To immunize or not: Proposed law could make it difficult to get vaccine exemption
By Jaimie Julia Winters
With the start of the new school year, while many parents will be handing in vaccine forms stating their children have received the required battery of immunizations in order to attend school, about three percent will file exceptions to not vaccinate their children.
Although there’s a list of vaccines required for public school attendance by law, New Jersey parents wanting vaccine exemptions only need to send in a letter to their district stating they are against vaccinating their children due to religious beliefs.
For decades, only medical exemptions have allowed for students with compromised immune systems or other medical issues to refuse vaccines. But a recent increase in states allowing for exceptions based on religious and philosophical beliefs has given parents who choose not to vaccinate their children more options.
In Montclair, a very small number of students, about five per year, get medical exemptions. But the number of students getting religious exemptions is on the rise, reflecting an overall trend in New Jersey.
For 2016-2017, 154 Montclair students in grades K-12 asserted religious exemptions from immunizations. For 2017-2018, the total was 180 total students.
“It is my understanding that the state considers Montclair highly compliant without a high number of exemptions as we are under three percent with religious exemptions,” said Superintendent Kendra Johnson.
In New Jersey, since 2014, the number of students with vaccination exemptions has risen by 64 percent, according to the New Jersey Department of Health (DOH).
In Essex County over the last four years, religious exemptions have risen by 46 percent. In Essex County for the 2013-14 year, about 713 students received exemptions based on religious reasons. In 2017-18 that number rose to 1,046.
During the 2017-18 school year, 2.4 percent of New Jersey students took religious exemptions to not vaccinate, according to the DOH.
In order for a student to get an exemption, a written statement is submitted to the district by the student, or the student's parent or guardian if the student is a minor, stating that "immunization interferes with the free exercise of the pupil's religious rights." The district must accept exemption.
Medical exemptions, which require a doctor’s recommendation, are also allowed but are harder to get, and are typically limited to a particular vaccine and sometimes only for a brief period of time.
Medical exemptions have remained steady at 0.2 percent over the last four years in Essex County, according to the state.
Armara Wagner, the owner of Amara Wellness and a volunteer with New Jersey Coalition for Vaccination Choice, said the issue is not about being against vaccination, the issue is about choice.
She attributes the rise in the number of vaccination requirements, which in New Jersey includes the influenza vaccine since 2008, to the rise in the number of parents applying for exemptions.
The exemption is all or nothing. So if a family is against getting an annual flu vaccine, but not the polio vaccine for example, they would need to submit a religious exemption for all vaccines. The New Jersey Coalition for Vaccination Choice cites as a concern that 90 percent of flu vaccines contain mercury and all contain egg protein, a concern with children with egg allergies.
“Parents who choose the exemption are not necessarily anti-vaxxers. They are not against any medical procedure really. They are against not having a choice,” she said. “The vaccine schedule is not based on the individual patient, it’s one-size fits all.”
In New Jersey required vaccinations include: DTaP (Diphtheria, Tetanus, acellular Pertussis), Polio Inactivated Polio Vaccine (IPV), MMR (Measles, Mumps, Rubella), Varicella (Chickenpox), Hepatitis B, Meningococcal, Tdap (Tetanus, diphtheria, acellular pertussis) and influenza.
Privacy is another issue, she said.
“All medical choices should be between the family and the physician, not mandated and recorded by the state and school,” Wagner said.
One mother who wished to remain anonymous said she began filling out the religious exemption form when the influenza shot was required for her children to attend school.
“After careful research and consulting with my doctor about that vaccine, I decided to take the exemption,” she said.
August is National Immunization Awareness Month, and the township held an immunization session Monday night with Dr. Everett Schlam of Hackensack Meridian Health Mountainside Medical Center, formerly a member of the Centers for Disease Control’s Advisory Committee on Immunization Practices.
“Vaccines are the most effective way to prevent community-spread illness,” said Schlam.
Severe reactions are very uncommon, he tells his patients.
He said there were several hundred flu-related deaths a year before the influenza vaccine.
“The less people with vaccinations, the more we will see outbreaks,” Schlam said.
He points to the now-debunked 1998 study by Dr. Andrew Wakefield, which falsely linked the measles, mumps, and rubella vaccine to autism. Schlam said that report, which was retracted by its publisher and led to the stripping of Wakefield’s medical license, helped fuel a dangerous universal movement of anti-vaccination.
“We saw an increase in outbreaks of measles and mumps,” he said.
STATE LEGISLATORS DEBATE EXEMPTIONS
A new bill that cleared a state assembly panel in April would severely limit families in taking the religious exemption. The legislation was introduced by Assemblyman Herb Conaway, a doctor who felt the law needed “tightening of state policies on exemptions from student immunizations.
"Medical science has shown vaccinations to be an extremely effective approach to securing public health," said Conaway (D-Burlington), a practicing physician. "We've heard too many people playing politics with vaccinations, despite vaccinations having long been proven as a safe and effective means of controlling and eliminating deadly illnesses plaguing humankind. In the end, the only thing government must balance is what's best for the overall public health, and that means unambiguously supporting vaccinations and making clear that any exemptions must be limited."
If the legislation passes, families would need to provide the following:
- A written statement submitted to the school, as applicable, by a licensed physician indicating that the vaccine should not be given for a specific period of time based upon valid medical reasons as determined by the Commissioner of Health and Senior Services, or;
- Documentation submitted to the school, as applicable, by the student, or the student's parent or guardian if the student is a minor, explaining how the administration of the vaccine conflicts with their bona fide religious tenets or practices.
All states currently grant religious exemptions. Currently, 18 states, including Pennsylvania, Maine, Vermont and Ohio, allow philosophical exemptions for those who object to immunizations because of personal, moral or other beliefs.
In January, a bill introduced by State Sen. Shirley Turner would allow for philosophical exemptions in New Jersey. Under the bill, a student seeking a philosophical exemption would provide the school with a notarized, written statement signed by the student, or if the student is a minor, by the student's parent or legal guardian, stating how a specific immunization conflicts with a personal, philosophical or moral belief. The student's school will be required to grant the exemption and keep the statement on file as part of the student's immunization record. Students with philosophical exemptions may be excused from school during a disease outbreak or threatened outbreak, as determined by the Commissioner of Health. That bill has seen no movement.
The National Childhood Vaccine Act of 1986 grants drug companies immunity from certain lawsuits from injuries or deaths tied to vaccinations. The National Vaccine Injury Compensation Program now handles all vaccine-related suits.
The vaccine debate is so controversial that during the recent presidential campaign, Russian bots and trolls took to social media to post pro and anti-vaccine messages, according to an article published last week by the American Journal of Public Health.
“Russian trolls promoted discord,” the conclusion read. “Accounts masquerading as legitimate users create false equivalency, eroding public consensus on vaccination.”