CT vaccination issue: Should public health trump religious beliefs?
Advocates call it a reasonable and necessary tightening of a law that is the most important public health achievement of the 20th Century.
Opponents call it a bullying tactic and infringement of their Constitutional rights.
In any event, by a margin of 86 to 56, the Connecticut House has approved and sent to the state senate a bill that would require parents to attest annually if they are, for religious reasons, declining to vaccinate their children who attend public school.
Testimony on HB 6949 at a public hearing earlier this year, both for and against, was spirited and passionate. It was presented against the backdrop of a measles outbreak at Disneyland.
Here, in excerpt form, are some of the public comments. The entire record of public testimony can be viewed here.
Regardless of your feelings about vaccines, the issue of our First Amendment rights and the freedom of religion that our country was founded on is being imposed upon. Each and every family should have the freedom to practice their faith as they see fit, without government mandates.
By removing or restricting these rights, you will be standing on the side of repression and, in my opinion, on the wrong side of history.
Connecticut has a long tradition of protecting freedoms and parental rights. Do not negate the hard work you have already done and that of those who came before you. Represent the interests of the people and believe that they will make educated and carefully considered decisions. Reactionary legislation based on fear and small-mindedness is irresponsible.
This bill will require parents or guardians who, due to religious beliefs, object to vaccination and therefore must submit a notarized statement they “have reviewed and understand information regarding risks of both immunization and failure to immunize.” To be clear, Connecticut allows for religious exemption.
Connecticut should not create substantive requirements for a parent/guardian to exercise their religious beliefs when taking exemption to vaccination.
Connecticut has one of the highest vaccination rates of any state. And no one has even attempted to make a case that religious exemptions are resulting in increased levels of disease. This bill is an added expense to all involved and violates First Amendment religious rights.
Furthermore, this bill would require a doctor to provide vaccine education to parents who claim religious exemption. Nothing a doctor says will change one’s religious beliefs: doctors have nothing to do with religious beliefs.
Parental informed consent is the standard in developed democracies around the world. There is no such thing as a mandated vaccine in Canada, the UK, Japan, Ireland, Australia, Germany, France, Denmark, Israel, Sweden, Norway, Finland, the Netherlands, Belgium, etc. Nineteen states allow exemptions for any reason including California, Pennsylvania, Ohio, Texas, Michigan and more than a dozen other where more than half of America’s population lives. Twenty-eight states , currently including Connecticut, allow a religious exemption upon presenting a form stating a religious reason not to vaccinate.
Connecticut religious exemption laws aren’t broken, please protect our First Amendment right of freedom to religion and do not support HB 6949.
I am submitting this testimony as the Chair of the Connecticut Vaccine Advisory Council – an entity created by the State of Connecticut to provide recommendations to the Department of Public Health’s Vaccine Program.
At our most recent meeting on March 11th we took up the matter of proposals to strengthen the requirements for exemptions for children to receive immunizations prior to entering school and daycare settings. As you are aware, this matter has taken on added urgency in light of the increasing number of vaccine preventable illnesses across this country in recent years. The current outbreak of measles that started in Disney Land is but one of many such illnesses that have affected thousands of people and represent an overall decline in the percentage of children who are immunized. Whooping cough, also known as pertussis, is another recent example of a life-threatening illness that we had virtually eliminated from this country, but have now seen cases rise over 20-fold to levels we have not seen in 60 years.
Immunizations have been universally recognized as one of the most important public health achievements of the 20th century. Indeed, measles vaccine alone is credited with saving over 15 million lives world-wide since 2000. As was the case with smallpox – a disease arguably the cause of more infectious deaths than any in human history – we have the capability to permanently eradicate diseases such as polio and measles and thus remove these scourges forever from the face of the earth. But for this to happen, we must insure that we achieve and maintain high levels of vaccination across all populations until the diseases are truly extinct – a goal that we had hoped, until recently, was within our reach in this decade.
