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Parents weigh decision to vaccinate

In low-rate Boulder, an illness reemerges

By Chryss Cada, Globe Correspondent, 9/9/2002

OULDER, Colo. - Claudia McLaren Lainson has never regretted not getting her children vaccinated for pertussis, commonly known as whooping cough - even when all three of them got sick with the disease.

''We were expecting it, and when it arrived we met its challenge,'' she said of the summer when her children - then ages 3, 7, and 8 - became ill with whooping cough. ''My kids weathered that storm, and now they are stronger because of it.

''Too many people let fear drive their decisions,'' she said. ''I let education drive mine.'' After her firstborn had an adverse reaction to his first DTP (diphtheria, tetanus, and pertussis) vaccination, Lainson began researching the vaccinations that the medical community recommends for all children.

''I saw really investigating these vaccinations as a moral deed I needed to do for my children,'' she said. ''And after what I found out about possible reactions, I came to the clear and distinct conclusion that this vaccination wasn't right for my children.''

Lainson is one of a small but growing number of parents nationwide who have chosen not to follow recommended guidelines for childhood vaccines. In this picturesque city at the base of the Rockies, a low vaccination rate is believed to be spurring a resurgence of whooping cough, which can be deadly for infants.

''Nationwide, parents who choose not to get any vaccinations for their children has held steady at less than one-half of 1 percent,'' said Barbara Fisher, president of the National Vaccine Information Center, which distributes information on possible side effects of vaccines. ''What is growing is the number of parents who pick and choose which vaccines are right for their children.''

If there is an epicenter of this trend, it is Boulder's Shining Mountain Waldorf School. About half of the 335 students enrolled at the school have received only some, if any, of the vaccinations recommended by the Centers for Disease Control and Prevention and the American Association of Pediatricians.

Boulder, whose residents pride themselves on their reputation for questioning convention, historically has the lowest vaccination rate in the state. Residents of what Coloradans call ''the People's Republic of Boulder'' are also highly educated - in fact, according to the 2000 Census, Boulder has the most highly educated residents in the nation.

''They ask questions until they have enough facts to make a decision,'' said Shining Mountain Director Robert Schiappacasse of the parents at his school. ''They aren't going to blindly go along with the status quo.''

But by straying from the herd, Boulder parents may be putting the good of the larger community at risk. Boulder has one of the highest per-capita rates of whooping cough in the country. The problem started in 1993 when 52 people in Boulder were diagnosed with the disease. Since then, there have been about 80 cases a year.

''We now characterize it as endemic to our area,'' said Heath Harmon, communicable disease coordinator for Boulder County. ''But the past couple of years, we've had fewer cases than the counties surrounding us.'' People in those surrounding areas say they know from whom they caught the disease.

''Usually we don't have any cases, and this spring we had six kids so sick we had to keep them out of school for an extended period of time,'' said Valerie Lambiase, the district nurse for the St. Vrain Valley School District in nearby Longmont. ''We have a high vaccination rate in our district, but it [whooping cough] is coming from Boulder, where the vaccination rate is much lower.''

Even those who have been vaccinated can contract whooping cough, but in those cases symptoms will be milder. The vaccine is about 85 percent effective, with immunity waning at about age 10, according to the CDC. There is no approved vaccine for children older than 7.

Pertussis begins with ''cold-like'' symptoms and a mild cough. The cough then progresses to fits of coughing, followed by a high-pitched whooping as the person tries to catch his breath. Many people will gag or vomit following a fit of coughing. The disease can last one to three months.

The number of cases is growing nationwide. There were 7,867 cases in 2000. At 1,411 cases, Massachusetts had the most cases of any one state in 2000. That year 17 people died from the disease, including two Colorado babies.

According to information from the vaccine center, possible side effects of the pertussis vaccine include ''persistent crying for three or more hours, fever over 103 degrees, excessive sleepiness, and convulsions or collapse/shock that may lead to either death or permanent brain damage.''

'' It's clear that fear of adverse effects are, for the most part, unsubstantiated,'' said Dr. Robert Brayden, a Denver pediatrician. ''I have an open mind, and I believe a parent should get all the information they can,'' he said. ''But in the end, I think they'll find that vaccination is the best choice.''

This story ran on page A3 of the Boston Globe on 9/9/2002.
© Copyright 2002 Globe Newspaper Company.