Sarah Hernandez spent two years in Haiti as a volunteer for Nurse Without Borders, vaccinating children against polio, measles, whooping cough and other diseases. She remembers parents lining up with their children at the village clinic, because they knew what it was like to have a child die of such diseases.
Today, as a Kent County public-health nurse, she wishes more local parents were as eager to immunize their children as those Haitian parents were.
“I saw people die of vaccine-preventable diseases,” said Hernandez, a veteran clinical nurse with the Kent County Health Department. “And it breaks my heart that here, where we have them readily available, parents are fearful to vaccinate and concerned about their children’s safety.
“I will often say to parents if I thought this was harmful in any way, I wouldn’t do it,” she added firmly. “I really wouldn’t do it.”
Despite her assurances, some local parents have exempted their children from immunization as this school year begins. They tell her why they have done so – sometimes angrily – under a new regulation requiring them to meet with public-health workers like her in order to obtain a non-medical immunization waiver for their children.
While parents may object that vaccines could harm their children, Hernandez said it’s her job to advise them otherwise. “I have an obligation to let them know they are putting their child and other children at risk” by not vaccinating, she said.
The approximately 15-minute educational meetings have kept her and other nurses busy. So far this calendar year, the Kent County Health Department has issued more than 600 waivers.
♥High Waiver Rates and Disease Outbreaks
The state implemented the change in January in response to Michigan’s high waiver rates — which at 4.8 percent are fourth-highest in the nation — as well as concern about increased incidence of preventable diseases. A series of stories in MLive last year highlighted the issue, including an outbreak of whooping cough (pertussis) at a Traverse City charter school.
As of this week, students must be up to date on vaccinations or have an immunization waiver or they may be excluded from class. Parents seeking a non-medical waiver, for religious or philosophical reasons, must sign it while meeting with a public-health worker.
The rule applies to children entering preschool, kindergarten or seventh grade, or transferring to a new school district. Some districts, such as Northview, have given parents a grace period to comply, but others like Kenowa Hills are strictly enforcing the rule: no waiver, no enrolling.
Until this year, parents could sign a waiver at the school. Now they must come to a public-health department to sign the waiver, which states “I may be placing my child and others at risk of serious illness” if the child contracts a vaccine-preventable disease.
‘Those laws exist for a reason, to keep our kids healthy and keep learning environments as healthy as possible.’ – Ron Caniff, superintendent, Kent ISD
The new requirement has many parents steamed, said Mary Wisinski, immunization program supervisor for the Kent County Health Department.
“There’s a lot of angry people out there,” Wisinski said. “The majority of people are angry they have to come here and angry we’re telling them what to do.”
As Michigan schools opened this week, new state rules kicked in for parents who don’t want to immunize their children for religious or philosophical reasons. The requirement raised concerns for parents on two fronts: those who believe vaccines could harm their children, and those who believe unvaccinated classmates could put their children at risk. Following are background sources on pros and cons of the issue:Michigan Department of Health and Human Services
She insisted their intent is not to harass parents, but to help them make an informed decision by offering information and dispelling myths. Nurses provide print-outs and websites from The Children’s Hospital of Philadelphia on how vaccines are made and tested, research on concerns about the increased number of vaccines, and alleged links to disabilities such as autism.
The literature points out the risks of diseases like whooping cough, which has been on the increase in Michigan and resulted in a 3-year-old’s death in 2012. Measles is also on the rise nationally, from 37 cases in 2004 to more than 600 last year, the health department says.
“Our job as public health is to be responsible for the health of the community,” Wisinski said. “They don’t always make that connection that by not vaccinating their child and sending them to school, they are endangering other people, maybe not only in the community but in their family.”
Parents Say They’ve Done Their Homework
The new requirement does not sit well with parents who choose not to vaccinate their children. Suzanne Waltman, who heads the non-profit Michigan Opposing Mandatory Vaccines, said the rule was like “poking a sleeping bear.”
“The parents making these decisions have already researched the pros and cons,” said Waltman, of St. Clair Shores. “So I really don’t think it’s going to accomplish the goal they set out, which is to increase vaccination rates.”
Kent County’s waiver rates are low compared to many other counties in the state, some of which are as high as 20 percent. In the 2014-15 school year, 3.5 percent of local kindergarteners had waivers compared with 5.3 percent statewide, according to health officials. But kindergarten waiver rates were over 10 percent in some Kent ISD public school buildings, state records show.
