Washington State's Efforts to Tighten Vaccine Requirements Seemed to Defeat

The bill to eliminate personal or philosophical exemptions from the measles, mumps and rubella vaccine was passed by the Democrat-controlled House 25-22 within the legislative timeframe. No Republican voted for it and one Democrat voted against it.

If, as expected, the bill was approved in the House, where an almost identical measure was passed last month and promulgated by Governor Jay Inslee (D), it would be the first time in four years that a State deletes personal exemptions in the face of rising anti-vaccine sentiment. California and Vermont abolished the personal exemptions in 2015. Other states have taken steps to tighten vaccine requirements, without, however, removing the exemptions.

The stricter rule would only apply to vaccinations against measles, mumps and rubella. Parents would continue to be able to invoke personal or philosophical derogations to avoid further compulsory school vaccinations for their children. Religious and medical exemptions will still be allowed for all vaccines, including the MMR vaccine.

The bill was passed in the United States Senate after 11 am, as the disease resurfaces near the record number and other states weigh in the same direction as similar legislation to close loopholes or eliminate exemptions personal or religious requirements for immunization.

Inslee, who supports the measure, also takes the chair on a platform focused on factual science and climate change. The vaccine debate has pitted science and public health advocates, who represent the majority of Americans who support vaccinations, with a minority of anti-vaccine activists who worry about personal choice. and the safety of vaccines, most of which have been discredited.

Advocates and legislators have been able to overcome the powerful lobbying by anti-vaccine groups, which are among the most virulent and organized in the country. These groups mobilized hundreds of supporters, who telephoned and e-mailed lawmakers, went to court, and proposed amendments to the poison pill.

The Republicans had proposed more than a dozen amendments aimed at weakening the bill and seemed about to kill him before a wave of last-minute actions.

Senator Annette Cleveland, the Democrat who sponsored the bill, spent more than two hours discussing Wednesday evening to refute the misinformation about the safety of the measles, mumps and rubella vaccine and the risk of measles in children. She told her colleagues that a vote against the bill would be "a vote against public health, a vote against the safety of our public spaces".

After the adoption of the measure, she spoke of the "unfortunate reality that many people are now more comfortable with conspiracy theories and alternative facts than science proves."

In a statement to the Washington Post, she added, "It is even more disappointing to hear colleagues on the other side share the unfounded theories of their constituents on the Internet, as well as the in-depth knowledge of the best medical minds in our country. to Centers for Disease Control and Prevention ".

Referring to the inaccurate anti-vaccine information that dominates social media, she added, "When users place more weight on Google searches than peer-reviewed research, we encounter a fundamental problem."

Immunization advocates were pleased with the passage of the bill.

"We are delighted!" Said Sarah Rafton, executive director of the Washington chapter of the American Academy of Pediatrics.

Rupin Thakkar, chairman of the AAP chapter, has accused the dangerous measles outbreaks of increasing the number of vaccine exemptions for their personal beliefs and congratulated the legislator for eliminating them. "The recent measles outbreak has sounded the alarm and today our lawmakers have bravely defended the facts to the detriment of fiction," he said.

Other national and local efforts to control outbreaks also meet resistance from opponents of mandatory vaccination: in New York, a group of parents sued on Monday for the Health Council's decision to vaccinate all the world over four postcodes severely affected in Brooklyn, home to tens of thousands of ultra-Orthodox Jews and the place of 329 cases of measles. At a meeting on Wednesday, the New York City Health Council voted unanimously to extend the order, although efforts in the capital to tighten laws on immunization do not seem to be moving forward.

Tuesday, the officials of Rockland County, N.Y.., has banned all unvaccinated persons exposed to the disease from public gathering places, including places of worship, for a maximum of three weeks. "Should we wait for someone to die?" Said Ed Day, Rockland County officer, announcing the measure.

Concurrent campaigns to strengthen the demands of the states of Iowa, Colorado, Maine, and Oregon also face stiff opposition, although the potential impact of Washington's success on lawmakers in these states remains blurring. Washington is one of 17 states that allow exemptions from mandatory immunizations for personal or philosophical beliefs.

Washington's outbreak prompted Inslee to declare a state of emergency on January 25, after authorities reported 25 cases of measles. As the numbers skyrocketed – 78 cases of measles in Washington and neighboring Oregon were confirmed, out of 555 cases in 20 countries – Olympia legislators began weighing legislation to eliminate personal exemptions or philosophical.

If the epidemics are not under control, health officials worry that measles cases will reach an all-time high in 2019 nearly two decades after the "elimination" of the United States. Once sent to hospitals every year, tens of thousands of Americans killed between 400 and 500 people, many of them young children.

Public health officials were concerned that the bill would be defeated. That would have sent a "bad message in the sense that the exceptions to the vaccines really have to be made only for medical reasons, if you adopt a pure public health perspective," said Michael Fraser, executive director of the Association of state and territory health. The officials.

"I think that would also suggest that a very active minority has a disproportionate influence on an issue that concerns everyone," he said.

Rafton said the public was largely supportive of the safety and effectiveness of childhood vaccinations, noting that 98% of American children were immune. But in Washington, the immunization rate for kindergarten to kindergarten children for the 2017-2018 school year was 86% – well below the 95% target set by the state to effectively prevent the spread of most diseases.

About 4.7% of preschool children in Washington said they were exempt from at least one vaccine, more than double the national rate, according to 2017-2018 health department data.

Nearly 9 in 10 children with a non-medical exemption cited personal or philosophical reasons.

Until Wednesday, proponents of the bill were not optimistic about his chances. A handful of Democratic senators had been uncomfortable with this measure, Rafton said. "A senator was hesitant because one family member reacted to a vaccine," she said.

But a burst of last-minute maneuvering allowed calling the bill to a vote. A procedural motion almost derailed the vote, which was delayed by a fire alarm that forced the evacuation of the room. Throughout the evening, Republican senators proposed 18 amendments to delay, weaken or amend the bill, all of which were withdrawn or rejected. An amendment would have reduced the protection of the youngest children, who are at greatest risk of serious complications of measles.

In the weeks leading up to the debate, the medical community was at a disadvantage, she said, as she was unable to mobilize the same kind of physical presence at hearings and meetings with lawmakers as anti-vaccine activists, she said.

Medical groups did not want "doctors and parents to fight in the corridors," she said. As a result, "we have not been able to represent our members with the same kind of palpable presence, despite the pediatricians' clear opinions that the law should change."

Doctors also want to dialogue with "parents who worry and wonder if they can be vaccinated," she said. "So we want to go in the direction of advocacy. We find that when doctors are attentive and really attentive to parents, they manage to get the right information over time. "

Read more:

The unique dangers of the measles epidemic in the state of Washington

Unaware that he had measles, a man traveled from New York to Michigan, infecting 39 people

Do I need another MMR vaccine and other questions about measles?