By MANDY SIMPSON
7:43 PM EDT, July 9, 2011
Conflicting labels are stuck to vaccines — villainous and vital. The majority of Americans credit Edward Jenner’s innovations with preventing countless Americans from getting measles, mumps, rubella, polio and other once-prevalent diseases.
But some express deep concern about risks they associate with the injections. The Kentucky Department of Public Health fueled the local debate once again this summer by announcing new immunization regulations that require more vaccines for children entering kindergarten and sixth grade.
Local pediatricians and public health officials continue to tout the importance of immunization, recognizing the regulations as an effort to align Kentucky’s schedule with federal recommendations.
However, some parents harbor reservations about the effects and efficiency of vaccines.
“We always have a few parents that don’t vaccinate,” said Eva Stone, nurse practitioner and Boyle County Schools health coordinator.
Danville pediatrician Dr. Robert Rettie cited three primary concerns that may keep parents from immunizing their children.
“The whole vaccine controversy started with measles, mumps and rubella, and the link between that vaccine and autism,” he said. “That paper has been discredited, and lots of research since that time has pretty much disproven any association between autism and MMR.”
The media — whom medical professionals criticized for sensationalizing Dr. Andrew Wakefield’s findings in his infamous 1998 study — have since produced numerous pieces contradicting the link, and, in February, David Kirby wrote a column for the Huffington Post titled “The Autism-Vaccine Debate: Why It Won’t Go Away,” puzzled at why many affluent people fear a connection science has debunked multiple times.
But Rettie said the mere mention of a causal relationship between autism and vaccines is enough to unsettle parents.
“Most of the concerns parents have about vaccines are pretty unsubstantiated,” he said.
Apart from autism, Rettie said parents worry about the amount of toxins, such as mercury, in some vaccines, which he called negligible.
Parents’ third primary apprehension is the sheer number of immunizations children must receive, Rettie said.
With the new regulations, students who attend Kentucky public schools from head start/day care through sixth grade must receive about 25 vaccinations, he said. These guard against diseases including chicken pox, whooping cough, hepatitis, meningitis, measles, mumps, rubella and polio, among others.
“We definitely do give more vaccines than we did,” Rettie said. “Fortunately, we see the benefits of those vaccines.”
American Academy of Pediatric statistics show vaccinations have reduced the number of infections from vaccine-preventable disease by more than 90 percent.
Some diseases like polio have become nearly nonexistent, decreasing from more than 20,000 cases in the early 1950s to about 10 in 1979, nearly a quarter century after the vaccine was introduced, according to the AAP.
Vaccines also help infections that are still relatively common, like chicken pox, because they prevent rapid outbreaks, Stone said.
“Kids that have been vaccinated are not as likely to transmit it through the air,” she said. “So we don’t have to be as worried if we only have one case.”
This touches on the concept of herd immunity, which physicians use to describe the decreased likelihood of a disease spreading in a vaccinated population even if one child doesn’t develop the ideal immune response.
“Not every child that receives a vaccine is 100 percent protected,” Rettie said. “That’s why we try to vaccinate as many kids as we can.”
Herd immunity did not, however, prevent about 25 vaccinated Lincoln County students from contracting whooping cough this winter, Stone said.
She said medical professionals are not entirely sure what caused the outbreak, but agree that the whooping cough outbreak could have been more severe and widespread if the students weren’t immunized.
“All those children had the illness, but none of those children were severely ill or had to be hospitalized,” she said.
Rachael FitzGerald, director of the Center for Rural Health in Danville, said the Lincoln County case may actually show the need to be more vigilant with vaccines.
A second dose of the varicella vaccine protecting against chickenpox is one of the added requirements for children entering kindergarten this year because the first injection has not reduced illness in classrooms as much as desired, Stone said.
FitzGerald said similar measures may someday be taken with the whooping cough vaccine. She acknowledged that all medical practices have risks, and vaccines are not fool-proof, but noted that parents vaccinating their children is a community responsibility.
“In the end, it goes back to the same argument,” she said. “What is the greater good, just looking after your one child or the other 400 children they’re in school with?”
The argument appeals to parents with utilitarian sensibilities, but Rettie explained that some parents find it difficult to see the scientific fact when words like autism, paralysis and seizure get used.
“You can have 10 people to tell you that something’s fine, but all it takes is one person to say, ‘I don’t know,’” he said.
A Danville mom against
Dinah Hopper of Danville is that one person, and she’s confidently saying no.
Her son Hector sat solemnly in an armchair on his 15th birthday Thursday. In the deep pools of his brown eyes, memories surfaced, momentarily shone, then drowned.
“I was the only kid in ‘Brush Up Your Shakespeare’ at West T. Hill,” he said with a weak smile. “I loved being in plays.”
