• Prickly issue
    March 30,2012

    Gov. Peter Shumlin this week jumped into the middle of a contentious debate over removing the philosophical exemption from the state’s immunization laws.

    All sides of the issue are deeply entrenched. The dialogue pits a growing coalition of Vermont parents against a physician community concerned about declining immunization rates statewide.

    This week, opponents of the bill, which was introduced in January and has evolved into one of the sleeper issues of this session, hand-delivered a petition signed by more than 1,000 Vermonters in favor of “vaccine choice.” The governor on Wednesday entered the fray.

    “We have a public health interest in ensuring as many Vermont kids as possible get inoculated,” Shumlin said. “At the same time, I actually believe parents in the end should be making decisions about what’s best for their children.”

    Shumlin has lined up behind a compromise measure that retains the philosophical exemption, but would require parents to speak first with a medical professional about the risks associated with their decision.

    Health Commissioner Harry Chen, a doctor, has said an outright elimination of the exemption would do more to reverse a trend that has seen vaccination rates drop over the last five years. He also supports a compromise.

    A decade ago, Vermont had some of the highest immunization rates in the country. State officials have stated those rates have since fallen to some of the lowest in the nation — a trend blamed on Vermont’s philosophical exemption, which is by all accounts one of the most lenient in the nation.

    In 2010, for example, the parents of 340 children invoked the exemption.

    Many lawmakers believe, as elected officials, they have an obligation to the greater good by protecting the public health from diseases. They point to advancements in medicine and technology that make immunizations safe and easy to track. In the end, some argue, without immunization, we potentially create pockets of vulnerable Vermonters, who are at greater risks for diseases like diphtheria, tetanus, pertussis, polio and measles.

    The state can’t force parents to have children vaccinated; however, it does make it a prerequisite for attending public school and college. Every child entering kindergarten in Vermont must be inoculated against eight communicable diseases, including measles, mumps, polio and chicken pox.

    Under the law, parents can sidestep regulations by stating they have a “philosophical objection” to vaccinations.

    The Vermont Coalition for Vaccine Choice went so far as to say that the proposed bill would violate the “prior, free and informed consent” standard to which all medical intervention should adhere. “To not give people a right to choose is a violation of that bedrock principle of medicine,” coalition leader Mary Holland said.

    Further, coalition members argue that the proposed state legislation removing the philosophical waiver on vaccines would manipulate access to public education by forcing children to be injected with an open-ended series of drugs, whose “combined and long-term interactions are unknown.” The only people who profit from vaccinations, they say, are the pharmaceutical companies that produce them.

    But the medical community counters less cynically, saying that with lower immunization rates, communities are more susceptible to outbreaks of infectious diseases, and the consequences of a decision not to immunize aren’t confined to the person making that choice.

    “For me it’s always come down to the single question of whether we can save a child’s life by protecting the greater public. We entered into this debate with a lot of questions and have spent the bulk of the session hearing hours of compelling testimony, studying the science behind the facts and listening to passionate parents on both sides of this issue,” Sen. Kevin Mullin of Rutland wrote recently on these pages.

    Mullin, a Republican and co-sponsor of the bill, had a son who had an adverse reaction to a vaccination.

    Mullin and others are sound in their position, however: Eliminating the philosophical exemption is not meant to infringe on parental rights. Rather, it is meant to narrow the scope under which Vermonters can opt out of immunizations and ensure more children receive life-saving vaccines.

    That will never appease or assuage parents whose children had an adverse reaction to one of the drugs.

    The compromise — requiring parents to speak first with a medical professional about the risks associated with their decision — is a practical solution, even though some parents who want the choice may lose sight of the greater good.

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