- They are as lively and rosy-cheeked as any 5- and
girls, their long, blond hair gleaming in the sun as they swing upside
down from the monkey bars at the playground.
- But Skyla and Iris Foxfoot are not like most 5- and
in America. The Nevada County, Calif., children have not been immunized
against childhood diseases such as measles, chicken pox and haemophilus
- "I think they are healthier for it," said their
mother, Cindy Foxfoot, a licensed midwife. "I think their immune
are stronger for it."
- Foxfoot and her husband are among a relatively large
number of parents in rural Nevada County who, based on personal beliefs,
have chosen to exempt their children from vaccinations otherwise required
by state law. In California, people can exercise that option simply by
signing the back of a school immunization record.
- Last year, California had its highest rate of
beliefs exemptions" in 20 years, at just more than three-quarters
of a percent of all entering kindergartners, or about 4,000
- Even so, Nevada County stands out. Last year, the Sierra
foothills county had the highest rate of exempted kindergartners and the
second-highest rate of exempted seventh-graders in California. More than
6 percent, or 54 out of 848 kindergartners, were exempted, and more than
11 percent, or 126 out of 1,130 seventh-graders. Statewide, just over 1
percent of seventh-graders were exempt last year.
- According to many in Nevada County, the difference has
a lot to do with the character of the place and its people. Many residents
have adopted "holistic" lifestyles, educating their children
at home, eating organic foods and preferring natural remedies to
for what ails them.
- Since the beginning of the last century, vaccinating
children against potentially deadly or disabling diseases has been a widely
accepted medical practice. But in recent years, vaccinations once
routine have come under attack, mainly from parent groups. The trend stems,
in part, from a growing interest in holistic medicine. But with so many
diseases under control, some parents also feel freer to weigh the
dangerous side effects vaccines can pose.
- Californians have been able to opt out of childhood
programs since the early 1970s. California is among 22 states that offer
personal-belief or religious exemptions in addition to medical
- Perhaps the most high-profile debate involving vaccines
stems from suspicions linking measles, mumps and rubella vaccine to autism.
Many parents of autistic children say their children seemed normal until
soon after the first inoculation, typically given between 12 and 18 months
- Last year, the House Committee on Government Reform held
lengthy hearings to explore the possible link. The panel chairman, Rep.
Dan Burton, R-Ind., told the story of his own grandson who was diagnosed
with autism soon after getting immunized, and called for more
- The federal government has asked the national Institute
of Medicine to set up a committee to analyze theories about immunization
- Meanwhile, the 20-year-old National Vaccine Information
Center, a parent-led safety organization, has called for a congressional
investigation into the nation's mass-vaccination program.
- "We believe the one-size-fits-all approach does
not acknowledge biodiversity," said Barbara Loe Fisher, co-founder
and president of the center. The center played a role in the Food and Drug
Administration decision in 1996 to develop a safer vaccine against
or whooping cough.
- Concerns have been raised about possible links between
inoculations and a range of conditions, including juvenile diabetes,
attention deficit disorder and sudden infant death syndrome. Medical
say there is no firm evidence to support such claims. They say all vaccines
carry some risks, but only for a fraction of the population.
- According to the federal Centers for Disease Control
and Prevention, for example, serious allergic reactions that can result
in brain damage occur in fewer than one in 1 million children who get the
diphtheria, tetanus and pertussis vaccine and the measles, mumps and
- Dr. Bruce Gellin, executive director of the National
Network for Immunization Information, an organization that promotes
education, said vaccines today are safer than ever.
- "We have the best system in the world to assure
they are as safe as they can absolutely be," he said. "But no
medical product is 100 percent safe."
- What troubles disease-prevention experts is the potential
erosion of what is known as herd immunity, in which immunized kids serve
as a protective barrier for kids who aren't.
- Dr. Natalie Smith, chief of the immunization branch of
the California Department of Health Services, calls it the "free-rider
effect." She says herd immunity only works to prevent outbreaks when
enough children are fully immunized. Children who haven't had their shots
are more likely to get sick themselves, and spread diseases to infants
and other children who haven't been immunized. They also pose a threat
to adults and children who have been immunized, but for whom the vaccines
were not 100 percent effective.
- In 1998, Foxfoot said, her daughters contracted
a potentially dangerous disease preventable with the DTap (diphtheria,
tetanus, pertussis) vaccine typically given at 15 months.
- The bacterial disease, which in about 9 percent of cases
leads to pneumonia and, more rarely, seizures and brain disorders, is
dangerous to infants. Worldwide, 30,000 people die each year from
according to the CDC.
- The Foxfoot girls became sick along with several other
unimmunized children in the area.
- Foxfoot said that when her daughters became ill, they
developed the telltale cough with a whoop as they tried to catch their
breath. She kept the girls at home for nearly six weeks while they
as required by law for unimmunized children with vaccine-preventable
She also isolated them from older adults - including her own parents -
and anyone who hadn't been immunized against the disease.
- Foxfoot put her children on a diet without dairy and
wheat products, and made sure they consumed plenty of clear broth to reduce
the mucous that she said exacerbated the coughing. They recovered
- "I was never worried for their lives," she
said. "They were strong and healthy."
- Her children, whom she educates at home, remain healthy;
neither has had an ear infection and neither has ever seen a primary-care
physician, she said.
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