American Academy of Pediatrics - Vermont Chapter

By Dr. Louis DiNicola, president of the American Academy of Pediatrics Vermont Chapter

There are many laws designed to protect children from harm – seat belt requirements, child labor restrictions and prohibitions against underage drinking come to mind – that parents aren't allowed to simply opt out of. So why then are parents allowed to opt out of getting their children vaccinated against potentially deadly and disabling diseases such as measles, meningitis, polio and whooping cough?

Under current state law, parents can enroll their children in public schools without being immunized if they cite either religious or "philosophical" reasons. Of the two, the philosophical exemption is the most troubling because since almost any reason can be deemed philosophical. It's a fill-in-the-blank exemption.

Only six other states have immunization requirements as relaxed as Vermont's, and unfortunately, we are beginning to feel the consequences of this leniency.

The Vermont Department of Health has reported that the immunization rate of incoming kindergarteners has dropped from 93 percent in 2006 to just 83 percent today. While that troubling decrease in immunization rates cannot be attributed to philosophical exemptions alone, they certainly are contributing to a growing problem. Last year 5.4 percent of all kindergarteners, or more than 1 in 20, were enrolled in public schools by parents who used the philosophical exemption to avoid immunizations.

An indicator of how Vermont's reduced immunization rate is leading to real-world consequences is the recent surge in the potentially deadly but preventable disease whooping cough. Last year the Department of Health reported 91 cases. In 2010 it was only 18. In January 2012 there was already more than 20 cases reported. Another state experiencing a dramatic increase in whooping cough is California, which perhaps not so coincidentally joins Vermont in the small group of states with lenient philosophical exemptions. There, more than 25,000 children became ill and ten children died from whooping cough. As nine of the 10 children where not immunized at all and the 10th was only partially immunized, it appears that these children contracted the disease from un-immunized or partially immunized older children or adults with whooping cough. All of these deaths were preventable as the lack of adequate immunization in these children and adults were the direct cause of these deaths. And the resurgence of whooping cough isn't the only disturbing trend, as outbreaks of measles, mumps and meningitis have been reported in other states.

It's important to remember that un-immunized children are not only a risk to themselves, but to others as well. I fear most for children who were appropriately immunized but are at increased risk for diseases because of their un-immunized classmates. While vaccinations are extremely effective, they are not 100-percent guaranteed. Parents of immunized children have an expectation when they enroll them in public school that they'll be entering a safe environment. But because of Vermont's lenient immunization policies, they are not.

The good news is that Vermont has the opportunity to protect its children from these and other horrible, preventable diseases by eliminating the philosophical exemption. Two bills under consideration in the Vermont General Assembly would do just that, while maintaining opt-outs based on the more restrictive religious belief exemption.

As a pediatrician who has seen great advances in health and science during my long career, including the introduction of vaccines that have saved countless lives and prevented untold suffering, I strongly urge the state legislature to pass this legislation.

Vaccines are safe and effective. Their introduction has been the most important advancement in medical science over the last century. Let's not lose the progress that has been made against disease and illness. Don't allow children to be opted out of a lifetime of health and happiness.