School immunization opt-outs are growing

School immunization opt-outs are growing

Michele Ellson

A dramatic jump in measles cases in California has prompted readers to ask what Alameda Unified’s vaccination requirements are and how many families are opting out. State law requires children to be vaccinated against a list of diseases before entering school, but parents can obtain waivers if vaccinating their children would violate their personal beliefs.

School district spokeswoman Susan Davis said 75 Alameda Unified students have signed waivers exempting them from shots, which is less than one percent of the district’s total student body. Still, immunization data collected by the California Department of Public Health show that use of the waivers here is on the rise.

Families for seven incoming kindergartners had signed waivers saying they weren’t going to be vaccinated for measles, whooping cough, polio and a host of other diseases during the 2009-10 school year, the data show; this year, 43 incoming kindergartners had signed waivers, including 11 each at Paden and Ruby Bridges elementary schools – more than the total number at all of Alameda’s public schools just two years ago.

Parents have resisted immunizations due to fears over their efficacy and safety, with many questioning whether one vaccine – to fight measles, mumps and rubella – may cause autism. In a guide to physicians, the American Academy of Pediatrics said that studies in the U.S. and Europe haven’t found a link between the vaccination and autism; a 1998 study in the British medical journal Lancet that claimed a link has since been retracted.

Alameda Unified’s goal is to adhere to a “no shots, no school” policy and to follow state law, according to Jodi Biskup, a school district nurse. And she said a new state law may bring the district closer to that goal.

Starting this year, families who don’t want to immunize their children will be required to present documentation showing they’ve talked to a health care practitioner about the benefits and risks of immunizations and the risks of communicable diseases before getting a pass on immunizations. Previously, families could sign a form objecting to vaccinations without taking that step.

California is one of 20 states that allow families to opt out of vaccinations for philosophical reasons, an analysis of the bill says. Assemblyman Richard Pan, D-Sacramento, its author, said he’s concerned lower immunization rates will mean more disease outbreaks.

“Exposure to these preventable diseases not only places the individual child at risk, but the entire community,” said Pan, a pediatrician. “This measure would rectify this problem by creating a process where parents would be able make an informed decision for their children.”

An EdSource story on the new law published Sunday says the near-elimination of many communicable diseases has reduced fears of those diseases, which resulted in hundreds of deaths a year before immunizations against them were widespread.

It says that “herd immunity” helps protect even non-immunized people if 90 percent or more of the population has received vaccines. But the protection may not be absolute.

Citing Centers for Disease Control statistics, the story says that 82 percent of the people who contracted measles in the United States last year hadn’t been vaccinated against it, and that 79 percent of the unvaccinated patients had foregone the shots due to philosophical objections.

California has counted 51 measles cases so far this year, up from four at the same time last year. The California Department of Public Health said the number of cases – the highest since 2000, when the measles was declared eliminated in the United States – is a reminder to people to get immunized, especially if they plan to travel abroad.

“This dramatic jump in the number of measles cases is a reminder to get fully vaccinated,” the department’s director, Ron Chapman, was quoted as saying in a press release.


Submitted by Matt (not verified) on Thu, Apr 10, 2014

Thanks, this is good information. But why is the "total" number stacked on top of the other numbers in the chart? Isn't that doubling the apparent result? For example in 2013-2014 the total number of opt-outs is 43, but the chart makes it look like 86.

Submitted by Michele Ellson on Thu, Apr 10, 2014

Argh! Thanks for pointing that out, Matt. Just made a fix.

Submitted by Bette Page (not verified) on Thu, Apr 10, 2014

Sadly it will take a few local cases of death or maiming by these diseases to get people to realized they are shortening their child's life every time the let them have one of these diseases.

As someone old enough to have suffered thru all of M-M-R and chicken pox, it not fun to have them either. I still have pox scars, mommy that can't be fixed by plastic surgery.

Submitted by Tom (not verified) on Fri, Apr 11, 2014

History of communicable disease mortality and morbidity and the triumph of vaccine prevention is not known by these parents who opt out of immunizations for their susceptible progeny.

Success and eradication of childhood communicable disease afflictions has rendered most of our parent populace ignorant.

It is a matter of time for measles, mumps, chicken pox (varicella), diphtheria, pertussis and tetanus ( just to name a few) to take the lives or severely damage some of these unfortunate up immunized children.

Submitted by Tom (not verified) on Fri, Apr 11, 2014

If the fequency of occurance of catastrophic events (ie: death and morbidity from communicable disease is common enough) then parents will willingly and actively ask for and submit to proven Immunization practices for their children.

Unfortunately for the human species when the event occurance rate of death and morbidity ( as is that from conquered communicable diseases because of immjnization successes) is low then parents have no real time anxiety and purpose to require that their progeny be protected from these conquered communicable infections.