In my lifetime I have seen people with faces scarred by smallpox, limbs withered from polio, eyes blinded from measles and hearing lost from haemophilus influenza meningitis, and I have seen children die of diphtheria and pertussis, of tetanus and pneumococcus. But it has been over two decades since I have last seen a case of one of these diseases and for this we owe thanks to vaccines capable of preventing these tragedies from ever happening again.
But we have been the victims of our own success, for how can we appreciate how devastating and how frequently children were stricken when so few people alive today can recall such times as those I have recounted? …
But while it is understandable that our sense of risk has been distorted by our seeming distance from these problems, as these new outbreaks of measles and pertussis demonstrate, we have only to let our vigilance down and they will come roaring back with a vengeance. And I am sure there is not a parent today that would want to see their child struck down with an illness that could have been so easily prevented.
It is for this reason that the Children’s Vaccine Advisory Council passed a motion calling for Connecticut to recognize only medical exemptions to the immunization mandates for school and daycare, a position that also has been advocated for by the Connecticut Chapter of the American Academy of Pediatrics.
While our preferred stance does not recognize a religious exemption, we are respectful of the fact that some families may harbor genuine religious objections to the concept of immunizations. So, as a compromise position, the Council’s motion also stated that if a religious exemption was to be preserved, it must be strengthened so as to require that those who seek to invoke it are practicing members of an organized faith that actually believes in proscribing immunizations, that the tenets of this faith extend to all immunizations and that they be required to have a leader of that faith attest to the existence of these tenets and the participation in this faith by those seeking the exemption. We believe that only by setting a high bar can this exemption deter those who seek to mask personally held beliefs as religious ones and thus undermine the goal of the population-based immunity that is critical to our efforts to succeed in controlling these preventable diseases.
With regard to the language now being considered, we do not believe that merely having a family be required to review materials about the importance of immunizations will be effective. In fact recent evidence suggests that such a requirement may actually increase parental resistance. While it might be better to require the receipt of counseling from a primary care provider, we do not believe that this has been shown to be effective enough to curb the rising number of non-medical exemptions.
It is essential for everyone to recognize that by asking someone to immunize their own child, we are also asking them to protect other children who medically may not be able to receive such vaccines, who may not have had the vaccine effectively protect them, or who may still be too young to have received such vaccines. We are asking parents to realize that we all have a societal responsibility to protect others around us, especially those most vulnerable who cannot protect themselves.
So I am submitting this testimony today to ask this legislature to strengthen the laws governing exemptions in the ways I have outlined because as the representatives of our society, you have the ultimate responsibility to establish the expectations for our duties to one another.
I am writing today to inform you that I oppose bill HB 6949: signing notarized forms that say I understand a medical practice, something which has nothing to do with my religious beliefs. This bill asks people to make a secular choice for a religious exemption, something which makes very little sense. I find it highly disconcerting that this bill also seems to violate not only the First Amendment, but also and even more compellingly the Fifth, wherein the verbiage of the bill requires parents to self-incriminate because they are being forced to agree to “the risks to such child and to others of such child failing to receive adequate immunizations” when they certainly may not feel that way.
It is my understanding that the state must show a compelling interest in overriding religious freedom. With a 98.53% vaccine compliance rate in the state of Connecticut, which is one of the highest, if not THE highest, compliance rate in the United States, and a roughly 1% vaccine exemption rate, I do not believe that the state of Connecticut has a compelling reason to override a religious exemption to vaccines.
I am completely opposed to this legislation and hope that you will oppose it as well. The threats to our Constitutional Rights are all around us and are even coming our own legislators. Just as “national security” is being used by the federal government to justify invading the privacy of citizens, the “greater good” is used to justify the unnecessary actions proposed under H.B. 6949, infringing upon the religious freedoms guaranteed to residents of CT under Connecticut’s own Constitution.
While researching this issue, I discovered that the American Medical Association’s Code of Ethics specifically recognizes that physicians may claim a religious or philosophic reason to not be immunized. AMA Code of Ethics Opinion 9.133 If doctors express the belief that it is ethical to claim a religious or philosophic exemption to vaccines, under what claim of right does the state have the capability of outlawing ethical behavior by its citizens?
