report from montpelier: Immunizations redux

By Rep. Kate Webb

As we enter the final week of the legislative session, there is no issue more divisive, emotional, and polarizing than whether to continue to allow the use of the philosophical exemption to the immunization requirement for admittance to school in Vermont. More politically charged than the right to bear arms. Tougher than finding a compromise to solve a $113 million budget gap, setting a plan to clean up Lake Champlain, reforming education funding or spurring economic development. It has spawned a plethora of emails, letters, phone calls, Facebook posts and tweets. Some of these provide links to important research or provide moving personal experiences. Some would take your breath away in their lack of civility and human decency in response to someone who disagrees.

Over the past week, I have worked with advocates, constituents, leadership and legislative members to find a way to bring some closure to this issue that appears to have precious little middle ground. Both sides present research as well as evidence to debunk the research of the opposition. Both sides provide painful personal and professional experiences. Both sides remind us of the rights of a parent to protect a child from harm. Even though these sides produce decidedly conflicting solutions, both sides tell me this is a simple “open and shut” case. Arguments presented to the House Healthcare Committee can be found here: http://legislature.vermont.gov/committee/document/2016/15/Bill/4020412.

I have made it clear to both sides that I support efforts to improve our immunization rates. I have made it clear that I accept the charge that when immunization rates fall below 95% of a group vaccinated, we lose the benefit of herd immunity for all. I have made it clear that I am troubled that a quarter of our public schools and nearly half of our private schools fall below herd immunity for TDaP (tetanus, diphtheria, pertussis), polio, MMR (measles, mumps and rubella) and HepB, and nearly half of all our students, public and private fall below the recommended rate for varicella (chicken pox).

Yet I also understand that some of the required immunizations such as tetanus are not contagious and are included perhaps as a matter of convenience rather than threat to the community. Some parents plan to immunize but prefer to stretch out the timing. I also learned that some doctors are recommending that parents simply go for the easier philosophical exemption rather than the medical, even though there is compelling evidence to suggest the child is a good candidate for the medical exemption. Is it worth considering different requirements for a school such as Marlboro Elementary where 30 percent are unimmunized compared to the palpable anxiety created when going after the 1 percent at CVU? Would more stringent requirements to “non-medical exemptions,” (vs. the arbitrary “philosophical” or “religious”) help move our schools to acceptable levels while allowing room for that small percentage that is truly, deeply opposed? This change in criteria resulted in a 17 percent increase in rates in Oregon. Or will it take an outbreak of a preventable disease to finally force us into action?

These questions are part of the process making this not a simple “open and shut” case. At the time of this writing, the final version of the bill is still under development so I am not clear what the final bill will be. I can say that I support finding a path to bring our immunization rates to within herd immunity standards throughout the state. To follow action this week, visit http://legislature.vermont.gov/.

Please feel free to contact me by email at kwebb@leg.state.vt.us or phone (802) 233-7798. Representative Lenes and I will be writing jointly over the coming weeks to address the final actions of this session.