Eleven-year-old Kara Robinson scrunched up her face as the needle went in her arm and proclaimed that, yes, it DID hurt.

Kara Robinson, 11, receives an immunization shot from firefighter Sean Dolan at the Shots for Tots clinic Aug. 13 at Aurora Fire Station #2.

Fortunately, her grandma, Aurora resident Ruthmary Robinson, was right there to soothe her.

“Ice cream will make it all better,” she promised her granddaughter.

As they strolled out of the Aurora Fire Department Station No. 2, near Sixth Avenue and Delmar Circle, Kara was given her choice of a stuffed animal for extra comfort.

And Robinson received the security of knowing her grandchild was now fully current on all the recommended vaccines for school.

Kara was one of about 300 children to get their shots at the fire station that Saturday, Aug. 13.

Shots for Tots a model health program

The Shots for Tots program, a collaboration of Tri-County Health Department, Aurora Fire Department and the Rotary Club, has made low-cost to free immunization shots available to nearly 10,000 Colorado school children in the past nine years.

If parents were charged full price for the range of vaccines available through Shots for Tots, it could cost them $200 to $500. Instead, they’re asked to simply pay what they can.

“We average about $14 per shot, which is the suggested amount, but a lot of families can’t afford that, especially if they have four or five children,” said Bryce Anderson, special projects nurse supervisor for Tri-County Health. “So they give what they can, and if they can’t pay anything, we don’t ask for anything.”

The program, deemed a model practice by the National Association of County and City Health Officials, sets up the clinic one Saturday a month in the Aurora fire station, and another Saturday at a fire station in Littleton. Another program in Denver offers free to low-cost shots on a third Saturday, so there are options for metro-area youngsters who need their shots on three out of four weekends.

Beyond the low cost of the shots, the fire station clinics help address a number of other barriers to immunizing children:

  • They’re in neighborhoods where immunization rates have historically been low;
  • They’re held on the weekends, which is a help to parents who might otherwise have to take time off work to get their children to a doctor’s office for the shots;
  • Going to a fire station and getting to climb on a fire truck is just way more appealing to the average kid than going to the doctor’s office.

State’s immunization rates, once abysmal, now 15th best

Outreach efforts such as this have boosted the percentage of Colorado school children who are fully vaccinated by age 2 to 79 percent, 15th highest rate in the country.

That’s a marked improvement from 2005, when Colorado ranked 50th.

But for all its efforts to boost the immunization rates among families who, in the past, couldn’t afford or didn’t know how to obtain vaccines for their children, some serious immunization-related issues remain in Colorado.

Increasingly, some parents are balking at immunizing their children, or at least at immunizing them on the schedule recommended by health authorities.

A 2010 national survey found that while most parents do follow the recommended vaccine schedule, more than half express some concern over it.

Too much time spent calming parental fears?

Pediatricians and family practice physicians are bearing the brunt of this uncertainty.

A 2009 survey conducted by researchers at the University of Colorado in Denver and the Centers for Disease Control and Prevention found that 79 percent of those physicians who care for children reported they had encountered at least one parent who refused to vaccinate a child.

By the numbers
In a 2009 survey conducted by researchers at CU-Denver and others, eight percent of physicians reported that at least 10 percent of the parents they saw refused to allow their children to be vaccinated.

Eight percent of the physicians reported that at least 10 percent of the parents they saw refused to allow their children to be vaccinated.

Even more common were parental requests to space out the recommended vaccinations over an extended period rather than getting them all at once, as health officials suggest.

As a result, more than half the physicians surveyed reported they now spend up 20 minutes per patient addressing concerns about immunizations.

Many feel that’s time that would be better spent on other topics, and they believe the ongoing fearfulness around immunization vaccines to be burdensome and distracting when it becomes the primary focus of a visit.

The reasons for this increasing parental reluctance are varied, but part of it may be the increased number of shots now either required or recommended.

Link to autism discredited but questions linger

No doubt some of the reluctance can be traced to a widely-reported study in the late 1990s by British researcher Andrew Wakefield that linked the MMR (measles/mumps/rubella) vaccine to autism. That study has since been retracted and Wakefield, fairly or not, has been thoroughly reviled by health authorities and the media.

But for many parents, questions remain.

“There’s a long list of reasons why a parent might choose not to vaccinate at all, or to pick and choose,” said Cindy Loveland, Colorado State Director for the National Vaccine Information Center.

