I No Longer Oppose Removing Non-Medical Exemptions

Once upon a time, I was against removing personal belief, religious, and non-medical exemptions that are often enshrined in the state laws that require children to receive certain vaccines to attend schools. These exemptions allow parents of under- and un-vaccinated children to send them to school.

I had wanted parents to happily and affirmatively accept vaccines for their children, and thought that by putting more obstacles to exemptions, parents could be given some time to come to the conclusion that vaccines are safe, effective, and necessary.

But time has run out.

In most states, the experiment of allowing parents to opt out of school vaccine requirements is relatively new. Certainly, when I attended school, there was no option to go to school unvaccinated. My Kindergarten Round-Up included swallowing the Oral Polio Vaccine. I am certain some parents in those days did not like vaccines, but that attitude was exceedingly rare.

I’m not going to go into a history of the anti-vaccine movement, but we know that vaccine refusal has become much less rare. And refusing vaccines is even more common in places that make it easy. According to one 2018 study:

[I]n the past decade, the number of philosophical exemptions to vaccination has increased in two-thirds of the states that allow such exemptions. As a result, researchers suggest that these areas are becoming increasingly vulnerable to vaccine-preventable disease outbreaks.

If it were simply a rise in vaccine refusal, though, I still would not have become an advocate of removing the non-medical exemption. I got involved in working on vaccine legislation in Minnesota in 2011, when we were in the midst of a measles outbreak. 2017 saw yet another, larger, measles outbreak. Things have gotten progressively worse:

  • In the midst of the outbreak, anti-vaxxers flew out Mark Blaxill for a seminar with the afflicted community on continuing to file vaccine exemptions.
  • I have been told stories about the anti-vaxxers hiring students, during the outbreak, to hang “informational” flyers on doors in the neighborhood where measles was spreading.
  • I have been told stories about anti-vaxxers going into this neighborhood and telling women that the measles outbreak was fake–a health department trick to get them to vaccinate their children. Appointments to get vaccines were subsequently canceled.
  • Anti-vaxxers scheduled the “Vaxxed Bus” to arrive in Minnesota at the end of the outbreak.
  • Parents in Minnesota have tried to coordinate measles and chickenpox parties to make their children sick on purpose. Whether or not these parties actually happened, I have no idea.
  • Since the outbreak, anti-vaxxers have held “legislator only” events. This year’s featured Robert F. Kennedy, Jr. promoting a conspiracy theory about the Autism Omnibus Proceedings.

In this stew of disease activism, anti-vaxxers are asking for their “rights” to send their unvaccinated children to school be preserved because most parents are still vaccinating. Alternately, they claim their children pose no risk to other children or that herd immunity is fake.

In the meantime, because of anti-vaccine activism across the world, we all saw a 30% spike in measles cases in 2017.  The outbreak of measles in Clark County, Washington has taken attention away from an even larger outbreak in Rockland County, New York. Because measles is our most contagious disease, it is a harbinger of outbreaks of other diseases as vaccine refusal becomes more and more widespread.

Vaccine refusal has real consequences. It makes our communities sicker, and it threatens our classmates and neighbors who cannot be vaccinated or who are medically fragile. We are seeing this threat increase before our eyes. We don’t have the time to wait for parents to change their minds.

Lawmakers need to stop allowing anti-vaccine parents to advocate for their supposed right to rely on everyone else vaccinating in order to stop outbreaks while simultaneously and actively trying to convince parents to stop vaccinating. Their approach is two pronged: let me send my unvaccinated child to school while I work hard to make sure more and more unvaccinated children are going to school.

One pediatrician explained to me that allowing vaccine refusal is much like allowing second-hand smoking. You have the right to smoke, but you don’t have the right to smoke everywhere you want. You also have the right to leave your children unvaccinated. But you do not have the right to bring an unvaccinated child into the place where children are exposed to the most germs and spend the bulk of their day.

And listen–I’m not giving up on convincing parents that vaccinating their children is the best choice. I do still want parents to understand fully the benefits of vaccinating so that they feel good about doing so. This mission is still my primary mission. I want every single one of those children protected from vaccine-preventable diseases.

If we are serious about protecting children, then we really need to bar vaccine refusal at the door to every school. I take no pleasure in asking schools to turn away children, but we have reached a critical point. The anti-vaxxers have forced our hand. We all have to sign on to eliminating non-medical exemptions.

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