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Vaccination effort, ‘religious exemption’ at odds

Regulations implementing a new California law aimed at reducing the number of unvaccinated youngsters attending school may do just the opposite.

A 2012 bill, which took effect Jan. 1, requires parents seeking an exemption from vaccinations against diseases like measles and whooping cough, to first talk with a health care provider about the risks and benefits of vaccines.

Flores Martin also notes that “if the form is used properly by parents seeking true personal beliefs exemptions this will impact a relatively low number of families.”

But the form designed by the Brown administration to prove the conversation took place includes a “religious exemption” that easily allows any parent to not only avoid having their children inoculated but avoid talking to health care officials at all.

“We disagree with the decision to include an option to exempt a child from immunization if a parent or guardian is ‘a member of a religion which prohibits  (them) from seeking medical advice or treatment from authorized health care practitioners,’ “ wrote Catherine Flores Martin, executive director of the California Immunization Coalition, in a statement last fall when the form was finalized.

Flores Martin also notes that “if the form is used properly by parents seeking true personal beliefs exemptions this will impact a relatively low number of families.”

America’s nationwide requirement that children be properly immunized before attending school has wiped out infectious diseases that were once killers and cripplers of both children and adults. Diseases like chickenpox, diphtheria, meningitis, polio and rubella.

In California all newly admitted students to a childcare facility or a public school, Kindergarten through Grade 12, and all those entering 7th grade must be immunized.

Even Christian Scientists, who primarily rely on prayer for healing, do not have a formal policy against vaccines.

All 50 states allow medical exemptions for the fraction of children whose immune systems are compromised or suffer severe allergic reactions to certain vaccines. Forty-eight states, including California, allow parents to claim a religious exemption from the vaccination.

California and 17 other states, including Arizona and Texas, provide a broader “personal beliefs” exemption that covers religious, philosophical and other objections to an inoculation.

Religious objections to vaccines generally focus on using human cells to create them and the “sanctity” of the body.  The Catholic Church isn’t opposed to vaccines but it does urge Catholics to seek alternatives, when available, to vaccines made using cells from aborted fetuses.

Even Christian Scientists, who primarily rely on prayer for healing, do not have a formal policy against vaccines.

But there is plenty of suspicion and apprehension over vaccines. In Africa and Asia, those suspicions are that vaccines are some type of Western plot, usually to sterilize or infect the population.

But suspicion and fears still persist. Several Internet sites offer advice on how to secure an exemption from immunizations, particularly for religious reasons.

Although widely discredited by medical research, a common fear is that vaccines — specifically the ingredient thimerosol, a preservative used in vaccines until 2001 – can cause autism.

The Centers for Disease Control and Prevention say studies show that’s not the case. Cited specifically by the CDC is a 2011 study by the independent, non-profit Institute of Medicine of eight vaccines given to children and adults. Results showed “the vaccines to be generally safe and serious adverse events following these vaccinations to be rare.”

But suspicion and fears still persist. Several Internet sites offer advice on how to secure an exemption from immunizations, particularly for religious reasons.

Although small, the number of students in California schools without state-required vaccinations is on the rise, increasing the possibility of an outbreak of a contagious disease.

A 2009 Los Angeles Times study found the number of pupils exempted form vaccines entering school had doubled since 1997. The University of Pennsylvania School of Nursing published a study in 2012 showing children entering California kindergarten with one or more “personal belief” exemptions increased by 25 percent form 2008 to 2010.

In San Diego, a 2008 measles outbreak was caused by a 7-year-old boy whose parents had chose not to vaccinate him or his siblings. The boy became infected on a family trip to Switzerland.

Research published online last September in Pediatrics examined California’s whooping cough outbreak in 2010 – the worst since 1947. In 2010, 9,120 people were sickened and 10 babies – too young to be vaccinated — died. People living in places with a concentration of “personal belief exemptions” were two-and-a-half times more likely to have a higher incidence of whooping cough cases, the study concluded.

As a way of reducing the number of non-vaccinated students, Assemblyman Richard Pan, a Sacramento Democrat, introduced AB 2109, which created a new form for parents to complete seeking a personal beliefs exemption from getting their children vaccinated. This new form requires the signature of a “health care practitioner” attesting that they provided the parents or guardians of a child with information regarding the benefits and risks of the immunization and the health risks of specified communicable diseases. “

Nothing in Pan’s bill calls for a “separate religious exemption” on the form or empowers the Department of Public Health – or the Democratic governor – to create one.

Gov. Jerry Brown says this in a September 30, 2012 message when he signs Pan’s bill:

“This bill is about explaining the value of vaccination – both the benefits and risks – for an individual and the community. Whether these are simple ‘information exchanges’ or more detailed discussion, they will be valuable even if a parent chooses not to vaccinate.”

Then the Democratic governor says:

“(I) am directing the Department of Public Health to oversee this policy so parents are not overly burdened in its implementation. Additionally, I will direct the department to allow for aspirate religious exemption on the form.  In this way, people whose religious beliefs preclude vaccinations will not be required to seek a health care practitioner’s signature.”

Nothing in Pan’s bill calls for a “separate religious exemption” on the form or empowers the Department of Public Health – or the Democratic governor – to create one.

At the top of the page-long “Personal Beliefs Exemption to Required Immunizations” form created by the department is a section for the signature of the doctor, nurse practitioner or credentialed school nurse who shares information about vaccines.

Below that section are two boxes for parents or guardians to check. The first says thy received information about vaccines. The second box says:

“I am a member of a religion which prohibits me from seeking medical advice or treatment from authorized health care practitioners. (Signature of a health care practitioner not required in part A.)”

In an Oct. 30 press release announcing the new form, Dr. Ron Chapman, director of the Department of Public Health says:

“It’s important that parents make an informed decision and this new form encourages education about vaccinations while protecting an individual’s constitutional rights.”

The department continues to stand by its form and limits its comment to Dr. Chapman’s statement. The Times criticized the Brown administration’s new form in an editorial last fall.

Groups monitoring implementation of the new law say they’ll wait and see if the number of exemptions increase before deciding what, if any action to take.

Ed’s Note: Greg Lucas, the editor and publisher of California’s Capitol,  is contributing editor of Capitol Weekly.


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