- Associated Press - Monday, November 28, 2011

ATLANTA (AP) - A rising number of parents in more than half of states are opting out of school shots for their kids. And in eight states, more than 1 in 20 public school kindergartners do not get all the vaccines required for attendance, an Associated Press analysis found.

That has health officials worried about possible new outbreaks of diseases that were all but stamped out.

The AP analysis found more than half of states have seen at least a slight rise in the rate of exemptions over the past five years. States with the highest exemption rates are in the West and Upper Midwest.

It’s “really gotten much worse,” said Mary Selecky, secretary of health for Washington state, where 6 percent of public school parents have opted out.

Rules for exemptions vary by state and can include medical, religious or _ in some states _ philosophical reasons.

Parents’ reasons for skipping the shots vary. Some doubt that vaccines are essential. Others fear that vaccines carry their own risks. And some find it easier to check a box opting out than to get the shots and required paperwork.

Still others are ambivalent, believing in older vaccines but questioning newer shots against, say, chickenpox.

The number of shots is also giving some parents pause. By the time most children are 6, they will have been stuck with a needle about two dozen times _ with many of those shots given in infancy. The cumulative effect of all those shots has not been studied enough, some parents say.

“Many of the vaccines are unnecessary, and public health officials don’t honestly know” the effects of giving so many vaccines to such small children, said Jennifer Margulis, a mother of four and parenting book author in Ashland, Ore., a small liberal community that has unusually high vaccination exemption rates.

But few serious problems have turned up over years of vaccinations, and several studies have shown no link between vaccines and autism, a theory from the 1990s that has been widely discredited.

To be sure, childhood vaccination rates remain high overall, at 90 percent or better for several vaccines, including those for polio, measles, hepatitis B and chickenpox. In many states, exemptions are filed for fewer than 1 percent of children entering school for the first time.

Health officials have not identified an exemption threshold that would likely lead to outbreaks. But they worry when some states have exemption rates climbing beyond 5 percent. The average state exemption rate has been estimated at less than half that.

Even more troubling are pockets in some states where exemption rates are much higher. In some rural counties in northeast Washington, for example, vaccination exemption rates in recent years have been above 20 percent and even as high as 50 percent.

“Vaccine refusers tend to cluster,” said Saad Omer, an Emory University epidemiologist who has done extensive research on the issue.

Parents who let their kids skip some vaccines put others at risk, health officials say. Because no vaccine is completely effective, if an outbreak begins in an unvaccinated group of children, a vaccinated child may still be at some risk of getting sick.

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