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Outbreak raises vaccine exemption concerns

Posted: March 27, 2012 - 8:44am

State health officials are concerned about the rising number of people seeking vaccination requirement exemptions.

An investigation has revealed a 7-month-old child recently was exposed to chickenpox at home by an older sibling who had a religious exemption from vaccination. That exposure led to an outbreak at a child care facility on the Kenai Peninsula.

The Alaska Section of Epidemiology (SOE) on Nov. 3, 2011 was notified of the outbreak, according to a March SOE bulletin.

"The issue is that the more people, children in the Kenai case, that haven't been vaccinated against a certain disease, the higher the risk of an outbreak and spread of the disease within a given setting," said Michael Cooper, SOE infectious disease program coordinator.

Health officials are working toward education so parents stop the trend of delaying or refusing vaccination. Certain religions will continue to disavow vaccines based on their beliefs.

State regulations require that all children in public and private schools, certified preschools and licensed child care facilities are immunized for various diseases -- mumps, polio and chickenpox among others -- unless the child is exempt for medical or religious reasons. An affidavit signed by the child's legal guardian is used to affirm that immunization conflicts with tenets and practices of their church.

Alaska had the highest immunization exemption rate in the U.S. for 2010-11, at nearly 9 percent, according to the Center for Disease Control.

The pool of unvaccinated children increases the risk of vaccine-preventable disease outbreaks in the state, said Gerri Yett, SOE immunization program director.

When a parent submits a religious exemption, it exempts the child from all vaccines. People may request the exemption because their child is behind on a particular vaccine, she said. In some cases, parents claim religious objections to avoid vaccines for their kids.

"Parents may have elected to do a religious exemption for that one dose (of chickenpox vaccine) even though the child is up to date on all other vaccines," she said.

This skepticism toward vaccines is causing outbreaks, she added.

"With vaccine hesitancy that we're seeing more and more of with parents, or delaying, we're starting to see an increase in the number of outbreaks," she said.

During last year's November incident, a total of three cases occurred due to the outbreak. The first two cases infected infants too young for vaccination, and the third case infected a child with a religious exemption, according to the bulletin.

People are not required to designate what religion they practice on state exemption forms. Yett said she believes people often are not discussing the decision with a medical doctor.

People can get a religious exemption without visiting a doctor, she said.

"The SOE is working with health care providers to be more vocal with parents, explaining that there are consequences to delaying or deferring vaccination, or even choosing to do an exemption," she said.

The Roman Catholic Church does not fall under the category of churches asserting all vaccines should be avoided, said the Rev. Steve Moore, Archdiocese of Anchorage chief operating officer, but some vaccines conflict with the Catholic Church's ethics.

"The one that is sometimes troubling for (Catholic) parents is the HPV vaccine, and also some vaccines which consist of fetal tissue," he said. "Those can be a problem."

HPV, the human papillomavirus, is transmitted through sexual contact. The CDC recommends boys and girls within an age range starting at 9 are vaccinated against the common sexually transmitted virus.

According to Catholic bioethics leaders, pursuing universal vaccinations for sexually transmitted viruses or diseases could have the unintended effect of setting up a false sense of security for boys and girls who are sexually active. Parents also are concerned they are sending the wrong message about pre-marital sex.

Another religion-based objection to vaccines is the presence of aborted fetal tissue.

But according the CDC, some vaccines, including a mumps vaccine, contain killed viruses. The virus is cultured in human cell-line cultures, and some of these cell lines originated from aborted fetal tissue. After processing, very little, if any, of that tissue remains in the vaccine.

Many other vaccines are produced in animal tissues. Christians may find conflict due to the tenet warning not to mix the blood of man with blood of animals.

Children should receive their first dose of chickenpox vaccine between 12 to 15 months of age, and their second dose between 4 to 6, according to the SOE.

"What we saw on the Kenai was unfortunate," Cooper said. "There were people who could not get the vaccine yet because of their age. They've lost some of the immunity they had from birth."

Other than the transmitted infections, three infants too young for vaccination were kept from the facility for 21 days.

Mississippi has lowest immunization exemption rate at 0.1 percent, according to the CDC.

"The states that have no religious exemptions and fewer medical exemptions found that they're having fewer problems with outbreaks of preventable diseases," Cooper said.

