By Wendy Y. Lawton (Oregon Live.com)
August 26, 2001
The number of Oregon children missing one or more vaccinations
because of religious reasons increased sharply during the last school year.
For nearly a decade, the percentage of children with religious exemptions
for immunizations hovered around 1 percent, according to the Oregon
Health Division. This spring, the figure jumped from 1.4 percent to 2.7
percent. That's at least 3,600 kids.
But many families aren't finding faith. They're joining the anti-vaccination
movement. Convinced that shots are dangerous, unnecessary or
unhealthy, a small but passionate group of parents is using a broadly
worded state rule to opt out of shots required for school and day-care
The choice is legal. Under Oregon's exemption rule, religion is defined
"any system of beliefs, practices or ethical values." Some parents do
believe immunizations go against God's will. But a church letter isn't
required. Parents simply sign a state health form. No questions asked.
Hank Collins, the health director in Jackson County, put it plainly: "That
rule is so big, you could drive a truck through it."
Jackson County has one of the most persistently high exemption rates in
the state. Ashland, in particular, is a hot spot. County figures show that
an estimated 12 percent of Ashland children have religious exemptions for
shots. At one preschool, the number of kids exempted runs as high as 34
Public health officials and pediatricians are taking notice. A health
department draft plan for Jackson County calls for everything from focus
groups to immunization fairs. Fearing disease outbreaks in the county and
other places, advocates this fall will launch a statewide vaccine education
"Vaccines aren't perfect," said Dr. Mary Brown, a Bend pediatrician.
"But the risks of adverse reactions are far less than the risks from the
diseases themselves. I've treated children over the years who had seizures
and hearing loss from haemophilus influenzae. My brother had polio."
But many parents -- and young doctors -- have never seen polio, measles
or other illnesses that largely have been wiped out by vaccines.
They do, however, hear stories about kids who've had fevers, speech
problems or other side effects after getting shots. Or they've read claims
that vaccines cause autism, asthma, diabetes, brain damage.
"I'm not ready," said Victoria Johnson, a Medford mother, "to play that
Fear and uncertainty aren't the only reasons Johnson and other parents
opt out of shots. These families, on the whole, say they are health
conscious. They breast-feed, buy organic, forbid junk food.
So the idea of injecting children with live or dead viruses, often mixed
with chemicals such as formaldehyde, goes against their parenting
principles. It also goes against their belief in the body's ability to protect
and heal itself.
Take John Schmidt. The Silverton chiropractor has never vaccinated his
six children, including two grown sons who contracted whooping cough
as children. Schmidt said the boys nearly died.
"But today they're healthy," he said. "Statistically, I was better off
Distrust grows Slapping themselves with labels ranging from pro-life
Republican to environment-minded Democrat, these anti-vaccine parents
don't like being told what to do. They distrust drug companies and federal
regulators. They do their homework. And the more they read, the more
The Internet offers plenty of fodder.
Some online information is true. Shots can cause fevers and, in rare
cases, severe reactions such as seizures. Thimerosal, a preservative
containing mercury that recently was phased out of vaccines, is under fire
in Oregon courts and under study by the National Institutes of Health.
But other postings are not proved. Controlled research studies have not
clinched a connection between vaccines and disorders such as autism.
Yet some possibilities are packaged as certainties.
There's no doubt, for example, that the number of children diagnosed
with autism is increasing. At the same time, the number of shots in
Oregon required to enter kindergarten has gone from 10 in 1997 to 15
today. Some families believe there's a connection.
Or parents have heard of -- or seen -- children falling ill after getting
shot. Was the vaccine the culprit?
There is always a chance, said Dr. Paul Cieslak, manager of the Health
Division's communicable disease unit. But Cieslak said the environment,
genes and general health also could be to blame.
"Too many people are making cause-effect associations that can't be
supported," Cieslak said. "The science isn't there."
No absolute proof Science, however, is at a disadvantage in the brewing
The Internet, where many safety claims crop up, is quick and cheap.
Research, which tests such claims, is slow and expensive. Science can't
give some parents what they're really after: irrefutable proof that shots
aren't to blame for elusive and incurable conditions such as autism.
The research is reassuring, said Dr. Robert Chen, chief of vaccine safety
and development activity at the federal Centers for Disease Control and
Prevention. But it is always evolving.
"We don't use absolutes in science," Chen said. "We can't, because we're
Improvements in vaccine study and surveillance are under way. The
CDC will spend $1.7 million this year to start a national network of
research centers that will train doctors to better spot and treat adverse
reactions and investigate what role biology and genetics may play.
Barbara Loe Fisher, head of the National Vaccine Information Center, a
watchdog group, said such an individualized study will go a long way
toward addressing parents' concerns.
"For too long, we've focused on a one-size-fits-all approach," Fisher said.
"But let's start looking at why some children don't handle vaccines. If you
don't look for the answers, you won't find them."
Focus on today Public health officials aren't focusing on the future.
They're worried about now.
Unvaccinated children weaken what's known as "herd immunity," a
community's ability to ward off infectious disease when enough people
are protected. Dips in preschool vaccination rates, for example, helped
fuel a national measles epidemic between 1989 and 1991 that sickened
55,622 people, sent 11,251 to hospitals and killed 125 children and
In Oregon, the viral infection gained its foothold in Jackson County.
Dozens of cases were recorded, and hundreds of young people were sent
home from schools. In Kennewick, Wash., two women died.
When outbreaks occur, kids who haven't been immunized are at much
greater risk of getting sick. A study published in December in the Journal
of American Medical Association showed that exempted kids were 22
times more likely to contract measles and six times more likely to get
whooping cough than peers who had shots.
But outbreaks aren't common, said Nancy Church, manager of infection
control at Providence St. Vincent Medical Center in Portland. And
parents hear more about vaccine problems than they do about the
diseases they prevent. Church said it's time for a reality check.
"Parents need to hear both sides of the issue," she said. "We need to get
all the facts on the table."
That's why the Oregon Partnership to Immunize Children, the pro-shot
coalition Church leads, will bring a CDC physician to Medford and
Portland to speak in October. Health care providers will learn about the
anti-vaccine movement and how to answer parents' questions with
At the meetings, and in the coming months, the coalition will distribute
dozens of vaccine education guides. A video, "Vaccines: Separating Fact
from Fear," will be sent to private doctors offices and public clinics.
The materials are unabashedly pro-vaccine. But the groups that created
them don't take drug company money; that's a deliberate decision made
to gain credibility with skeptics.
A handful of anti-vaccine advocates will continue their own campaign to
change Oregon's immunization law. A bill to allow parents to opt out of
shots for philosophical reasons died in the Legislature this year. Bob
Snee, a Portland parent and attorney, plans to reintroduce the idea in
"If you decide to vaccinate, that's your choice," Snee said. "But parents
who make another decision should have a choice, too." You can reach
Wendy Lawton at 503-294-5019 or by e-mail at
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