February 28, 2015
SALEM, Ore. — Jennifer Margulis has her kids vaccinated and she gets shots herself. But she doesn’t like the idea of government telling parents they must get their children immunized.
That’s why she spoke at a recent legislative hearing to oppose an amendment to an Oregon bill that takes aim at the state’s highest-in-the-nation rate of non-medical vaccine exemptions.
“I really feel this is an assault on parental freedom and medical choices. I am really strongly in favor of vaccines. I get into trouble among people in southern Oregon for speaking out about why I chose to vaccinate my kids,” said Margulis, a parent from Ashland, a city in Oregon with a high vaccination exemption rate.
If the bill passes, Oregon would join Mississippi and West Virginia as the only states allowing exemptions solely for medical reasons, and no longer for religious, philosophical or personal reasons. Washington, California, and Vermont are considering similar bills that remove either the personal, religious or philosophical exemptions.
Last year, Oregon put into effect a law requiring parents with kindergartners to consult with a health professional or watch a one-hour educational video before shots are waived. That bill was prompted by Oregon’s high rate of exemptions for kindergartners — about 7 percent. Nationwide, the median exemption rate was 1.8 percent for last year’s class, according to the Centers for Disease Control and Prevention.
Exemption figures for this year have not been released. But some legislators say they are hearing of anti-vaccine parents who go through the motions when they attend the consultations.
“People can look at the video at school-based health centers and they’ll sit there and multitask,” like looking at their iPhones, said state Sen. Elizabeth Steiner Hayward, D-Portland. “Most of them go in saying pretty clearly, ‘Ok I’ll sit through this thing, but it’s not gonna change my mind.’”
Steiner Hayward, a family physician promoting the bill, said she has also heard of parents badgering doctors into signing waivers.
Parents who choose not to vaccinate their children have become lightning rods during the scare over a measles outbreak traced to Disneyland. The CDC says 133 people from seven states, including one from Oregon and two from Washington, were linked to the outbreak.
The CDC has said the measles-mumps-rubella vaccine is 97 percent effective at preventing measles. They say vaccines are the best defense against many diseases and the suggested vaccine schedule can protect newborns from serious infections when they are at their most vulnerable.
But there are pockets of parents around the country who choose to delay or forgo certain shots, or opt out of state-recommended vaccine schedules.
Some cite religious reasons for opting out, while others prefer alternative medicines. Others spurn government mandates.
Under the Oregon proposal, families who decide against shots would be barred from sending their children to schools or daycares, though they still could use online charter school programs or homeschool their children.
The Legislature has been holding public hearings on the proposal. Testimony has been heated, and has sometimes focused on parents’ rights to make choices for their children. Parents opposed to the bill say the number of vaccines is unnecessary and questioned their safety.
Those who spoke in favor of the bill said the shots benefit the child receiving them and those who are too young or unable to get immunized.
“We had a leukemia patient from outside of Portland who was finally given medical clearance by his oncologist to go back to school with his friends, although it was not yet safe to receive live virus vaccines,” said Dr. Judith Guzman-Cottrill, a pediatric infectious disease specialist at Oregon Health and Science University.
That patient came down with chickenpox and varicella pneumonitis but survived, she said.
Those who support the bill argue that Oregon’s high rate of exemptions makes it hard for the state to achieve “herd immunity,” which means enough people are vaccinated to prevent disease from spreading.
Herd immunity varies by disease. More contagious diseases, like measles, require a higher percentage of the population to be immunized, said Dr. Paul Cieslak, medical director of communicable diseases and immunizations at the Oregon Health Authority. Oregon can’t afford to sustain such a high exemption rate, he said.