Vaccine Exemptions Often Result of Laziness and Lies
May 15, 2013

On the subject of school vaccination exemptions, I want to get one thing straight.  I’m not against them.
My efforts to inform people about the impact exemptions have on the health of children in school is to ensure that we don’t allow parents to abuse the exemption process.  The way I look at it, exemptions must – first and foremost – remain available for those children who are medically unable to be vaccinated.    These students are at the heart of my concern as school vaccine exemption rates climb in certain areas.

The Risk to Those With Medical Exemptions

While medical exemptions are limited to those who have documented medical conditions which prohibit them from receiving certain immunizations, these children remain vulnerable to disease, and may also be more susceptible to serious complications or death as a consequence of a compromised immune system.  Therefore, maintaining a high percentage of immunized children in school not only protects the children who can be immunized, but also those who can not.  The concern begins when the number of unvaccinated children rises to the point at which it negatively impacts the protection we all receive through community immunity.

The Impact of Non-Medical Exemptions

Currently, every state (with the exemption of Mississippi and West Virginia) offers parents the opportunity to claim non-medical exemptions from required school vaccinations based on either religious or philosophical reasons.  However, as the exemption rates climb in specific schools, outbreaks of vaccine preventable disease seem to be occurring more frequently.  This has sparked concern among health care providers, infectious disease specialists and public health professionals who believe these outbreaks may be avoidable through immunization.  One research study suggested that children who are exempt from vaccination requirements were more than 22 times more likely to contract measles and nearly six times more likely to contract pertussis compared to vaccinated children.  And states with loose exemption policies has approximately 50% more cases of whooping cough compared to stricter states.

Exemptions Often More Convenient than Vaccinations

In most cases, an exemption can be as simple as a parent signing a form and then submitting it for approval.  If a child is not vaccinated for a specific disease and an outbreak should occur, than the child is typically restricted from attending school during the outbreak.  This is intended as both a protection to the unvaccinated student and a means by which to limit the spread of disease.  Unfortunately, this is a fairly common occurrence, as can be seen recent news covering 33 students who have been restricted from school activities, to include their upcoming graduation ceremony, as a result of a case of chicken pox.
As research had begun to examine the exemption data, it appears that the ease by which a parent can obtain an exemption is often associated with the number of exemptions filed.  For instance, in 2006 exemption data determined that the 19 states with the most formal requirements had the lowest number of exemptions compared to states with less formal requirements.  Since this suggests that the number of exemptions has a to do with the ease in which parents can obtain these exemptions, many state legislatures have begun introducing new laws that will ensure exemptions are only granted to parents after thorough consideration of the risks.  In other words, by altering the exemption process, some states are requiring parents who seek an exemption to talk with a health care professional about the dangers of the diseases, as to allow them to address their questions or concerns about vaccination.
As long as it remains easer to obtain a non-medical exemption than it is to actually bring a child in for a vaccine, than we’ll continue to have parents skip vaccines out of convenience, rather than a true religious or philosophical conviction.  This is when our nation’s successful immunization program has some parents thinking that vaccine preventable diseases are no longer a threat to their children.  They often fail to see the importance of vaccination because they either (1) think the diseases aren’t common in the United States, (2) mistakenly believe that certain diseases are not dangerous to their children, or (3) don’t understand that the risks of the diseases far outweigh the minimal risks of vaccination.  It’s often a choice as to whether they want to simply fill out an exemption form, or go through the lengthy process of scheduling a doctor’s appointment, bringing their children in for that appointment and then paying the insurance co-pay for the visit.
In response to these misguided opinions, some states are working to put conditions on non-medical exemptions and require an educational element before a parent is granted an exemption for their child. The hope is that if these parents take the time to really examine the facts, they may be inclined to choose vaccination.  And in Washington state, that is exactly what is happening.  After new legislation was enacted last year, they have already noted a significant decrease in exemption rates.

Many Religious Exemptions Unsupported

Unfortunately, parents who remain adamant about not vaccinating will often go to great lengths to obtain exemptions.  Many have admitted to securing a religious exemption under false pretenses so that their personal decision is less likely to be called into question.  Obviously we should not be tolerant of parents who purposely lie to avoid adhering to the law.  Instead we should acknowledge that most religious exemptions are unsupported and require further documentation.
Upon close examination of various religious doctrine the only religion that I understand to be outwardly opposed to vaccines is Christian Science.  Since they believe they can heal all things through prayer, rather than medicine, it’s understandable that they may refuse vaccines.  However, there is evidence to suggest that vaccines are acceptable to almost all other religions.
Certainly you’ve heard vaccine critics claim that Amish parents do not vaccinate their children.  While some may not, vaccination is not actually prohibited by their religion.  And in 1978, the Church of Jesus Christ of Latter-day Saints came out in support of childhood vaccinations by stating, “We urge members of The Church of Jesus Christ of Latter-day Saints to protect their own children through immunization.  Then they may wish to join other public-spirited citizens in efforts to eradicate ignorance and apathy that have caused the disturbingly low levels of childhood immunization.”  In 2010, the Tibetan Buddhist spiritual leader the Dalia Lama helped launch a polio eradication drive in India and there are many areas of the world with large Hindu populations, that have taken proactive efforts to eradicate vaccine-preventable diseases like polio.  Even the Jehovah’s Witnesses have gone on record as stating “We have no objection to vaccines in general.”
Some argue that their religious opposition to vaccines stems from the components used in making the vaccines.  However, even these suggestions are misleading.  For instance, Islamic scholars made a statement in 1995 that concluded, “The transformation of pork products into gelatin alters them sufficiently to make it permissible for observant Muslims to receive vaccines containing pork gelatin.”   Many Jewish rabbis have pointed out that there is no objection to porcine or other animal-derived ingredients in vaccines.  And while Roman Catholics may allude to a concern regarding specific cell lines that were once derived from aborted fetuses, a 2006 journal article states, “Those who use…vaccines…do not cooperate with the destruction of life and arguably do not facilitate it, nor do they intend the destruction. Further… using cell lines for vaccines… does not deplete the cell supply in a significant way and thus does not necessitate or encourage further destruction of human life.”
What we are beginning to see is a movement to protect public health by encouraging parents to vaccinate their children and to limit the exemptions of convenience.  If this means that a few parents who are strongly opposed to vaccination must take some extra steps which then allows them to ignore the law intended to protect our children and communities, than by all means I think that’s a reasonable request.  It’s not as though they are being forced to have their child vaccinated.   And don’t believe them if they tell you they are.   

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