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West Virginia tough on vaccine exemptions

Last updated on August 24th, 2019 at 12:20 pm

The state of West Virginia (WV) has one of the toughest child vaccination regulations in the United States, not allowing any religious exemptions to vaccinations required before attending school. Only Mississippi has regulations this strict for allowable exemptions. Of course, as I have written, religious exemptions have been abused by vaccine deniers by creating “fake” religions so that parents’ antivaccination beliefs will be recognized by the state. In fact, only medical exemptions are accepted by the state (pdf), and their standards on who can meet the medical exemption are quite tough.

According to West Virginia Department of Health regulations for medical exemptions, the following rules must be followed:

10.1. The provisions of this rule may not apply if a child has a valid medical contraindication or precaution to a particular vaccine. To obtain a medical exemption the child’s parent or guardian shall present a written request for an exemption from a physician who has treated or examined the child to the local health officer in the county where the child attends school. 

10.2. The physician’s request for exemption from immunization shall state specifically which vaccine or vaccines the child should be exempt from receiving, an explanation of the medical contraindication or precaution relied upon to make the request, and whether the reason for the exemption is permanent or temporary. If the medical exemption is temporary, the request shall also provide the future date or time when the exemption should be reevaluated. 

10.3. Requests for medical exemption from vaccine requirements shall be reviewed and approved or denied initially by the local health officer in the county where the requestor attends school. Approval or denial of a request shall be in writing and a copy of the response shall be sent to the State Health Officer. 

That’s it. That’s the only exemption allowed by the state.

There have been several lawsuits by antivaccination groups in WV in an attempt to block the Department of Health’s authority in these matters. In 2011, the US 4th Circuit Court of Appeals decided, in Workman v. Mingo Board of Education, that “Workman’s constitutional challenges to the West Virginia statute requiring mandatory vaccination as a condition of attending school are without merit.” The plaintiff, Workman, had “alleged that Defendants’ denial of her application for a medical exemption violated her First Amendment rights” to free exercise of religion.

In October 2012, a WV court ruled that the WV Department of Health retained the authority to keep children out of school who have not received the proper vaccinations for their age. In the ruling, it also support the Department of Health’s ability to add vaccines or change the schedule. In this particular case, WV had added Haemophilus influenzae type b (Hib), Hepatitis B, and Varicella (chickenpox) vaccines to the schedule, which the plaintiffs had tried to stop through the lawsuit. The judge wrote that, “the rule is entitled to substantial deference as it represents the best judgment of a national group with undoubted expertise and experience whose judgments are vetted before the public.” In other words, the CDC and WV Department of Health’s science based medical understanding of vaccinations trumps the anti-science beliefs of the antivaccination group.

This week, a WV judge ordered that although the Department of Health can prevent a child from attending a school because they weren’t properly vaccinated, the school district must provide home instruction. It’s difficult to understand why some person who refuses to get perfectly safe vaccines can’t just pay for a private school education. But the state needs to protect its children from communicable diseases, and this is probably an acceptable compromise for now. My concern is that more and more antivaccination parents are going to abuse this court decision, just to have the state pay for their kids education. Make them pay for their kid’s education if they are going to ignore sound science with regards to vaccines. 

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