The Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services have reported that the ongoing measles epidemic has, as of 19 September 2019, has resulted in 1241 cases in 31 states. This makes 2019 (which is around 9 months old) the worst year for measles since 1992, when there were 963 cases for all 12 months.
At this rate, we can expect well over 1500 measles cases for 2019, making it the worst year since the major measles epidemics of the late 1980s.
As a result of the ongoing measles epidemic, a lot of states are restricting or removing non-medical vaccine exemptions. Recently, the Maine vaccine exemption bill was signed into law. It eliminates all personal belief exemptions for children attending school, though it still allows for medical exemptions.
Eventually, the Maine House agreed to the language in the Senate version, which eliminated religious exemptions, and it was sent to Maine’s Governor Janet Mills, who signed it into law on 24 May 2019.
The Maine vaccine exemption bill is similar to strong pro-vaccine laws in California, Mississippi, and West Virginia that limit so-called “personal belief exemptions,” that is, vaccine exemptions that are for any reason other than medical contraindications.
An iconic photo of the Maine coastline. And protected from vaccine-preventable diseases. Photo by Keith Luke on Unsplash
The bill’s sponsor, Democratic Maine House Representative Ryan Tipping, said:
As we hear more reports of measles and other preventable diseases in Maine and across the country, it has become clear that we must act to ensure the health of our communities.
The abuse of these personal belief exemptions has led to a decrease in vaccination rates, which brings the rate below the level necessary to maintain herd immunity – that is, a sufficiently high enough percentage of individuals who have been vaccinated that prevent the disease from spreading to unvaccinated individuals.
Opponents of this law are promising a court fight as they have done in California (and losing every single time). They are trying to present an argument that removing religious exemptions are an infringement of “religious liberty.” However, numerous Supreme Court decisions, such as Prince v Massachusetts and Jacobson v Massachusetts, give the state quite a bit of latitude to protect its citizens and, especially, its children.
Our immunization jurisprudence gives states substantial leeway to protect the public health via vaccination requirements, specifically, in this context, by allowing states to decide whether, and under what conditions, to exempt students from school immunization requirements. But states have to actually use that power to achieve anything. By leaving the floor to the passionate, if passionately wrong, anti-vaccine minority, we are allowing them to undermine the right of the rest of us to be free from preventable diseases.
In other words, the “religious liberty” argument is extremely weak, especially, as I mentioned above, there are no mainstream religions that oppose vaccines. In fact, most strong support them because they protect the lives of children.
At any rate, let’s congratulate Maine for strengthening vaccine laws. And for keeping religion out of a medical decision. Irony intended.
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After extensive efforts from public health and the immunization coalition to revise Maine vaccine exemptions, and in the face of determined opposition, on Tuesday, May 14, 2019, the Maine Senate voted for a bill removing religious and personal belief exemptions to school vaccination requirements. The bill will now go to the Governor’s office, and Governor Janet Mills – whose administration already expressed support for the bill – is expected to sign it.
The bill, LD 798, has been in the works for a while, over strong opposition from the resident anti-vaccine groups. It simply removes the language creating the non-medical exemptions, such as for religion and personal beliefs.
Bar Harbor, Maine. Now protected from vaccine-preventable diseases. Photo by Gibson Hurst™ on Unsplash
On the support side, the grassroots group Maine Families for Vaccines spoke in favor of the bill, and medical associations, including the Maine American Academy of Pediatricians, worked to explain it and support it. A previous bill, similar in language, passed through the Maine Legislature, but it was subsequently vetoed by the (then) governor.
The new Maine vaccine exemptions bill went through the legislative process with some drama. After passing through the House, the Senate approved the bill, but – in an 18:17 vote – added back a religious exemption.
On returning the bill to the house, the House reaffirmed their commitment to the removal of both the personal belief and the religious exemptions – in procedural terms, it “insisted”, and sent the original bill back to the Senate to vote on it again. After negotiations, one of the Senators who supported adding the religious exemption back in reversed course, and the original bill – removing both the personal belief and the religious exemption – passed 18 to 17.
Portland, Maine. Also protected by removing some of the Maine vaccine exemptions. Photo by frank mckenna on Unsplash
As mentioned above, the Governor is expected to sign it.
The price of the change appears to be somewhat weakening the controls on religious exemptions by preventing the Department of Health and Human Services from regulating them and allowing a nurse practitioner or physician assistant to grant them.
In addition, children with an individualized educational plan can continue to attend, as long as the parents – or the student, if over 18 – have consulted with a licensed physician about “the risks and benefits associated with the choice to immunize.”
On 4 January 2019, the Maine Coalition for Vaccine Choice – a Maine anti-vaccine organization – posted an article about a proposed bill that they called “The Maine Vaccine Consumer Protection Program.” As with the coalition’s previous attempt to pass such a bill, in 2015, the proposal is ill-founded. The premises it is based on are flawed, and the proposals themselves range from directly misleading to not very meaningful. Continue reading “Maine anti-vaccine legislation appears again – flawed and misleading”
This article examines a recent Maine Supreme Judicial Court ruling on parental rights and vaccines – they upheld a decision to vaccinate a child in the custody of the state over a mother’s objections. This post explains the decision, explains why the lone dissenting judge was wrong, and reminds the reader that this decision is consistent with the majority of states deciding the issue – for good reasons.
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.
In the United States, the Centers for Disease Control (CDC) recommend certain vaccines. CDC cannot, and do not, mandate vaccines. However, states can and do require their residents to have received certain vaccines on the CDC recommended schedule in order, most notably, for children to enroll in school. All states, however, also offer exemptions from school immunization requirements, and some – like Maine – offer very easy-to-get ones.
There are, however, two significant problems of the Maine Coalition for Vaccine Choice legislation – the premises underlying the alternative law, and the content of the proposal. The proposal is based on premises that are either simply untrue or inaccurate and misleading. And it’s extremely bad law. Continue reading “Maine Coalition for Vaccine Choice legislation–bad premises, bad law”
Yesterday, I wrote about the CDC reports regarding pediatric deaths from the flu. Those were just numbers, but there are real kids and real parents of those kids who constitute those numbers.
The Maine Public Broadcasting Network (MPBN) reported about the death of an elementary school child from the flu. The child was healthy, so it wasn’t that the flu increased some risk factor because of an underlying disease.
According to Maine’s CDC Director, Dr. Sheila Pinette, pediatric flu deaths are not common in the state. She stated that flu can be fatal in people who are elderly or have a compromised health status, but this elementary school child was believed to be healthy. Dr. Pinette wants everyone to get vaccinated against the flu, unless the vaccine is medically contraindicated (which is very very rare). According to the MPBN article, “that’s an expansion from previous CDC recommendations that focused on the young, the elderly, and health care workers.” Continue reading “A child dies from the flu in Maine”
