The Fight for Exemption: Should We Have a Choice in Vaccination?

By Sydney Mineer

In December, a measles outbreak occurred at Disneyland in Anaheim, California. The outbreak affected 147 people, 131 of which were Californians. On April 17, the California Department of Public Health declared the outbreak over after 42 days without a new case.

Katrina VandeBunte, a Nurse Practitioner at the Minute Clinic at the CVS Pharmacy in Glover Park, says that the measles outbreak should push the medical community to improve vaccine education.

“I think we need to do better as a medical community coming out with an across-the-board plan to get the right information out there,” VandeBunte said, “because there is no debate within the medical community whether vaccines are safe and effective or not. All of our research indicates that they are very safe— they are some of the safest medicines that we use— and they’re very effective.”

In recent years, there has been a rising trend of parents  not vaccinating their children for religious and philosophical reasons. In California, 17, 253 kindergarten-aged children  were not vaccinated under the religious and philosophical vaccine exemptions.

The trend began sometime after a now discredited 1998 study by Andrew Wakefield was published in The Lancet medical journal linking vaccines to Autism.

All but two states have exemption policies for religious reasons– 20 have philosophical exemption policies. According to the National Vaccine Information Center, for a parent to obtain a philosophical exemption, also known as the personal belief exemption, they must object to all vaccines. In Washington, Oregon and California, parents seeking a personal belief exemption must first obtain a signature from a medical doctor or other state-designated health care worker in order to file the exemption or, in Oregon, may be required to complete a state vaccine education program.

Untitled Infographic

Vaccine Demographics in the US

After the measles outbreak, California legislators began work in February on Senate Bill 277. The bill would abolish religious and philosophical vaccine exemption laws from the state. If the bill passes, California would become the third state to offer only medical exemptions.

On April 28, the California Judiciary Committee voted 5-1 that the proposed bill upheld “California and federal law that protects the public’s health and safety over individual rights,” the San Jose Mercury News reported.

Earlier this month, in response to the debate over the California legislation, Health Choice, an anti-vaccine advocacy group based in Michigan, released an ad that featured a baby having a seizure. In the video, the narrator states that the baby, Lorrin Kain, began suffering from seizures two hours after she had gotten her first vaccine shot. According to the Washington Post, the seizures caused irreparable damage, and Kain died at 15 years-old from causes resulting from her vaccinations, according to the National Vaccine Injury Compensation Program. The ad ends with a plea to preserve “parental choice” for vaccines.

Robert Kennedy, Jr, nephew of President John F. Kennedy and son of the former US Attorney General Robert Kennedy, is an ardent anti-vaccine advocate. At a rally against California Senate Bill 277 on April 8, Kennedy compared the mandate of vaccines in California to the holocaust.

“They get the shot, that night they have a fever of a hundred and three, they go to sleep, and three months later their brain is gone,” Kennedy said. “This is a holocaust, what this is doing to our country,” The Kansas City Star reported.

As part of the anti-vaccine movement, Kennedy has been promoting the documentary Trace Amounts. The film follows Eric Gladen who suffered from mercury poisoning he believes was the result of a thimerosal-induced tetanus shot. After conducting research, Gladen travels across the country interviewing medical professionals and families across the country about thimerosal, mercury poisoning and Autism.

Thimerosal is an antiseptic and anti-fungal chemical that is 50% mercury in weight, according to the FDA. It is commonly used as a preservative for vaccines.

Because the chemical contains mercury, VandeBunte said it has been removed from all pediatric vaccines.

“The research on thimerosal has been that it’s safe, but it’s been removed to decrease the barriers for children getting vaccines,” VandeBunte said, “and thimerosal is actually something that is found in a lot of different products like contact solution.”

According to VandeBunte, her patients have expressed concerns about thimerosal when coming in for vaccines either for themselves or their children.

“I think it’s really interesting to talk about,” VandeBunte said. “If people don’t want thimerosal than I say well let’s talk about thimerosal a little bit. — ‘What are your fears and do you know that it’s used in other commonly used products that are safe and effective?’ Because I think that there’s just been so much fear monger surrounding anything to do with vaccines.

This kind of fear mongering is common among the media and anti-vaccine groups. Heidi Armstrong, a business development administrator at Boeing and mother of two, feels that social media does a lot to build up misconceptions about vaccines.

“I think that everyone has the right to their opinion,” Armstrong said. “I do, however, feel that social media blows the opinions out of proportion, and it becomes something you can’t avoid hearing about.”

Kitson Jazynka, a freelance writer and mother of two, recently wrote a children’s book about wolves for National Geographic. Jazynka spent a lot of time with scientists during her research project. Aside from her experiences as a member of the media, she felt seeing an issue from a scientist’s perspective gave her a better grasp on the realities of controversial issues as opposed to the sensationalism that is often publicized in the media.

