Proposal to Reduce Vaccine Exemptions While Respecting Rights of Conscience

According to the World Health Organization, vaccine resistance is one of the top 10 threats to global health in 2019. Here in the United States, New York City is currently experiencing the worst epidemic of measles for decades, which has caused the death of many children in ultra-Orthodox Jewish neighborhoods.

Other group epidemics of deadly and highly contagious, but vaccine-preventable diseases are becoming more and more routine in the country. These epidemics are caused by the decision of some parents to ask for religious and philosophical exemptions under which children must be vaccinated in order to go to school.

In response, leading health organizations and advocacy groups have called on state legislatures to eliminate religious and philosophical exemptions.

However, in almost all states, the lobbying power against vaxxers would probably make it politically impossible to do so. In addition, this approach may ultimately be counterproductive, which can ignite the pbadions that politicize and unnecessarily undermine bipartisan consensus around the immunization policy that is critical to its continued success. Finally, it would be preferable to respect individual freedom and parental rights if the public health objective of maintaining sufficiently extensive immunity can be achieved without unnecessary compulsion.

In collaboration with lawyers and experts in public health, we have developed an alternative approach: a model law aimed at reducing the number of parents who refuse to vaccinate their children while respecting the freedom of conscience.

Success Story in Public Health

Vaccination is one of the greatest achievements of the 20th century in public health. There are an estimated 42,000 deaths each year in the United States, more than the combined seatbelt and child safety seat. It is also safe.

Yet, vaccination is a victim of its own success. Because parents do not regularly see the devastation of vaccine-preventable diseases, an increasing number of them are now more worried about vaccination than the diseases they prevent.

At the national level, vaccination rates are very high. However, local homes where many parents have requested waivers have witnessed epidemics. For example, in Oregon, more than 250 schools have failed to achieve the 92% vaccination rate required for community immunity. In some schools, only 37% of students are vaccinated. As a result, the Portland area is currently experiencing a rapidly growing measles outbreak.

By choosing not to participate in the vaccination, parents put their children at risk.

More importantly, they also weaken what public health experts call "community immunity," the protection everyone enjoys when a critical mbad of people is immunized. Community immunity protects people who can not be vaccinated safely, for example because they are too young or not healthy enough.

A proposal to maintain the immunity of the community

We propose to "push" reluctant parents to vaccinate their children without completely removing the right of parents to withdraw due to deeply held religious or philosophical beliefs.

In many states, it takes more time, effort and cost for children to vaccinate their children than for an exemption. Compliance with immunization requirements may require a long list of obstacles: missing work to get children to the doctor; witnessing the suffering of a child because of vaccines; physically restrict recalcitrant children; transfer the correct form from the doctor to the school, sometimes every year for a fee; and bear the psychological weight of wondering if we are doing anything dangerous for her children.

On the other hand, in some states, simply signing a form available online or submitting a personal written statement to school officials once may be sufficient to obtain an exemption. One study found that states with the relatively less complex red tape requirements required higher exemption rates. This suggests that at least some parents opt for the exemption for the sake of convenience rather than for deep convictions against vaccination.

Our proposal modifies this calculation by making vaccination as easy as possible and slightly more difficult to obtain an exemption.

First, to reduce the time burden on parents, states should consider offering free vaccination at school clinics or in partnership with local pharmacies. In addition, parents who opt out should be kept informed of the risks. To do this, they should follow public health education every year or advise on the benefits of immunization. This could be provided at the office of a pediatrician.

Studies in the states of Michigan and Washington indicate that even the slight change in the parents' educational obligation significantly reduces the number of parents who decide not to participate.

Our model law would also tighten the immunization requirements in another way. Today, medical exemptions are sometimes granted by chiropractors, holistic healers and doctors specializing in areas not related to immunization, such as dermatology. Our model law would limit those who can grant medical exemptions to licensed medical professionals who work in immunization-related practices. It would also establish firm grace periods for compliance, which some states currently do not provide, and impose strict enforcement of school exclusion policies to ensure that unvaccinated children stay home. in case of epidemic.

In addition, this model law would also apply to parents of home-schooled children, which most states do not currently require. Although parents of home-schooled children may think that their children are not at risk because they are not as exposed, home-schooled children are active members of the community. They participate in sports, arts, camps and other group activities in which diseases can spread.

Respect parental rights

We recognize that public health policies should generally use the least restrictive measures possible to achieve the public health objective. We believe that our approach could maintain the immunity of the community and prevent epidemics while respecting the right of parents to choose medical treatment for their children.

Recent studies have shown that making it more difficult to obtain a waiver and facilitate vaccination could increase vaccination rates significantly – enough to maintain the immunity of the community – even if the Non-committed vaccinators still choose not to vaccinate their children.

This proposal offers a way out of the current political stalemate with regard to immunization mandates. It will save lives and respect individual freedom.