Rise in preventable diseases tied to refused vaccinations

Parents who refuse immunizations may not know risks

Nurse Joyce Willis administers a chicken pox vaccine to 10-year-old Alexis Gales of Cedar Rapids on Oct. 17 at Cedar Rap
Nurse Joyce Willis administers a chicken pox vaccine to 10-year-old Alexis Gales of Cedar Rapids on Oct. 17 at Cedar Rapids Pediatrics. (Cliff Jette/The Gazette)

The 1-month-old baby didn’t stand a chance, even with the best care available at University of Iowa Hospitals and Clinics.

Suffering from whooping cough and in grave condition when brought to the Iowa City hospital, the tiny boy became one of the victims of a vaccine-preventable disease.

Dr. Jody Murph, associate professor of pediatrics at the University of Iowa Children’s Hospital, said while infants that young cannot be vaccinated against whooping cough — also known as pertussis — their caregivers can.

“His parents had never been told they needed the Tdap (tetanus, diphtheria and pertussis) vaccine in order to protect their baby,” she said. “They have to live with their son’s death the rest of their lives.”

Whooping cough is one example of a vaccine-preventable disease that has skyrocketed in recent years, with 27,550 cases reported in the United States last year, including 427 in Iowa. That’s more than double the 10,454 cases of pertussis reported in 2007.

Fueling that rise, experts say, is the choice of parents to forego immunizations for their children.

Nationwide, 85,000 cases of vaccine-preventable diseases are reported every year, according to a study presented this week at the annual meeting of the Infectious Diseases Society of America.

Respondents to a survey of pediatricians in nine Midwestern states showed Iowa has the highest rate — 39 percent — of doctors discharging families from their practice for continued refusal of all vaccines.

Those pediatricians reported seeing 1 percent to more than 50 percent of their parents delaying or altering the recommended vaccine schedule and up to 40 percent of their patients refusing at least some vaccines.

“It’s like spinning a roulette wheel,” said Murph, who was not involved in the study. “You don’t know what you’re going to be exposed to.”

The most frequent reasons given for refusing vaccine were fear of autism, too many shots and serious side effects, noted study author Dr. Tom Tryon of Children’s Mercy Northland Urgent Care Center in Kansas City, Mo.

Measles/mumps/rubella, the human papilloma virus and influenza shots were vaccines parents most often refused or deferred.

Iowa requires immunization against 10 diseases before a child can enter kindergarten. Some shots, such as the Tdap, require multiple doses. State law allows parents with a religious belief against immunization to claim a non-medical exemption by filling out a card and having it notarized.

During the 2010-2011 school year, 4,206 students in kindergarten through 12th grade had a religious exemption in Iowa. That number is less than 1 percent of the 506,002 children in school, but more than double the amount from just eight years earlier when 1,778 of the state’s 513,072 students had religious exemptions.

Iowa’s immunization rates generally are among the top 10 in the country, with about 95 percent of children entering kindergarten having their vaccines, according to Terri Thornton, nurse consultant for the Iowa Department of Public Health’s immunization program.

The rate for 2-year-olds is substantially lower, at 78 percent, according to the U.S. Centers for Disease Control and Prevention.

“We are still concerned when we have clusters,” Thornton said, pointing to the 236 religious exemptions in Johnson County and 403 exemptions in Linn County.

Cindy Dircks, board president of the Marion-based East Central Iowa Autism Society, said a majority of the group’s parents are wary of vaccines, believing in a correlation between the onset of autism and their children’s immunizations.

“They took their kids for their vaccinations and something happened,” she said, noting her own son’s language regressed and he exhibited other unusual behavior after receiving his shots.

Dircks cited ingredients in vaccines, such as mercury and aluminum, as the basis for objections of many parents. Parents should do their homework when it comes to vaccines, she said.

The UI’s Murph said any connection between autism and vaccine was debunked years ago. Autism has been increasing worldwide, even among children who are not immunized, she noted.

Parents — not old enough to remember the ravages of diseases like polio — can sometimes be misled, she said.

“The antivaccination people are very vocal,” she said. “There is no doubt parents want to make good decisions for their children, but it’s hard for them to assess what they read on the (Internet).”

While a risk exists with any medical procedure, Murph said studies show over and over again that the benefits of vaccines outweigh the risks.

Dr. Mark Reinertson said about 1 percent of the parents he sees at Cedar Rapids Pediatrics refuse vaccinations for their children. He tries to convince them of vaccine benefits.

“That’s what we do as pediatricians,” he said. “Try to prevent life-threatening diseases or long-term consequences of those diseases.”

Jim Gales of Cedar Rapids, who brought his children, Alexis, 10, and Gavin, 6, to Reinertson’s office for their annual checkup, did not have to be swayed.

“We have no issue with that,” Gales said. “They’re up to date on all of their shots. We don’t get to live in a bubble.”

On the Net

  •  The Iowa Department of Public Health provides free vaccine through the Vaccines for Children Program. The program is open to children age 18 and younger if they are enrolled in Medicaid, uninsured, underinsured, American Indian or Alaskan native. Details:
  • For information on vaccines:


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