I interviewed a non-vaccinating parent last weekend because I’ve read the broad characterizations about anti-vaxxers: that they’re selfish, free-loading narcissists, and that their refusal to vaccinate puts vulnerable people at risk. Some of this I agree with and some I don’t.
So I talked to Justine (not her real name), a 39-year-old mother of three in Ithaca, New York. Justine vaccinated her first son (who’s now 19), decided not to vaccinate her second, 11, and because of the religious exemption, can’t vaccinate her third, age 8.
I asked her why the change of heart between kids 1 and 2. “I was 20 when [my first] was born, and I was still in the mode of being a good little patient, do what the doctor tells you, don’t ask any questions…. Seven and a half years later I have Charlie. And right from the start things were different. Even when I was pregnant things were different. There’s that little mommy voice in your head that says, ‘Something’s wrong here.’ … When he got his first sunburn I put aloe on him, and he broke out in a rash from the aloe, that’s how sensitive he is. He was a wreck. He was very, very sensitive. He can’t tolerate dairy, soy or corn. He was a miserable ball of crying, screaming baby for years. [Now] he’s going to be 12, and he’s almost a human being.”
“I think it’s crap that I have to sign a religious exemption that says that God told me not to vaccinate my children.”
Justine says that by the time her second son arrived, she had researched vaccines and didn’t agree with the schedule. When I point out that doctors will let parents adjust the schedule, she named other concerns about vaccines that are standard anti-vaxx talking points: vaccines aren’t tested rigorously enough, the aggressive schedule may be linked to SIDS, she’s okay with her kids possibly getting the measles or whooping cough. She sent me a link to a site—though she said she hasn’t had a chance to look into it—that claimed there are more deaths attributable to the measles vaccine in the last 10 years than to actual cases of measles.
When I brought up the (in my mind) indisputable fact that the advent of vaccines has meant the eradication of miserable and dangerous diseases, she said, “Measles rates plummeted before the vaccine was introduced…. Even with these outbreaks, we’re not seeing people dying. There have been more deaths related to the vaccines than there have been from the diseases.”
(During the 1988-1990 measles outbreak in California, 16,400 people were infected and 75 died. The highest incidence was in infants under a year old. I spoke to Dr. James Cherry, a pediatrician and infectious disease specialist at UCLA, last week for another story, and—just in case you need to hear it again—he said, “One in 500 people with measles will die. One in 1,000 will get encephalitis, and some of those will develop an autism-spectrum disorder in follow up. The risks of the MMR vaccine are one in a million for anaphylaxis and one in 2,500 for febrile convulsions. Six thousand deaths were prevented last year by vaccines. The risk-benefit is clearly in favor of vaccination.”)
When I raise the possibility that if everyone took her view, these diseases would come roaring back, she basically shrugs, suggesting that our contemporary nutrition and sanitation standards would mean less-severe outbreaks. (This is neatly refuted here, if you’re interested.)
But all that said, Justine emphasized that her decision to not vaccinate Charlie was based on his specific and troubling health concerns. She had no formal diagnosis for him and so couldn’t get a medical exemption, and in any case she says a medical exemption can only be for a single vaccine, not the 16 we routinely give children. She has a strong family history of autoimmune disease and worried about the vaccines being a trigger for Charlie. She’s managed his health with a restricted diet, and she reports that he’s greatly improved—he even had Halloween candy this year, previously off-limits due to corn syrup.
But that still leaves her third kid, Henry, now 8 and unvaccinated. He’s healthy, with none of the problems the second child has had. “I was much less worried about Henry, but at that point I had already signed a religious exemption for Charlie.” Because she didn’t vaccinate her second child, she can’t vaccinate her third child. The religious exemption means that she can’t “take it back” for subsequent children.
I looked at the New York State instructions for submitting a religious exemption form, and it does appear that the granting of the exemption is up to the school. If the school has reason to believe that the religious beliefs aren’t sincere—like, you hold them for one kid and not another—they can deny it: “Philosophical, political, scientific, or sociological objections to immunization do not justify an exemption.”
“I think it’s crap that I have to sign a religious exemption that says that God told me not to vaccinate my children,” Justine said. “I wanted to fill it out as the Flying Spaghetti Monster told me not to vaccinate my children.”
Now I doubt there are a ton of families like Justine’s—most non-vaccinating parents decide based on reasons that would apply to all their kids and not just one. But for herd immunity, every vaccination counts. And Justine makes another, compelling point: The religious exemption means that public health officials are losing valuable data on exactly why parents aren’t vaccinating.
Says Justine: “How about you just let me document what my reasons are, and if someone wants to actually follow up and do some research, they’ll actually have real information, right? I think there’s real information there—’my family has autoimmune disease, what risks are there with vaccines? How many families with autoimmune diseases aren’t vaccinating?’—but right now they just have ‘God told me not to vaccinate my children.’ There’s information they’re losing by not doing that.”
While it does seem that no amount of argument or research or data will convince anti-vaxxers to immunize their children, it is worth at least knowing why they’re doing what they’re doing. The religious exemption is nonsense anyway—a fig leaf. But with the right information, it might be possible to sway the vaccine fence-sitters, those who still might be convinced. And that would mean just a few more vaccinated children.