Jerzy Shedlock can be reached at

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shanaloshbaugh 03/27/12 - 10:06 am
this is dangerous

My understanding is that some years back some Kenai Peninsula babies died of whooping cough following an instance like this. The event was not publicized, but it should have been. Maybe local physicians can comment on cases they've seen?

akmd5 03/27/12 - 11:54 am

I am a local physician, and although do not profess myself to be an expert in this particular topic, I thought I might offer some personal perspective that hopefully will spur more informative responses.

I’m an Emergency Physician, and in my practice, I have seen an increase in parents declining to vaccinate children for a variety of reasons but the most common, as the article notes, is for ‘religious preferences’. Although my experience is anecdotal, I do find this interesting, as almost nobody who uses this answer is able to provide further information regarding which religion they are referencing or the specifics of why the religion they ascribe to denies children immunizations. As the article notes, this does at least raise the question of whether this answer is being used as a means to an end.

The article also highlights an important tenant of epidemiology as it pertains to vaccination. When some choose not to vaccinate, the choice they make puts others at risk (in addition to their own children). When a few individuals are not protected against infectious disease, the disease is allowed a niche to establish itself and does so in the form of an outbreak. This typically involves young children who have either partial immunity or no immunity as of yet (effects the innocent, not just those who are declining vaccination) but can involve adults as well. Illnesses like whooping cough and chicken pox are good examples, because they have not been eradicated completely, and yes, can be serious or even fatal. This can be heartbreaking to witness, particularly, in a time when we have an easy, safe and reliable way of preventing them. Although no part of medicine is 100% safe, and though many will disagree with this, the facts are that the complication rates and potential harmful effects of vaccines have not been shown, over time, to outweigh the benefits they offer individuals and society as whole.

It should also be noted that this is a highly emotional topic, and not all will feel this way. It would not be surprising to see a surge in comments from parents offended by either this article, my comments or both. I do, however, agree with the author, that physicians need to be more vocal to patients about consequences of this to their patients. This is best done through the physician with which the patient has an established relationship. I am surprised to find that most parents endorsing this philosophy are blissfully unaware of how this choice could potentially adversely effect their child, and get most of their information from the internet, not their doctor. Full disclosure is an appropriate trend in current day medicine, and even parents who do not change their behavior would be better served knowing the potential ramifications of the choices they are making for their own children and how these choices can effect others.

In addition, I would encourage those who comment to use this venue as a way to convey their thoughts to create meaningful discussion and avoid personal attacks. Open dialogue can be a wonderful pathway to education and, hopefully, changes in behavior that will allow our state to catch up in ways it is obviously significantly behind, for the safety and longevity of our children.

Angus M. Warren, MD

Offcenter 03/27/12 - 01:02 pm
trust in danger

I appreciate that the writer of this piece appeared to be trying to be fair and balanced, but unfortunately failed.

I am one of those parents who has deliberately delayed if not completely skipped certain vaccines for my children. And I resent the implication that I am doing this because I am naive or ill-informed. Quite the contrary. When my first child was born, my midwife was all a flutter with anti-vaccine sentiments, which I thought crazy. My first child had all of her shots (save HepB) on schedule in her first year. But I kept hearing grumblings and did some research. At that time, polio vaccine was still being administered as OPV, the live virus. Granted, this was almost 18 years ago, but even then, it had been almost 20 years since a case of "wild" polio in this country. All cases of polio in that time period had been caused by the VACCINE. But the ever wise "powers that be" still continued to use the vaccine, taking children who were NOT at risk for polio and putting them AT RISK for polio because the medical establishment could not change its paradigm.

I lost faith, to say the least. And if you do a little research, you will find that all vaccines carry some risk--risk of health damage and even in small number of cases, death. The numbers might sound small to the authorities, but they don't feel so small when it is your child who is hurt or killed.

The recent push for the chickenpox vaccine on closer examination sounds equally disastrous. The argument is that chickenpox can develop into more threatening illness, something that happens only occasionally in cases involving children. Adults who contract chickenpox, however, are at a high risk for complications. The CDC's website admits that "The length of protection/immunity from varicella-containing vaccines remains unknown." Compound that with the fact that adults are notorious for not getting boosters, does not sound like an organization that has me or my child's best interest at heart in the long run.

