Inside immunizations: Parents weigh the risks and benefits
Lana Quinn of Waynesville has lost friends, been called crazy and was turned away from a pediatrician’s office because of her decision to not vaccinate her three sons.
Waynesville resident Janet Presson’s son was diagnosed with autism at 2 years old, shortly after he received his scheduled vaccines. She isn’t against vaccinations completely but feels like small children are over-immunized at a young age.
Katie Seymour of Sylva is an adamant supporter of vaccinations and believes parents should be required to vaccinate if they want to send their children to public schools.
Canton mom Darcia Sirianni said the risks associated with vaccines aren’t worth the slight chance her children might contract a rare disease.
Despite their different opinions about vaccines, all these parents have done extensive research on the topic and feel confident in their conclusions.
Vaccinations have become a polarizing issue that has been exacerbated by the recent outbreak of measles in 17 states. The once-eradicated disease seems to be making a comeback and has a majority of the medical community concerned for the public’s safety as more people decide against immunization.
Measles was considered eliminated in the United States in 2000, but the Centers for Disease Control and Prevention reports there were 644 cases in the U.S. in 2014. The largest outbreak hit unvaccinated Amish communities in Ohio last year.
More than 100 people have contracted measles since Jan. 1, after the first case was linked to an out-of-country visitor at Disneyland. According to the CDC, the majority of people who have gotten the measles are not vaccinated.
While measles is considered eradicated in the states, it still hits underdeveloped countries each year. The CDC reports that an estimated 20 million people get measles and 146,000 people die from the disease each year worldwide. If measles can return to the states, healthcare professionals are worried about resurgence of other diseases they say can be prevented by vaccines, including polio, Hepatitis B, pertussis and rubella.
N.C. immunization law
North Carolina law requires immunizations for every child in the state. Every parent or guardian is responsible for ensuring that their children receive required immunizations unless the parent receives a medical or religious exemption.
If a parent with a religious exemption decides to get just one vaccination for their child, the exemption is voided. Some students receive a medical exemption because of compromised immune systems.
Parents starting their child at a daycare or public school have to present vaccination paperwork or their exemption, but the exemption isn’t any type of formal documentation.
“There is no form for religious exemptions; parents write a note and sign it, stating they have a bona fide religious belief opposing immunizations,” said Carmine Rocco, the head of the Haywood County Health Department.
The public health departments have vaccination statistics for a majority of students in the public school system, but they don’t keep stats on homeschooled children.
The 60,950 homeschools in the state are required by law to keep students’ vaccine records or exemptions on site, but no one is enforcing that law. The state keeps no records of religious or medical exemptions.
During the 2013-14 schools year, there were 1,944 homeschooled students being taught in 1,265 homeschool sites in Haywood, Jackson, Swain and Macon counties.
Unvaccinated in schools
Bill Nolte, associate superintendent for Haywood County Schools, said the school system follows the state laws regulating immunizations unless a parent receives a religious or medical exemption.
“If they have a religious exemption, we stick that note in the folder where the immunization records usually are, but it’s not a lot,” he said. “I feel pretty confident that if we have a measles outbreak in North Carolina, a vast majority of our students will be in pretty good shape.”
If the schools did have some sort of outbreak, whether it is measles or chickenpox, Nolte said the schools have the capacity to determine which students haven’t been vaccinated within 24 hours and decide whether those children need to be removed from the school to prevent the spread of the outbreak. He added that the schools would rely on direction from the local health department before making that call.
With such a small percentage of children not vaccinated, Nolte said, the school system hasn’t received any complaints from parents. Even if there were complaints, he said they would be misdirected.
“We don’t make state law, so I would encourage them to communicate with the General Assembly if they want something changed,” he said. “Many of us have strong religious beliefs, and we honor other people for having those too.”
Seymour, a mother of three, grew up with a physician father and a nurse mother. She vividly remembers interviewing her father for a school project when she was 13 and asking him what he considered the greatest medical advancement in his lifetime.
“He said, ‘Without a doubt it has been vaccines,’” Seymour said. “It’s been because of vaccines I’ve never had a friend lose a child to chicken pox or smallpox.”
She had her first child at the height of the autism/vaccination media hype. Celebrity Jenny McCarthy was all over TV talking about how vaccines made her son autistic. And even though Seymour grew up with medical professionals as parents, she still questioned whether vaccinations were safe.
“It was scary — I read a lot of literature and the doctors gave me info sheets about vaccines,” she said. “Knowing it was a concern for me, my dad would read medical journals and keep me updated.”
Her children all received vaccines as recommended and experience little to no side effects. But what really sealed the deal in her mind is when McCarthy publically said she was wrong and apologized for all the parents who had listened to her claims.
“What scares me for these moms is when we have these outbreaks — there is no doubt there is a link between that and not vaccinating their children,” Seymour said.
