Quarantine for Unvaccinated Kids, or Scare Tactic?
Arizona officials worry that thousands at risk

Kerry Fehr-Snyder:The Arizona Republic

     Thousands of Arizona children are showing up for the new school year without all of the standard vaccinations against childhood diseases. The problem is so severe, and school officials are so frustrated, that at least one school is threatening to separate unvaccinated children from the others.
     "We don't know what to do any more," said Chris Martinez, school secretary at W.R. Sullivan Elementary School in Phoenix. "Without those shots, they can't be around other kids."
     Because of the fear of contagion, the school may segregate the unvaccinated children in the cafeteria or library on the first day of school if their parents can't come pick them up. State law prohibits them from attending classes until they can show proof of immunization.
     It is unclear how many Arizona children go to school without the required vaccinations against childhood diseases, including polio, measles, mumps and rubella.
     It is up to each school to ensure that their students have received the shots, but it's a challenge.
     At W.R. Sullivan, for example, school officials have sent several letters to parents this summer, reminding them "No shots, no school." Of the 80 seventh-graders who were sent notices, only three came in to update their immunization records.
     "We used to call parents to remind them, but that's just too much," said Martinez, who has been helping the school nurse get the word out to parents.
     For decades, state law has required school children to provide proof of inoculations. But not every parent remembers the vaccination schedule, or is aware of the free clinics the county holds. Some parents shun immunizations as too risky for their children. Add to this is a nationwide vaccine shortage of tetanus and diphtheria booster shots, and thousands of Arizona children are returning to school this month without their shots.
     In Maricopa County, schools and licensed day-care centers require children to be vaccinated against 12 diseases, including hepatitis A because of an outbreak several years ago. Children in other parts of the state must be vaccinated against 11 diseases.
     This year, the Arizona Department of Health Services is making a temporary exception for children 7 and older who are due for their tetanus and diphtheria boosters. Students will be required to show proof of both vaccines once the shots are more widely available. The deferral does not apply to children entering school or day care at younger ages.
     Even though a tetanus booster is not required at Arizona State University, Tempe parent Chris Moss is concerned because her 18-year-old son, Graham Berry, is overdue for one.
     On Wednesday, he moves into dorms where the university requires that incoming freshmen only show proof of two sets of measles, mumps and rubella vaccinations.
     But Moss, spokeswoman for Tempe St. Luke's Hospital, said she is worried that her son is susceptible to tetanus, also known as lockjaw.
     Nadine Zimmermann, a Glendale mother, believes vaccines are risky. Zimmermann said she doesn't believe in vaccinating her two young sons against such diseases as polio, hepatitis B and some strains of the flu.  "I think if they're around healthy kids and not growing up in filth and poverty, their bodies are strong enough to fight it," Zimmermann said. Besides, she said, contracting chicken pox, mumps and measles are rites of passage. "When you and I were kids, everyone got chicken pox," she said.
     But health officials insist that is outdated thinking, sparked in part by misinformation circulated on the Internet and through other sources. "We do hear that rite-of-passage argument," said Dr. Larry Pickering, editor of a health-advisory journal, The Red Book, published by the American Academy of Pediatrics.
     "But I tell people, 'How would you like to have 600 clear lesions all over your body, have to stay out of the sun, have your eyes hurt in the light, be at risk for pneumonia, encephalitis, kidney problems and stay home for two weeks?' " he said.
     "Or, would you rather have a shot?"
     Before the chickenpox, or varicella, vaccine was developed in 1995, about 4 million children developed the disease. That's about 90 to 95 percent of all kids.
     Some parents resist vaccinating their children because of a purported link between immunizations for the measles, mumps and rubella (also known as German measles) and autism.
     Generally, students entering kindergarten, first grade, and junior and senior high school are due for booster shots, according to the schedule of required childhood immunizations. "I'd be flipping out if he got a cut from a rusty nail," Moss said. "Tetanus
is a hideous, horrible death." But three prestigious research groups, including the American Academy of Pediatrics, have shown that there is no causal relationship. Pickering advises parents to request the recommended immunization schedule for children from birth to 18 and stick to it. The schedule is complex but is being simplified for next year.
     He also suggests that parents obtain vaccine information statements from the U.S. Centers for Disease Control and Prevention in Atlanta so they can learn about risks and reactions from each vaccine. They also should make sure their child is getting the appropriate immunization before and during each doctor's visit, Pickering said, because 5 to 10 percent of all children are overimmunized.