Immunization encouraged locally

Amidst growing public concern about a statewide measles outbreak and ongoing debates over whether to tighten immunization requirements for public school children, Dr. Nurit Licht, chief medical officer at the Petaluma Health Center, states that the organization unequivocally supports use of the measles vaccine. She just wants to make sure that parents and healthcare professionals have an open dialogue to answer questions about the benefits of all vaccines to children.

“Of course we encourage vaccination,” Licht said. “Vaccinations are the No. 1 way to approach child wellness.”

Still, Licht said that whether or not to vaccinate is far from a black-and-white issue.

“Every family has its own set of concerns,” she said. “The American Academy of Pediatrics encourages that we talk to all families about vaccinations. Fifty percent of those families fall into a gray area where they see no real harm in vaccination, but also have questions about the potential risk.

“We promote coming in for vaccinations, but we also know all vaccines come with questions. Yes, they are effective. And, yes, we always want to talk to people to answer their questions and ease their concerns.”

Licht makes clear that the center’s interest in discussing the use of vaccines doesn’t indicate that the healthcare industry questions the effectiveness of the measles or any other vaccine.

“We called to talk to parents whose children were due for vaccination,” she said. “Most all of them came in and got the vaccines. It’s always worth a conversation. Think of the implications if we don’t talk about whether or not to vaccinate.”

The measles outbreak that began in December at Disneyland has reached 113 cases statewide, yet many parents still refuse to vaccinate their children.

Schools require proof of immunization for measles, which comes in the form of the measles, mumps and rubella (MMR) vaccine. Under existing California law, some children are allowed to skip immunizations if a parent submits a personal beliefs exemption or a medical or religious exemption at enrollment, which must be signed off on by a medical professional. Other unimmunized children may be admitted to school on the “condition” that they complete any remaining vaccinations when due.

California lawmakers have proposed legislation that would eliminate the parents’ “personal belief exemption” and most all other exemptions that allow parents to avoid mandatory vaccinations.

People who decline to vaccinate their children face critics who fault them for disregarding public welfare. Parents who oppose vaccination say they’re asserting a right to make important healthcare decisions for their children. Petaluma residents’ vaccination rates reflect these differences of opinion.

According to data from the California Department of Public Health, Petaluma is roughly split in half in its number of schools that have above 90 percent vaccination rates versus those that have below that percentage.

Petaluma’s Live Oak Charter reports that just 33 percent of kindergarten students are vaccinated against measles, mumps and rubella, according to state data. Wilson Elementary reports 71 percent of its students are vaccinated.

The immunization rate at the Petaluma Health Center, Licht said, shows about 87 to 90 percent of children are vaccinated - a “really common percentage across the United States.”

Still, it’s hard to determine overall vaccination rates, she said, because many children aren’t being vaccinated against all diseases. Some parents choose to vaccinate against some illnesses, while declining or delaying vaccination against others.

“Measles is one of the more controversial vaccines - if people are going to elect to partially vaccinate kids, measles is one they would delay,” Licht said.

Some people still believe that the measles vaccine is related to the development of autism - a connection that has been proven false.

British researcher Dr. Andrew Wakefield’s study that connected the vaccine to autism has been discredited and retracted in the journal in which it appeared originally. Wakefield lost his medical license. The most prominent autism advocacy group debunked the research, too.

“Extensive research has asked whether there is any link between childhood vaccinations and autism,” said Autism Speaks’ chief science officer Rob Ring. “The results are clear: Vaccines do not cause autism. We urge that all children be fully vaccinated.”

Parents who oppose vaccination are sometimes worried about live vaccines that include a small amount of the weakened version introduced into the body to build immunity.

“There’s a fear around these vaccines,” Licht said.

Licht said that the public health perception is clearly that the burden of childhood illnesses over the world has decreased greatly because of vaccines that work. She is encouraging people to have open discussions with their doctors and in schools about how each vaccination works, when it should be administered and how vaccination addresses different possible health problems.

“Some [families] see a potential health risk to children that outweigh the benefits of vaccines,” Licht said.

Sometimes, the disagreement is about the overall structure of vaccine schedules, with some people believing that too many vaccines are given to children at one time.

Other parents are wary of vaccinating children who are fighting illnesses like auto-immune disorders or who have serious diseases like leukemia that weaken immune systems. Doctors often suggest those children not be vaccinated until their immune systems are strengthened.

Reassurance can come from the concept of “herd immunity” - meaning that the vaccination of a significant portion of a population (usually 90 percent in the case of measles) provides a measure of protection for individuals who have not developed immunity.

“That’s why the conversation needs to happen in a more open way,” Licht said. “If people think [vaccines] are harmful, why haven’t we (healthcare professionals) allayed those fears? What is it about medicine that allows people to feel wary about treatments?

“That’s why it ends up being a personal conversation within each family. It needs to be a conversation with parents and doctors so that all the issues are really discussed.”

Sharon Helmer, a registered nurse and certified school nurse who provides care to students at all five schools in the Old Adobe Union District, said those students have a very high rate of immunization.

“School nurses are meticulous about this - we submit a report to the state every October to tell how many [students] are completely vaccinated,” Helmer said.

She hasn’t seen a lot of concern about the measles outbreak among parents at her schools where immunization rates are high. “I would just encourage parents to continue to immunize their children,” she said.

Sonoma Mountain Elementary principal Michele Gochberg said that as a parent and school administrator, she’s been following the debate over vaccinations closely, but she hasn’t heard a lot of concern from parents.

“If we had a child with measles, we would notify the school community, and our kids with the waivers would have to stay home,” Gochberg said.

It’s a similar story at Grant School, where principal Catina Haugen said immunization rates are high. “We take our lead from the health department,” Haugen said. Like other Petaluma schools, Grant School has posted information on its website about measles and the MMR vaccine.

“We need to have some tolerance for people’s individual choices. We may not agree with them, but this is our society,” Haugen said. She encourages the idea of parents “being informed, being aware of symptoms, and checking in with a pediatrician.”

(Contact Annie Sciacca at argus@arguscourier.com)