Calling the Shots

By Jennifer Crumrine 

More and more students attend school every day without vaccinations. And parents have a lot of questions, including should the government be able to mandate what goes in a person’s body? Are children unprotected against illness they’ve had vaccinations for while they’re at school because of unvaccinated children? What can schools do to protect themselves against issues that could arise as a result of unvaccinated students? These are hot button issues in the world of education and parenting, and misinformation is widespread.

What does the law say?

Each state has slightly different laws regarding vaccinations. Every state has a medical exemption. This allows children who are allergic to vaccinations or have other medical issues that prevent them from being vaccinated to be exempt. Medical exemptions must be signed by a doctor. In most states parents have two options; have your child vaccinated, or have paperwork signed denoting that vaccinations violate your religion. However 19 states in the U.S. also have a third option, which is a “personal belief exemption”.  This exemption does not need to be signed by any official.

States that allow for “personal belief exemptions” often struggled to get that legislation passed. Personal belief exemptions can be filled out for basically anything. Some states have guidelines on what they’ll accept, but for most states regulating what is an acceptable personal belief is just too difficult.

The State of Iowa does not have a personal belief exemption, however it does have a religious exemption. Sioux Center Community School District’s School Nurse Sarah TeGrotenhuis believes that misuse of the religious exemption is wrong and should possibly be illegal. “In Iowa, if parents don’t want to vaccinate their children because of personal reasons they often fill out paperwork saying that they aren’t vaccinating due to religious reasons, which is a lie, but it’s their only option if they want their children to attend school.” says TeGrotenhuis.

TeGrotenhuis faced a unique challenge this fall when the state of Iowa required all seniors to get a Meningitis booster shot. This announcement came in late summer, not allowing much time for seniors to get this done before school started. TeGrotenhuis was tasked with sending letters to parents notifying them of this new requirement. “Most parents had no problem with it. A few said they might not be able to get it done by the time school started.” said TeGrotenhuis. Only one parent said they didn’t want their student to receive the booster shot. “I don’t put in this position a lot, but when I don’t I simply tell them what is required by law and what their options are.” The parent felt that misuse of the religious exemption was wrong and ultimately opted to vaccinate her student.

Some parents feel that keeping up with the changes in vaccination laws in too difficult. “I have no problem with vaccinating my kids. Why wouldn’t I protect them against preventable diseases? But I will say that all these changes are hard to keep up with. I wish they would simplify it for busy parents.” said Judy Hooyer, a mother of four boys. Printable updated immunization requirements can be found here.

Why do parents choose not to vaccinate?

The PEW Research center found that 82% of parents believe that healthy children should be required to be vaccinated in order to attend school because of potential risks to other children; but what about the other 18% of parents? Why don’t parents want to vaccinate their children?

Some parents believe that vaccines expose children to harmful chemicals. Some of those chemicals include Formaldehyde, Mercury, and Aluminum.  “If you actually look at the label on these vaccines you will see that they’re full of junk.” says anti-vaccine mom Shane Ellison in this article.   Ellison holds a master’s degree in Chemistry and is the author of Over the Counter Natural Cures.

Other parents believe in a now disproven theory that vaccines cause autism. In February of 1998 a study by Andrew Wakefield was published saying "Rubella virus is associated with autism and the combined measles, mumps, and rubella (MMR) vaccine… has also been implicated." Anti-vaccine groups used Wakefield’s article as rational to opt of of vaccinating their children. Between 2003 and 2012 a reporter by the name of Brian Deer investigated these claims thoroughly. Deer accused Wakefield of "falsifying medical histories of children and essentially concocting a picture, which was the picture he was contracted to find by lawyers hoping to sue vaccine manufacturers and to create a vaccine scare." In 2004 10 of the 12 co-authors of Wakefield’s study released a statement saying "We wish to make it clear that in this paper no causal link was established between MMR vaccine and autism as the data were insufficient." In 2011 the British journal of Medicine published an article stating that Wakefield received over $674,000 from lawyers and that, of 12 children examined, five had developmental problems before being vaccinated and three never had autism. As a result, on May 24, 2011, Britain stripped Wakefield of his medical license. Still some vaccines list Autism as a potential side effect on their packaging.  

Many parents believe that children can build immunity naturally. “Just as hand washing saved millions from infant mortality in a hospital setting, healthy habits minimize exposure and boost our natural defenses.” says Ellison She also claims that the body is hardwired with special receptors that recognize foreign invaders and activate our immune response.  Then special cells of the immune system possess the unique capacity to activate the immune response, which clears biological nasties from the body. “And all of this occurs without vaccination!” Ellison says.

Another common reasons parents don’t vaccinate their children is that they don’t believe in the theory of herd immunity. Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not. In other words herd immunity serves as a human shield – a type of immunity – for “at-risk” individuals. For herd immunity to work about 95% of “the herd” needs to be vaccinated according to the theory. Many parents believe that the 5% of the unvaccinated “herd” should be reserved for children who have allergies or other medical conditions that don’t allow them to be vaccinated, not for healthy children whose parents don’t support vaccination.

In theory if herd immunity is true, when parents with healthy children choose not to vaccinate them, they are putting children, even ones who are vaccinated, at risk of infection. In other words, a parent’s choice to not vaccinate their child could make all other children’s vaccinations worthless. This is just one of the reasons tensions between pro and anti-vaccination parents are high.

What can schools do?

Can schools refuse students with personal belief immunization exemptions? One school in Traverse City, Michigan called The Children’s House has stopped admitting students who don’t have required immunizations. Their only exemptions are for students with medical and valid religious exemptions. The state of Michigan as a whole does allow for personal belief exemptions.

The Children’s Home serves preschool through eighth graders. The change came when Jill Vollbrecht, an endocrinologist and Children’s House parent of three children ages 4 through 9, read a disturbing report by a local news outlet, the Traverse Ticker. Vollbrecht discovered that almost 23% of the students at The Children’s House were not vaccinated. "I’m not a family practitioner or an infectious disease specialist, but these numbers set off alarm bells for me," Vollbrecht said. "All physicians have the common goal of wanting to keep our kids and our communities safe, and we have a core understanding about science and herd immunity." stated Vollbrecht. About a month after this realization the country health department confirmed an outbreak of 22 cases of Pertussis at the school forcing it to close for several days.

This prompted the school’s administration to reconsider their rules regarding immunizations. The school now refuses to accept new students whose parents opt them out of vaccinations due to personal beliefs. Most parents were fine with this change. However a few parents were extremely upset. One parent said "I believe the school is about embracing options… yet, there was no open forum for parents to discuss the policy before it was enacted, nor were parents of unvaccinated children invited to share their opinions or suggestions.”

Many legislators see other schools following The Children’s House’s lead. In 1905, in a case that’s still cited to this day, Jacobson v. Massachusetts, the U.S. Supreme Court held that states have the legal authority to mandate vaccinations for all residents.  And in 1922, the court reinforced the government’s ability to require vaccinations as a condition of school attendance. “Schools can and should protect themselves” said Michigan Senator Gary Peters. “If parents do not agree with their school’s immunization rules, they have other education options.” says Peters.

The issue of vaccinations in schools is a complicated issue. What makes it even more complicated is the patchwork of legislation in each state and district.