It's just information," she said. "People do with it what they want to do. Our objective is to help people make an informed decision."
Reader comments
Sort by: Oldest first | Newest First
Show all 10 comments
You must be a registered user of MaineToday.com to post a comment. Register or log in.