Lawmakers should end religious exemption

Iowa lawmakers dispatched two proposals that would have allowed more parents to forgo required and necessary vaccinations for their children. That’s good, but not enough. It’s time to take a closer look at the state’s lax vaccination rules.

According to the Iowa Department of Public Health, more parents are seeking religious exemptions to vaccination requirements – four times the number from only 15 years ago. At the county level, the percentage of parents taking a religious exemption varies widely. In Buchanan County, for example, 356 religious exemptions were filed in a total enrollment of 3,515. Larger Linn County had 744 religious exemptions from a total enrollment of nearly 40,000.

That’s partly because state law doesn’t require parents to cite specific religious teaching against vaccinations to claim the exemption. All it takes is a form, claiming immunization “conflicts with a genuine and sincere religious belief,” signed by the parent. Nevermind that no major religion appears to be advocating against vaccinations.

Although the state added language to the religious exemptions in 2016 that requires parents to explicitly acknowledge health risks from forgoing vaccinations, only new parents see the warning. Iowa law doesn’t require parents to renew the exemptions yearly.

A vial of the measles, mumps, and rubella virus (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle on March 20, 2019.
A vial of the measles, mumps, and rubella virus (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle on March 20, 2019. Unvaccinated people who come into contact with a person infected with measles have a 90 percent chance of contracting the virus. In addition to typical rash, cough and fever, measles symptoms can include diarrhea, ear infection, pneumonia, encephalitis, seizures and death. Also, subacute sclerosing panencephalitis (SSPE) is a rare, fatal disease of the central nervous system that can occur seven to ten years after a person catches measles. (Lindsey Wasson/Reuters)

The state requires all children entering public institutions to receive immunizations. (Author’s note, Feb. 24: Because state law includes different requirements, dependant on child care and school entrance, the previous list of vaccinations included in this column has been removed. For clarity, the Iowa Department of Public Health maintains information regarding the state’s immunization requirements, which are governed by state code and adminstrative code.) The reason is simple: Vaccinations are vital to stopping the spread of these diseases, and for preventing some diseases once nearly wiped out from recurring in society.

It’s a lesson that residents of other states are learning firsthand as they battle measles and other disease outbreaks. Lawmakers in New Jersey, New York, Maine, Oregon, Vermont and elsewhere are debating a rollback of personal and religious exemptions. Iowa lawmakers have such a bill too, filed by Rep. Mary Mascher, D-Iowa City. Unlike in other states, however, it is unlikely the Iowa proposal will gain much traction.

Despite widening holes within the state’s “herd immunity” – which is how the vaccinated protect those who cannot be vaccinated because of medical prohibitions or compromised immunity (such as those undergoing chemotherapy) – the Hawkeye State hasn’t yet experienced an outbreak. Unfortunately, such a spectacle has often proved necessary before lawmakers will act to close existing loopholes. But, according to one federal government official, states soon might be required to change their laws.

U.S. Food and Drug Administration Commissioner Scott Gottlieb said the federal government might step in if state laws are creating an opportunity for outbreaks, now creating national implications. There were 17 measles outbreaks in 2018 that sickened 372 people, according to the Centers for Disease Control and Prevention. From Jan. 1 to Feb. 14 of this year, 127 cases of measles have been confirmed in 10 states, according to the CDC. All this after measles was proclaimed eradicated in the U.S. in 2000.

Iowa lawmakers need to close the loophole. Only those with a documented medical reason should be allowed to waive vaccination requirements.

Since 1905, the U.S. Supreme Court has affirmed the right of states to claim a compelling state interest in limiting the spread of serious communicable diseases. The case, made concerning the smallpox vaccine, allows states to limit individual rights.

It’s a state right that Iowa lawmakers need to embrace now, before they’re given an opportunity to regret and mourn an outbreak.

This column by Lynda Waddington originally published in The Gazette on Feb. 24, 2019.