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Vaccine Bills Spark Intense Debate About Medical Exemptions And Student Mandates

The Massachusetts State House. (Jesse Costa/WBUR)
The Massachusetts State House. (Jesse Costa/WBUR)

More than 400 people weighed in Tuesday on bills that Massachusetts lawmakers are considering related to vaccines.

Many of the comments related to vaccination requirements, including from medical groups that believe stronger requirements are needed and from parents who objected to vaccine mandates.

Rep. Andy Vargas filed a bill (H 2411) that would maintain the medical exemption for student vaccinations, but remove the current religious exemption. And Sen. Becca Rausch and Rep. Paul Donato filed legislation (S 1517, H 2271) to standardize immunization requirements and exemption processes, fill gaps in vaccine rate data and boost outreach efforts.

Vargas, a Haverhill Democrat, said all but one county in Massachusetts has one or more schools where herd immunity for measles has not been met. He said several other states, including Connecticut, New York and Maine, have removed non-medical exemptions for childhood vaccines.

"Above all the lessons learned through the pandemic, perhaps the most powerful one is that whether we like it or not, Americans, Massachusetts residents and human beings have a responsibility for the health and safety of one another," he said. "As lawmakers, we have to reason with the facts, listen to trained experts, trust the science and make tough decisions to stop preventable death and illness. We learned this the hard way during the pandemic."

State law requires students entering school to be immunized against "diphtheria, pertussis, tetanus, measles and poliomyelitis and such other communicable diseases as may be specified from time to time by the department of public health," but allows exemptions in cases where a physician certifies the child's health would be endangered by a vaccine or in cases where the parent or guardian states in writing that vaccination or immunization conflicts with his sincere religious beliefs.

Last summer, the Department of Public Health added flu shots to the list of required immunizations for students and then removed that requirement in January 2021, citing preliminary data showing a mild flu season to date.

A state average of 1.1% of kindergarteners had either religious or medical vaccine exemptions in 2020, according to the Department of Public Health, which said that most exemptions claimed in Massachusetts are religious. The rates vary, from 0.7% in Suffolk County and 0.8% in Middlesex County, to 8.5% in Dukes County, 7.3% in Nantucket County, and 2.7% in Franklin County. Many students, the DPH said, have exemptions to only one or two vaccines and are otherwise immunized.

Dr. Sylvia Fogel, a psychiatrist who opposed the bills, told the committee that removing religious exemptions or "having DPH implement or prove exemptions" would be "simply targeting the wrong thing, with large potential downsides." She said several schools with the lowest measles vaccination rates do not have any exemptions on file.

Several parents who testified against one or both bills said they wanted more flexibility in the timeline for vaccinating their children to observe effects or decried government mandates around health decisions that they said belong with parents.

Timothy Murzycki, who described himself as a "frightened and frustrated" father, said the bills pose limits to medical and religious freedoms.

"When evaluating the proposed bills, please contemplate the following questions," he told the committee. "Is this freedom? Is this a democracy? Is this a free and fair society?"

Another parent, Beth Cook, said the bills are "discriminatory towards families whose sincere moral and religious beliefs influence their decisions regarding vaccination and medical intervention."

Supporters of the bills pointed to a need to protect immunocompromised people, cancer patients, transplant recipients and others who cannot get vaccinated.

Senator Rausch described the state's current youth immunization law as "Swiss cheese at best."

"Our current laws simply don't cut it," Rausch said. "If the fault lies in our statutes, so too must a solution."

The Massachusetts Health and Hospital Association, Massachusetts Nurses Association, American Federation of Teachers-Massachusetts and Massachusetts Association of School Superintendents are among the groups that have endorsed the bill.

The Massachusetts Medical Society "strongly supports" eliminating the religious exemption and backs "certain provisions" of the community immunity bill "that would improve the remainder of the vaccine system by centralizing, standardizing, and streamlining the medical exemption process while improving the collection, monitoring, and publication of immunization data," the organization said in a statement.

Dr. Carole Allen, the MMS president and a retired pediatrician, told the committee that in her 40-year career, she "encountered numerous instances of vaccine-preventable infections and witnessed and welcomed the miraculous development of vaccines to prevent them."

"Just as we have seen with the COVID pandemic, the health of communities of color and low-income populations continues to be disproportionately threatened by these diseases," she said.

Versions of both bills were proposed in 2019, months before the COVID-19 pandemic took hold and intensified interest in issues around infectious diseases and immunization.

Last session, the Public Health Committee killed Vargas' vaccine exemption bill by including it in an order for further study, but advanced redrafted versions of the Donato and Rausch bills, which went on to die in the Health Care Financing and Senate Ways and Means committees, respectively.

This term, the Rausch and Donato bills are co-sponsored by a total of 27 lawmakers, including 17 of the 40 state senators. Nineteen lawmakers are signed on to the Vargas bill, which also has the support of the Lexington School Committee.

"If we have learned anything during this pandemic, it is the need to be proactive and not reactive. We need to act now to ensure vaccination rates are high enough to prevent outbreaks of highly contagious diseases," Kathleen Lenihan, the school committee's chair, told lawmakers.

With reporting by State House News Service's Katie Lannan

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