Required vaccinations are a hot topic in the legislature this session. Long-standing scientific consensus summarized by the Centers for Disease Control and Prevention (CDC) and the Washington State Department of Health underlines the safety, effectiveness, and importance of these vaccinations. A recent measles outbreak centered in Southwest Washington, almost entirely among unvaccinated children, reminded us of the public health risks from low vaccination rates, likely fueled by fears based on shoddy evidence that has been debunked for years and again last month by a large study finding that the the MMR vaccine does not increase the risk of autism.

Renewed calls to end non-medical exemptions from the Measles, Mumps, and Rubella (MMR) vaccine requirement led to introduction of four different bills. Public hearings were filled with passionate pleas from state and county health officials calling for measures to help ensure the safety of school children, and vocal opposition from anti-vaccination proponents. One bill remains standing as of April 8: EHB 1638, sponsored by Representative Paul Harris and amended differently in the House and Senate. The original bill did two major things: it removed the exemption for those with a personal or philosophical objection to the MMR vaccine, and it allowed exemptions if proof of disease immunity is shown through a documented antibody titer test or a health care provider’s attestation of a child’s history of a particular disease.  The bill passed the full House with the following amendments:

• Requiring volunteers and employees at licensed day care centers to have either the MMR vaccine, laboratory proof of immunity to measles, attestation by a provider of a history of measles, or certification by a provider that the MMR vaccine is not advisable.
  

• Allowing high school students who are already exempt from a vaccine to remain exempt through high school.

• Exempting a student if any licensed physician, naturopath, physician assistant, or advanced registered nurse practitioner certifies that a required vaccine is not advisable because a biological parent or sibling has a “documented history of immune system problems” or “a documented adverse reaction” to that particular vaccine, but only so long as the vaccine is contraindicated.

• • Exempting a student from a required vaccine if a parent or legal guardian certifies in writing that a healthcare practitioner has documented that a biological parent or sibling has a history of immune system problems or adverse reaction to a particular vaccine, which would contraindicate that vaccine under Centers for Disease Control and Prevention guidelines.

• Exempting from further vaccination students who “fail to mount a positive antibody response” following a complete vaccine series.

March 29 Senate Health & Long Term Care committee hearing testimony by the Department of Health and others opposed the last four of these exemptions as too broad to protect the public health. On April 1, that committee approved an amended version that deleted those provisions. The full Senate has yet to consider the bill, and if a Senate-passed version differs at all from the House’s, the bill would require further House action before becoming law.

Enacting the Senate health committee’s approach – limiting proof of medical exemptions to titer tests and provider attestations provisions – would be a positive change to mandatory vaccine policy. As The Columbian – the newspaper in the Washington community most hit by the measles outbreak – advocates, it would be a step toward removing all non-medical exemptions for all mandatory vaccines: “… failing to receive the MMR vaccine because of philosophical concerns places others at risk, and that is where the argument about personal liberty falls short. Clark County has spent $823,000 in response to this year’s outbreak — an unnecessary cost that is borne by all residents.”