As students prepare to head back to school in a couple of weeks, some Vermont parents will have to decide whether to immunize their children.
Data on vaccination coverage among children in kindergarten released by the Centers for Disease Control and Prevention show that Vermont had the second-highest rate of non-medical exemptions in the country for the school year 2012-2013.
The exemptions ranged from 0.1 percent in Mississippi to 6.5 percent in Oregon, with Vermont second at 5.7 percent. Vermont’s rate has fluctuated from 5.7 percent to 6.7 percent, so this year is not out of the range, said Christine Finley, immunization program manager at the Vermont Department of Health.
After the heated debate on immunization last year and earlier this spring, parent choice advocates are surprised that the numbers weren’t higher.
The overall immunization rate for children entering kindergarten is around 90 percent, much like the rest of the country, data from the Centers for Disease Control and Prevention show.
The percentage of students entering kindergarten who were fully immunized was consistent over the past two years — 86.9 percent in 2012-2013 and 87 percent for the previous year, according to the Department of Health.
Public schools generally have a higher immunization rate than private schools. The public school with the lowest immunization rate was Barre City Elementary and Middle School with 60.4 percent of the students having received all of the required vaccines. Among schools with the highest rate is Woodstock Elementary School with 100 percent immunization, according to Health Department statistics.
Some of the statistics from the Department of Health could be misleading, said Lisa Boisvert Mackenzie, a midwife and member of the Vermont Coalition for Vaccine Choice.
More Vermont children are immunized against several of the diseases for which immunizations are mandatory, but when one child uses an exemption for one vaccine or is not up to date on all his shots, he is not included in the overall vaccination statistics, Boisvert Mackenzie said.
Children in Vermont are expected to have received vaccinations for DTaP (diphtheria, tetanus and pertussis) – five doses; and TDaP (tetanus, diphtheria and pertussis) – one dose for seventh-grade entry; polio, four doses; MMR (measles, mumps and rubella) – two doses; hepatitis B – three doses; and varicella (chickenpox) before entering kindergarten and seventh grade. The varicella vaccine was added to the mandatory list for school year 2008-2009. In total, that is more than 20 shots, Finley said.
For parents who don’t want their children to be vaccinated, a “philosophical” exemption has been in place since the mandatory immunization law was passed in 1979.
A controversial attempt in the 2012 legislative session by Sen. Kevin Mullin, R-Rutland, restarted the debate over immunization. Mullin wanted to remove the philosophical exemption for children in kindergarten and middle school.
The bill was first passed in the House, but after parents and advocates showed strong opposition, the measure failed. The updated bill, called Act 157, still contains the philosophical exemption.
Since the law was implemented in July 2012, parents must sign an exemption form
annually, acknowledging that they have read and understood educational material on immunization handed out by the Department of Education.
A study group put together by the Legislature to discuss what to do about unimmunized children and the prospect of moving vulnerable students from their local school to one with a higher immunization rate, again sparked debate earlier this year.
There is currently no plan to push for removal of the philosophical exemption during the next legislative session.
“We have not received any inquiries from the Legislature,” Finley said. “And they would come to us if they were planning on that.”
The Health Department wants to give Act 157 more time, she said. In April it launched a statewide campaign called “It’s OK to ask,” where parents can pose vaccine-related questions online.
There are four reasons parents can use to opt out of vaccinations: medical, religious, philosophical and proof of immunity. Of those students entering kindergarten who have not received a specific vaccine, philosophical exemptions were identified for one-third of the students for each vaccine, according to Health Department data.
Dr. Joseph Hagan, professor of pediatrics at the University of Vermont, is concerned about the philosophical exemption. It is in the unimmunized population these diseases and outbreaks are seen, he said.
Hagan said he has a hard time understanding why people are afraid. “These are incredibly safe vaccines,” he said. “It’s more likely to get run over by a car.”
According to Hagan, a child daily receives an average of 8,000 to 10,000 antigens, substances that are introduced to the body and stimulate the production of antibodies. When giving a 2-month-old child four immunizations about 28 more antigens are introduced, he said.
“They are confusing the issue without an argument,” Hagen said of parent-choice groups who oppose removal of the philosophical exemption.
“Parents need to take deep breath and realize that anxiety is driving their research,” he said. “Don’t read the things that are anecdotes and stories.”
Yet hundreds of people came to speak about their adverse vaccine reactions at a public hearing in March, and Jennifer Stella, president of the citizen advocacy group Vermont Coalition for Vaccine Choice, says there are still many unanswered questions about vaccines.
“No medical intervention is 100 percent safe,” Stella said. “And every family has the right to decide what is right for them and their family.”
A reason why the risks of vaccines have not gotten the same amount of attention is that most research is funded by the pharmaceutical companies or the U.S. government, which is a stakeholder, she said.
Stella, who wrote an op-ed in VTDigger earlier this year, was at first happy with the Department of Education’s new website, “It’s OK to ask.” Parents need a platform where they can discuss, she said.
But much of the information is incorrect, she said.
Another way to look at vaccination data is that since the implementation of universal vaccines, they have just grown, and vaccination rates in the U.S. and Vermont are higher than they have ever been, said Boisvert Mackenzie.
“I really come from the place of parent choice,” she said. “The right to choose is fundamental and I think each parent would have to research that for themselves.”
