After the outcry, a search for accommodation on vaccines

In the polarized battle over vaccines, Gov. Ned Lamont thought he’d found common ground with Trisha Connelly, one of the mothers who laid siege to the Legislative Office Building last month, staying overnight to testify against legislation that would bar unvaccinated children from school in September.

When Connelly first approached Lamont at a public event Feb. 26 at Eastern Connecticut State University, it seemed like she was asking the governor to back less restrictive rules for medical exemptions to vaccines.

Without offering details, Connelly insisted vaccinations were inappropriate for her son, whom she described as both “vaccine-injured” and “a bright, healthy, brilliant boy.” She says he had an adverse reaction to a vaccination 10 years ago, when he was 3. It was his last.

“My concern is he doesn’t qualify for a medical exemption,” Connelly told the governor, who had welcomed questions from the public on any topic after the recent forum at ECSU on workforce development. “He is one of the silent victims that will never qualify for a medical exemption.”

Lamont, the father of three adult children and husband of a venture capitalist who specializes in health care, replied that sound public health policy means “having as many people vaccinated as can be safely vaccinated,” but he also was open to exploring whether the list of medical reasons for exemptions was too restrictive. 

“There is no middle ground on this issue.”

Senate Majority Leader Bob Duff

“It sounds to me, in your son’s case, he cannot be safely vaccinated,” Lamont said.

Lamont misunderstood. Connelly was the person who had decided vaccinations were wrong for her son — not a pediatrician. She wants the state to maintain the religious exemption, which gives any parent the ability to avoid inoculations, so long as they attest the basis of their objections is a matter of religious faith. 

The morning after Connelly talked to Lamont, she made clear on her Facebook page that her view of vaccine injury was all-encompassing. She wrote, “No one can be vaccinated safely. Not one person.” 

Not much to talk about.

“There is no middle ground on this issue,” said Senate Majority Leader Bob Duff, D-Norwalk, a father exasperated by the anti-vaccine movement and convinced that the state’s easily obtained religious exemptions endanger public health, even if Connecticut’s vaccination rate for kindergarten students still was a respectable 96.1% last year.

But Duff and others are worried by the increasing use of religious exemptions and the fact there are now 134 Connecticut schools where the measles, mumps and rubella vaccination rate for kindergarten students falls below 95%, the federally recommended threshold to preserve community immunity for those who cannot be vaccinated. The percentage of kindergarten students with parents claiming religious objections increased last year from 2% to 2.5%, a statistically significant jump that places Connecticut above the 2.2% national average of non-medical exemptions.

Backpedaling toward compromise

Out of the public eye, a small number of legislators, mostly House members from both parties, are exploring whether in fact there is a middle ground, a way to maximize vaccination rates while minimizing disruption to the children of parents who won’t yield to the overwhelming scientific and medical consensus about the safety, efficacy and necessity of childhood vaccines.

They are trying to finish what a bipartisan working group began over the summer, an effort that ground to a halt for reasons unclear. It won’t be easy.

“Whenever things go into the fight or flight mode, we’re not focused on solutions,”  said Rep. Cristin McCarthy Vahey, D-Fairfield, who supports curtailing exemptions. “Unfortunately, I think that happened in this building, because there was some pretty intense emotion here.”

Deputy House Minority Leader Vincent J. Candelora, R-North Branford, who says he is having cordial discussions with Democrats about possible compromises, agreed with McCarthy Vahey’s assessment. He said a hastily scheduled vote on the bill alienated Republicans, provoked the parents who have not vaccinated their children and complicated efforts to craft a compromise. 

“We may be able to get there,” Candelora said. “But at this point in time, you’ve put a large minority segment of our population on defense now, and they are going to be lobbying their legislators who aren’t on the Public Health Committee, who haven’t seen all the issues. So I’m not sure where this issue goes.”

“In order for us to figure it out we have to try to depoliticize this, which we should be doing anyway, because this is about science and public health and not politics.”

Rep. Sean Scanlon

An overnight hearing concluded a couple hours after the sun came up on Feb. 20, a Thursday. The next day, the legislature’s Public Health Committee placed the bill on an agenda for a vote the following Monday, stunning legislators still trying to digest the testimony presented over 21½ hours, a record for the Connecticut General Assembly.

The version before the committee set a deadline of September 2020 for every student to be vaccinated, except for those with medical exemptions. It ignored the testimony of Renée D. Coleman-Mitchell, the state commissioner of public health, who warned at the public hearing that 2020 was too soon.

“How in the world did they rush this through?” asked Rep. Whit Betts, R-Bristol, who had been leaning toward ending the religious exemption but felt moved by the passion of opponents. “I don’t know what’s true and not true. I was just beginning that process. This is not ready for prime time.”

Rep. Kathleen McCarty, R-Waterford, a retired teacher, was furious. Not only was the deadline aggressive, she said, she was stunned to learn the state Department of Education had yet to be consulted about how the state might cope with a mass expulsion from public schools.

Betts and McCarty were hardly alone among Republicans, who questioned the quick vote scheduled by Democrats. House Minority Leader Themis Klarides, R-Derby, call the “quick pitch vote” by Democrats a clear tactical error, one that invited GOP opposition.

Rep. Sean Scanlon, D-Guilford, scrambled over the weekend between the hearing and committee vote, looking for changes that might keep the year’s signature public health issue from becoming partisan, as it has nationally. One of his calls was to Candelora, a committee member who had been on the working group.

