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 Such exclusions may not be so easy to obtain going forward. This
year’s highly publicized measles outbreaks, which have infected more
than 150 people in 17 states, are no longer front page news. But
they could well have a lasting public health legacy. Already,
lawmakers in at least 10 states are promoting legislation that would
make exemptions far harder to obtain.
The proposed laws have been introduced in statehouses by both
Democrats and Republicans and include a range of approaches, from
requiring schools to post immunization rates to entirely eliminating
religious and philosophical exemptions. But they all respond to one
undeniable fact: Most of the recent measles cases have been in
people who were not vaccinated against the disease.
Lawmakers say they are optimistic about the chances of the bills,
though most of them aren't far enough along in the pipeline to
predict their fate. Many of the authors say the extensive coverage
this year has helped their case.
Legislators also say the laws they are proposing have received
bipartisan support and that they are likely to survive consideration
by legislative committees and be voted on in the coming weeks and
months. In eight states, Democrats introduced the legislation, while
in Texas and Vermont bills have been proposed by Republicans.
“This is not the last outbreak we’re going to see,” said Washington
Rep. June Robinson (D). “The issue will continue to be in the public
conversation.”
The year’s largest measles outbreak has been traced to Disneyland in
Anaheim, California where visitors were exposed to the disease in
mid-December. The vast majority of cases have been in that state,
which allows both philosophical and religious exemptions.
In all, 10 of the 17 states with reported measles cases have allowed
parents to opt out of vaccines on philosophical grounds, creating a
far easier way out of immunizations than states that only exempt
families with extensively documented religious objections or health
conditions that preclude vaccinations. Six of the 10 affected states
with easy opt-out laws have proposed new legislation.
Oregon and Washington have already held hearings on the proposed
laws. But in most other states, bills have only recently been
introduced or have yet to be scheduled for committee hearings.
While nearly 80 percent of Americans believe all children should
receive vaccinations, according to a Reuters/Ipsos poll, the
proposed laws have mobilized a small but vocal community of
anti-vaccine advocates who say parents should decide whether their
children receive immunizations. Some of the so-called "anti-vaxers"
fear vaccines may cause autism, a link scientists say has been
thoroughly debunked. Others say they oppose government intrusion in
parental decisions.
Several parents opposed to vaccinations testified at the Oregon and
Washington hearings and larger numbers showed up last month at a
Texas town hall where Rep. Jason Villalba (R) discussed a bill he
introduced that would eliminate personal belief exemptions.
In the past, local and national anti-vaccine organizations have
successfully thwarted legal efforts to curb exemptions through
grassroots efforts. Anti-vaxers quickly mobilized when Colorado,
which permits personal and religious exemptions, introduced a
measure last year that would require parents to complete an online
module about immunizations or consult with a doctor before opting
out. The bill passed the state’s House of Representatives but failed
in the Senate after parents lobbied and testified in hearings.
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The National Vaccine Information Center, a non-profit with 37,000
subscribers to a portal that monitors all legislation concerning
vaccines, has urged its members to raise their voices against this
year’s crop of proposed laws, which they say could be a tougher
fight because of the attention the measles outbreak has received.
“It’s about respecting everybody’s lives,” said Barbara Lowe Fisher,
the group’s co-founder and president.
LEGAL IMPEDIMENTS
In some states with easy exemption rules, decades-old court
decisions will make changing the laws difficult, if not impossible.
In Maryland, for example, the state’s Supreme Court ruled in 1982
that schools could not deny exemptions to parents with religious
objections, saying that could lead to discrimination. The state
does, however, have a law mandating vaccines in the case of a public
health emergency.
Courts in other states have decided vaccination cases differently.
In 1979, for example, Mississippi’s Supreme Court upheld a
vaccination requirement for school enrollment, holding that
exemptions, including religious ones, put children at risk.
Mississippi lawmakers have re-introduced legislation this year that
would allow philosophical exemptions, but those efforts have been
shot down several times in the past.
Health officials and local representatives said they worry that
allowing nonmedical exemptions means that some parents opt out
simply because it's easier.
In Idaho, for example, many parents sign a personal belief waiver
simply because the school has pointed out that a child is missing a
required vaccine, said Tom Shanahan, public information officer for
the Idaho Department of Health.
Less than 1 percent of children in the state have received no
vaccines at all, Shanahan said, but there is a 6.3 percent exemption
rate across the state for one or more immunizations. Parents can use
a waiver to exempt their child from some vaccinations or all of
them. Idaho has not introduced legislation this year that would
limit exemptions because “there’s a pretty strong culture of
individual rights,” Shanahan said.
And even if they are passed, stronger laws may not convince parents
who oppose vaccines to immunize their children. One pediatric nurse
practitioner, who requested anonymity for fear of retribution at
work, said she has decided to home-school her four-year-old son
after a Brooklyn school denied her repeated appeals to exempt him
from his hepatitis B and flu shots.
"It's completely unfair and it's ridiculous and a violation of the
Constitution," the nurse practitioner said.
For a graphic examining measles cases in the United States go to:
http://graphics.thomsonreuters.com/15/measles/index.html
(Reporting By Yasmeen Abutaleb, Editing by Michele Gershberg and Sue
Horton)
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