Hector Hopper enjoyed and excelled in many activities after Dinah Hopper adopted him from Guatemala at age 7. The straight-A student at Danville Christian Academy ran cross country, sang in the church choir, took piano lessons and played soccer.
“My favorite position was to be a rover, basically the most busiest kid on the team,” he said.
But Hector Hopper doesn’t play sports anymore. He doesn’t sing or play instruments. He doesn’t take center stage.
After receiving a diphtheria, tetanus, pertussis (DTP) and varicella vaccine in 2009, Hector has been diagnosed with multiple medical conditions that prevent him from continuing his once vibrant childhood, Dinah Hopper said.
“He has been plagued with total body pain, severe migraine headaches, loss of memory, loss of balance,” she said. “I can’t tell you the amount of tears and anger.”
Dinah Hopper, who has long opposed vaccines, took Hector to receive the tetanus vaccine in July 2009, primarily because his sports coaches preferred players to have the immunization. She said she was less resistant to the tetanus vaccine because it targets bacterial rather than viral infections. So she called ahead to request a purely tetanus vaccine.
Employees at the medical facility, which she declined to name, assured her they could meet her specifications, but Hector’s release papers showed he’d received DTP and varicella vaccines.
“The day of the immunization, his temperature went to 104, and he immediately developed bowel issues,” Dinah Hopper said.
The most common risks of vaccines are irritation at the injection site, fever and fussiness in infants, Rettie said. In 13 years of pediatrics, he said he’s never seen a reaction more severe than those and rarely sees any negative response at all.
But Hector Hopper’s symptoms continued to worsen, Dinah Hopper said. He began experiencing severe body pain, developing food allergies and losing some muscle control and memory.
“I couldn’t get up and walk,” Hector Hopper said. “I really couldn’t do anything for, like, five months.”
Even after the worst symptoms eased, he could no longer attend school and required assistance to walk.
As a single mother with no one else to take care of Hector, Dinah Hopper left her job in the fall of 2009. The pair spent months seeing doctors and specialists, looking for a diagnosis for Hector’s condition, which they believe resulted from the vaccines. He’s now been diagnosed with eosinophilia, a condition resulting from excessive production of a certain type of white blood cell and causing stomach pain, diarrhea and other intestinal issues. He’s also received autism and auto-immune diagnoses, Dinah Hopper said. She said she’s seen about 20 medical professionals, including physicians, physical therapists and specialists.
“Most of them are unwilling to admit that this drastic change was the result of an immunization,” she said.
But three professionals, whom she declined to name, have attributed Hector’s medical problem to the vaccine.
”It just basically wasted two years of my life,” Hector Hopper said. “I already cried enough to fill a whole river.”
Exemptions to the rules
The federal government has awarded more than $2 billion to children and adults injured by vaccines under the National Injury Compensation Program established in 1986, according to the National Vaccine Information Center.
The Center for Disease Control and Prevention and the Food and Drug Administration also co-sponsor the Vaccine Adverse Event Reporting System, which allows anyone who has experienced a negative response to a vaccine or witnessed another having such a response to report their experiences.
Since medical professionals and patients alike can report to VAERS, judgments about whether the vaccine truly caused the reaction cannot be made. “Most of those reporting systems are just that, just reporting,” Rettie said. “It really doesn’t actually imply any sort of a causal relationship.” However, VAERS receives about 30,000 reports annually, with 13 percent considered “serious,” according to the CDC.
Since the system began in 1990, Kentuckians have entered nearly 4,000 adverse responses, 1,712 of which required an emergency room visit. Dinah Hopper said she does not intend to seek government compensation for Hector’s reaction because the litigation is too expensive and time-consuming for the two who spend about six hours a day at physical therapy and various doctor’s visits.
But Dinah Hopper said she wants to spread an important message to parents about their vaccine rights. Kentucky allows two exemptions from vaccinations for public school children.
One is a medical excuse given primarily to children with severe allergies that prevent them from receiving certain vaccines, Stone, the school health coordinator for Boyle County, said. For example, children with serious egg allergies cannot have the MMR vaccine. These exemptions must be approved by a physician.
The second is a religious exception and calls for the signature of a “physician, health department, or other designee,” but it may give parents more leeway to object.
Stone said the schools allow any religious denomination on the form.
“If they turn in what the state requires that we have, we don’t question that,” she said.
In Boyle County last school year, one student had a medical exemption and two had religious exemptions. Stone also works in Lincoln County and estimated that most school systems in the region have less than five exemptions a year.
Eighteen states offer philosophical exemptions for vaccines, and Dinah Hopper said Kentucky should adopt one as well.
“People should clamor for these waivers,” she said.
Whatever measures the state takes in the future, FitzGerald, with the Center for Rural Health, said one thing is for certain — people will continue to see vaccines as both hero and villain.
“It’s a debate that’s going to go on,” she said. “It’s not going to go away anytime soon.”
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