Immunization Legislation

It’s National Infant Immunization Week (#Ivax2Protect).  What?!  Why is an adolescent medicine physician blogging about infant immunizations?!  With all the measles going on (seriously, I cannot even deal with the current measles outbreak – 704 cases this year alone!), we need to talk about immunizations and the current laws.

I specifically want to draw attention to the Wisconsin Student Immunization Law. Current state law requires children attending school to be vaccinated against various diseases, like measles, tetanus, hepatitis B, etc. This makes sense, since hundreds of kids are in close proximity to each other for 8 hours every day, and diseases can spread rapidly through a school (can you say cesspool?). Our current state law does allow for some exceptions:

  • Medical – when a vaccination could harm a child due to other health conditions
  • Religious – when a vaccination runs counter to a student or parent’s religion
  • Personal/philosophical – a parent may decide to exempt their child from a vaccination due to personal reasons

Wisconsin is just one of 19 states that allow a personal/philosophical exemption to required school vaccinations. Since the 1997-98 school year, the percentage of Wisconsin students requesting a medical or religious exemption has been relatively constant, while those requesting a personal conviction exemption has grown nearly 400%.  This increase in personal conviction exemptions has led to an overall drop in the percentage of students who meet the minimum immunization requirements (the current 91.9% of students meeting vaccine minimum is the lowest rate in nearly 10 years). Sadly, this is below the “herd immunity threshold” for measles, the level at which we can slow or stop the spread of a disease. This puts people who are unable to get vaccinated (due to age, medical conditions, etc) at high risk for getting the diseases that vaccines were designed to prevent. Not good.

California has some of the nation’s strictest vaccine laws. California has a current bill proposed to strengthen their already strict vaccine laws, by ensuring that medical providers are providing evidence of medical contraindication to vaccines, since many doctors were offering illegitimate medical exemptions from vaccinations (for a fee, of course).  California already prevents personal and religious exemptions after the 2015 Disneyland measles outbreak. Compared to California, Wisconsin’s immunizations laws seem lenient, although this may change. Earlier this week, Wisconsin State Representative Gordon Hintz from Oshkosh circulated a proposal that would remove the personal conviction exemption from the Wisconsin Student Immunization Law (leaving in place the medical and religious exemptions). Similar bills have failed in Wisconsin in the past, but the coinciding of the proposal with the largest measles outbreak in decades may give this bill the momentum it needs to pass.

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