“For instance, some parents might prefer their children get chicken pox rather than get the vaccine because many think having chicken pox provides better immunity down the road.”

Immunization proponents dispute that, by the way.

“We’re not anti-vaccine,” Loveland said. “We don’t tell people not to get vaccinations. We just say they need to make informed decisions, and we fight for laws that support that right.”

‘If you had to live with what we’ve lived with…’

Take the Prine family of Littleton, for instance. When their eldest son, Eric, now 20, was 10 months old, his parents took him to the health department for his required vaccinations.

“I was vaccinated. My wife was. We never thought that anything bad could happen. That never crossed our minds,” said Ronnie Prine. “We were never told that our child could develop seizures and be brain-damaged.”

That night, the baby wouldn’t stop crying. Within a week, he had his first seizure. Within a month, he had 24 seizures in one day.

One family’s story
“We never thought that anything bad could happen … We were never told that our child could develop seizures and be brain-damaged.”
Ronnie Prine, Littleton

Today, Eric Prine weighs 45 pounds, and has never walked or talked. He has regular seizures and requires round-the-clock care. Prine is convinced his son’s condition is a direct result of the DPT (tetanus/diphtheria/pertussis) vaccine. Consequently, his 11-year-old daughter has never been vaccinated for anything.

“We’re not looking to sue anyone. We’re not that kind of people,” Prine said. “We just want answers. And we’re not out here saying ‘Don’t vaccinate your kids.’ We’re saying it should be your choice, not the government’s or the school’s. But when the media gets hold of this, then we become the bad people who won’t vaccinate. But if you had to live with what we’ve lived with for 20 years, you’d say we deserve to have our say on this.”

Castle Rock couple Shawn and Susan Kelley have a similar story. Their 5½-year-old daughter, Julia, suffered a severe reaction to the MMR shot she got as part of her 1-year wellness checkup. She developed encephalitis, was hospitalized for a month, and was left permanently disabled. The child received a settlement from the National Vaccine Injury Compensation Program.

“The government acknowledges that this happens. Enchephalitis is a side effect. But they’re not honest about how often it happens,” said Susan Kelley, a veterinarian who now restricts her practice to animal dentistry and spaying and neutering because she refuses to vaccinate pets. “They say it’s one in a million, but I know two other people this has happened to (and) I don’t know three million people.”

Kelley acknowledges that parents who want to do what’s right are caught in a bind.

“If I had another baby, I wouldn’t vaccinate it,” she said. “But then, what if it caught some disease? So you’re damned if you do and damned if you don’t.”

Colorado exemption policy lenient

Colorado has long had a lenient policy about exempting children from immunization requirements for school.

For more information

While school children are “required” to show proof they’ve been vaccinated for a list of diseases – including Hepatitis B, tetanus, diphtheria, pertussis, polio, measles, mumps, rubella and chicken pox – they may, in fact, be exempted not only for medical or religious reasons, but also for “personal” ones.

Parents merely need to sign the Statement of Exemption on the back of their child’s immunization certificate stating they adhere to a “personal belief opposed to immunizations.”

Loveland fears that state officials will, in the future, attempt to remove the personal exemption clause, and force parents who object to the vaccinations to provide statements signed either by physicians or religious leaders in order to obtain the medical or religious exemptions.

“This would be a change to longstanding Colorado law,” she said.

She also feels parents may be confused about what’s required versus what’s merely recommended, such as flu vaccine or the vaccine for meningitis.

Earlier this year, state health immunization leaders launched a statewide campaign entitled “Immunize for Good,” in hopes of reassuring parents who do vaccinate their children that they’re making the right decision, and providing easy-to-understand information about how vaccines work for parents who are still undecided.

“There is a lot of controversy about vaccinations,” said Erin Suelmann, acting executive director of the Colorado Children’s Immunization Coalition, an independent, non-profit organization that accepts no funding from vaccine manufacturers.

“But the majority of parents do choose to vaccinate their children, close to 88 percent. A little over half still have some concerns, but even though they have concerns, they’re vaccinating. They weigh the risks, and conclude that not vaccinating is the more dangerous.”

Suelmann notes that some children cannot be vaccinated, either because they are too young or because they have medical conditions that preclude it. She believes that parents of healthy children have an obligation to the community to get their children vaccinated, to help protect the health of those who cannot be.

“It simply makes the community safer for everyone,” she said.