“If you look at it from a scientific point of view, you realize it’s like calculated risk,” Jazynka said. “There’s a risk that one wolf will get killed or there’s some child out there that’s going to be negatively impacted, but is it more important to save the population? That’s their focus. I think people just don’t understand that.”

Many schools across the country have vaccine policy which do not let children enroll in school if they have not gotten the required vaccinations. In Washington, D.C., D.C. Public Schools have a strict vaccination policy for all students enrolling in Preschool through 12th grade. The District’s policy is that “after 10 days of school, students who have not submitted their immunizations will be excluded from classes and supervised separately.”

Marianne Noble, a professor of Literature at American University and mother of two, sends her children to schools with vaccine policies– as do Armstrong and Jazynka.

Noble believes in vaccines so much so that she had her son vaccinated twice when his first round of vaccinations failed.

“I think vaccination is obvious– It makes sense,” Noble said. “In fact, both of my kids are adopted, my son was vaccinated in Korea and for some reason the vaccines didn’t take. We don’t know why, but we had to re-vaccinate him for everything, which we did.”

In March, a study was released that surveyed 534 doctors in 2012 about their vaccine practices. According to the New York Times, one in 5 doctors said at least 10 percent of parents had requested vaccine delays by spreading them out over more months than is recommended.

Of the patients that VandeBunte sees at the clinic, 40% are children. Most of the pediatric patients come in for sick visits, but vaccinations are quickly becoming the second most frequent service VandeBunte performs.

“I think pediatricians are trying not to alienate families,” VandeBunte said, “but I really think that more important than acquiescing to [a parent’s] alternate schedule that is based on sort of the whim and fancy of whatever blog they’re reading, that we need to spend more time with our families actually talking about healthcare and prudent measures and really how safe these vaccines are.”

Jazynka trusts her doctor when it comes to vaccinations.

“I feel like as a parent the best thing I can do, rather than get 1/8 educated reading articles online and making decisions based on that,” Jazynka said, “my feeling is I find a pediatrician that I trust and I just do what she says.”

Though Armstrong has always had her own children vaccinated, she has friends in her social circle who have spread out their children’s vaccinations “for peace of mind.”

Noble is a supporter of vaccines, but she understands parents who would choose not to vaccinate their own children.

“A lot of people talk about how they have signs of autism that appear shortly after vaccinations,” Noble said, “but I have read some stuff because my son is at a special-ed school with a lot of autistic kids. I’ve read a little bit about autism and that seems to have been very resolutely disproved– it’s just not a viable scientific thought, but people are silly. They want to be good parents.They want to be better than average.”

Jazynka knew someone whose daughter was diagnosed with Autism shortly after getting her vaccinations, but that did not discourage her from continuing to vaccinate her own children.

“A girlfriend of mine has a sister whose beautiful daughter, was a perfect baby and had a vaccine and immediately was a medical mess. I’m sure there are cases, but it’s like people are killed in car accidents, does that mean you’re not gonna drive?”

According to the CDC, prior to the Disneyland outbreak, there were large measles outbreaks in 2014 and 2013 as well. “In 2014, there were 23 measles outbreaks, including one large outbreak of 383 cases, occurring primarily among unvaccinated Amish communities in Ohio. Many of the cases in the U.S. in 2014 were associated with cases brought in from the Philippines, which experienced a large measles outbreak,” according to the CDC’s website. In 2013, the U.S. experienced 11 outbreaks, three of which had more than 20 cases, including an outbreak with 58 cases.

Screen Shot 2015-04-29 at 10.47.03 AM

Because we live in a country where measles was effectively eradicated in 2000, VandeBunte believes that the recent outbreaks should serve as a wake-up call for both parents and medical providers.

“I think that there’s a lot of misinformation. I really feel for my parents who come in who are really hesitant or really scared about vaccines,” VandeBunte said, “because I think the parents are bombarded with all kinds of information from both sides whether it’s reliable information or not. I really just try to sit down and figure out where the parents are — what are their specific concerns, what are their specific questions.”

In 2008 and 2011 when Armstrong was getting the first vaccines for her children, ages 4 and 7, there was less controversy in the media surrounding vaccines. For her, like Jazynka and Noble, the most important thing was listening to her doctors.

“To be honest, with my kids being the ages they are, the vaccination controversy wasn’t as public,” Armstrong said. ” I was told with both of my boys that they were going to receive vaccines that day and what each vaccine was for.  There was no conversation asking whether I was opposed to it or not.  I have faith in doctors.  And quite frankly, when you are sitting there with a brand new baby, you don’t feel inclined to argue over vaccinating your child.  At least it didn’t cross my mind.”


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