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All US states require parents to vaccinate their children against certain preventable diseases, including measles, mumps, rubella and pertussis, so that they can go to school. Such laws often apply to children in private schools and nurseries, as well as public schools.
At the same time, beyond the medical exemptions, most states also allow parents to evade this immunization obligation for religious reasons. And seventeen states allow other exemptions, allowing families not to be forced to be vaccinated at school for personal or philosophical reasons.
Michelle Mello, a professor of law and health and policy research at Stanford University, said the number of waiver requests for immunization requirements was very low in many states. "You can believe that vaccines are not working, that they are dangerous or that they are simply going against your parenting philosophy," she said.
But measles outbreaks across the country this winter are leading to many derogations: at least eight states, including some with measles outbreaks this year, want to remove personal exemptions for measles vaccine. And some States would abolish the exemption for all vaccines.
Most of this year's measles cases involve children who have not been vaccinated against the virus.
Once considered eradicated in the United States, measles has made at least 159 people sick since the beginning of 2019, according to the Centers for Disease Control and Prevention, in homes ranging from Washington and Oregon to Texas. At New York. Last year, 372 cases of measles were reported nationwide.
The decision by state legislatures to tighten vaccine requirements is good news for Diane Peterson., the Deputy Director of Immunization Projects, Vaccine Defense Group, Immunization Action Coalition.
"Measles is not like a cold," says Peterson. "The children are very very sick and can be hospitalized," she says, adding that measles can even lead to death.
The virus is highly contagious, is airborne and spreads easily. He can survive in the air for a few hours.
"A patient with measles can go to the doctor, cough in the examination room and two hours later, another patient entering the same examination room may be infected," Peterson said.
The virus is spreading quickly this winter, she says, because of "pockets of children who have not been vaccinated, mainly because of parents who have decided not to vaccinate them".
This leaves not only unvaccinated schoolchildren vulnerable to the virus, but also many adults whose immune systems are inhibited and infants who are not old enough to be vaccinated.
According to the Association of State and Territorial Health Officials, draft laws to limit exemptions are pending in a growing number of states.
None of this is appropriate for activists who want their states to maintain personal and philosophical exemptions.
"No one should judge the religious and spiritual convictions of another person," says Barbara Loe Fisher, spokesperson for the National Vaccine Information Center, a group that campaigns against compulsory vaccination and who thinks that parents should have the choice. "No one should be allowed to force someone to violate his conscience when he makes a decision regarding the use of a pharmacological product involving a risk of harm."
The scientific consensus on the risks of vaccines is that serious side effects are extremely rare. A suggestion that vaccination could be linked to serious consequences such as autism had been refuted several years ago, after the findings supporting this link had been proven fraudulent.
Mello, the Stanford Law Professor who followed the debate on the exemption, notes that the courts have repeatedly reiterated that when a public health intervention is necessary to protect public health, individuals can usually be forced to give up some personal freedom, especially if that freedom is bound to a governmental advantage such as public school.
So far, only three states – Mississippi, West Virginia and California – prohibit all vaccine-related exemptions, including the exclusion of families who say their religious beliefs conflict with vaccination.
The state legislature of California made this decision in 2015, less than a year after the state experienced a major measles outbreak that occurred for the first time among non-status children. vaccinated from Disneyland.