The Philosophical Exemption To Vaccination: Worst. Idea. Ever.
Why are New York legislators pushing a bill that would sicken children?
New York State now has three confirmed cases of measles, a disease thought to have been eradicated in the United States 15 years ago. Hundreds of other cases have been confirmed in other states. In 2014, the Centers for Disease Control and Prevention documented over 600 cases; last month alone, 100 more were diagnosed.
To potentially make matters worse, a bipartisan group of state lawmakers, including Republican Assemblyman Brian Kolb of Upstate New York and Democratic Sen. Martin Malavé Dilan of Brooklyn, now proposes allowing unvaccinated children to enter school using to a new “philosophical exemption.”
This legislation is as bad as bad ideas get.
New York schools, like schools in every other state, require students to be vaccinated for a number of common, often highly contagious, childhood illnesses. And, just like other states, New York offers exemptions for medical and religious reasons. Some states are stricter, allowing exemptions only for medical reasons (Mississippi and West Virginia) while others (such as Colorado) allow medical, religious and philosophical exemptions.
This variation offers a natural experiment in vaccination policies: States with the narrowest exemptions, it turns out, have the fewest cases of vaccine preventable diseases. (Mississippi's strict vaccination policies have resulted in the nation's highest measles vaccination rate, which has helped to protect the state from the current outbreak.)
There are legitimate medical reasons for offering narrowly-tailored vaccine exemptions. Children undergoing chemotherapy are in no shape to receive vaccines. And constitutional protections for religious freedom obviously support a religious exemption. But what about exemptions based on “personal belief”? If you believe vaccines cause autism, should you be permitted to send your child to school unvaccinated?
The answer is, assuredly, no.
People can hold any opinions they want. But sending unvaccinated children to public schools exposes others, including children with compromised immune systems, to potentially lethal infections. Having almost everyone vaccinated is critical. When it comes to measles, we need about 95% of a population vaccinated to maintain so-called “herd immunity,” where a few cases are contained thanks to high immunization levels.
Here, New York shines. Only 13 school districts statewide have immunization rates below 95%; 97% of kindergarteners statewide are vaccinated for measles, mumps and rubella.
If misguided legislators have their way, a new “personal belief” exemption will increase the risk of serious outbreaks and deaths. Twenty states, including the current outbreak's epicenter, California, already have these exemptions and have vaccination rates 2% lower on average than states without them.
Measles is particularly worrisome. Among an unvaccinated population, one person with measles is expected to infect about 18 others, making it more contagious than Ebola or SARS.
Even religious exemptions come with a price. In 2013, an Orthodox Jewish community in Brooklyn saw 58 cases of measles, mostly among children and infants, after an unvaccinated teenager returned from a trip to London. In 2014, an unvaccinated Amish community in Ohio experienced another major measles outbreak, with at least 138 recorded cases, according to the CDC.
While religious exemptions can be problematic, numerous studies have found a strong relationship between contagious disease outbreaks and more lenient philosophical exemptions. California granted over 10,000 non-religious personal belief exemptions for kindergarteners in the 2014-2015 school year, compared to only 2,600 religious exemptions. These exemptions undoubtedly made it easier for the measles virus to spread in the golden state.
Repeated studies in the U.S. and Europe have debunked the link between vaccines and autism or other neurodevelopmental diseases. Moreover, while the risk of serious complications from a vaccine is about 1 in 40,000, one in 333 people who contract measles will die. A philosophical exemption in New York will only expand the pool of vulnerable children who may be hospitalized - or die — because of diseases we learned to conquer decades ago.
Parents have the right to decide whether to vaccinate their own children. But they don't have the right to play Russian roulette with other children's health.
This piece originally appeared in New York Daily News
This piece originally appeared in New York Daily News