In quest to repeal vaccine exemption, legislators seek powerful ally

Governor's office

DPH Commissioner Renee Coleman-Mitchell

Lawmakers intent on wiping out Connecticut’s religious exemption to vaccines are courting a powerful ally they hope will help sell their case next year.

But so far, the state’s new health commissioner is taking extraordinary pains to remain outside the political fray.

“The department takes no position regarding whether there should or should not be religious exemptions,” Renee Coleman-Mitchell, who took up her post in April, told members of the General Assembly during a hearing last spring. Legislators suspended their quest to repeal the provision days later.

But with a fresh effort planned for next year, lawmakers have not given up on trying to win Coleman-Mitchell’s support.

In May, House Majority Leader Matthew Ritter told reporters that the health commissioner must weigh in on the prospect of curtailing the exemption. A month later, four legislative leaders sent a joint letter to Coleman-Mitchell asking, among other things, “Should Connecticut remove the religious exemption from state law?”

A response to their inquiries is still pending. So why do they keep pressing?

A review of recent efforts in Maine, New York and Washington – all of which succeeded in eliminating religious or philosophical exemptions to vaccines this year – show each state had the backing of its public health officials.

Health czars in those states were vocal about the need to abolish the exemptions. One even joined legislators on a media tour before the vote.

Connecticut lawmakers said they are looking for similar support.

“On this subject, I think it’s crucial they take a position,” said Rep. Liz Linehan, D-Cheshire, a proponent of the repeal. “This is a public health issue and eliminating the exemption would go a long way to protecting people that need to be protected.”

Effort persists

In March, as the measles outbreak intensified nationally, a handful of lawmakers gathered in Connecticut to call for an end to religious waivers. Children who can’t be vaccinated due to allergies or other ailments shouldn’t be put at risk by those who willingly abstain, they reasoned.

Two months later, the health department made public for the first time its school-by-school assessment of child immunization rates. The data showed 102 schools where fewer than 95 percent of kindergarten students were vaccinated against measles, mumps and rubella – the threshold recommended by the Centers for Disease Control and Prevention.

Connecticut has a high vaccination rate, but state officials worried about a measles outbreak found much to concern them in school-by-school assessment of child immunization rates.

That touched off a flood of angry comments from state leaders, who by then had recorded three measles cases in Connecticut.

“This data is startling and needs to be addressed,” Gov. Ned Lamont said at the time. “This cannot become a public health crisis as we have seen in other states. Making sure all of our young students in Connecticut are safe is the No. 1 priority.”

Lawmakers called a public hearing and began discussing ways to introduce a repeal late in the legislative session. As they did, they tried to pull a reluctant Coleman-Mitchell into the spotlight.

The commissioner refused to take a position after the data release. In May, she told Ritter she would review his request for an opinion and respond “as soon as possible.” Her reply to legislators’ June letter was the same. She declined to be interviewed for this story.

Although the proposal is on hold until next year, Senate President Pro Tempore Martin Looney, one of the authors of last month’s letter, said it’s important to keep seeking Coleman-Mitchell’s input.

“It just seems highly appropriate to have an opinion and analysis from that agency as a precursor to adopting legislation,” he said. “We’re not aware of any state that has adopted a ban on the religious exemption that was opposed in doing so by its Department of Public Health. In most cases, they supported it.”

Rep. Josh Elliott, D-Hamden, a backer of the plan to erase the exemption, said Coleman-Mitchell’s support is crucial in gaining the public’s trust and buy-in. Opponents of the effort have lobbed alarming accusations, he said, including that lawmakers “are in the pocket” of Big Pharma.

“The more institutional players we have that can back up the legislature, the more the public will trust that we’re doing this for the public good,” Elliott said. “There are enough people planting seeds of doubt that we really ought to continue to make sure the institutional players are pushing this alongside us.”

‘It’s critical’

Those key players were visible as lawmakers in other states pushed to roll back religious exemptions, sometimes referred to as philosophical or personal belief provisions.

In Maine, whose governor in May signed into law a measure removing all non-medical vaccine exemptions, the acting director of the state’s Center for Disease Control and Prevention testified in favor of the repeal, saying that 5 percent of school-aged children had claimed religious or philosophical exemptions, compared to 2 percent nationally.

“When someone chooses not to vaccinate, that decision can jeopardize the health and safety of entire communities, especially the weakest and most vulnerable among us,” acting director Nancy Beardsley said. “Those who are unable to be vaccinated, such as young infants, pregnant mothers or children with cancer, face the most risk from disease complications.”

Reps. Matthew Ritter, center, Josh Elliott, left, and Liz Linehan, right, called for an end to the religious exemption on vaccines during a press conference in March.

Legislators also heard from the Maine Public Health Association, the Maine Medical Center, Southern Maine Health Care and the Portland Public Health Department, among others.

“Having universal testimony from our public health officials in support of passing a bill that repealed the philosophical and religious exemptions did give it a lot of weight, and balanced concerns expressed by those individuals that don’t trust vaccines,” said Sen. Rebecca Millett, a Democrat who voted in favor of Maine’s legislation. “It’s very important for the medical profession scientists to come forward and give their perspective. It’s critical.”

When officials in neighboring New York – the epicenter of the country’s measles outbreak – sought to dismantle their religious exemption, the health commissioner backed them. A bill wiping out the provision narrowly passed in June.

“Although the state can claim high immunization rates overall,” New York Health Commissioner Howard Zucker said in a public statement, “preventable diseases like measles remain a public health threat when administrative loopholes allow children to go unvaccinated.”

In Washington state, which repealed its personal belief exemption to the measles, mumps and rubella vaccine this year, the health secretary not only testified in favor of the proposal, he also joined lawmakers on a press tour.

The secretary and some legislators had hoped to roll back the exemption for all vaccines, but faced tremendous pushback and settled for the MMR immunization.

“It would’ve been extremely difficult to do this without his help,” Rep. Paul Harris, a Republican who supported the effort, said of Health Secretary John Wiesman. “Our Department of Health – they were 100 percent behind it and driving it.”

In public remarks, Wiesman said he favored plans to remove all personal belief exemptions.

“Vaccine programs are one of public health’s greatest accomplishments,” he said. “They are under great threat and we need to reverse course.”

A continued push

Connecticut lawmakers are still hopeful Coleman-Mitchell will come through with an opinion that helps their cause.

Ritter, the House majority leader, said he expects to hear from her by the fall – months before the February start of the next legislative session.

Jacqueline Rabe Thomas :: CtMirror.org

Senate President Pro Tempore Martin Looney said lawmakers will likely move ahead with a repeal, regardless of the health department’s input. But he is hopeful the commissioner will respond.

“At the end of the day, the department is charged with compiling information and this is a public health issue, so we want their opinion,” he said.

A few legislators have privately pondered reaching out to the governor to increase pressure on the commissioner, but said they aren’t ready to do that. Though Lamont said the exemption issue “needs to be addressed,” he has not offered specifics on what approach the state should take.

A spokesman for the governor did not respond to requests for comment.

If Coleman-Mitchell remains neutral, some lawmakers have considered moving ahead without her blessing.

“We wouldn’t allow the failure of the department to opine to block any initiative,” said Looney, the Senate president pro tempore.

But that won’t stop them from asking for it again.

“I understand the hesitancy a new agency head might have regarding … a hot-button political issue. On the other hand, it is the role of the DPH to be political on issues that affect public health and safety,” Elliott, the Hamden representative, said. “This is one clear area where diving head first makes total and complete sense.”