So hoes the rhythm of learning and ignorance of existence.

Submitted by Michael (not verified) on Fri, Apr 11, 2014

This is beyond disturbing. Our orthodontist is closed because someone came in with full-blown measles and exposed the entire office staff. What are the odds that it was a child unvaccinated that brought this?

It would be one thing for parents to choose not to vaccinate themselves and then get these diseases. They're adults and can make that decision, but for them to not vaccinate their children is beyond irresponsible and is simply ignorant and cruel.

As they say, you have to pass a test to get a drivers license but anyone can have a child.

Submitted by Keith Nealy (not verified) on Sun, Apr 13, 2014

Just curious. If those who have been immunized are immune, how does the fact that some have chosen not to be immunized put those who have been immunized at risk. Doesn't it only affect those not immunized? Do the immunized contract the disease, and if so are they truly immunized? Please don't flame me. Can we stay civil? I'm just asking about the logic here.

Submitted by Sarah (not verified) on Mon, Apr 14, 2014

As a parent with a child beginning kindergarten at Paden this fall, I am alarmed and a little angry. While there can be medical reasons to forego vaccinations, obviously that can't account for all the unvaccinated. Such behavior will be putting all the children (even vaccinated) at increased risk. And there's nothing I can do about it.

Submitted by Michele Ellson on Mon, Apr 14, 2014

Hi Keith: My understanding of the risks at this point are that in addition to themselves being at risk of contracting one of the diseases vaccines are given to protect against, children (and adults) who aren't vaccinated put other susceptible people at risk - babies who haven't been fully immunized yet and older adults whose protection has maybe weakened over the years. If 90 percent or more of the local population is immunized it's believed that they offer a "herd immunity" that protects people who aren't immunized or whose immunity may be compromised in some way. Less than that, and the herd immunity apparently goes away. (It's probably fair to note also that there are children who don't get immunized due to medical reasons, and I would speculate that they could be at risk also.)

EdSource posted a chart Friday showing a county-by-county breakdown of the percentage of kindergartners who have been fully vaccinated, and that's here: They're saying 88.8 percent of kindergartners in Alameda County are fully vaccinated - a little less than the 90 percent number.

Submitted by Sarah (not verified) on Mon, Apr 14, 2014

In addition to herd immunity protecting the unvaccinated (or un-vaccinatable, due to medical concerns), it also protects the vaccinated group from the fact that vaccines are themselves not always 100% effective. So if a vaccine is 95% effective, it means that 5/100 vaccinated could still contract disease if exposed. If enough people are vaccinated, the group is still protected from a major outbreak, because the 5% failure rate is not enough to overcome the fact that most are protected and disease cannot spread through the population.

Submitted by Keith Nealy (not verified) on Fri, Apr 18, 2014

I'd like to point to an article challenging the effectiveness of "herd immunity."

The epidemiologist appears to have good data to question the effectiveness of this concept from a purely medical standpoint.

Submitted by Isara (not verified) on Sat, Apr 19, 2014

Hi Keith:

Consider also that these diseases get stronger, every time they're available to overcome an existing vaccine. I am 7 months pregnant, and the R in my MMR vaccine has worn down and I need a booster. But I can't get one, because the booster - and, more importantly, exposure to infected people - would mean that my fetus would end up with a whole variety of nasty birth defects or a miscarriage. Because of people not immunizing themselves or their children, the percentage chance of my catching and transferring rubella to my fetus goes way up.

As to your link, consider your source. That website is run by vaccine-deniers (despite the very large volume of studies that have looked at supposed health risks and have not found a link), who are vehemently anti-science, in favor of alternative medicine. Having some skepticism against "the system" is one thing, but to do so without reason or by using specious "facts" to confirmed a pre-decided opinion is another.

Submitted by Keith Nealy (not verified) on Thu, Apr 24, 2014

Well, the reason I submitted the link was because it appears to be by a reputable doctor who cites published studies in reputable journals. They certainly do have an anti-vaccine point of view, but I haven't heard refutation of the problems associated with mass vaccinations cited in the studies. Did you read the entire link? Are you disputing the published studies? It's possible to be in favor of mass vaccinations without reason as well. It is because of the apparent scientific evidence of problems with mass vaccinations that I provided the link. It is not anti science to cite scientific studies, unless you can refute them scientifically.

It doesn't appear that vaccines are going to completely eliminate diseases. In fact the over-use of medications is producing greater resistance to them. Isn't this part of what you're concerned about, -that you need stronger and more frequent innoculations? Maybe we should take a step back and take another look at where we're headed.

Submitted by Sarah (not verified) on Fri, May 9, 2014

Please look into the whooping cough outbreak at Earhart.