Vaccine Exemptions Schools

Starr Roden, left, a registered nurse and immunization outreach coordinator with the Knox County Health Department, administers a vaccination to a 6-year-old at the facility in Mount Vernon, Ohio. States are debating whether to make it more difficult for students to avoid vaccinations for religious or philosophical reasons, but children using such waivers are outnumbered in many states by those who give no excuse for lacking shots. Data reported to the Centers for Disease Control and Prevention shows a majority of unvaccinated or undervaccinated kindergartners in 10 of 27 states reporting were allowed to enroll in school without any exemption.

To vaccinate or not is a contentious issue in Colorado, with one side claiming that vaccine mandates amount to harassment and the other arguing that they are a matter of public safety. 

Two bills targeting both sides of the debate are making their way through the General Assembly. On Monday, a third bill addressing discrimination in the workplace died in committee.

The most contentious, unveiled Feb. 3 and set to be introduced as early as this week, is similar to last year’s failed bill to address school vaccination rates. The proposal would make it harder to exempt school-age kids from vaccinations by requiring parents who have chosen not to vaccinate their children take an online education course, or to produce a form signed by a physician's assistant or doctor. The legislation would also require each school to notify parents of its vaccination rates. 

Currently, the only requirement for Colorado parents who don’t want their children vaccinated is to submit a statement to the school office. Colorado law also honors medical and religious exemptions. The bill would require parents to refile every school year. 

The idea of being forced to take an education course frustrates parents who have made the choice not to vaccinate their children, according to National Vaccine Information Center Executive Director Theresa Wrangham. 

“These choices are not made lightly,” Wrangham said. “They’re assuming we are idiots. I consider this discrimination. If we’re going to educate, let’s educate everyone.”

When the law was discussed, all eyes were on Gov. Jared Polis for reaction because his opposition to last year’s version of the bill was key in its defeat. At that time, he described himself as “pro-choice” on vaccines. But this session,  Polis has reversed his stance, explaining in a statement that he “believes immunizations are key to protecting our children’s and Colorado’s public health.” 

Polis spokesman Conor Cahill added, “The most recent draft of the bill honors the rights of parents while supporting the administration’s efforts to boost immunization rates, and that is a bill that the governor can support.”  

The bill, which has not yet been introduced, will be sponsored by Sen. Kevin Priola, R-Henderson, Sen. Julie Gonzales, D-Denver, and Rep. Kyle Mullica, D-Northglenn. Mullica is the only lawmaker who is a nurse. 

Those lawmakers declined to comment on the legislation until it is formally introduced.

According to the Colorado Department of Public Health and Environment and the Centers for Disease Control and Prevention, Colorado’s kindergarten MMR (measles, mumps, rubella) vaccination rate is the lowest in the United States, at 88.4% in compliance for the 2018-2019 school year.

Michelle Ames, a spokesperson for Colorado Vaccinates, a group that supports children receiving a full range of immunizations before they start school, says Colorado has an “embarrassing” track record when it comes to vaccinated kindergarteners. 

“Measles, mumps, rubella is the most dangerous,” Ames told Colorado Politics. “I know these parents who don’t vaccinate feel they are making the best decisions for their children. But the science does not support the decisions they are making.”

But State Rep. Lori Saine, R-Firestone, is opposed to tightening the rules on exemptions, explaining that the real issue is not about the percentages, it’s in the way immunizations are reported. 

“Records are incomplete in almost all school districts,” she said. “If the concern is about the percentage, then why aren’t we tackling the problem, which is under-reporting?”

Vaccinations required by the CDPHE for children K-12 include Hepatitis B, Diphtheria, tetanus, pertussis (DTap), MMR and tetanus. By a wide margin, most parents who opted out of vaccinating their children did so for personal beliefs, which The National Vaccination Center defines as “conscientious objection” and only requires a signed statement. Colorado is one of 15 states that allow such exemptions.

But the personal belief exemption is exactly a portion of what the latest unveiled vaccination bill wants to address. 

“Parents don’t have to do anything except sign their names and say you don’t believe in vaccinations. And it doesn’t matter why,” Ames said. “It takes me longer to sign my kid up for club soccer than to exempt my kids from vaccinations at school.”

This session’s version includes several changes on how it handles medical exemptions by widening the range of professionals who can provide them to all immunization providers. 

Wrangham believed the medical exemption is a no-brainer. “Some adults and kids have very bad reactions to certain vaccines,” she said.

Ames agreed that medical concerns are absolutely real, “but they are a small sample of the population.” 

Opponents of the bill know they are in the minority but say they see common ground.

“The bottom line is, I think parents want to keep their kids safe,” explained Wrangham. “I don’t know any vaccinating parents who don’t want to keep their kids safe.”

Other bills in play

A second bill on vaccinations is a little further along in its journey through the legislature. Rep. Dave Williams, R-Colorado Springs, is a co-sponsor of House Bill 1239, which would force doctors and other health care providers to fully inform parents of the risks and benefits of vaccinations. 

Williams says the bill is about consumer protection. 

“The goal is to keep the government from forcing parents into a situation where they are vaccinating. It’s not an anti- or pro-vax bill. It allows people to decide for themselves.”

The bill has been assigned to the Health & Insurance Committee, with a hearing tentatively set for Feb. 26.

The third bill, which was killed 3-1 in the committee, sought to address perceived discrimination in the workplace regarding vaccines.

Senate Bill 84 would have prohibited employers, including health care facilities, from taking actions against workers who refuse to get vaccinations. 

Saine told Colorado Politics the bill she is co-sponsoring with Sen. Vicki Marble, R-Fort Collins, was not expected to pass, but health care professionals would testify at a hearing Monday afternoon.

Saine said that the discrimination mainly hits health care workers. “Many of them are required to wear masks. They may be put on leave or have their hours cut because they aren’t vaccinated,” she says. 

Saine explains that SB84  “isn’t about anti-vaccine” but health care workers who refuse vaccinations for medical reasons. 

“They’re not refusing vaccinations, they’re refusing some of them because of bad reactions. Where there’s risk, there should be choice,” says Saine.

After hours of testimony Monday, the bill failed on a 3-1 party-line vote.

Not a partisan issue

Saine said that though the legislative votes suggest that the vaccination debate runs along party lines, that’s not the picture she sees among her constituents. 

“It's interesting that Republicans are chanting this when probably 80% of the parents who come regarding this issue are Democrats.”

Ames agreed that political party does not define the vaccination argument. 

“There is absolutely no political divide on this issue. It’s young, old, male, female, Republican, Democrat, Independent, rural, urban. It doesn’t matter… . We all believe in public health.”

NOTE: This story has been updated on the status of SB84.

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