The rates of Ohio students who aren’t vaccinated for personal or religious reasons has nearly tripled in the past decade, although the numbers remain low.
Recent outbreaks of measles and mumps across the country have reignited a national debate about vaccination.
MORE: TIMELINE OF VACCINES | OHIO KINDERGARTEN IMMUNIZATION RATES
About 14.3 percent of Clark County kindergartners and 3.6 percent in Champaign County entering public schools are not fully up-to-date on their immunizations, most simply because they haven’t complete their shots.
That includes less than 1 percent of students in Clark County and 1.2 percent in Champaign County who are exempt for medical, religious or philosophical reasons. That’s according to 2012-13 school data, the most recent available from the Ohio Department of Health.
One Springfield elementary school — Snowhill — had more than twice the rate of exemptions than the rest of the district.
Many have been quick to blame so-called “anti-vaxxers”— parents who have chosen not to vaccinate — for the outbreaks and at least 14 states have introduced legislation to do away with non-medical exemptions that allow parents to opt out of school requirements. Parents who opt out say they are making educated decisions.
Health officials are seeing more parents request alternative vaccine schedules or reject vaccines they believe are harmful, as well as more people who are complacent about getting their children immunized, thinking diseases like measles and polio are no longer a real danger.
For most parents it’s an education issue, said Patty Free, nursing supervisor for the Clark County Combined Health Department. Once the vaccines are explained by a doctor, they agree to the recommended schedule.
“The (immunization) rate has gone down,” she said. “We get more people that question the vaccines. They just want more information.”
Immunization rates vary by community
“There is a train crash right now,” between people who follow the standard pharmaceutical-based medical recommendations and those who want to move toward a different way of looking at health, said Barbara Loe Fisher, co-founder and president of the non-profit National Vaccine Information Center. “Vaccination is at the epicenter of this struggle between two views of how health can be maintained.”
The national center is committed to protecting informed consent. It isn’t anti-vaccine, but believes people have a right to be educated about all of the risks and make their own health decisions without government intervention.
The proportion of Ohio children 19 months to 35 months old who had received all doses of the measles, mumps and rubella vaccine in 2013 was 86 percent, down from 93.6 percent in 2010, according to data from the CDC and the Ohio Department of Health.
But nationally, immunization rates for most vaccines are up. The MMR vaccination rate went up from 90 percent to nearly 92 percent between 2009 and 2013, according to CDC data.
More recent data wasn’t available at either the state or national level, despite a requirement that every school in the state submit a report to the state each October.
The Springfield News-Sun requested the 2014-15 school year data submitted in October for all schools in the Miami Valley, but the state says it will take several weeks to provide the information. The newspaper will report those numbers when they become available.
During the 2012-13 school year, Champaign County schools had one of the highest rates in the state with more than 96 percent of students in all grades fully immunized.
In Clark County, nearly 94 percent of public school students and 91 percent of private school students in grades 1 to 12 were fully vaccinated that year. Kindergarten rates were lower, with 86 percent of public students and 89 percent of private students fully immunized.
The News-Sun attempted to collect immunization data directly from local schools. Some refused to release the number of students who aren’t vaccinated citing the Family Educational Rights and Privacy Act, and some didn’t respond to the request in time for this story.
Districtwide, less than one half of one percent of Springfield City school children weren’t vaccinated due to medical, religious or personal belief exemptions at the start of this school year, but some individual school buildings have higher rates.
Snowhill Elementary had the highest rate of exemptions in October at 2.6 percent.
Springfield schools typically have some children in October who aren’t fully immunized and don’t have exemptions, but district nurses work with parents to get those children up-to-date as soon as possible.
The number of unvaccinated children is a growing concern for Jessica Dobyns, whose 12- and 7-year-old sons attend Snowhill. And not just for the health of her children.
She and her husband got vaccinated for whooping cough recently after their sons were exposed at a church group. Her youngest son is six months old and just got some of his shots last week.
“I don’t take my little one out very often,” to prevent possible exposure while he’s unvaccinated, she said. “To me as a parent, it’s pointless for a child to suffer through something, an illness, if it can be prevented.”
Other districts had similarly high student immunization rates:
- Clark-Shawnee Local Schools has less than 1 percent of all students with exemptions and Reid Elementary had the highest rate with 1.3 percent. They reported five students with incomplete immunization as of October, but all are up-to-date now.
- Urbana City Schools reported 25 students districtwide that aren't fully immunized this school year. Only nine of those have had no immunizations at all. "Most of our non-immunized students are because of parent philosophical objections, rather than for a medical or religious reasons," said Lynn DiLoreto, district nurse. North Elementary has the highest rate of unvaccinated students at 2 percent.
- Triad Local Schools had only one exemption and five students with incomplete vaccination records among their incoming or new students as of October.
Personal choice versus public health
Parents who have chosen not to vaccinate their children said they find fighting against the established medical community to be isolating. One local mother who spoke to the News-Sun didn’t give her name because she feared her child would be negatively stigmatized.
Ashlee Palmer has been outspoken about her choice not to vaccinate after her son suffered serious, unexplained medical issues immediately after a round of shots.
“Both of our kids were immunized as babies, but then my son had a really bad reaction,” she said.
