Health Team

Parental dilemma: To get kids immunized or not

Posted November 14, 2007
Updated September 26, 2008

— To get the shots or not to get the shots – that's the dilemma many parents face when they suspect their child is at risk of developing problems from immunizations.

A little more than 99 percent of children get their recommended immunizations in North Carolina. Fewer than 1 percent of parents opt out for religious or medical reasons.

However, there are indications that one in every 150 babies born in this country will develop autism, and some parents say they believe there's a link to vaccines, so they're reluctant to have their children immunized.

From the start, Chris and Kelly Steffens closely tracked their oldest daughter's development. Marly, 5, was born seven weeks premature. They followed their doctor's advice, including vaccinations.

At age 2 she was diagnosed with autism, characterized by social difficulties, language abnormalities, narrow interests and ritualistic behavior.

"My husband and I kind of suspected vaccines may have something to do with it," Kelly Steffens said.

That was why they watched their second daughter, Skylar, now 22 months old, more closely as she got her shots.

Similar behaviors popped up, especially after her third dose of DTaP vaccine, or diphtheria, tetanus and acellular pertussis, when she was 12 months old.

"I decided right then and there that there was going to be no more vaccines," Kelly Steffens said.

"Unfortunately, some of the signs and symptom of autism do tend to show up around the time that children are receiving some shots," said David Laxton, communications director with the North Carolina Autism Society.

Suspicions surround thimerosal, a mercury-based preservative once used in many vaccines, but it hasn't been available for children under 6 since 2003. Still, research continues to show no link to autism.

"Despite the fact these vaccines no longer contain thimerosal, actually the rates of autism have continued going up," said Dr. David Weber, a UNC infectious disease specialist.

He says the benefits of immunization far outweigh the risk. In fact, immunization is listed as one of the 10 greatest health achievements of the 20th century.

"We've eliminated polio from North and South America. We've gone from 20,000 cases of congenital rubella – a horrible disease – just to a single case. [And] 800,000 cases of measles to under 100 cases in the U.S.," Weber said.

But the Steffenses said they still believe their girls are at risk from something in the vaccines.

"[Marly] was premature. Her immune system was not fully developed as it was. These children are getting 24 immunizations or more before they're 24 months old," Kelly Steffens said.

Laxton, with the NC Autism Society, concedes studies show thimerosal might not be the cause, but the advocacy group supports parents' desire to work with pediatricians and their schools.

The state requires full immunization as children enter kindergarten.

"See what options are for maybe spacing things out and putting them on a different schedule," Laxton said.

The Steffenses said they might consider immunizations in the future, but not in combination vaccines, just one immunization at a time.

"Spread them out and watch them carefully and see how they do," Kelly Steffens said.

The Steffenses said a gluten-free diet and special developmental therapy have helped their daughters.

“[Skylar’s] really doing great. She's very verbal. She's very social,” Kelly Steffens said.

Public school systems in the state accept both religious objections to vaccination and genuine medical reasons. For medical concerns, the parents take a form from the school nurse to their child's pediatrician.

The form requires the doctor to check boxes on the forms that apply, such as a specific medical allergy or other medical contraindications. If the reason is not listed on the form, the doctor needs to write about it in detail.

You can obtain a full recommended schedule for immunizations from the Centers for Disease Control and Prevention. More information is available about the Autism Society of North Carolina, too.


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  • peace and joy Nov 16, 2007

    I really investigated the science when my oldest was little and found out the rate of serious neurological side effects from the old pertussis vaccine was higher than the rate of the disease - so I waited for the acellular version. And I chose to let my kids get the chicken pox rather then the shot because I'm afraid that there will be an epedemic among adults in 15-20 years that will have serious consequences (like the Measles epidemic at my college among folks who were vaccinated that left many sterile). And finally, I did space them out. It just doesn't seem logical to me to expose an immature immune system to 6 diseases at once! And I feel strongly that I should have a choice as a parent if the risks are higher than the benefits (although meningitis is dangerous it is also extremely rare and I suspect there will be a higher rate of side effects than the disease). Just my thoughts....

  • lettered olive Nov 16, 2007

    Billo---clearly YOU are the one who is seeing what you want to see. What I am talking about is not "junk science." Read Healing the New Childhood Epidemics by Bock, M.D. or Changing the Course of Autism by Jepson, M.D. Valuable info backed up by research.

