Parents Troubled by Bill To Tighten up Immunization Exemptions

Hank Kalet | September 21, 2012 | Health Care
Advocates argue it’s a matter of public health, critics claim it's a violation of religious and parental freedom

Legislation that would clarify what constitutes a legal exemption under the New Jersey’s school immunization law was approved by the state Senate Health, Human Services and Senior Citizens Committee Thursday after nearly three-hours of contentious testimony. The bill now goes to the full Senate for a floor vote.

The legislation, S1759, with amendments, was approved by 6-2 vote after about a dozen people spoke, mostly against the bill saying parents have a right to opt out of child immunization. The law would require documentation when a parent wants to exempt a student from mandatory immunizations for either medical or religious reasons. The bill to strengthen New Jersey’s existing immunization policy was introduced after an outbreak of whooping cough this year.

The hearing was held the same day that a study was released by doctors at Emory University in Atlanta that found that nonmedical exemptions increased more rapidly in states with what it called “easy exemption policies” than in states with more stringent policies. Rates of exemptions for nonmedical reasons, the study found, were 2.31 times as high in states with less stringent rules.

Critics of the bill, who attended the hearing on Thursday wearing buttons that said “No on 1759,” called it a violation of their religious and parental freedoms and questioned the safety and efficacy of vaccinations.

Promoting the General Health
Proponents say the bill, sponsored by Senate Majority Leader Loretta Weinberg (D-Bergen) and Sen. Joseph Vitale (D-Middlesex), would codify the exemption process, limiting the ability of parents to claim general philosophical or safety concerns as religious objections and should lead to an increase in the percentage of students who are immunized. They say there has been a marked increase in the number of students who have claimed religious exemptions over the past five years.

“The intent of this bill is to spell out the very specific guidelines that a student or parent would have to go through to be exempted from mandatory student vaccination,” Vitale said. “While we want to respect people’s religious beliefs and legitimate medical concerns, we cannot allow widespread exemption from immunization based on fear and false science. Not only does it put the student at risk, but it creates a risk to the general public health and wellbeing.”

A Doctor’s Note

Under S-1759, a student or a student’s parents would be required to present a written statement from a physician “indicating that the vaccine is medically contraindicated for a specific period of time” and why, according to the bill’s statement.

For a religious exemption, the student or parent would need to explain how the vaccine conflicts with “the bona fide religious tenets or practices of the student, or the parent or guardian,” The bill says that “a general philosophical or moral objection to the vaccination is not sufficient for an exemption on religious grounds; and an exemption on religious grounds may be suspended by the Commissioner of Health and Senior Services during the existence of an emergency as determined by the commissioner.”

Required documentation under the legislation includes a notarized written statement that:

  • outlines the religious tenet or practice and explains the conflict;
  • makes clear that the objection is not solely a political or philosophical belief or related to concerns about vaccine safety;
  • and shows that the student or parents understand “the risks and benefits of vaccination to the student and the public health,” vouched for by a signed statement from a physician saying that the student has been informed of the risk.
  • The student or parents also must acknowledge that the student could be excluded from school in case of an outbreak.

    Religious Freedom

    Opponents of the legislation said it infringed on their religious freedoms. They said that meeting the new requirements would be both time-consuming and expensive and that it would put the government in the position of ruling on what constitutes legitimate religious belief.

    “The legislation legitimizes a witch hunt,” said Louise Kuo Habakus, director of the Center for Personal Rights, an anti-vaccination group. “The burdens placed on religious parents are too high.”

    Habakus, co-editor of The Vaccine Epidemic (Skyhorse Publishing, 2011), told the committee that the rules would impose a financial cost on religious parents, while forcing them to jump through an unnecessary set of hoops. More problematic, she said, was placing public officials and doctors in the “role of religious inquisitors.”

    “You are telling them they have to deem who is religiously sincere enough,” she said.

    Victoria Jakelsky, who also testified against the bill, echoed many of the concerns raised by Habakus. Jakelsky, who is state coordinator for but was not speaking on behalf of the organization, said the bill raises constitutional questions.

    “This bill, if passed, clearly is an overreach of power,” she said. “If parents have objections to immunization, they should have the right to opt out.

    “It goes farther than freedom of religion,” she added. “It goes to parental rights, which are also covered in the constitution. No state division should ever be allowed to compel treatment when a parent objects.”

    Howard Britt, a pediatrician, testified in favor of the bill, saying that states have the authority to enact compulsory immunization laws and that there is “plenty of proof that vaccines work.”

    “The state has an overriding interest in protecting the health of the community,” he said.

    Drew Harris, chairman of the New Jersey Public Health Institute, said there has been a threefold increase in exemptions over the past four years, since the state streamlined the exemption process and allowed a simple statement to be submitted. The exemption has been used to mask other issues, he said.

    He cited The New York Times report on the immunization study, which found that the 17 states with the most rigorous exemption processes also had higher rates of children being vaccinated.

    According to the Times, the study showed that state efforts to “educate the public on the risks of forgoing immunization” were having little impact and that more parents were opting out of mandatory immunization programs.

    “The opt-out rate increased fastest in states like Oregon and Arizona,” the paper reported, “where it was easy to get an exemption. In such states, the rate rose by an average of 13 percent a year from 2006 to 2011, according to the study. In states that made it harder to get an exemption from vaccination, such as Iowa and Alabama, the opt-out rate also rose, but more slowly, by an average of 8 percent a year.”

    “People couch it in terms of religious freedoms, but it is really about concerns about health and the safety of vaccines,” he said. “It subverts the intent of the religious exemption.”

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