Doctors could never say what caused his sudden respiratory issues that landed him in the hospital.
“It almost took my son’s life,” she said. “But I’m looked down upon.”
She wants other parents to know she has no intention of putting children in harms way.
“I would remove my children from school (if there was an outbreak) anyways, just to protect them because they are not fully vaccinated,” she said. “I think I’m making the best, educated decision for my family.”
Doctors say it’s crucial that as many people as possible be fully vaccinated to protect the public as a whole. The more people with immunity, the less likely someone who cannot be immunized will be exposed, they say.
The federal Healthy People 2020 initiative aims to achieve a consistent 90 percent vaccination rate for 17 infectious diseases by that year.
"I'm a firm believer in the scientific evidence established for 80-90 years. It really favors that vaccines work," said Springfield physician Bernadette Deguzman. "It's one of the greatest public health interventions in history. We cured small pox. We are close to eradicating polio."
Measles was declared gone from the U.S. about 15 years ago after less than 100 cases were reported annually, mostly from outside the country. But more than 600 cases were reported nationwide in 2014 and at least 170 in early 2015, many tied to a multi-state outbreak that began at Disneyland.
Preventable diseases have deadly histories
The latest debate over vaccines started more than a decade ago when a small study linked them to autism. Scientists have repeatedly debunked that and Free said she now hears more questions from parents about aluminum. But there’s more aluminum in breast milk than in immunizations, she said.
Parents questioning immunizations isn’t new, though, and immunization rates have dropped at other times.
In the early ’90s, only about 61 percent of children treated by the Clark County and Springfield health departments were up-to-date on their immunizations by age 2, according to News-Sun reporting at the time.
The county received grants to increase awareness and availability of vaccine clinics after a national measles outbreak in 1989 killed about 100 children. About 2,720 cases of measles were reported in Ohio that year, according to news archives.
The disease remains deadly in other parts of the world, although no deaths have occurred from the most recent U.S. outbreaks.
Before a vaccine became available in 1963, nearly every American child got the measles.
Virginia Weygandt, 64, who is now the director of collections for the Clark County Historical Society’s Heritage Center, had measles as a child along with her sister.
“It’s itchy and it’s uncomfortable,” she said.
Neither suffered any lasting side effects, but many did.
Measles causes high fever and a red rash that spreads over the entire body. Infections can cause permanent injuries, including blindness and brain damage.
“I remember in school hearing about children having hearing problems after having the measles,” Weygandt said.
The CDC estimates 3 million to 4 million people got measles each year in the United States prior to 1963. Of those, 48,000 were hospitalized annually, 4,000 developed brain swelling and 400 to 500 died.
It’s one of the most contagious diseases — much more so than Ebola, according to the CDC.
"People freak out about Ebola," Deguzman said. "If there was an Ebola vaccine, how many people would line up to get it? Probably the people who wouldn't get vaccines for their children."
But when polio and measles deaths aren’t in the news, people tend to forget about the danger, said Tom Payton, former superintendent of Springfield City Schools.
“If it no longer hurts, you stop treating it,” he said.
Payton, 84, was a principal in Springfield schools from 1960 to 1969 when many vaccines were introduced.
“In those days all the immunizations were handed out by the city health department. It was an accepted requirement,” he said.
The Internet and social media have allowed the spread of information, he said, so parents with objections now are heard.
“Fortunately we have a more informed society. But when you are more informed, you question more, right or wrong,” Payton said.
Are vaccines safe?
While medical professionals almost unanimously agree that immunization is a crucial preventative health measure, vaccines have never been 100 percent without risks.
Local doctors said the most common issues they see are allergic reactions to vaccines and irritation at the injection site.
About 5 percent of people getting the measles vaccine will develop a measles rash, but aren’t contagious, said Free of the Clark County health district.
The CDC says the chances of a vaccine causing serious harm or death are extremely low.
“Getting MMR vaccine is much safer than getting measles, mumps or rubella,” according to the center’s vaccine information statement.
One out of six people will experience a fever from the MMR vaccine, one out of 3,000 could experience a seizure and one out of 1 million could suffer a severe allergic reaction.
More than 84 million doses of versions of the MMR vaccine have been administered nationwide since 2006.
Anyone who believes they or their family member have suffered adverse effects from a vaccine can report the incident to the Vaccine Adverse Event Reporting System, a database maintained by the CDC and the Food and Drug Administration.
In 2014 more than 33,500 events were reported to the system, with Ohio representing more than 1,000 of them, including three deaths and 38 hospitalizations.
The VAERS database only tracks symptoms that patients reported after getting shots so the incidents listed could be side effects of vaccines or could be unrelated illnesses.
The U.S. Department of Health and Human Services investigates claims of disability or death due to vaccines through the National Vaccine Injury Compensation Program. It has paid out more than $2.8 billion on nearly 4,000 cases since 1986.
The more than 15,000 complaints filed with the program include 1,156 deaths, although not all of those received damages.
Detractors say this is proof that getting immunized can be just as much, if not more of a health risk than forgoing vaccines.
Gary Person of Springfield got both of his sons vaccinated, but said he was concerned about the decision when he researched the possible risks.
“The side effects on some of these vaccines are worse than some of the diseases,” he said.
About the Author