Oregon and Washington state lawmakers struggle to pass new vaccination laws as a rapidly spreading measles outbreak rages in Washington’s Clark County, a hotbed of anti-vaccine sentiment just north of Portland, Oregon.
New bills aim to eliminate personal and philosophical exemptions for standard life-saving vaccines in schoolchildren — exemptions that have fueled such outbreaks and allowed once-past infectious diseases to resurface in the United States. But as lawmakers work on drafting their new bills, they might do well to keep a close eye on their California counterparts, who are now realizing the pitfalls of such laws — and discussing how to avoid them.
Since California banned the non-medical vaccine waiver three years ago, the number of children with medical waivers in the state has tripled. The percentage of medical exemptions rose from 0.2 percent to 0.7 percent statewide. Although the overall vaccination rate in California has increased by two percent, there are still small areas where vaccination coverage is low. With the surge in medical exemptions, vaccination rates in some provinces have fallen below the threshold needed to prevent diseases, such as measles, from spreading.
Researchers and health officials blame largely unscrupulous doctors for the problem. Some doctors have been found to loosely write waivers for families trying to evade vaccination requirements because of fearsome and misinformation spread by anti-vaccination advocates. Officials have even complained about doctors charging fees for handing out medical waivers.
“We’ve delegated that power to licensed physicians, and the problem is that physicians are misusing that power,” Democratic state Senator Richard Pan told CALmatters.org, a nonprofit media company. Pan is a pediatrician in the Sacramento area who wrote the state’s ban on personal waivers in the wake of the 2015 Disneyland-related measles outbreak, which sickened 147 people.
He is now working with medical organizations to come up with new legislation to tackle the false medical exemptions. “I think we need the health departments to basically say when someone is abusing” [their] authority — and to revoke that authority and invalidate exemptions that were fraudulent,” Pan said. Other ideas being discussed in the state include having state officials collect data on doctors who grant medical exemptions, as well as creating a review process for those exemptions, according to CALmatters.
“They are not going to make us change our mind”
The discussion is probably worth it for lawmakers in Washington and Oregon. Clark County in Washington, just north of the border with Portland, Oregon, is a hotbed of anti-vaccine sentiment and is currently the epicenter of a raging measles outbreak. As of Feb. 10, Clark County had 53 confirmed and two suspected measles cases since the beginning of the year. As of Feb. 7, Oregon has reported four confirmed cases related to the outbreak.
In Oregon, about one in five schools has vaccination coverage below the protective 93 percent, and about 15,500 schoolchildren have non-medical exemptions, according to state data reported by the Oregonian. State Representative Mitch Greenlick (D-Portland) is now working on legislation to overturn the state’s personal vaccination waivers.
“People have the right to make bad decisions about their children’s health care,” Greenlick told the paper. “But that doesn’t give them the right to send unprotected children to school.”
The proposed bill is likely to meet fierce opposition. Similar legislation was scrapped in 2015 amid protests from anti-vaccination advocates. Greenlick said he wouldn’t be deterred this time.
Similarly, Washington State Representative Paul Harris, a Republican representing Clark County, is now working on proposed legislation that would eliminate personal exemptions, leave medical exemptions and tightly regulated religious exemptions, according to the After.
“You can’t find peanuts in any of my schools [due to concerns over allergies], but there are unvaccinated children in my schools because of a personal waiver?” Harris told the After. “I find it horrible.”
In a public hearing Friday, Washington State Secretary of Health John Wiesman praised the safety and efficacy of vaccines while exposing common anti-vaccine bundles such as the harmful, long-discredited idea that vaccines cause autism. He urged lawmakers to scrap personal exemptions. “In states with stricter exemption laws, there is less suffering, fewer hospitalizations and more deaths.” [from preventable diseases],” he said.
But, as in Oregon, the bill will face stiff opposition from vocal anti-vaccination proponents, who wrapped up Friday’s hearing and muttered disapproval when Dr. Wiesman gave factual information about vaccine safety. A lawyer told After reporters that if the legislation is passed, opponents of vaccines “would leave the state or go underground, but they won’t abide by it.” Another, Nicole Wilson, 32, who is pregnant and against vaccinations, said she would also consider moving if the bill is passed.
“I’ll tell you something,” she added. “They won’t make us change our mind.”
List image by CDC/NIP/Barbara Rice