Wednesday, June 28, 2017

Form for religious exemption from vaccination can now be obtained online, with no role for any health-care provider

By Melissa Patrick
Kentucky Health News

Kentucky parents who don't want their children vaccinated for religious reasons can now get the religious exemption form online, have it notarized and submit it to their school upon enrollment -- instead of having to obtain it from their health-care provider along with their signature.

Laura Begin (pronounced buh-GEEN), health coordinator for the Cabinet for Health and Family Services Office of Policy and Budget, told the legislature's interim joint health committee that the changes had been in the works for several years, in response to complaints that a medical entity should not have authority over a religious exemption; that a co-payment was often required to get a provider's signature; and that parents and guardians were having trouble finding providers to sign the forms.

"It's still not a perfect form. I feel like it still exceeds the law's requirement. The law simply requires a signed, sworn statement to exempt yourself religiously from vaccines -- that's it," said Erika Calihan of Lexington, who said she was a representative for a "whole lot of moms" who believed in religious liberty. "This is like a thousand times more, but it's better and it's improved and that is because of voices in the community speaking out and standing up for religious beliefs."

Begin said that fewer than 2 percent of Kentucky's children have a religious exemption for vaccinations. In 2016, of the 99,805 students enrolled in Kentucky's schools, there were 202 medical exemptions and 521 religious exemptions.

The new form also includes educational information about the symptoms and effects of the communicable diseases that are prevented by immunization.

In response to public comments on the proposal, the cabinet changed the wording on the form to say "according to the CDC and KDPH," when describing the symptoms and effects of each disease, instead of "I acknowledge that there are increased risks associated if exposed to this disease." Those are acronyms for the federal Centers for Disease Control and Prevention and the Kentucky Department of Public Health. 

After the meeting, Eric Clark, legislative director for the cabinet, said the health department  is "compelled under the law" to share this educational information.

"The decision whether or not to immunize a child is a medical decision, with a vested public-health interest at stake. If an individual can make that decision on a form available online, rather than through the consultation and discussion of a health-care provider, it is the role of the Kentucky Department of Public Health to share information with the public on the risk and symptoms associated with diseases," Clark said.

Dr. Patty Swiney, former president of the Kentucky Academy of Family Physicians, told the committee that the religious decision to not immunize a child should be an informed decision based on "good information and evidence" and not on "fears and misinformation."

Research has disproven any relationship between vaccines and autism, a common concern among those who choose not to vaccinate. The 1998 study that claimed there was a link between the measles, mumps and rubella vaccine and autism has been declared fraudulent and been retracted.

"The best way to treat disease is to prevent it and that is what immunizations do," Swiney said. She added that we no longer have smallpox or polio, and that cases of chicken pox, measles and mumps are rare because of immunizations. But she also said, "We do have epidemic of these preventable illnesses because of children and patients that are not vaccinated."

In 2016, there were 70 confirmed cases of measles across the U.S., and most of those who contracted the disease were not vaccinated, according to the CDC. As of June 17, that number is already up to 108, with 78 of the cases in Minnesota, mostly in children who were not vaccinated, according to the Minnesota Department of Health.

Swiney also spoke to the dangers of meningitis, noting that 10 to 15 percent of people who get meningitis will die and of those who do survive, 20 percent will have a permanent disability.

"Your individual right only goes so far as it affects the public rights to health, and that is why I'm here standing up for this immunization policy," she said.

People who aren't eligible for certain vaccines, like infants, pregnant women and immuno-compromised individuals, depend on others to be vaccinated for protection, a concept called "herd immunity."

Calihan told the committee that the amendment wasn't about immunizations, but instead about religious liberty. "If a parent decides that it is against their religious beliefs to vaccinate  their child under state law we have a right and that is all there is to it," she said. "So it doesn't really matter what physicians say at this point because you are going to find physicians on both sides of the issue."

Calihan said many vaccines have "aborted fetal tissue, among other things that I find objectionable morally." However, the Children's Hospital of Philadelphia says: "Fetal cells are used to make five vaccines: rubella, chickenpox, hepatitis A, shingles and rabies. Fetal cells used to grow the vaccine viruses were isolated from two elective abortions performed in Sweden and England in the early 1960s. Further abortions are not necessary as the cells isolated in the 1960s continue to be maintained in laboratory cultures."

The updated immunization regulation requires a meningitis booster before 11th grade and a hepatitis A vaccine; consolidates the immunization certificate and medical exemption form; and requires home-schooled children who participate in school-sponsored activities to attend in-school classes to provide proof of immunization or an exemption.

It also adds meningitis B to the list of recommended, but not required, immunizations. Meningitis B is responsible for nearly 50 percent of all cases of bacterial meningitis.

The cabinet removed a requirement in the proposal that would require health-care providers to use the Kentucky Immunization Registry by July 1, 2018 in response to comments received.

The Interim Joint Committee on Health and Welfare and Family Services approved the religious exemption form as part of the updated immunization regulation June 21. It will go into effect July 1, 2018 for the 2018-2019 school year. The religious exemption form can be downloaded on the Kentucky Department of Education website and the CHFS and DPH websites.

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