Parents seeking a doctor’s permission not to immunize their children against some diseases could have a streamlined process for doing so, under an amendment being floated to a controversial bill dealing with vaccine policy in Oregon.
That bill, House Bill 3063, would eliminate the religious or philosophical exemptions thousands of parents in the state use to avoid having their children vaccinated for communicable diseases. Such vaccinations are otherwise required for a child to attend schools.
But parents would still have the option of seeking a doctor’s permission to delay or altogether skip vaccinations for medical reasons — typically because of allergic reactions to chemicals in vaccines. Lawmakers are considering ways to make that process easier.
At a packed public hearing Wednesday morning, Sen. Elizabeth Steiner Hayward, D-Beaverton, introduced amendments she said were "in response to concerns we heard from parents that the current medical exemptions process is cumbersome and inconsistent."
Currently, Steiner Hayward explained, a medical exemption signed by a doctor must be approved by county health departments, a process that she said “interferes with the relationship between the patient and the health care provider and can result in inconsistencies in approvals.”
Under amendments that have been recommended to the Joint Subcommittee on Human Services, health departments would be cut out of the process. Instead, doctors would submit medical exemptions they signed directly to the Oregon Health Authority. Parents would receive a copy as well, which their child’s school or daycare would be required to accept.
The amendment would allow naturopaths to sign off on medical exemptions, something Rep. Rob Nosse, D-Portland, said opponents of the bill would be "very happy about."
Exemptions would be scrutinized by state medical boards and the OHA to ensure they weren't being abused, and the medical exemption process would have to be repeated on a yearly basis.
"Sometimes a child needs a medical exemption for a year or two, but not permanently,” said Steiner Hayward, who works as a physician.
The tweak is one of a host of proposed changes that have been suggested to a bill that is among the strongest policies being considered by areas grappling with measles outbreaks this year.
Washington, which saw dozens of measles cases in the Vancouver area earlier in the year, is considering eliminating non-medical exemptions for the measles vaccine. New York City has also focused on that vaccine, after hundreds of measles cases emerged there.
Oregon's bill would eliminate non-medical exemptions to vaccines for 11 diseases, including tetanus, whooping cough, Hepatitis A and B, and measles. Maine's Legislature is considering a similar bill. Currently, California, Mississippi and West Virginia are the only three states that don't have religious or philosophical exemptions, according to the National Conference of State Legislatures.
While medical science overwhelmingly supports the safety of vaccines, the bill in recent months has tapped into a well of mistrust over the shots. Around 7.5% of Oregon kindergartners have claimed a vaccine exemption, according to the Oregon Health Authority — the highest rate in the country.
That skepticism has inspired large rallies outside of the Capitol, including one on Tuesday afternoon, and hallways packed with parents and children imploring lawmakers to kill the bill.
The bill’s opponents often share stories of adverse reactions they say they’ve had to vaccines, and concerns that genetic conditions will put their children at risk. Others say their children came down with serious conditions after they were vaccinated, and believe that chemicals in the shots are to blame.
A Madras woman named Kora Hollyman testified at Wednesday’s hearing that she lost consciousness and had facial paralysis after being vaccinated for HPV. She later developed autoimmune diseases, she said.
“I shouldn’t have to tell you this today,” she said, adding that her daughter would not qualify for a medical exemption. “I shouldn’t have to use my personal medical story.”
Many opponents also claim mainstream medical organizations have been co-opted by pharmaceutical companies into supporting vaccines, and proffer studies they argue reveal real dangers.
“Who do we turn to when the corruption and capture are happening at the highest levels,” a Washington-based activist named Jaclyn Gallion asked demonstrators at Tuesday’s rally. “What’s left except revolution?”
Paul Thomas, a Portland-based pediatrician who has become prominent among vaccine skeptics, also spoke. He said concerns over this year’s measles outbreak are overblown, despite dozens of children becoming sick with the virus.
“There haven’t been any cases in the past few weeks,” Thomas said. “It’s over. The epidemic is completely done, and no one died.”
As he often does, Thomas also linked vaccinations to cases of autism. That connection gained prominence because of a 1998 study that has since been retracted and debunked.
Medical professionals widely support HB 3063, saying that a higher rate of immunization will stymie the spread of preventable diseases. At Wednesday’s hearing, nearly every person who testified in favor of HB 3063 was in the health care field.
“Vaccines are one of the few things I recommend without hesitation,” said Alanna Braun, a pediatrician at Oregon Health & Science University. “I am speaking here today on behalf of my patients.”
Dana Braner, a physician at Doernbecher Children’s Hospital, mirrored testimony from many of his colleagues, recounting the story of an infant who’d nearly died after being exposed to whooping cough.
“The hell of it is we have the means to stop these children from getting sick or dying,” he said.
The back-and-forth nature of the debate extends to lawmakers, some of whom have voiced deep skepticism about HB 3063.
At Wednesday’s hearing, Steiner Hayward faced pointed questions from Republican legislators about whether the bill would force parents to rush vaccines in a way that could be unhealthy for children. As currently written, the bill would require children to be vaccinated by August 2020 in order to attend school.
Steiner Hayward and the Oregon Health Authority’s Paul Cieslak both testified that children would not be put at risk by a faster immunization schedule, which they said would still meet CDC guidelines. Steiner Hayward said children could qualify for a medical temporary exemption if their doctors felt a rushed schedule put them in danger.
There are also concerns about whether provisions in the bill that would keep unvaccinated children away from school activities like field trips would extend further than intended — say, to the point of banning a child from the state Capitol if an unrelated field trip group was also there.
Rep. Cedric Hayden, R-Roseburg, said he had an opinion from legislative lawyers that the bill would have that effect. Steiner Hayward argued otherwise.
“It is completely unacceptable to ban unimmunized children from public places,” she said. “The intention is to protect children in licensed school settings and licensed daycare settings.”
Lawmakers are scheduled to formally take up amendments to the bill Wednesday and Thursday.