‘The parents making these decisions have already researched the pros and cons.’ – Suzanne Waltman, Michigan Opposing Mandatory Vaccines
At Rockford’s Meadow Ridge Elementary last year, 15 kindergarteners had waivers, or 5.9 percent. This fall, a newly enrolled kindergartener received a philosophical waiver because of a genetic condition and a family history of skin and auto-immune disorders. His mother, Marie, said she is concerned the number and combinations of required vaccines could make him more susceptible. She did not want her full name used out of concern for singling him out and negative backlash.
“I don’t want to vaccinate my child knowing he has what he has, and possibly severely injure him for the rest of his life,” Marie said. “My family is my first priority – his health, his happiness.”
She said her family eats an organic diet and takes probiotics to keep their immunity strong, and that her son has never needed a prescription or over-the-counter medicine. A former speech therapist who worked with autistic children, she said she has thoroughly researched medical literature and cited it when she met with a public-health nurse. The nurse did not try to talk her out of her decision, Marie said.
While concerned the requirement may be the start of trying to take away her freedom of choice, she insisted, “I’m not upset about it. I understand some people need a little extra education, and that’s what they’re trying to do.”
Officials Aim to Keep Schools Safe
Other parents, however, say unvaccinated students put their own children at greater risk. Health officials say no vaccination is 100 percent effective, and that the fewer vaccinated children there are in a group, the less protection there is for all. It also poses risks for those who cannot be vaccinated for medical reasons, such as children receiving chemotherapy, officials say.
‘I want to protect those children.’ – Sarah Hernandez, public health nurse
Debra Scott is the parent of a sixth-grader at Grand Rapids’ North Park Montessori School, where 10 percent of kindergartners received waivers last year. She said her research convinces her vaccines have safely and significantly reduced disease. But “misinformation and fear-mongering” fuel the belief that the risks of vaccines are greater than those of the child getting sick, she said.
“Most of us with school age kids were fortunate enough to grow up after diseases like measles and polio were controlled by our parents vaccinating us,” said Scott, who supports the new rule. “I am concerned that failure to fully vaccinate puts our school community at risk for an outbreak of serious illness.”
When it comes to school, lack of immunization can create problems for learning as well as students’ health, said Ron Caniff, superintendent of Kent ISD.
He pointed to an incident in Greenville early this year, when a high school student diagnosed with whooping cough prompted officials to send unvaccinated classmates home for 20 days. Such cases are “disruptive to the learning environment” as well as a health risk, Caniff said. Parents could also start pulling their children out of school if there was a rumor of a disease outbreak, he added.
The new regulation is not meant to burden parents, but ensure they make an informed choice, he said.
“Those laws exist for a reason, to keep our kids healthy and keep learning environments as healthy as possible,” Caniff said. “We want our schools to be a safe place to be.”
No Vested Interest, Nurses Say
Back at the Kent County Public Health Department, Sarah Hernandez is among half a dozen nurses who saw a steady stream of parents seeking waivers before school began. Many did not like having to come to the department at all, perceiving it as a “place for the underserved,” she said.
‘There’s a lot of angry people out there.’ – Mary Wisinski, Kent County Health Department
She said it has been stressful for both parents and nurses to comply with the new regulation. In the past, parents were happy to have nurses vaccinate their children, but now much of the focus has shifted to the waivers. Hernandez said she understands parents’ frustrations and wants to help them through the process in a non-judgmental way.
“These are good parents that want to do the best for their children,” said Hernandez, a health department nurse for 13 years. “I want to provide them with the right information and tools they need to make a very informed decision, to protect their children and to protect the community.”
Many parents are misinformed about the health department’s motives for doing so, she added. Some see it as “some kind of government conspiracy to make people conform,” backed by big bucks for pharmaceutical companies.
“The health department has no vested interest,” Hernandez said. “We don’t get any money from manufacturers.”
Neither does the Advisory Committee on Immunization Practices, a national body that recommends vaccine schedules, said Wisinski, the county immunization supervisor. “They’re not associated with ‘big pharma,’” Wisinski said.
A few parents have taken literature home to reconsider before signing, Hernandez said. But most “have their minds made up,” and she doesn’t try to force the issue, she said.
Despite the difficulties, Hernandez said she hopes parents are better educated about their children’s safety.
“I want to protect those children,” she added, “and I want to make sure that the community is protected.”