By David Riley

More Massachusetts parents are saying vaccines conflict with their religious beliefs so their children do not have to get immunized before they enter school, according to state records.
 
Most children have to be immunized to go to school with exemptions very rare. Less than 1 percent of children in the state are allowed to forgo mandatory vaccines with exceptions allowed only for medical reasons, such as an allergy confirmed by a doctor, or religious objections.
 
Medical exemptions have fluctuated over the last decade, but religious exemptions have climbed steadily, more than doubling from 210 in the 1996-97 school year to 474 last school year, according to the state Department of Public Health.
 
WCVB-TV (Channel 5) reported the increase Sunday and raised questions about whether some parents claim to have religious objections when they actually have other concerns or philosophical problems with vaccines.
"Obviously there's no religious test to question it, but we trust people's basic honesty about what they're doing," said Dr. Alfred DeMaria, director of communicable disease control for the state health department.
 
Vaccinations have long divided medical professionals and parents concerned about side effects. MetroWest health care providers said yesterday not every person needs to be immunized - if most people are vaccinated, diseases still cannot spread easily - but most should get shots to maintain that level of protection. Today's vaccines also are very safe, they said.
But a Framingham mother who has two children with autism said parents should be able to opt out if they believe their child has had an adverse reaction to a past vaccine, or for other objections.
 
Philosophical exemptions are allowed in some other states.
 
A doctor might not agree that a child has had an adverse reaction to a vaccine, but "ultimately the parent has the responsibility for the child," said Marjorie Hansen, whose family has a federal claim pending that alleges mercury used in immunizations is linked to autism. "If the child is disabled, ultimately we are responsible for their lifetime."
 
Hansen said she doubts there would be a sharp enough increase in exemptions to cause public health concerns if philosophical exemptions were allowed.
 
Dr. Michael McKenzie, a Natick pediatrician, said the current number of exemptions is nothing to worry about. But he said he is concerned it is growing, and he would not want to see the state allow other ways to opt out.
 
"If everybody was to make that choice, then we would get to the point where we would not have the threshold that is needed for immunization to protect everybody," McKenzie said. "All of the diseases we take for granted as being gone would show up again."
 
McKenzie, along with DeMaria, also said there is little reliable evidence that modern vaccines can be harmful. "Vaccines are safer than virtually all over-the-counter medications you can buy in a pharmacy," DeMaria said.

There are valid reasons for exemptions, but overall, vaccinations provide "community immunity," said Rebecca Donham, a program officer at the MetroWest Community Health Care Foundation. For that reason, the foundation favors immunization, she said.
 
But she saw no way to tell if people who file religious exemptions are being honest.
 
"That's not something for Massachusetts lawmakers to look at," Donham said.
 
The MetroWest Autism Alliance urges parents to vaccinate their children, said director Nannette Ohman. But the group suggests waiting until children are a little older, spacing out immunization shots, and requesting single vaccine doses that do not contain thimerosal, a mercury-based preservative, she said.
 
DeMaria said he would not want to see other vaccine exemptions offered. "We like the law as it is," he said.