Religion, defined as “any set of beliefs, practices, or ethical values.” This definition of “religion” encompasses the “rights of conscience.” That protection is in jeopardy and will further eliminate Connecticut’s Constitutional rights. No citizen should have to prove or fight for their right to exercise their beliefs, it is a dangerous and dark hole which is eerily reminiscent of the yellow stars which emerged in pre-WWII Germany.
Vaccines fall into a class of products considered “unavoidably unsafe.” This “unavoidable” word comes from the National Childhood Vaccine Injury Act itself, “products which, in the present state of human knowledge, are quite incapable of being made safe.” If government in America is allowed to force its fellow citizens to risk injury or death without their voluntary, informed consent, then we are no longer free Americans. Our bodies are then owned by the state and can be sacrificed by the will of the state. Once you take away a parent’s right to make medical decisions based on informed consent or religious beliefs for their children, it is only a short step before everyone loses that right to determine what substances will enter their body, since mandatory adult vaccines will quickly follow.
In today’s current landscape where the shrinking of human rights seems to be exponentially growing theme, I urge you to support a strong interest in protecting the individual rights and liberties of your constituents, please continue to fully consider the limitations on the personal liberties and freedoms of those who exercise their right to exemption based on their strongly held religious beliefs and oppose this bill.
Sandra Carbonari, MD
President, CT Chapter of the American Academy of Pediatrics.
I have been a primary care pediatrician practicing in Waterbury for over 32 years and am also the president of the CT Chapter of the American Academy of Pediatrics. …
As you know, recent outbreaks of vaccine preventable diseases have generated much discussion about immunizations. Currently, of the children entering kindergarten and 7th grade in Connecticut public and private schools, 218 have a medical exemption and 1,028 have a religious waiver. This is a 15-fold increase from 2000 in religious waivers while the number of medical waivers has remained virtually constant. This translates to an exponential increase in the exposure of vulnerable individuals to vaccine preventable diseases.
We certainly respect the right of parents to make decisions about their children’s health care; however, they do not have the right to put vulnerable children and adults at risk. This is a critical matter of public health.
Requiring adequate immunization of children in our schools has been proven to be an incredibly effective intervention preventing many diseases. Viral illnesses such as whooping cough, polio, measles, diphtheria, tetanus, mumps, rubella, and varicella, once contracted, have no effective treatment.
The best we can offer is symptomatic and supportive care and hope the unprotected child’s immune system can fight the disease. Even bacterial illnesses for which we have antibiotic treatment can cause severe illness and death.
Early in my career, before the existence of the immunization for Hemophilus influenza type B, it was not uncommon to have otherwise healthy patients become ill with meningitis and epiglottitis caused by this strain of bacteria. Meningitis is an infection of the fluid surrounding the brain and epiglottitis causes the swelling of a structure in the throat that can result in the inability of air to pass through to the lungs. I will never forget one night when I was on call at Waterbury Hospital and I saw 6 children in the emergency room with fever and difficulty breathing. All 6 needed to go to the OR to be intubated (have a tube placed into their trachea to allow them to breathe) and then to the ICU for IV antibiotic treatment and supportive care for several days. And these were the lucky ones. Those who did not get treatment in time did not survive. Since the introduction of the Hemophilus influenza type B vaccine, I have not seen one case of the disease in an immunized child.
I have cared for patients whose immune systems do not function properly. This can be caused by conditions they were born with, treatment for cancer, treatment after kidney or heart transplant, or infectious diseases. We have so much success treating these children and helping them to lead normal lives. Going to school should not expose them to a preventable life threatening risk.
We believe that the only exemption to immunization for a child attending school should be medical necessity. This is critical to maintain the crucial level of immunization for what is known as herd immunity.
Herd immunity protects the vulnerable of our population-infants too young to be immunized and children and adults with medical conditions affecting their ability to be immunized or adequately fight disease. As a mother, caregiver of elderly parents, and a leader of pediatricians in Connecticut, I commend your willingness to take on this issue and urge you to allow medical necessity as the only reason for waiver of the requirement for full immunization of a child attending