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Tuesday March 19, 2019

New bills result from troubling measles outbreaks

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Alarmed by what is now by far the largest measles outbreak in the country this school year, and inspired by a young man who got himself vaccinated as soon as he was legally able, legislators in New York State are considering bills to enable more vaccinations for kids.

Outbreaks in New York City and Rockland County have totaled more than 300 cases in 2018-19, according to recent reports from those two jurisdictions.

In one town, 42 unvaccinated students have been prohibited from attending their private school even if they had religious or medical exemptions, because of concerns that they could spread the disease, or be sickened themselves. The parents of the students at Green Meadow Waldorf School in Rockland County sued, but a judge upheld the health officials’ decision. According to a report in the New York Times, as of a couple of weeks ago, the school’s vaccination rate was an abysmal 56 percent; the level at which herd immunity will protect students is 95 percent.

At around the same time as these events, an Ohio teenager became a celebrity by going for the vaccines that his staunchly anti-vaccine mother had refused for him, taking the step as soon as he turned 18. The young man, Ethan Lindenberger, later testified before Congress about the difficulty of knowing he needed those vaccinations to protect his health but not being able to get them, and inspired voices of protest from other science-savvy teenagers who are not old enough to make their own medical decisions.

One of the bills introduced in New York during this legislative session would allow teenagers 14 and older to go to the doctor themselves for vaccinations that are recommended by the U.S. Centers for Disease Control and Prevention or that are required under state law.

Generally speaking, parents make important medical decisions for their minor children. But there already are exceptions to that rule. Minors in all states are allowed by law, generally by age 12 or 14, to seek out treatment for sexually transmitted diseases; 26 states have laws that allow minors 12 and older to receive contraceptive services. At least some minors that young can do the same in 20 additional states.

Public officials have realized that when a safe and effective treatment is available and recommended, and the health of young people as well as public health in general are at stake, these considerations outweigh narrow adherence to parents’ permission.

That is especially important with the vaccine to prevent the strains of human papillomavirus that cause most cases of cervical cancer in the United States and many throat and other cancers. The vaccine is most effective when given in two doses to preteens or young teenagers; if these young people have to wait until age 18, they are forever at greater risk.

The irony is that because HPV is sexually transmitted, these minors could go to the doctor to be treated once they are infected with HPV, but not to obtain the vaccine to prevent it.

Undark Magazine interviewed Allison Winnike, president and CEO of The Immunization Partnership, on other ways in which teens make important medical decisions.

Despite some parents’ concern regarding the idea of a child consenting to a medical procedure, Winnike emphasizes that because all vaccines recommended by the CDC are held to rigorous standards, they “should be generally considered safe for a teen to consent to.” In Texas, she points out, along with Alabama, Illinois, and many other states, teenage parents are entitled to make medical decisions for their children without further oversight.

Another bill introduced in New York would ban all non-medical exemptions from vaccinations required for school. California passed such a law a few years ago, when a big measles outbreak occurred as a result of an infected visitor to Disneyland. West Virginia and Mississippi have long required vaccination for all students unless there’s a valid medical reason why they cannot be vaccinated.

But, as in New York, several other states also are considering restrictions, including Washington state, where a measles outbreak has sickened dozens of people in a single county.

According to a report by The Hill:

Lawmakers in Iowa, New Jersey and Vermont, which already ban personal or philosophical exemptions, are now debating proposals to eliminate religious exemptions. 

Proposals in Maine and Oregon would eliminate both exemptions, while measures in Minnesota, Colorado, and Washington state, where there are 66 confirmed measles cases this year, would only eliminate personal exemptions and leave religious exemptions in place.  

Doctors and public health officials have been warning for years about the growing numbers of parents who do not have their children vaccinated, in most cases having been persuaded by debunked myths  that they often find on social media. Now the measles outbreaks occurring across the country – Texas has had 11 cases so far this year – are showing that the threat is real.

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