Living Without Vaccinations
By Dorsey Griffith
Sacramento Bee

They are as lively and rosy-cheeked as any 5- and 6-year-old girls, their long, blond hair gleaming in the sun as they swing upside down from the monkey bars at the playground.
But Skyla and Iris Foxfoot are not like most 5- and 6-year-olds in America. The Nevada County, Calif., children have not been immunized against childhood diseases such as measles, chicken pox and haemophilus meningitis.
"I think they are healthier for it," said their mother, Cindy Foxfoot, a licensed midwife. "I think their immune systems are stronger for it."
Foxfoot and her husband are among a relatively large number of parents in rural Nevada County who, based on personal beliefs, have chosen to exempt their children from vaccinations otherwise required by state law. In California, people can exercise that option simply by signing the back of a school immunization record.
Last year, California had its highest rate of "personal beliefs exemptions" in 20 years, at just more than three-quarters of a percent of all entering kindergartners, or about 4,000 children.
Even so, Nevada County stands out. Last year, the Sierra foothills county had the highest rate of exempted kindergartners and the second-highest rate of exempted seventh-graders in California. More than 6 percent, or 54 out of 848 kindergartners, were exempted, and more than 11 percent, or 126 out of 1,130 seventh-graders. Statewide, just over 1 percent of seventh-graders were exempt last year.
According to many in Nevada County, the difference has a lot to do with the character of the place and its people. Many residents have adopted "holistic" lifestyles, educating their children at home, eating organic foods and preferring natural remedies to pharmaceuticals for what ails them.
Since the beginning of the last century, vaccinating children against potentially deadly or disabling diseases has been a widely accepted medical practice. But in recent years, vaccinations once considered routine have come under attack, mainly from parent groups. The trend stems, in part, from a growing interest in holistic medicine. But with so many diseases under control, some parents also feel freer to weigh the potentially dangerous side effects vaccines can pose.
Californians have been able to opt out of childhood vaccination programs since the early 1970s. California is among 22 states that offer personal-belief or religious exemptions in addition to medical exemptions.
Perhaps the most high-profile debate involving vaccines stems from suspicions linking measles, mumps and rubella vaccine to autism. Many parents of autistic children say their children seemed normal until soon after the first inoculation, typically given between 12 and 18 months of age.
Last year, the House Committee on Government Reform held lengthy hearings to explore the possible link. The panel chairman, Rep. Dan Burton, R-Ind., told the story of his own grandson who was diagnosed with autism soon after getting immunized, and called for more research.
The federal government has asked the national Institute of Medicine to set up a committee to analyze theories about immunization safety concerns.
Meanwhile, the 20-year-old National Vaccine Information Center, a parent-led safety organization, has called for a congressional investigation into the nation's mass-vaccination program.
"We believe the one-size-fits-all approach does not acknowledge biodiversity," said Barbara Loe Fisher, co-founder and president of the center. The center played a role in the Food and Drug Administration decision in 1996 to develop a safer vaccine against pertussis, or whooping cough.
Concerns have been raised about possible links between inoculations and a range of conditions, including juvenile diabetes, asthma, attention deficit disorder and sudden infant death syndrome. Medical experts say there is no firm evidence to support such claims. They say all vaccines carry some risks, but only for a fraction of the population.
According to the federal Centers for Disease Control and Prevention, for example, serious allergic reactions that can result in brain damage occur in fewer than one in 1 million children who get the diphtheria, tetanus and pertussis vaccine and the measles, mumps and rubella vaccine.
Dr. Bruce Gellin, executive director of the National Network for Immunization Information, an organization that promotes vaccination education, said vaccines today are safer than ever.
"We have the best system in the world to assure they are as safe as they can absolutely be," he said. "But no medical product is 100 percent safe."
What troubles disease-prevention experts is the potential erosion of what is known as herd immunity, in which immunized kids serve as a protective barrier for kids who aren't.
Dr. Natalie Smith, chief of the immunization branch of the California Department of Health Services, calls it the "free-rider effect." She says herd immunity only works to prevent outbreaks when enough children are fully immunized. Children who haven't had their shots are more likely to get sick themselves, and spread diseases to infants and other children who haven't been immunized. They also pose a threat to adults and children who have been immunized, but for whom the vaccines were not 100 percent effective.
In 1998, Foxfoot said, her daughters contracted pertussis, a potentially dangerous disease preventable with the DTap (diphtheria, tetanus, pertussis) vaccine typically given at 15 months.
The bacterial disease, which in about 9 percent of cases leads to pneumonia and, more rarely, seizures and brain disorders, is particularly dangerous to infants. Worldwide, 30,000 people die each year from pertussis, according to the CDC.
The Foxfoot girls became sick along with several other unimmunized children in the area.
Foxfoot said that when her daughters became ill, they developed the telltale cough with a whoop as they tried to catch their breath. She kept the girls at home for nearly six weeks while they recuperated, as required by law for unimmunized children with vaccine-preventable diseases. She also isolated them from older adults - including her own parents - and anyone who hadn't been immunized against the disease.
Foxfoot put her children on a diet without dairy and wheat products, and made sure they consumed plenty of clear broth to reduce the mucous that she said exacerbated the coughing. They recovered fully.
"I was never worried for their lives," she said. "They were strong and healthy."
Her children, whom she educates at home, remain healthy; neither has had an ear infection and neither has ever seen a primary-care physician, she said.

This Site Served by TheHostPros