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Official pleads for fall immunizations, despite “misinformation”

on October 1, 2008


Renee Cheney-Cohen, the coordinator of Alameda County’s immunization program, says the words with conviction. The phrase is her mantra as she reaches out to community groups, organizes free immunization clinics and works through the busy back-to-school vaccination season, insisting to parents that just because a disease isn’t common doesn’t mean it’s not dangerous.

Cheney-Cohen’s assertion is echoed by the Centers for Disease Control and Prevention (CDC) statistics, which placed incidences of vaccine-preventable diseases at all-time lows and vaccination rates among children at all-time highs in 2007.

Too bad parents don’t always believe her.

California state law requires that all children entering school and childcare facilities be vaccinated. If guidelines are followed exactly, children will receive about 30 immunizations to protect against more than a dozen illnesses by the time they are 18. In addition to the bevy of required immunizations against diseases like mumps, whooping cough and chickenpox, health departments across the state recommend “optional” immunizations, such as vaccines against the flu and human papillomavirus, which causes certain types of cervical cancer. (See related article.)

But California law, like that of most other states, also grants provisions allowing parents to decline vaccinations using medical or “religious belief” waivers that have to be signed by doctors and the parents themselves, respectively.

For more information:

HPV vaccine recommended for pre-teen girls

Vaccinations, as recommended by the CDC

All Oakland schools, including District schools, Charter Schools and private schools, require that parents provide an immunization record upon registration in order for their children to attend classes. If parents choose to not have their children immunized, they must present a signed waiver to the school every year. Immunization records are maintained at individual schools sites, allowing the administration to keep track of which student has received what vaccine. This comes in handy, especially in the event of an outbreak.

According to national CDC surveys, about three percent of the nation’s 4 million new kindergartners started school without all their vaccinations in 2007.

While records for individual students are maintained, statistics regarding the number of students entering Oakland schools in recent years were not available.

“Sometimes it’s misinformation,” says Cheney-Cohen, ticking off on her fingers the reasons why some parents decline to vaccinate. “Sometimes it’s fear. A lack of trust in the government, in the medical establishment.”

Then there’s what she calls “the Berkeley syndrome.”

“That’s when parents are so educated, but sometimes they’re educated through processes that aren’t all that scientific,” says Cheney-Cohen. “There are a lot of anti-vaccine sites online and, you know, there’s a lot of good information out there and there’s some not-so-good information.”

Dr. F. Ralph Berberich, a Berkeley-based pediatrician, is less forgiving.

“Ignorance is a growth industry,” says Berberich. “Not vaccinating is an option — a bad option, but an option.”

Berberich’s point was illustrated this January, when word spread that a non-immunized 7-year-old boy in San Diego had contracted measles, which can cause brain damage, deafness, seizures and death. Within a month, the boy’s two siblings, five schoolmates and four children with whom he had shared a pediatrician’s office were also infected.

The cases weren’t isolated, and in July, the CDC announced that the first half of 2008 was marked by the greatest boom in measles cases in the past decade, breaking the trend of dropping instances reported in 2007. At least 131 people in 15 states and the District of Columbia contracted the illness in a matter of six months, up from an annual average of 63 cases. Of those infected this year, 112 were not immunized. 

Closer to home, East Bay Waldorf School in El Sobrante was forced to close temporarily in May after 16 students at the Contra Costa County private school contracted the contagious lung disease whooping cough.

Despite the reports of national and local outbreaks, Berberich says he “constantly” faces parents who question the safety of vaccinations.

While his practice, Berkeley’s Pediatric Medical Group, does not permit children with no immunizations to enter the office for fear of increasing the risk of infection among infants too young to receive vaccinations, Berberich says he deals with a fair number of “bargainers.”

“They’ll say, ‘I’ll give this one, but I won’t give that one,'” says Berberich.

In those cases, Berberich works with the parents to ensure children get the immunizations he deems most important, the ones like measles that can be transmitted by coughing, sneezing and breathing on others.

Despite a recent spike in media coverage following a 2007 episode of The Oprah Winfrey Show in which actress Jenny McCarthy publicly claimed that childhood immunizations caused her son’s autism, Berberich says opposition to immunization is nothing new. “The fears linking them to other things, those fears have been around ever since immunizations came into being,” he says.

According to the CDC, Benjamin Franklin, for example, declined the small pox inoculation for one of his sons in case the boy should die from side effects. His son contracted small pox, and died of the disease in 1736 at the age of 4.

But just because the fears are familiar doesn’t mean doctors and public health officials can afford to be lax about enforcing immunization recommendations, says Cheney-Cohen.

“What we really try to promote is that while a waiver is absolutely within the right of the parent, it’s not something to use because they don’t want to be bothered,” says Cheney-Cohen. “The 2010 guidelines call for 90 percent of children to be up to date with their vaccines by age 2. We [Alameda County] are well over 50, well over 60, well over 70; we’re not getting 90 percent in all groups.”

Gail Paula Udkow, a pediatrian with Kaiser Permanente Oakland Medical Center, says she doesn’t think all parents can simply be convinced that immunizations are the right choice for their children.

“I’m old enough to have seen all the immunizations,” says Udkow, who’s been a practicing pediatrician for 30 years. “The vaccines are safe. Many parents have just made up their minds. If they don’t want my medical opinion, that’s their right.”

Links for more information:
Alameda County Public Health Department
American Academy of Pediatrics Childhood Immunization and Support Program
National Vaccine Information Center
U.S. Centers for Disease Control and Prevention
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