In public health circles, they are known as “exempters” – parents who for reasons of faith or philosophy choose not to immunize their children against diseases such as measles and whooping cough.
Some exempters claim that childhood vaccines contain unnatural or harmful ingredients. Others say they regard vaccination as a “dark force” that conflicts with their belief in a benevolent deity. Others are members of a religion that bars invasive procedures.
Regardless of the reason, the ranks of parents exercising nonmedical exemptions to vaccination are growing, public health officials say.
Although the number remains small and involves an estimated 2 percent to 3 percent of the roughly 3 million children who start kindergarten annually, the trend alarms some experts. They worry that parents' fears are being stoked by the misinformation about vaccines that abounds on the Internet and are using religion as an excuse to opt out of immunization. This refusal, scientists say, threatens a cornerstone of public health.
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“People are motivated by their fears,” said Paul Offit, chief of the division of infectious diseases at Children's Hospital of Philadelphia and one of the most outspoken defenders of vaccines. “Young mothers today don't see these diseases; they didn't grow up with them. Vaccines were not a hard sell” several decades ago, when people saw children killed by measles, brain-damaged from haemophilus influenzae or deaf after a case of mumps.”
Half a dozen studies, Offit noted, have found no link between vaccines and autism, one of the major objections cited by those who spurn immunization. The overwhelming consensus among scientists, he said, is that the benefits of vaccination greatly outweigh the risks.
But not all parents are convinced. Lisa Jillani, who lives in northeast Charlotte, says she thinks over-vaccination of her eldest daughter Savannah, now 16 years old, caused her to get autism. She said it was after her daughter, at age 2, was given too many vaccines at once – the DPT, polio, HIB and MMR – that her daughter's teachers alarmed Jillani to “red flag behavior.” Savannah would walk across bridges that were eight feet wide as if she was walking on a balance beam, her mother recalls.
After her daughter's diagnosis with autism at age 31/2, Jillani started researching the content of vaccines and was horrified to learn that at that time some contained mercury and aluminum. Some experts have have linked autism to some kids' inability to expel mercury in vaccines.
“The body is God's temple. I don't feel like God's temple should be polluted with these vaccines,” Jillani says.
She filed an exemption on religious grounds so her other daughter would not have to get vaccinated. She also started a state-wide nonprofit group called People Advocating Vaccine Education to educate parents about the harmful effects of vaccines, www.vaccineeducation.orgSome parents are selectively vaccinating their children. Elizabeth Kelley of Belmont remembers feeling shocked that her son Ethan was vaccinated for hepatitis when he was one month old. “It didn't seem right to give all these things to a perfectly healthy baby,” she said.
Kelley started reading articles on how vaccines could damage the immune system and possibly lead to autism.
She decided to hold off on giving Ethan further vaccinations until he turns 3 in August. “He has not had to go to the doctor in three years, and I want to say it has something to do with his immune system,” Kelley said. He'll get the tetanus shot, but she thinks the chicken pox vaccine and another hepatitis vaccine are unnecessary. “It's not like he's sharing needles with anyone or having sex with anyone,” she said.
Nationally, the claims of safety are rejected by such anti-immunization groups as Vaccine Liberation and Citizens for Vaccine Choice. They say the shots are harmful and urge parents to exercise their right to avoid them.
Two weeks ago, a Virginia-based group called the National Vaccine Information Center launched a campaign calling for “broad exemptions for medical, religious and conscientious belief reasons.” According to Barbara Loe Fisher, the group's co-founder, “forcing vaccination is a violation of human rights.”
Every state and the District of Columbia grants medical exemptions to children who are allergic to components of vaccines or whose immune systems are too compromised to benefit from them. And all but two states – West Virginia and Mississippi – allow parents to opt out on religious grounds.
In some states, parents need only sign a form claiming a religious exemption. In recent years lawmakers in 21 states, none of them local, have created “personal-belief” or philosophical exemptions that permit children to skip vaccines on the grounds that they conflict with a parent's views.
“Many states are making personal-belief exemptions easier,” said Saad Omer, a vaccine researcher at the Johns Hopkins Bloomberg School of Public Health. “Filing for an exemption should at least be a function of conviction, not laziness.”
In 2006, Omer and other vaccine researchers published a study in the Journal of the American Medical Association that examined rates of pertussis, or whooping cough, in states with personal-belief exemptions and those where nonmedical exemptions were easy to obtain.
They found that the incidence of the disease was about 50 percent higher in states with personal-belief exemptions than those without them and in jurisdictions where religious exemptions were easy to obtain than in those with more stringent requirements.
Researchers also found a substantial increase in personal-belief exemptions: The rate grew from 0.99 percent in 1999 in states that allow them to 2.5 percent in 2004.
Parents who decide not to immunize, Omer noted, are making decisions for children other than their own. No shot confers 100 percent immunity, and unvaccinated children can spread disease to those who are too young or too medically fragile to be immunized, including those suffering from cancer.
Currently, Omer noted, a measles epidemic is unfolding in San Diego, where 64 cases of the disease have been reported.
All but one of the affected children, he said, had not been vaccinated, some because they were too young for the shot, which is administered at about 12 months.
Observer staff writer Kristine Crane contributed.