This article is more than 5 years old. Information may no longer be current.

Elimination of vaccine exemptions serves children's best interests

NEW YORK — The elimination of personal belief exemptions to vaccination, which have no scientific or medical basis, is required to protect children from the potentially life-altering dangers associated with vaccine-preventable disease, according to a presentation at the 2015 Infectious Diseases in Children Symposium.

States without laws prohibiting personal belief exemptions are failing to protect children by allowing parents to needlessly refuse vaccinations for their children, according to Paul A. Offit, MD, chief of the division of infectious diseases at The Children’s Hospital of Philadelphia, and an Infectious Diseases in Children Editorial Board member.

Paul A. Offit

“I think in many ways that vaccines are the perfect storm of fear,” Offit said. “We ask citizens in this country to give vaccines to prevent 14 different diseases in the first few years of life, which can mean as many as 26 inoculations during that time, and as many as five shots at one time, to prevent diseases that most people don’t see — using biological fluids that most people don’t understand.

“At least 1% to 2% [of parents] are choosing no vaccines, and somewhere between 10% and 20% are choosing to delay, withhold, or space out the vaccine. And the reason that they are doing it is because they can.”

Religious exemptions nonsensical in some cases

According to Offit, religious doctrine is both misinterpreted and misused to avoid vaccination, which can result in outbreaks of deadly diseases.

“Religious exemptions don’t make sense from the standpoint of either biblical scripture, constitutional law or religious morality,” Offit said

He argued that because religious scriptures were written thousands of years before the development of vaccinations, they cannot logically be used to justify exemptions to vaccination.

“The first vaccination was the smallpox vaccine, developed by Edward Jenner in the late 1790s,” Offit said, “while the Old Testament was written between 1400 B.C. and 400 B.C., and actually never mentions vaccines or predicts their existence.”

According to Offit, the tumultuous legal history between vaccine exemptions and constitutional law has led to individual states allowing certain exemptions, but has not given citizens the constitutional right to refuse vaccines.

“Although there is no constitutional right to refuse vaccines, states may allow exemptions,” Offit said.

Currently three states do not allow exemptions based on personal beliefs: California, Mississippi and West Virginia, according to Offit.

“Mississippi has vaccination rates in the 99% range,” Offit said. “This is a state that is not necessarily lauded for its public health achievements, but regarding vaccinations, they are excellent, because it is very hard not to get a vaccine there.”

Offit noted that the idea of withholding vaccines from children runs counter to the core principles of religion.

“If religion teaches us anything, it is to care about our children, our families and our communities,” Offit said. “A choice to put a child in harm’s way, to allow them to catch and potentially transmit a fatal infection, is a profoundly nonreligious thing to do — and therefore shouldn’t be given the legal protections of religion.”

Philosophical exemptions for vaccinations

According to Offit, the line between religion and philosophy has been blurred; thus with religious exemptions came philosophical exclusions. These exemptions translate to vaccine refusal based solely on a personal belief that vaccination should not be administered.

“I have a problem with the terms, “phila,’ meaning love and ‘sophos,’ meaning wisdom, [being used here],” Offit said. “Where exactly is the wisdom that it makes more sense to not get a vaccine than to get one?”

Offit argued that the concept of personal belief has no bearing on whether or not vaccines should be administered.

“Vaccines are not a belief system, they are an evidence-based system,” he said. “Vaccines stand on a mountain of evidence — you don’t have to believe in vaccines any more than you have to believe in gravity or evolution.”

According to Offit, 17 states allow personal belief exemptions. California recently passed legislation prohibiting exemptions based on religious and philosophical reasoning.

“In other words, parents don’t own their children,” Offit said. “When you have a child, you have a certain responsibility to keep them safe and well, and if you don’t meet that responsibility, then there are times that the state can step in.”

Offit said California’s recent legislation hopefully signals a future of more restrictive laws nationwide, requiring that more vaccinations are given, and ultimately, more lives will be saved.

“Parents always talk about parents’ rights, I just don’t see it,” Offit said. “I don’t think it’s the parent’s right to put their child in harm’s way, and what nobody ever talks about are children’s rights. Children have rights, too.”

Offit offered advice to pediatricians, who he said are on the front lines of the vaccine refusal debate, and bear the heaviest burden in the effort to ensure children are properly vaccinated.

“Be passionate,” Offit said. “Tell them: ‘Let me love your child, and don’t put me into a position where I have to send your child into a potentially more dangerous world — and please don’t make me practice substandard care.’ ” – by David Costill

Reference:
Offit PA. “Confronting Personal Belief Exemptions to Vaccination.” Presented at: IDC NY; Nov. 21-22, 2015; New York.

Disclosure: Offit reports no relevant financial disclosures.