Parental Concerns Regarding Vaccine Exemptions
Jun 03, 2011

Vaccine exemptions.
They’re something many parents are concerned about, and many want to be informed about.

Just this week, the Centers for Disease Control and Prevention issued their latest report on Vaccination Coverage Among Children in Kindergarten in the US for the 2009–10 School Year.  Upon first glance, the report looks pretty good.  More than half of the states reporting vaccination information to the CDC indicated that their overall exemption rates were around 1% or less.  A few states, like Mississippi, Alabama and Tennessee reported less that 1% medical or non-medical exemptions.

Image provided by the CDC

However, upon closer examination, there are some definite areas of concern.  Four states — Washington, Alaska, Oregon, and Vermont — had exemptions above 5%.  While that may not sound like a large percentage, it’s dangerously close to the herd immunity threshold for certain vaccine preventable diseases.  Take for instance the numbers in Washington State.  With the highest percentage of exemptions, the report indicates that 6.2% of WA state’s children had a parent-signed exemption form recorded for one or more vaccines.  But that is an overall state statistic.  The Seattle Time’s reports that one county in particular – Ferry County – has nearly 20% of Kindergarteners opt out in 2009-2010.
As I engage in discussions with other parents, I have heard various concerns regarding vaccine exemptions.  While reports like those we’ve seen from the CDC this week are certainly important for public health officials to get a snapshot of where we stand – state by state, and as a nation overall – parents are more interested in specific data for their own area.  In other words, they are concerned about how exemptions relate to them personally, in their own schools.
On the one hand, there will always be parents that argue about their right to choose an exemption.  The fact is they don’t need to argue this point, as exemptions are currently available in every state.  Their only restrictions on this “liberty” applies to how each state has chosen to allow for medical, philosophical or personal exemptions and the procedures that are required to apply for these exemptions.  Some states have tried to limit personal exemptions that they believe may be taken as a matter of convenience – the old, “I just didn’t have time to take little Johnny in for his shots” type of convenience.  For instance, WA state recently passed legislation that will require a health care worker’s signature on all personal exemptions in hopes that parents will take the time to understand the risks in rejecting a specific vaccine.
On the other hand, let’s consider the rights of the parents who are doing their part to protect our overall public health. The parents who are fully vaccinating their children, as recommended.  Many of these parents understand that a child’s immunizations not only benefit the children directly, but that they also contribute to overall herd immunity, thereby working to protect even those who remain unvaccinated.  Some of these parents feel that they should have the right to know how many of their childrens’ classmates are unvaccinated. After all, if there is a large enough percentage of unvaccinated children, it may be putting their own vaccinated children at risk.
Yet, there is another interesting situation to consider.  One that has been frequently discussed on our Vaccinate Your Baby Facebook page.  What is a parent to do if their child has a medical condition?  They may or may not be able to vaccinate their child fully, and yet vaccine preventable diseases pose a serious health risk to their children?  They rely on herd immunity – the same herd immunity that may be threatened with a large percentage of unvaccinated children in one concentrated area.  How can they be assured that their child is not at an increased risk of disease due to the personal decisions of other parents in their child’s school.  Do they have a right to know the exemption rates of the school their child is attending?
In a conversation with a mother from our Vaccinate Your Baby Facebook page, Sue Robinson explained her concerns, “I understand that in some religions they do not believe in getting their children vaccinated. I am ok with that (it is their right).  My problem is, I want to know which students in my daughter’s school have not gotten them. With my daughter’s health issues, I need to know these things. She is so easily prone to getting sick due to her weakened immune system from not only her heart/asthma/allergy issues but, from being premature as well. I haven’t tried but, I’m wondering if I confronted the school about my concerns, if they are allowed to give me that type of information.”
Of course, the issue comes down to privacy.  Unfortunately, it seems unlikely that parents will ever be provided with specific immunization information for their children’s school.  However, why wouldn’t it be acceptable to provide a school specific immunization statistics to parents, exclusive of anything that could identify exemptors by name?  When parents request a personal vaccine exemption, are they not doing so based on their belief that they are entitled to a decision based on “informed consent”.  Well, I say it’s time that parents who vaccinate their children demand similar liberties.  Information regarding specific exemptions may help alert parents to an increase risk of contracting certain vaccine preventable disease.  They should be entitled to that information.  Maybe with this information in hand, parents will begin to see that immunization decisions impact more than just themselves.  Maybe then more parents will be encouraged to become active immunization advocates within their own community and use their influence to help educate those who use exemptions as a matter of convenience.

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