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| The Resurgence of Pertussis in California -Dec 2014 |
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Although all 50 states have laws specifying what vaccinations are required for school children, nearly all provide for religious belief exemptions, and 20 states allow for exemptions based on "moral, philosophical or other personal beliefs" grounds.
Unfortunately, the number of communicable disease outbreaks due to (formerly) common childhood illnesses is on the rise, with both measles and Pertussis making huge comebacks in recent years (see Updating California’s Pertussis Epidemic).
It is a contentious debate - and while some may choose to characterize these exemptions as a matter of personal and religous freedom - increasingly the medical community views them as a serious public health hazard.
Recently Vermont - which has one of the lowest vaccination rates in the nation - repealed their personal belief exemption, but many parents are apparently planning to switch to a `religious exemption' as no documentation or proof is required (cite Burlington Free Press).
On Monday the AMA (American Medical Association) announced their support for more stringent school vaccination regulations, allowing only for medical exemptions.
AMA Supports Tighter Limitations on Immunization Opt Outs
For immediate release:
June 8, 2015
CHICAGO – Addressing the re-emergence of vaccine preventable diseases in the United States requires states to move toward barring non-medical exemptions to immunization mandates, according to new policy adopted by the nation's physicians at the American Medical Association's annual meeting. Under new policy, the AMA will seek more stringent state immunization requirements to allow exemptions only for medical reasons.
Immunization programs in the Unites States are credited with having controlled or eliminated the spread of epidemic diseases, including smallpox, measles, mumps, rubella, diphtheria and polio. Immunization requirements vary from state to state, but only two states bar non-medical exemptions based on personal beliefs.
"When people are immunized they also help prevent the spread of disease to others, said AMA Board Member Patrice A. Harris, M.D. "As evident from the recent measles outbreak at Disneyland, protecting community health in today's mobile society requires that policymakers not permit individuals from opting out of immunization solely as a matter of personal preference or convenience."
New AMA policy recommends that states have in place an established decision mechanism that involves qualified public health physicians to determine which vaccines will be mandatory for admission to schools and other public venues. States should only grant exemptions to these mandated vaccines for medical reasons.
In recognition that highly transmissible diseases could pose significant medical risks for vulnerable patients and the health care workforce, new AMA policy also states that physicians and other health professionals who have direct patient care responsibilities have an obligation to accept immunization unless there is a recognized medical reason.
The AMA also intends to support the dissemination of materials on vaccine efficacy to states as part of the effort to eliminate non-medical exemptions.
