Preventable diseases on the rise as more parents defer, refuse vaccines

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.

Experts say fueling that rise 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 Thursday, Oct. 20, 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 discharging families from their practice for continued refusal of all vaccines. That compares to Minnesota, the lowest at .9 percent, and the overall average of 21 percent.

Those pediatricians reported seeing 1 percent to more than 50 percent of parents delaying or altering the recommended vaccine schedule and up to 40 percent 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, according to 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 ten diseases before a child can enter kindergarten. Some shots, such as the DTaP, 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 enrolled, but more than double the amount from just eight years earlier when 1,778 of the state's 513,072 students had religious exemptions.

Terri Thornton, nurse consultant for the Iowa Department of Public Health's immunization program, said Iowa consistently has a high compliance rate for children entering kindergarten, at about 95 percent.

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.

She pointed to the 236 religious exemptions in Johnson County and 403 in Linn County.

Measles and other highly contagious diseases can spread when even just 5 percent of a population is unimmunized.

“All it takes is a traveler coming back from an endemic area,” Thornton said.

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, finding a correlation between the onset of autism symptoms 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, who question the effect of those substances on a child's development.

Parents should do their homework when it comes to vaccines, she said.

The UI's Murph, however, said parents - not old enough to remember the ravages of diseases like polio - can sometimes be misled.

“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 net.”

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

While a risk exists with any medical procedure, Murph said studies show over and over again that benefits of vaccines outweigh the risks. That includes the flu shot, with influenza claiming about 36,000 lives annually.

Dr. Mark Reinertson said about 1 percent of parents at his office at Cedar Rapids Pediatrics refuse vaccinations.

Reinertson tries to convince those parents of the benefits of immunization.

“That's what we do as pediatricians,” he said. “To 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.”

FYI

Don Callaghan, Bureau Chief of the Iowa Immunization Program, noted that Iowa's immunization rates generally are among the top 10 in the country.

The Iowa Department of Public Health provides free vaccine through the Vaccines for Children Program. Iowans age 18 and younger are eligible for the program if they are enrolled in Medicaid, uninsured, underinsured, American Indian or Alaskan Native.

See details at: www.idph.state.ia.us

For more information on vaccines, see www.immunize.org

The East Central Iowa Autism Society, offers meetings and free information at its office at 642 10th St., Marion.

For more information, call (319) 431-9052 or see:

www.eciautismsociety.org