Though not the splashiest headline coming out of Super Tuesday 2020, news in Maine that voters came out to support the state’s law eliminating the exemptions for philosophical and religious reasons for not vaccinating their children. Maine Question 1, a people’s veto referendum looking to reject the law passed by the legislature in May 2019, qualified to be on the ballot as critics of the law had gathered enough signatures from voters in the state. As the Bangor Daily News reported late Tuesday, nearly 70 percent of voters supported the measure going into effect.
The law (Public law 154) was passed following reports that the rate for vaccination in the state had dropped below 95 percent for a number of diseases as more than five percent of kindergartners had forgone vaccinations for non-medical exemptions. As the organization behind the efforts to defend the law, Protect Maine Children, writes on their site “Maine has the 4th highest rate of vaccine opt-outs in the nation, which puts our community immunity below safe thresholds for disease outbreak.”
Now, whether you’re from Maine or not, it’s important to understand what exactly a vaccine exemption is and why states are enacting measures to get rid of them. Here’s what you should know.
What are religious and philosophical exemptions?
According to the National Conference on State Legislatures (NCSL) “all 50 states have legislation requiring specified vaccines for students. Although exemptions vary from state to state, all school immunization laws grant exemptions to children for medical reasons.”
A religious exemption refers to provisions that allow parents to not vaccinate children if it goes against their religious beliefs, philosophical exemptions — which were previously allowed in Maine prior to this legislation — refer to exemptions offered based on “moral, philosophical or personal beliefs.”
— NCSL (@NCSLorg) March 2, 2020
What do laws removing these exemptions mean for kids?
Legislation like Public law 154 make it so the philosophical and religious exemptions are no longer a factor for school-required immunizations for public, private day care and preschool facilities, k-12 and post-secondary schools. If an individual is seeking a medical exemption, they require a written statement from a medical provider (a physician, nurse practitioner or physician assistant) confirming that they don’t advise the person be vaccinated.
Parents can still spread out their vaccinations based on guidelines from the Centers for Disease Control and Prevention (CDC), provided they are up to date at the milestone grades of Kindergarten, 7th and 12th grades.
While there’s a number of reasons parents might object to having their kids vaccinated, experts note that the risks associated with opting out for non-medical reasons can extend beyond their own families.
“The most serious risk is to children who haven’t yet received all of their vaccines, and others who can’t be vaccinated for medical reasons (for example, because their immune system is suppressed due to another illness). The more people start opting out, the broader the risk becomes,” Stanford Law Professor Michelle Mello said in another post on Stanford University’s Law Blog. “We need most people in the population to be vaccinated in order to maintain our ‘herd immunity.’ That’s our collective ability to protect ourselves from disease by stopping it from passing from person to person.”
Studies show that states where it’s easier to have a non-medical exemption have seen an uptick in rates of people choosing not to vaccinate for those reasons. For people in the public health policy space it raises the complicated question of how to navigate a serious public health matter that often feels like a parental right issue to many parents and politicians.
“Parents who object to vaccinations, for either religious or philosophical reasons, have strong lobbies in many states,” Michael S. Wald, a professor and children’s health policy expert at Stanford Law School said in a Q&A for Stanford Law Blog. “They receive support from legislators who see decisions regarding health care, like decisions regarding schooling, as an aspect of parental rights. However, in most states, exemptions from vaccination laws can be overridden if the failure to vaccinate creates a substantial risk of serious harm to public health. For example, in the event of an outbreak of a communicable disease a state may order that a child be vaccinated.”