She knows parents are only trying to do what’s best for their kids but said public health should be a greater priority than individual rights.
Quinn and her husband are second-generation non-vaccinators after they experienced bad reactions to vaccines as babies. She received her six-month MMR vaccines in 1984 and had a horrible reaction, including a 104-degree fever and projectile vomiting. Her parents began digging into the research, which wasn’t as accessible as it is today, and decided not to vaccinate her again.
She was homeschooled for a few years, attended public school and then got a degree that required her to spend a lot of time in a hospital. At 30 years old, she’s never had a serious illness except for chicken pox as a child.
When it came time for her to have children, she did research online and read many books on the subject but she just didn’t find enough positives to outweigh the risks.
“I’m not wholeheartedly anti-vaccine, but I wholeheartedly think parents should have a choice,” she said. “I need serious information proving effectiveness and a guarantee there aren’t the risks.”
Quinn said she nursed her children to pass on a strong immune system and her family is focused on great nutrition to keep them healthy. Her 5-year-old son goes to Haywood Christian Academy and the younger children are still at home.
“It was surprising that they hadn’t run into someone not vaccinated before, and they didn’t really know how to deal with me at first,” she said. “But I do have the religious exemption because I don’t believe God created us flawed.”
When it comes to her children mixing with vaccinated children, she said she doesn’t see the threat to public safety. If they do come in contact with something — a cold or stomach bug — they stay home, isolated to prevent spreading anything.
“My kids aren’t a public safety risk if others are vaccinated,” she said. “If those parents feel vaccines work, then my child shouldn’t affect them.”
Sirianni said she made the conscious decision not to vaccinate her two children when they were babies, but now at ages 16 and 11, they are both vaccinated.
She received a religious exemption, but then family pressured her to vaccinate her son for pertussis (whooping cough) because it ran in the family. Sirianni said she asked the health department if she could just get that one vaccine without getting the others and was told that wouldn’t be a problem.
“But then I got a letter in the mail (from the health department) saying my religious exemption didn’t apply since I got one,” she said. “So months later he had to get the other shots — five in one day.”
She later vaccinated her daughter because she was going on a trip outside the country.
In her research, Sirianni found that most of the diseases doctors vaccinate against are not life-threatening. She said it didn’t make sense to vaccinate a baby for a sexually transmitted disease like Hepatitis B, and it didn’t make sense that a 10-pound baby and a 200-pound man should receive the same vaccine.
“If you get the mumps and measles it doesn’t kill you, and you can still get them with the vaccines,” she said.
Quinn, Sirianni and Presson are all concerned about the ingredients used in vaccines. They will never be able to accept that it is safe to inject substances like mercury into a young child’s body.
Presson, a former nurse and current owner of A Small Miracle, which provides services for children and adults with autism, feels like her son might have had a better quality of life had she not vaccinated.
At 14 months old, her son was meeting developmental milestones and speaking clearly, but after his vaccines at 15 months, he stopped speaking, he stopped meeting his milestones and one side of his face started drooping. Doctors diagnosed him with autism when he was 2 years old.
“We immunized my son until we brain injured him,” Presson said. “We’re injecting babies and adults with carcinogens and neurotoxins — that’s not safe.”
Charles Toledo, a pediatrician with WNC Pediatrics and Adolescent Care in Sylva, said extreme side effects from vaccines are very rare and the benefits are great.
“The data is super strong for the positive effects of immunization,” he said. “The benefits far outweigh any risks of vaccines.”
In his 30 years of practicing medicine, he has noticed an increase in the number of children not being vaccinated. He believes that everyone should do their part to vaccinate for public health reasons, but he also understands that parents have the right to decide.
When he looks at the drop-off in diseases once vaccines were introduced, there’s no doubt in his mind that vaccines are effective. He also doesn’t want to see any of those diseases return.
“Measles is a terrible disease — it causes extreme high fever and people do die from it,” Toledo said. “There are rare forms that result in encephalitis that can be fatal.”
He said online research isn’t always a reliable way for parents to decide whether to vaccinate because it’s hard to seek out objective information.
“Case reports or testimony are important, but when you look at how rare those are, I think that’s not always obvious,” he said.
Another misperception is that vaccinated people are completely protected from people who are not. That’s because vaccines are not 100 percent effective. They significantly decrease the odds of catching something but some people still get sick. For example, the pertussis vaccine is known to wane after age 9, Toledo said. Pertussis isn’t deadly for a 9-year-old, but it could be very dangerous if passed on to a baby.
“If enough people in society are not immunized, all of a sudden we have a critical mass that can spread the disease,” Toledo said. “We could end up with a significant population of children with full-blown diseases that can pass it along.”
Rocco said he hasn’t noticed an increase in non-vaccinated children at the Haywood County Health Department.
“If anything, we have noticed an increase in the number of people bringing children in for vaccinations, in part due to new and revised N.C. immunization rules and requirements, and eligibility criteria for vaccine usage through the North Carolina Immunization Program,” he said.
