Before Karen Jackson even had children, she knew that she would never get them vaccinated.
When Jackson, a Bridgeport resident, was studying to become a social worker, she wrote a paper on vaccinations and was floored by what she learned.
"The contents aren't viable," she said. "Giving my child a living virus is not my idea of saving their lives."
She is now the mother of three school-aged boys, none of whom have been vaccinated. Though the state requires several vaccinations for students starting school and at other periods, it is possible to get exemptions for either medical or religious reasons. Jackson chose the latter, which she said wasn't hard to do.
She is one of a growing number of parents in the state who have obtained exemptions from vaccinations for their children. The Connecticut Department of Public Health reports that last year 1,056 children entering kindergarten and seventh grade received exemptions, a 127 percent increase from 2003, when the state recorded only 465 such exemptions.
First, some parents worry vaccines could be linked to autism and other health problems in children, though experts have repeatedly said there is no evidence supporting that link. Another theory, he said, is that vaccines are a victim of their own success. Most modern parents haven't lived in a world where measles, polio and other illnesses are a common experience.
"You're much less likely to feel threatened by something if you don't see it around," Murray said.
Getting their shots
Depending on a child's age and grade level, different vaccinations are required to enter school.
For instance, children entering kindergarten in Connecticut this year need to have at least four doses of the diptheria, tetanus and pertussis (DTap) vaccine, at least three doses of the polio vaccine, two doses of the measles, mumps, and rubella (MMR) vaccine, three doses of hepatitis B vaccine, two doses of varicella (or chicken pox) vaccine, two doses of the hepatitis A vaccine, one dose of the pneumococcal vaccine and one dose of the Haemophilus influenzae type B vaccine.
Vaccination coverage in Connecticut remains high despite the rising number of exemptions. For instance, according to the CDC, of the 45,695 students entering kindergarten in the state in 2011-2012 school years, 97.4 percent had their MMR vaccination; 97.8 percent had their DTap shots and 97.7 had percent their polio shots.
Yet even with those high numbers, some doctors in the region said they're concerned about the rise in exemptions.
"If you have more and more kids not getting vaccinated, then you have more and more of a pool for illness to take hold," said Dr. Robert Chessin, a pediatrician at Pediatric Healthcare Associates in Bridgeport and Shelton.
In Connecticut, the state Department of Health said there have already been 111 cases of pertussis reported this year and that the state could reach a 10-year high for cases of the disease. Last year, there were 68 cases in the entire year.
Unvaccinated children typically can't attend school without an exemption, said Stephanie Knutson, school health counselor with the state Department of Education. Even if parents do get their children properly excused, they have to sign a form stating that, if there's an outbreak of a contagious illness, their unimmunized child can't come to class.
There are two main categories of vaccine exemption -- medical and non-medical. In Connecticut, the only non-medical exemptions allowed are those given for religious reasons, though some states allow exemption for "philosophic" reasons.
The medical exemption requires a written statement from a physician. There are multiple valid medical reasons that a child can be excused from getting immunized, including an allergic reaction to the vaccine, pediatric cancer, or HIV or other immune disorders.
The religious exemption is easier to get, requiring parents or guardians only to provide a written statement that the immunization is contrary to their religious beliefs.
A Shelton mother of three, who didn't want her name used, said she received religious exemptions for her children. She said she does get her children vaccinated, but doesn't go by the prescribed immunization schedule, preferring to space the vaccinations out as much as possible. However, she couldn't do that without an exemption. Because her kids didn't qualify for a medical exemption, her only option was the religious exemption. She said her actions aren't uncommon among parents who object to immunization requirements. "There are a lot of parents who virtually lie and say `My religion is against this,' even though it's not," she said.
For years, some parents have expressed fears that vaccines might do more harm than good. Primarily, there were concerns the MMR vaccine was linked to autism in children, largely sparked by a 1998 article in the medical journal The Lancet. The study, led by Dr. Andrew Wakefield, followed 12 children who had developed behavioral issues as well as certain intestinal problems. Eight of them had received the MMR vaccine.
It was later revealed that Wakefield had received money from a lawyer suing vaccine manufacturers. Also, in 2004, a report from the Institute of Medicine concluded there is no link between autism and the vaccine. In 2010, The Lancet retracted the study.
For parents like Jackson who are worried about the content of vaccines, Dr. Nimrod Dayan, a pediatrician with Pediatric Healthcare Associates in Trumbull, points out that those that contain live viruses include them in a weakened form.
"It's designed so that it doesn't make you sick -- it tricks the body into thinking it has the disease, and fighting that disease," he said.
Dayan is one of many pediatricians in the region who won't see children if their parents refuse to get them vaccinated without a valid medical reason. He said it's his practice's policy to turn away a family who won't let children receive any vaccinations, because these children put other children at risk.
But some area doctors will see these families, including pediatrician Dr. Sophia Leonida, of Stratford. Though careful to point out that's she's not anti-vaccine in general, Leonida said parents who either don't vaccinate their kids at all or don't vaccinate them according to schedule think they're making the best decisions for their children. "I always felt if a parent makes a choice that's different than what's expected of them, their children should not be penalized," she said.