Almost as fast as measles is spreading across the nation, efforts to contain future outbreaks are spreading among the states. A number of states
are debating vaccine-related measures, tightening up those opt-out provisions that allow parents to refuse vaccination because of personal beliefs. Some legislators, however, are reacting to the outbreak by loosening requirements because freedom.
The most prominent action is in the state where the current outbreak started. In California, three Democrats have introduced legislation to require vaccinations before students enter school, with a child's medical condition being the only exemption allowed. That would make California as strict as Mississippi and West Virginia, which only allow medical exemptions. The California bill's author is considering adding a religious exemption.
Their efforts were bolstered by support from U.S. Sens. Barbara Boxer and Dianne Feinstein, who have asked state health officials to clamp down on exemptions.
To see what other states are doing to address the outbreak—good and bad (we're looking at you, Montana and New York)—head below the fold.
- Two bills by Democrats in Maine would tighten up restrictions. One would eliminate the philosophical exemption and another would require that parents consult with a medical professional about the risks of not vaccinating and obtain a signed form to receive an exemption for anything other than medical reasons. Republicans have offered a proposal to create a vaccine safety office to educate and consult with concerned parents.
- Michigan, which has one of the highest vaccination waiver rates, is ahead of the game. A new rule went into effect on January 1 which requires parents to consult with a local health department about the risks of not vaccinating before they can obtain a waiver.
- In Minnesota, lawmakers are considering a bill that would still allow both medical and personal belief exemptions, but would require that parents getting the philosophical exemption consult with a doctor and acknowledge that their kid could be barred from attending school in the event of an outbreak.
- Mississippi, which has a 99.7 percent vaccination rate, is considering making it a little simpler for parents to get a medical exemption. Exemptions now have to be approved by the state health department, but this measure would allow the exemption simply with a doctor's approval.
- A Montana Republican is bucking the trend. Democrats there got legislation through the House to add whooping cough and chicken pox to the vaccinations required by the state, but Republican Rep. Greg Hertz added an amendment to that bill that would allow a personal belief exemption. Currently the state allows for medical and religious exemptions. The Democratic sponsor of the original bill is asking a Senate committee to remove Hertz's amendment.
- Lawmakers in New York have revived an effort to broaden exemptions. Parents now can obtain medical or religious waivers, but legislation in both chambers would expand that to personal beliefs. This legislation has been introduced in the state before, without getting a vote. Chances are it's not going to get a vote this time, either.
- South Dakota has religious and medical exemptions, but apparently a confusing process for schools to access vaccination records. Legislation in the state now would allow schools and daycares to access the state's vaccination registry unless they have a signed refusal by parents preventing them from getting the record.
- Oregon, with the highest rate of non-medical waivers in the 2012-13 school year, is trying to tighten up restrictions by making it harder for parents to get personal belief exemptions. In 2013 they passed legislation requiring that parents with children entering school meet with a doctor before getting the exemption. Now they're trying to expand that restriction to parents of children returning to school.
- A Washington state physician and legislator introduced legislation to do away with that state's personal belief exemption, allowing just medical and religious waivers.
- West Virginia is up there with Mississippi on vaccination rates because it had a strict medical waiver-only policy. Republican Sen. Ryan Ferns tried to change that, by adding a religious waiver. He failed when his language was stripped from legislation being considered.
With the five infants diagnosed in Illinois, and a likely new infection in New Jersey, this measles outbreak shows no signs of slowing down. This year is well on pace to have the most measles cases since the disease was declared eradicated in the use in 2000. Swift state action now could help stem the spread and reverse the trend.