In response to a measles outbreak that has spread from Clark County to King County and Oregon, legislators have introduced a bill that would prohibit children from being exempted from vaccinations for the disease out of personal or philosophical reasons.
While all 50 states require students to be vaccinated, 18 states, including Washington, allow exemptions for families who object to vaccinations for philosophical, moral or other reasons. Some families use the provision to opt out of vaccines out of concern that they cause autism, a claim that has been repeatedly debunked.
House Bill 1638 would no longer allow families to use a philosophical or personal objection to exempt their children from the measles, mumps and rubella vaccine. State Rep. Monica Stonier, a Vancouver Democrat who is among the bill’s sponsors, said the impetus for the legislation was the Clark County outbreak, which has seen 38 confirmed cases so far. Stonier said she understood that people may view vaccinations as a matter of personal choice, but she added, “I think every child has a right to participate in our community as a healthy, thriving child.”
“Personal rights are important as long as they don’t impose on the rights of others,” she said.
The outbreak of the highly contagious disease was made possible by the high rate of unvaccinated children in Clark County. According to 2017-2018 data from the state Department of Health, nearly 6 percent of children enrolled in public and private schools in Clark County had claimed a personal exemption for some vaccine and 5 percent had been exempted from the measles, mumps and rubella vaccine.
Statewide, 3.7 percent of students had claimed a personal exemption, and just under 3 percent had specifically been exempted from the measles, mumps and rubella vaccine.
Stonier said some children are unable to be vaccinated because their immune systems are weakened from cancer treatment or other conditions and are put at risk by families who choose not to vaccinate. She also said the current measles crisis has undermined previous public health investments and pointed to its cost, which has exceeded $200,000.
Since a 2015 outbreak of measles in Disneyland, state legislatures have been taking another look at personal exemptions to vaccines.
California made a major change to vaccine exemptions with SB 277, which was signed into law in 2015. The bill was a response to the Disneyland measles outbreak and a 2010 whooping cough outbreak that recorded about 9,000 cases, 808 hospitalizations and 10 infant deaths.
The California law disallowed personal belief exemptions and limited exemptions to school vaccination for children with a medical contraindication to vaccination, California Department of Public Health Director Karen Smith said in a teleconference call with media Wednesday.
Smith explained eliminating personal exemptions for children entering school has made immunization rates rise by nearly 5 percent. Ninety-five percent of California students were fully vaccinated at school entry for the 2017-18 school year, she noted.
Between 90 percent to 95 percent vaccination rates are needed to reach herd immunity, a level of disease resistance that helps insulate communities from outbreaks. When rates are that high, it’s hard for a disease to spread in a community, even if the disease is introduced.
That 2015 California measles outbreak tallied more than 130 measles cases, spread to Michigan, Canada and Mexico and cost more than $4 million to fight. The outbreak was contained within two months, Smith said.
“The fact the initial exposures and transmissions took place at Disneyland made this outbreak an international media event,” Smith said, “which over the course of the outbreak became a very robust public dialogue about the value of vaccination and ultimately mandated vaccinations for school entry.”
In 2011, Washington lawmakers passed legislation requiring parents wanting to opt out of vaccination requirements to first speak to a health care provider. In 2015, the Legislature considered a bill that would have done away with personal exemptions for all vaccinations, not just the measles, mumps and rubella vaccine that’s being targeted by the current bill. However, the bill was not passed.
Rep. Paul Harris, a Vancouver Republican who is also sponsoring HB 1638, said that the measles outbreak, which Gov. Jay Inslee has declared a public health emergency, could give the more narrowly focused legislation more momentum. He said he was encouraged that Rep. Eileen Cody, chair of the House Health Care and Wellness Committee, had signed on and he expects it to be heard next week.
“We are going to take a small step and see if we can’t get it passed,” Harris said.
In Clark County, about 1 percent of families claimed a medical exemption to vaccinations and just under 1 percent opted out for religious reasons. Harris said that lawmakers would be working with staff to “tighten up” the religious exemption to make sure people have a “bona fide” reason to go unvaccinated.
The previous attempt to eliminate personal exemptions was met with resistance from lawmakers who felt that it would infringe on parents’ rights. In 2015, most of the Republicans in Clark County’s legislative delegation were unsupportive or skeptical of the bill to remove the personal exemption.
Both Sen. Annette Cleveland and Rep. Sharon Wylie, both Vancouver Democrats, supported the previous bill and the current one. Wylie said in a text that she supports the current bill although “it is more modest than many of the citizens who are contacting me would like.”
“Our babies and most vulnerable are particularly at risk,” Cleveland said in a text. “As policymakers, we must carefully consider taking action that addresses this threat, and better protects all of us.”
Rep. Brandon Vick, R-Felida, said in a text that he had not been able to examine the bill. Rep. Larry Hoff, R-Felida, said that while he’s in favor of vaccinations and that his family has received their immunizations, he was not in favor of removing the personal exemption.
“It’s just a matter of taking away a parent’s right to choose,” he said.
Other members of Clark County’s legislative delegation didn’t respond to a request for comment.
Clark County Public Health Director Dr. Alan Melnick said he hadn’t read HB 1638, and couldn’t comment on it specifically, but said “policies, in general, that improve the immunization rate would be helpful.”
Inslee was supportive of the 2015 bill and the current legislation, according to Tara Lee, a spokeswoman for the governor. Clark County Council Chair Eileen Quiring said in a text that the council would discuss whether it would support the legislation.