    The studies that have been done looked simply at the thermerisol/autism issue, ONE variable. What most of us are saying is that this is only ONE of the many things that can cause autism. It is like a bucket full of toxins that overflows. Most of us can keep that bucket from overflowing because we can process out the toxins, heavy metals, etc. Kids with weakened immune systems have more trouble with that process and parents are afraid to give the vaxes because that may just be the thing that overflows the bucket. It would be nice to see a slower, more cautious approach to vaxes. Spread it out and get the ones that are really important like polio instead of chicken pox. That way kids' immune systems have time to process it.

  • clrh Nov 16, 2007

    I am a public school teacher. Two years ago, I spent over two weeks in bed because I got whooping cough--most probably exposed by someone at school. I had every shot I was supposed to in childhood, but immunity for that particular disease (and probably some others) wears off after awhile. Although the germ was likely carried to me at school, no children that we knew of at school had the disease, likely because most of them were vaccinated.

    The first two days of my illness, I attended school because I thought that I only had a cold. After I returned to class, I had to be questioned by my principal and the school nurse--WHY? Because some parent (of a child not in my class) found out that that I had been ill. HER child was not vaccinated, and so she wanted to complain about my exposing her child to the disease.


  • kimmimom Nov 15, 2007

    I cannot gain immunity to rubella for whatever reason. I have had the vaccine as a child and again twice as an adult after my 2 were born, yet my rubella titer is negative. So when I was pregnant I was at risk of being exposed to someone who might have rubella. In fact, I worked at DSS during my first pregnancy and a client came in. She called back a couple days later to tell us her child had rubella. I then had to go get immunoglobulin shot to hopefully prevent birth defects in my unborn child through no fault of my own (i had been immunized, but it did not "take"). So there are risks to people. Same thing wtih young children who have only recieved part of their series of a particular shot (MMR, DTAP,etc). No fault of their own, but they are still at risk for getting the disease.

  • kimmimom Nov 15, 2007

    local know it all.....

    Yes, they do try to do 4 shots at a time. With my third child, I chose to take a slower shot schedule. She got, at most, 2 at a time, sometimes only 1. Even at age 4/5, I split her K shots up to have some at her 4 YO check and she will have 2 more at her 5 YO check to prevent having 4 sticks in one visit. All it took me was to tell the dr I wanted to go slower and they had no problems. She was "caught up" by age 2.

  • jgirl5830 Nov 15, 2007


    I see what you are saying, for instance I have a little girl and I don't want it mandated that she get the vaccine for sexually transmitted dieases, I think that should be a choice.
    I just worry that one loop hole is going to create another and another and before you know it everyone is going to have an excuse not to vaccinate, I'm referring to religious exemptions and the like.

  • bill0 Nov 15, 2007

    wcnc - I'm sure you come into contact with unvacinated people all the time. 1% of 275 million is 2.75 million people in the US, so you are bound to run across some. Fortunately, most of them don't actually have any disease. If we keep the overall levels at 99% or so, there is a very small chance of diseases running rampant through society. The real problem is places like hospitals and schools. If you only have 1 in a 100 in danger of getting a disease at a school of 500, you probably won't get much spread with only 5 kids. What about 10, 15, 20? There is some critical level where the disease can really spread like wildfire. I don't know exactly what that level is, but I do know we don't want to get anywhere close to it as a country.

  • wcnc Nov 15, 2007

    I hear what you are all saying about protecting the babies- believe me, I want that, I LOVE babies!! But, where do we stop immunizing?? A baby could die from a sibling or stranger who passes on germs from a common cold....that baby could get RSV and die. Do we "force" a "cold vaccine" or cold medicine (which we can't buy without showing our driver's license now!!) because of the risk, however small, of passing it on to the babies?? I'm all for protecting the little ones, but we have to be careful not to go overboard....

  • jgirl5830 Nov 15, 2007

    Kristin RN

    Thank you for saying that, its been my point all along, there will be babies and pregnant woman exposed to unvaccinated children and are at risk of diseases how ever small ( 1% or whatever) but it does happen and you have no way of protecting these people that I mentioned because you cant tell who is or isnt vaccinated when you're at a school function or the park.

  • wcnc Nov 15, 2007

    bill- I really know nothing about the religious exemption, but if that is the reason behind it, then why doesn't the logic apply that those parents are putting their own children in danger (like the loaded gun comparison) and therefore can't use a religious exemption?? I don't think those people have their children's best interests or health at heart!!

    But, if 1% of the population isn't getting immunized, for this religious exemption or otherwise, wouldn't it be true that most people at some point in their life will come into contact with that 1%, putting them in danger??

    I guess I should clarify by saying I'm not talking about the "deadly" disease shots, but what about forcing the chicken pox shot (which has only been used in the past 10 or so years), the HPV shot, etc.....that's what I don't want to happen...