House bill would relax immunization standard

Parents who object to state laws that require childhood immunizations were scheduled to testify before the House Health and Human Services Committee last month.

The parents, part of a group called Kansans for Vaccine Rights, support House Bill 2094, which would create an exemption for parents who do not want their children immunized.

Already, state law exempts children who are medically fragile, home schooled or belong to a religious denomination that opposes immunization.

House Bill 2094 would expand these exemptions to include a parent?s personal beliefs.

Current practice

In Kansas, children are required to be immunized against chicken pox, diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B and influenza type B before or shortly after being allowed to enroll in a public or private school, a licensed preschool or a licensed day care facility.

Enforcement of the law is left to local school districts. Some districts?there isn?t an exact count?require kindergarteners to be immunized before they enroll, while others allow a 30-day grace period. Some choose not to enforce the law.

Immunizations are available at county health departments across the state and at most primary care doctors? offices.

 

Opposition

Kansans for Vaccine Rights Director Erika Higgins declined a KHI News Service request for an interview, noting in an e-mail that members of the group did not ?? want any personal names published in association with the bill.?

She referred instead to the group?s website, which states, ?We believe it is medically, ethically, and scientifically irresponsible to mandate vaccina?tions without also providing unrestricted exemptions for medical reasons, religious reasons and reasons of conscience.?

The website claims it is unconstitutional to have an exemption that applies to one set of religious beliefs and not another.

In testimony before the committee last year, Higgins said she and her husband had been told they weren?t eligible for the religious exemption because they were Catholic and the Catholic Church ??has no teachings that mandate or oppose the use of vaccinations for disease prevention.?

According to minutes of the committee meeting, Higgins also said: ?Disease prevention is an individual responsibility and an individual decision for each unique child. It is a decision reserved to the parents who should work with their doctors to make the decision. Admission to school should never be used to force children to receive vaccinations. When you support this bill, you are standing up for life, for individual liberty, for freedom of conscience, for parental rights, and for true and unrestricted consent.?

According to the group?s website, more than 700 people have signed a petition in support of House Bill 2094.

Bill?s outlook

The committee?s chairwoman, Rep. Brenda Landwehr, R-Wichita, wouldn?t predict whether the bill would get out of her committee.

?I?ve had quite a few legislators ask me to work this bill,? she said. ?These are people (Kansans for Vaccine Rights) who have a lot of concerns. They don?t have a bunch of money behind them. They don?t have a paid lobbyist.

?So we?re going to take the time to hear it, but I have not been supportive of this in the past because, frankly, I?m old enough to remember polio. Vaccines have put a halt to a lot of diseases that I don?t want to see come back.?

Time constraints prevented the committee from working the bill last year, Landwehr said.

Health officials respond

Several health officials are expected to testify against the bill.

?Vaccines are safe,? said Dennis Cooley, a Topeka pediatrician, chairman of the Kansas Blue Ribbon Panel on Infant Mortality and president of the Kansas Chapter of the American Academy of Pediatrics.

?When a parent sends a child who?s not immunized to school, they?re putting all the other kids at risk, especially those who for various reasons can?t be immunized?a child in chemotherapy, for example,? Cooley said.

The Kansas Chapter of the American Academy of Pedia?trics represents more than 90 percent of the state?s pediatricians.

?In a way, I think it?s unfortunate that our vaccines have been so successful, because now we have parents who?ve never seen a case of measles or chickenpox,? Cooley said.

?People tend to forget that these vaccines weren?t developed because these were innocuous diseases. They were developed because these were diseases that caused and can cause some very serious problems.?

?Toothless? impact?

Michelle Ponce, executive director of the Kansas Associa?tion of Local Health Depart?ments, said House Bill 2094 would cause the immunization requirement to become a toothless recommendation.

?Our concern is that a lot of times, parents don?t realize they?re behind on their kids? immunization or that they?re even due,? Ponce said.

?So when they?re told, ?You need to go get this done,? for some it?ll be a lot easier to just sign a note that says you don?t want to. It wouldn?t matter what your religious beliefs are.?

Rate of compliance

According to a recent KDHE report, 398 children?about 1 percent of the state?s public-school kindergarteners?opted out of the immunization requirement last year: 287 for religious reasons, 111 for medical reasons. At least 82 percent of the state?s kindergarteners were fully vaccinated.

Charlie Hunt, state epidemiologist at KDHE, said his office is gathering data on the roughly 17 percent of kindergarteners whose immunization status is unclear.

?We suspect that some school districts either aren?t enforcing the policy or that they?re allowing longer periods for being in compliance,? Hunt said. ?We are anxiously awaiting the arrival of that data.?

The anxiety, he said, stems from recent in-state outbreaks of measles, whooping cough and mumps.

?Our concern is that exemptions tend to cluster,? Hunt said. ?So when vaccination rates fall to a rate that?s not sufficient to suppress transmission, everybody in that community is put at risk, including those who?ve been vaccinated because no vaccine is 100 percent effective.?

Statewide outbreaks

The KDHE report noted that in 2008, the state experienced a widespread outbreak of mumps that was kept in check by high rates of vaccination. It also warned that in 2008 the United States had 140 confirmed cases of measles, the most in any year since 1996. And in the first five months of last year, 118 measles cases had been confirmed.

Hunt said outbreaks of whooping cough were becoming ?fairly regular? in Kansas.

?Right before Christmas, we had about 30 cases of whooping cough that were clinically confirmed,? said John Hultgren, who oversees the Dickinson County Health Department in Abilene.

?The first case happened to be a teacher, so we had to set up vaccination clinics in all the schools in the county.?

In June, six whooping cough cases were confirmed in Dodge City. In January, the Finney County Health Department confirmed two cases of measles.

Hunt and other health officials say these outbreaks likely would have been worse if more families had been allowed to opt out of the immunizations.

?These really are risk-versus-benefit decisions,? said physician Melinda Wharton, referring to the hearing on House Bill 2094.

?Vaccines, like any medical intervention, do have adverse events associated with them. We know that,? she said. ?But when we compare these risks to the benefits, there is no question in my mind, both as a parent and as a physician, that the safest thing for my children is to protect them from vaccine-preventable diseases, which still occur in many parts of the world.?

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