In response to the current measles outbreak, which has ballooned to 121 cases in 17 states, lawmakers across the country are taking a hard look at exemptions that allow parents to opt out of the mandatory vaccinations their children must receive before attending public school. Most legislators—including lawmakers in California, Maine, and Minnesota—are attempting to close loopholes and make it more difficult for people to get around inoculation requirements. Some, however, are actually trying to make it easier for parents to say “no” to vaccines.
Currently, 48 states allow parents to opt out of vaccine requirements for non-medical reasons. (Mississippi and West Virginia limit exemptions to medical reasons.) Most states allow for religious exemptions, but 13—including Idaho, Texas, Colorado, and Pennsylvania—also allow parents to claim exemptions based on their personal beliefs.
Most of these states do not define “personal belief” in their statutes, beyond calling it a matter of conscience or a personal conviction. Therefore, such exemptions are potentially limitless. Given the country’s current debate over vaccines, though, it seems likely that parents who believe vaccines cause autism, those who distrust government regulations, or those who question the motives of pharmaceutical companies are the ones choosing to use these loopholes.
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Some public health experts and lawmakers have cited abuse of these exemptions as one cause of our current outbreak. There are now large pockets of unvaccinated children in certain communities. In California, for instance, where the current outbreak began, 27 counties have measles vaccination rates that are lower than the 92-to-94 percent recommended by the Centers for Disease Control and Prevention to ensure herd immunity, allowing the virus to spread faster than it would have otherwise. Some areas, especially in Northern California, have even slipped below 85 percent. This is, in part, caused by the availability of personal exemptions—2.54 percent of the 2014-2015 kindergarten class statewide had personal exemptions to vaccines when they entered school.
In response, lawmakers in California are now trying to stall the declining vaccine rates by putting an end to non-medical exemptions. Last week a group of state legislators, led by Sen. Richard Pan (D-Sacramento), introduced a bill that would remove parents’ ability to obtain personal and religious exemptions for vaccinations. (They have since indicated that they may restore the religious exemption.) Speaking at a press conference, Pan, who is also a pediatrician, said, “Every year that goes by we are adding to the number of unvaccinated people and so that’s putting everyone at greater risk. We shouldn’t have to wait until someone sickens and dies to act.”
In recent years, Washington, Oregon, and Michigan have passed their own measures requiring parents to be educated about vaccines by health professionals before their non-medical exemption can be approved. Other restrictions, which would either similarly mandate parental education or eliminate personal belief exemptions altogether, are pending votes in Minnesota and Maine.
Such measures to make it harder for parents to opt out of vaccines make sense, as we witness what can happen when vaccination rates fall too low, herd immunity is lost, and measles strikes. Seven infants at a daycare center in Illinois—all of whom were too young to be vaccinated—have contracted the disease. A family in Arizona, meanwhile, is worried about their two children after they were exposed in a clinic waiting room. At ten months old, their son was too young for the vaccine, and their daughter cannot get it because she is undergoing treatment for leukemia.
These cases can have serious consequences: Kids infected with the virus can get ear infections, pneumonia, and encephalitis. They can suffer hearing loss, permanent developmental delays, and they can die.
So it is frankly unbelievable that in the midst of this outbreak, some lawmakers are actually calling for more and easier-to-obtain exemptions. Take New York Assembly member Tom Abinanti (D-Hudson Valley). His state has a religious exemption already, but he wants to add a philosophical one, which sounds similar to the personal belief exemption in others states. In an interview with Fios 1 Newsmakers last week, Abinanti explained that he finds it unfair that parents claiming religious exemptions must undergo so much scrutiny. Even as he advocated for individual freedoms, however, throughout the interview, Abinanti demonstrated a lack of understanding of how vaccines work and an astounding disregard for public health.
In arguing for parental choice when it comes to vaccinations, he said, “Right now we require kids to get 26 vaccinations and some people believe that that’s too many.” The mere fact that some people think this is too many vaccines does not make it a valid scientific opinion. All major medical organizations believe the vaccines we give now are vital to the health of our children and our nation. To use just one example, these vaccines are the reason that we no longer have any kids who are paralyzed by or die from polio. Measles itself was declared eliminated in 2000.
He went on to say that we should have each parent sit down with their doctor to decide if the vaccine is right for their kid:
That way, the parent or the person themselves will be much more comfortable in knowing, “Hey, someone has looked at my kid, this is not a blanket requirement for everybody, my kid is not going to be collateral damage for some [word mumbled] argument out there that we need to vaccinate the herd.”
First, individual children who receive inoculations are not going to be “collateral damage,” because vaccines are safe and side effects are minimal—the link to autism has been disproven and the safety has been extremely well documented. Second, herd immunity is not “some argument”; it is a scientific fact that vaccines work if almost everyone gets them, and that they do not work to keep populations safe if given on a case-by-case basis.
What is neither proven or sensical is the concept of personal beliefs or philosophical exemptions. These are loopholes so large that we can drive truckloads of junk science and conspiracy theories through them. And the result is a resurgence of diseases that previous generations worked so hard to eliminate. (In addition to the measles outbreak, there is a smaller outbreak of mumps—prevented by the same vaccine—in Washington and Idaho.)
Unfortunately, Abinanti is not the only lawmaker who is taking this opportunity to pander rather than promote public health. Republicans in Mississippi—which has a 99.7 percent vaccine rate because it offers no non-medical exemptions—introduced a bill that would allow for “conscientious” exemptions. An article in the Washington Times on Monday suggested we may see even more to come:
That such bills remain viable amid the measles outbreak stands as a testament to the strength of the so-called anti-vaxxers or vaccine skeptics’ movement, which has found pockets of support across the political spectrum among environmentalists, civil libertarians, and a small band of religious followers.
I find this trend remarkably distressing. I had hoped that anti-vaccine rhetoric would go away once the autism connection was thoroughly debunked. It didn’t. When people started getting sick, I had hoped that we could have a sensible conversation about public health and social responsibility. We didn’t. At the very least, I had hoped that lawmakers would take this moment to reassure constituents that vaccines are safe and important. They didn’t. Instead, the mainstream media continues to pretend there are two equally legitimate points of view on vaccines, and lawmakers have started arguing that it should be even easier for parents to choose not to protect their own child—thereby putting other children at risk.
With those hopes dashed, I’m left only with the fear that we will keep having these arguments and expanding exemptions until somebody’s child dies from measles.