Vaccine exemptions and private schools – what are the facts?

vaccine exemptions

As measles outbreaks – centered on unvaccinated children – continue to pop up in areas with low vaccine rates,  one approach private schools and daycares reach to is keeping out unvaccinated children. An Ohio Jewish school announced it will not accept unvaccinated children, and I know other private facilities are considering this. So what does this all mean with respect to vaccine exemptions within private schools?

Note that this is a separate issue than the question of whether unvaccinated children can be kept home during an outbreak. All states have a provision in law to keep unvaccinated children at home during an outbreak, and some of the affected states – like New York – are doing that.  Continue reading “Vaccine exemptions and private schools – what are the facts?”

California SB277 lawsuit analysis – anything there?

California SB277 lawsuit analysis

California enacted SB277 on 1 July 2015. This new law removed the “personal belief exemption” (PBE) to vaccines required for school entry.  The law went into effect 1 July 2016.  One group filed a suit against SB277 in California courts in May; I discussed that complaint in previous article. This California SB277 lawsuit analysis is about new litigation against SB277 filed in the state. (Note, there is an update to this case, California SB277 vaccination law – litigation update 1.”)

This second lawsuit, with a different group of plaintiffs, including Ana Whitlow, was filed in a federal district court on 1 July 2016. The suit was brought by several individual plaintiffs and a number of organizational plaintiffs. It contained both state and federal claims, claims on constitutional grounds, and claims that focused on implementation of the act.

As the complaint states, California has had a personal belief exemption from its school immunization requirements since at least the 1960s. The complaint does not note that between 1996-2010, California’s exemption rate increased 380%, from 0.5-2.3%.  The increase continued until at least 2014.

While the number never went over 3%, the exemption rate was not evenly distributed: some areas and some schools had much higher rates of PBEs than others, making them hot spots for outbreaks. In 2010, California experienced a dramatic outbreak of pertussis in which ten babies died. Pertussis has continued to circulate at a higher rate than in the past.  While the pertussis outbreak was partly the fault of a less effective vaccine, studies repeatedly found that areas with high rates of exemptions were more vulnerable to outbreaks.

In 2014, California had the highest rate of measles since 1994, and the famous 2015 measles outbreak caused even higher numbers. This background led the California Legislature to reconsider its immunization policy – already tightened once, in 2012 – and to decide to remove the personal belief exemption.

Understandably, those influenced by anti-vaccine claims were distressed by the new legislation. These parents evidently feel trapped, caught between a reluctance to vaccinate their children and their desire for their children to access educational opportunities, now closed to them by the new law’s provisions. Hence the lawsuit.

This complaint does not suffer from the lack of professionalism and the severe problems of the previous claim, filed by a different attorney in state court.

Nevertheless, while you can never be certain how a court will decide, my best assessment is that the plaintiffs’ constitutional claims have very low chances of success. While some of the statutory issues call for interpretation, they won’t lead to the law being struck down. And several of their implementation claims suffer from serious procedural problems.

Note that the discussion here refers both to the content of the complaint itself and the content of the memorandum submitted in support of the Temporary Restraining Order – both together present the plaintiffs’ arguments.

The complaint also tries to reframe the narrative drawing on anti-vaccine factual claims that are either misleading or downright incorrect. My focus in this post is on the legal claims, but I will touch on a few of the counter-factual assertions. Continue reading “California SB277 lawsuit analysis – anything there?”

Selective vaccine exemptions – measles and schools

vaccine exemptions

The best way to increase immunization rates and protect a community from outbreak is anything but settled. Serious, thoughtful, provaccine policy scholars and policy makers disagree on whether it’s better to remove all non-medical vaccine exemptions, tighten exemptions, and so forth. A new proposal takes the discussion in a different direction.

In a recent article in Pediatrics, Douglas J. Opel et al. made a case for limiting non-medical exemptions for the measles vaccines only. The authors explained that, “Our goal is simple: to see as many children immunized as possible.”

However, they don’t think removal of nonmedical exemptions is the way to get there. While acknowledging alternatives – making non-medical exemptions harder to get, or enforcing current laws better – their contribution is to offer a new alternative: allowing non-medical exemptions to all vaccines except measles vaccines, and removing non-medical exemptions for those.

This post examines their arguments. For each argument it explains the authors’ claims, the response editorial’s rebuttal, and adds some thoughts. In short, while the proposal is interesting and enriches the debate, its drawbacks, in my view, far outweigh its benefits.

Why do Opel et al. think removing non-medical exemptions from measles vaccines only is a good idea, superior to removing all non-medical exemptions?  Continue reading “Selective vaccine exemptions – measles and schools”

Vaccines and religious exemptions – recent legal decision

This article is by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines, medical issues, social policy and the law. 

Professor Reiss writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

On October 5, 2015 the Supreme Court of the United States denied cert in Phillips v. New York, a group of three cases that considered issues surrounding vaccines and religious exemptions. This post shortly explains the case and what denying cert means (and does not mean).

Continue reading “Vaccines and religious exemptions – recent legal decision”