“I think this bill, like many issues in politics today, has gotten too political,” said Scanlon, the father of a five-month-old baby who has begun his recommended inoculations. “And I think in order for us to figure it out we have to try to depoliticize this, which we should be doing anyway, because this is about science and public health and not politics.”

“I didn’t vote against vaccines. I voted against the process and the specific bill.”

Rep. William Petit

Scanlon proposed an amendment: Any student with a religious exemption could finish their schooling. The committee passed it on a 16-9 vote, with every Democrat and two Republicans in favor, McCarty and Rep. Christie Carpino of Cromwell.

But no Republican supported sending the amended bill to the House. It passed 14-11, with two Democrats who believe vaccines are unsafe, Reps. Jack Hennessy of Bridgeport and David Michel of Stamford, siding with the GOP minority.

Rep. William Petit, R-Plainville, a retired endocrinologist and one of two physicians on the Public Health Committee, voted against the bill, knowing that he would be at odds with pediatricians and infectious disease specialists, some undoubtedly members of the Hartford County Medical Society he once led.

“I didn’t vote against vaccines. I voted against the process and the specific bill,” Petit said. “I believe in vaccines. I’m vaccinated. My family is vaccinated. I don’t think this will serve the purpose. I think we need a bill that will actually serve the purpose, which is to maximize the numbers of vaccinated in the population.”

Candelora, Petit, Scanlon and others who are talking about alternatives said there is no debate among them about the science of vaccines or the well-established right of the state to act in the best interest of minor children.

“I think the science is clear, and I believe in vaccines,” Scanlon said. “But I also believe that the people who came here believe they are doing what’s in the best interest of their children. And on this issue and many other issues, we always have to look at what is the difference between personal and individual rights and the greater good. And we’ve been having that debate in this country since the founding of this country, and we have it here all the time on issues like guns.”

Personal freedoms vs. the greater good

The return of measles, a disease absent from the U.S. for 20 years, has prompted the debate in Connecticut and other states over religious or personal philosophy exemptions. Last year, the Centers for Disease Control and Prevention confirmed 1,282 cases of measles in 31 states, including three in Connecticut. Nearly 130 patients were hospitalized and 61 reported complications, including pneumonia and encephalitis. 

About three quarters of the cases were in New York, grouped in Brooklyn and Rockland County. Washington State reported an outbreak of 71 cases, all but one in Clark County, where fewer than 40% of kindergarten students at some schools had received the combined vaccine for measles, mumps and rubella (MMR). The countywide rate was 78%.

Washington State responded by eliminating a personal philosophy exemption for the MMR, but left the religious exemption intact. It increased education efforts about vaccines, requiring a more rigorous informed consent process for anyone seeking a religious exemption. Petit said there are early signs that such an approach is improving vaccination rates, and he would like to see Connecticut try a similar approach.

“The struggle I have with this issue is that there are children who cannot receive vaccinations, and they are at risk if we don’t have a 95% immunity rate,” said House Majority Leader Matt Ritter, D-Hartford, a key voice for limiting exemptions who has been talking to Candelora about compromise.

Ritter said perhaps the state should focus on schools where the vaccination rates have fallen below 95% or even 90%. “Why would we kick somebody out of a school if it has a 96% rate?” he said.

No major religion prohibits vaccinations. Some Catholics say they object to the use of human fetal cell lines in the development of some vaccines, though the Catholic bishops in Connecticut issued a statement in January saying that has no basis in their faith.

Still, the bishops said any infringement on religious liberties should be weighed against the need to protect public health: “all religious exemptions should be jealously guarded. Any repeal of a religious exemption should be rooted in legitimate, grave public health concerns,” they wrote.

In 1972, a polio outbreak in Greenwich at the Daycroft School, a Christian Science prep school, was attributed to a reluctance by some parents to vaccinate their children. About a dozen were stricken and three paralyzed, according to a New York Times account at the time.

But Christian Science does not prohibit vaccinations, instead urging adherents to consider what is in the greater good.

“For more than a century, our denomination has counseled respect for public health authorities and conscientious obedience to the laws of the land, including those requiring vaccination,” the church says on its web site. “Christian Scientists report suspected communicable disease, obey quarantines, and strive to cooperate with measures considered necessary by public health officials. We see this as a matter of basic Golden Rule ethics and New Testament love.”

The U.S. Supreme Court has ruled that states cannot question the sincerity of religious beliefs, but for more than a century it consistently has granted the states great discretion in matters of public health. In 1905, the court rejected a challenge of a vaccination requirement in Massachusetts to fight a smallpox outbreak.

“There are manifold restraints to which every person is necessarily subject for the common good,” Justice John Marshall Harlan wrote for the majority. “Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy.” Harlan was better known for his dissents in decisions restricting civil liberties.

In 1944, Justice Wiley B. Rutledge wrote for the majority that Jehovah’s Witnesses were not exempt from child labor laws, but he cast his opinion in broader  terms that seemed to anticipate today’s controversy over religious exemptions and vaccines.

“The right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death,” he wrote. “Parents may be free to become martyrs themselves, but it does not follow that they are free, in identical circumstances, to make martyrs of their children.”

For now, Lamont is deferring to lawmakers, but he hopes they act. On Friday, he said, “I just don’t want this to be another issue they punt away to some commission for another year, especially now with coronavirus and everything surrounding us.”