So if you want to run with the herd and immunize your child on schedule, go for it. Me, I'm going to take my time and do my own research and think for myself. Because I'm not a cow running in a herd.

jlmh 03/27/12 - 11:26 pm
I appreciate that the Clarion

I appreciate that the Clarion published a balanced article that dared to discuss some of the religious objections that parents might have against vaccines. As the parent of an infant, I would hope that parents who feel passionately about this would take responsibility for those choices - meaning staying at home with your children when they are young, if you choose to delay vaccines, or homeschooling them entirely if you choose to never vaccinate. Of course this plea only applies to matters of public health. The HPV vaccine is a private matter, since children aren't at risk for contracting it simply by attending daycare or public school. But pertussis and chicken pox (which is odd for me to say, since my generation all contracted it) is unavoidable and involves suffering. Please don't ask other families to risk their health, suffer pain, medical expenses and sick leave for your decisions. If it means that much to you, you should be willing to make the necessary sacrifices to keep your children out of daycare and school. Let's not let this tragedy happen again for the babies in our community and their families.

arctictern 03/29/12 - 08:54 am
Full disclosure for vaccines

"Full disclosure is an appropriate trend in current day medicine, and even parents who do not change their behavior would be better served knowing the potential ramifications of the choices they are making for their own children and how these choices can effect others."

I wish that full disclosure was applied to the risks of vaccines as well. It is difficult to find a doctor that will discuss the potential ramifications of the choices parents are making when they choose to vaccinate, it is often hard to find one that even knows the ingredients in vaccines or how to get single vaccines. Perhaps Dr. Warren could be a recourse in our community for this. You don't have to be an expert to be knowledgeable of the risks of vaccines, just educating parents on the fact that the chicken pox vaccine does not last in the body and when their children reach adulthood they will be at risk for shingles would be a great place to start.

I would have to say that as a parent who chooses not to vaccinate I am also a bit offended that we are the ones referred to as uneducated. When it comes to discussions on vaccines I am most often the one that has information on the history of vaccines and epidemics, current issues, risks on both sides, possible out comes, and so on. The parents I talk to that vaccinate often have, "I love my child" or "my doctor told me to" as their only reason.

I agree with Dr. Warren, "Open dialogue can be a wonderful pathway to education and, hopefully, changes in behavior that will allow our state to catch up in ways it is obviously significantly behind, for the safety and longevity of our children." But I'm hoping that open dialog will push our state forward on a path it is already on to lead the way toward health that first does no harm.

arctictern 03/29/12 - 09:20 am
one more thing

I realize my comment about discussing vaccines with other parents was too broad. Parents who do their research and choose to vaccinate have my highest respect. They generally fall into the catagory of, "we are traveling over seas where the risk of contracting _____ out weighs these _____ risks of the vaccine" or something similar.

Watchman on the Wall
Watchman on the Wall 04/01/12 - 03:13 pm
My personal opinion of

My personal opinion of vaccines for children or the flu shots freely given as well to adults have also great potential for death or debilitating healty issues.
I was afforded free flu shots when this became the rage & supposed right thing to do for public health. I got the shoot & almost died from the flu. Never More saith this man, and have never taken those supposed good flu shoots again.

As for children being vaccinated for the good of all i would add these new facts which came out this morning about children being vaccinated on time according to the Laws of the Land.
This morning news is being released that the number of kids that come down with Autism after being immunized due to Govt. laws requiring it has increased from 1-156 in 2002, to now being 1-88 in 2008, thats a 50% increase of kids coming down with Autism in six years, no telling how low that number is now 4 yrs later. It has to do with Genetics & our neurological system & how differant people respond to these differant vaccines.

Of course there will be some that will say there is no proof that the vaccines are causing this to happen and they may be correct. I will say this though, i don't think there are any cases i know of where kids that waited a few years after the age of 1 year and allowed their little bodies & brains to develope have come down with Autism.
My wifes nephew was just on the front page this week and he was a perfectly healthy baby until he got those shoots, and wam, he came down with Autism.
We cared for him on periodically and i noticed that he all of a sudden became totally isolated to anyone or any outside interferances when he was focusing on any perticular item. Nothing distracted him from his gaze. I told my wife that i thought that he was Autictic & she shared this info with her sister who got him checked out and discovered that he was indeed Autistic & treatment was begun which really helped in this case.
But this happened right after he was vaccinated.

