For now, parents with schoolchildren in California can opt out of vaccines by simply signing a personal belief exemption (PBE). And they're doing so at a growing rate.
According to the Orange County Health Care Agency, 1.1 percent of kindergartners at public schools had exemptions in 2001. The latest 2011 data pin the county rate at 2.9 percent, slightly higher than the statewide rate of 2.4 percent.
But the issue intensifies in South County. In communities such as San Clemente, Laguna Beach, Laguna Niguel, Aliso Viejo, Mission Viejo and Capistrano Beach, where Dr. Bob Sears practices, there are clusters of unvaccinated children. Last year, at 15 of the 40 elementary schools in the Capistrano Unified School District, more than 10 percent of kindergartners had waivers, according to data from the California Department of Public Health. At one public charter school, Journey, 56 percent of kindergartners were unvaccinated, at least partially, due to their parents' beliefs.
The Centers for Disease Control and Prevention (CDC) estimate that infections can spread quickly within a group when as few as 5 percent to 10 percent lack vaccination.
"We're seeing a resurgence of vaccine-preventable diseases such as measles and pertussis," says Dr. David Nunez, family-health medical director of the Orange County Health Care Agency. "Many of these diseases have the potential to causes severe illness or death for infants." In 2010, more than 9,000 cases of pertussis, also known as whooping cough, were reported in California, including 10 infant fatalities, which is the largest the state has seen in more than 60 years. The CDC recently announced that 2012 will likely be a record year for the disease.
According to Marcus Walton, spokesperson for the Capistrano Unified School District, it's not up to school officials to impose on family decisions. "As a district, we can inform parents about the value of immunizations, but ultimately, it is up to the parents to determine what is in the best interest of their child," he says.
Parents who choose to not vaccinate are generally well-educated and from affluent areas. Nicole Rafferty, a 37-year-old in Mission Viejo, is part of Moms In Charge, a thousand-member group that discusses issues related to children and health. While the organization, which often meets in South Orange County, doesn't have an official stance on vaccinations, many of the moms at least question them—including Rafferty, who has decided to not vaccinate her 3-year-old son and 3-month-old daughter.
"I haven't been convinced that vaccines won't damage my child's life," she says. "Catching whooping cough means two weeks of treatment, antibiotics, high doses of vitamin C. But if my child has an adverse reaction to the DPT vaccine, that can mean lifelong brain damage."
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She adds, "The CDC is looking at it for the larger population. It's like when you go to war. You know a certain amount of civilians are going to die. It's sad, but that's part of war. I have to weigh the pros and cons for my child."
This article appeared in print as "Host Bodies: A closer look at OC's anti-vaccination cluster."