Even though the percentage is a small one, Rocco said it is still a major public health concern in today’s mobile society. With the current measles outbreak affecting 102 people across 14 states since Jan. 1, he said, it only takes one sick person to begin the transmission of disease to those around them.
“Vaccination is the most important strategy in the prevention of measles and other diseases like whooping cough, polio and meningitis,” Rocco said. “The community is better protected when all people who can be vaccinated are current on their immunizations.”
“An ounce of prevention is worth a pound of cure,” is what Rocco tells parents who are apprehensive about getting their children vaccinated. The health department staff also points to facts from the CDC.
Newborn babies are immune to many diseases because they have antibodies they got from their mothers, but Rocco said that immunity goes away during the first year of life. A child less than a year old may not be strong enough to fight off a disease if they are not vaccinated.
“Before vaccines, many children died from diseases that vaccines now prevent, such as whooping cough, measles and polio,” Rocco said. “Those same germs exist today, but because babies are protected by vaccines, we don’t see these diseases nearly as often.”
Immunizing individual children also helps to protect the health of the community, he said, especially people who can’t be immunized for medical reasons and the small proportion of people who don’t respond to a particular vaccine.
Some of these diseases can be fatal in rare cases and also can be costly because of doctor’s visits, hospitalizations and medications. Sick children can also cause parents to lose time from work, Rocco added.
Link to autism
Toledo said he tries to figure out a parent’s true concerns when they ask about vaccines. He said the most common notion is the alleged link to autism or other developmental delays.
A study was published in a British medical journal in 1998 outlining Dr. Andrew Wakefield’s research paper claiming a link between vaccines and the increased number of autism cases. The article was retracted in 2010 and Wakefield lost his license for falsifying data. Even though the article was retracted, the claim continues to be a concern for parents.
“In my 30 years, I can’t remember an article being retracting from a peer journal — that was a big deal,” Toledo said.
He said continued research has resulted in a better understanding of chromosome abnormalities occurring in children diagnosed with autism. He said genetic testing information from autistic children is still being compiled and patterns are starting to emerge showing abnormal chromosome sequences.
Toledo said children can have a genetic predisposition to autism and other factors can trigger its manifestation — like an infection or certain food products. Toledo said more advancement is needed in the genetic testing before it’s conclusive.
“So I tell parents that it seems like there’s a huge genetic component (in autism) and that vaccines do not cause autism,” he said.
Presson has a much different opinion based on extensive research and her own personal experience with her son. Since Wakefield lost his license, she said, his research has been replicated.
“Wakefield never said vaccines cause autism,” she said. What he did say was that there was a large group of children with autism who also had unexplainable stomach issues. The common denominator was that those autistic children had a vaccine strain of measles found in their gut that children without autism did not have.
Still, Presson isn’t completely confident in studies from medical journals. Most receive substantial funding from big pharmaceutical companies that push vaccines.
“I have no doubt that they become doctors to help people, but they don’t realize they’ve been brainwashed in medical school,” she said. “They want to believe vaccines are safe and effective, but I think they will be jumping off buildings when the truth comes out.”
Common substances found in vaccines
• Aluminum gels or salts of aluminum, which are added as adjuvants to help the vaccine stimulate a better response. Adjuvants help promote an earlier, more potent response, and more persistent immune response to the vaccine.
• Antibiotics which are added to some vaccines to prevent the growth of germs (bacteria) during production and storage of the vaccine. No vaccine produced in the United States contains penicillin.
• Egg protein is found in influenza and yellow fever vaccines, which are prepared using chicken eggs. Ordinarily, persons who are able to eat eggs or egg products safely can receive these vaccines.
• Formaldehyde is used to inactivate bacterial products for toxoid vaccine (these are vaccines that use an inactive bacterial toxin to produce immunity). It is also used to kill unwanted viruses and bacteria that might contaminate the vaccine during production. Most formaldehyde is removed from the vaccine before it is packaged.
• Monosodium glutamate (MSG) and 2-phenoxy-ethanol are used as stabilizers in a few vaccines to help the vaccine remain unchanged when it is exposed to heat, light, acidity or humidity.
• Thimerosal is a mercury-containing preservative that is added to vials of vaccine that contain more than one dose to prevent contamination and growth of potentially harmful bacteria.
For children with a prior history of allergic reactions to any of these substances in vaccines, parents should consult their child’s health care provider before vaccination.
By the numbers
Number of students in public school systems not vaccinated
Haywood County: 53 out of 7,500 students
Jackson County: 31 out of 3,716 students
Macon County: 25 of 4,400 students
Swain County: 15 out of 1,985 students
Required vaccinations in North Carolina
• Hepatitis B
• Hib Disease
• Pertussis (whooping cough)
• Varicella (chickenpox)