Forgive me here but, i view this as just another attack against people that are afforded rights to still choose to regulate their children & selves for any reason, even religious. All of which has now become a War being waged by advocates for an all inclusive desire by the STATE, GOVERNMENTS to regulate everyone & everything as they wish to it's end game of a single Govt. & Single Religion for ALL, the one the Govt. says it acceptable, no others.

With the Governments continual research in Genetics & the altering or manipulation of ALL genitics, even now clooning of humans, i must say that i will never take anything that the Govt. says is good for you.
My personal opinion of the Governments of the World is that they ALL seek to redo or remake creation into a thing of the past and replace ALL Natural seeds, even Human seeds, with Genetically created altered seeds of the Unnatural kind, for the supposed good of all.
When the Govt. fines people $1 Million dollars for growing any kind of Natural foods, thats foods from Natural seeds, seeds that have not been Genetically altered, i'll say this about their plans, they are not ment for the good of anyone Period. There is even talk of fines of $50.00 & upwards for those of us that refuse to take their flu shots now being leveied

I will say this, it is still everyones Free choice, but this article is ment to incourage people to join against ALL that refuse to join the UNION of ONE, a supposed GOOD For All UNION.
It's gonna get far worse and especially against those that decide to go against this World UNIONS wishes, with Religious Freedoms being the foremost accusation against NON-UNION World Order rejectors like me & parents that refuse to risk their childrens health or ours by complying.
This is one of the first step towards segragation of those who desire a OWO and those apposed to a OWO, everyone will have to decide which way to vote, with only one FORCED Choice for ALL real soon.

Laugh now at what i say, but time will prove who is right, it always does in most cases.

Jeremiah 6:17

astrongheart 03/30/12 - 08:43 am
3 whole cases!!! OMG

This article should be in the opinion section because it is in no way an objective article. The title alone is the epitome of fear-mongering. Three children coming down with the chicken pox is hardly an "outbreak".

I am a proud mom who made the educated decision to not vaccinate my 2nd child. I wholeheartedly agree with the comment made by Watchman on the Wall.

I dutifully succumbed to peer pressure from doctors and family and had my 1st daughter vaccinated. At 18 months old she received her MMR vaccination and at the same time began regressing and losing her speech and other skills. She started exhibiting autistic behaviors. She became nearly completely non-verbal, she has many sensory integration issues, no impulse control, physical and occupational issues and engages in self stimulating (stimming) behaviors.

There may not be any concrete "proof" that vaccines lead to autism but I am not/have not taken that chance with my second child. My 2nd daughter already has a 17% chance of developing the same autistic condition as her sister so why in the world would I increase that risk and get her immunized?

The battles and struggles my 4 year old faces every day are exhausting. She receives Speech, Physical and Occupational therapies many times a week. I cannot simply ignore the fact that all of this started immediately after she was vaccinated. I will not take that risk with my 2nd daughter.

There are many other reasons to opt out of vaccinating your child, but we are forced to claim "religious" reasons so that our children can attend school. We can blame it on religion but are not allowed to simply state that we are making an informed educated decision concerning what we feel is best for our child.

I applaud parents on both sides of the fence who make informed and educated decisions about vaccinating their children. I frown upon and scold not only those who do not but also reporters who resort to fear-mongering to get attention for their writing. Come on step up and be an honest objective reporter!

Watchman on the Wall
Watchman on the Wall 04/01/12 - 03:14 pm
astrongheart, very good to

astrongheart, very good to see and hear your opinion on this issue which does seem to be a pushing against all those that refuse to submit to Govt. control in every aspect of OUR lives.
Sorry that you had to learn the hard way about vaccinating babies with your childs Autism. It does amaze me though that still the majority of folks will march to the beat of Govt. without any idea of the cliff they are being ushered towards.

Take for instance the Bird flu virus, many don't realize that it targeted mostly Hispanic/mexican people that had a certain Genome in their bodies?
There are so many things being done to control the Human race as well as replace us with nonhuman beings that it would actually boggle the mind, maybe thats why most people refuse to accept whats really going on by a few of us that are trying to warn them.

Take the movie Avatar for instance and it's message of protecting the enviroment. Look up what an Avatar is and be amazed at what you find an Avatar to be, a created being with no soul.

Enjoy our freedoms while we can as they are slipping away rapidly for a United World Union of One & removal of all apposed to it's control.

Jeremiah 6:17

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