Western States Tighten Vaccination Rules

The stereotype that rural “back-to-the-landers” are the biggest group of vaccine resisters needs an update. The anti-vaccine movement cuts across geography and politics. Some states are changing their laws in response.

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The Old River Trading Post in Paonia, Colorado, is the kind of place where you might expect to find parents who choose not to vaccinate their kids.

Tucked at the end of a long dirt driveway just outside this small town of 1,400, the Trading Post is where people go to buy raw milk and bulk quinoa. Hardly anything on their shelves contains refined sugar or unpronounceable preservatives, and local farmers can barter their produce in exchange for other groceries. On a recent visit to the Trading Post, the first three employees I spoke with all said they didn’t vaccinate their kids.

Many rural Western Colorado school districts have pretty high rates of un- or under vaccinated kids – upwards of 15%, or nearly four times the state average (and that doesn’t account for the many homeschoolers in the area).

In some ways, that’s not that surprising: For decades, people who wanted to homestead, live off the grid and generally escape the long arm of government have settled here. And Colorado makes it easy to opt-out of vaccination. All a parent has to do is sign a form saying vaccines violate their personal beliefs.

But it’s not just rural homesteaders and homeschoolers who are forgoing vaccination. Around the U.S., the rate of un- and under-vaccinated school kids is on the rise. Their parents’ reasons for opting-out range from the paranoid to the pseudo-scientific to the down right wrong: conspiracies about “Big Pharma” being in cahoots with the Centers for Disease Control and Prevention; the debunked connection between vaccines and autism; or concern that vaccines do more harm than good, even though they prevent diseases like measles and whooping cough.

Parents can opt-out for medical or religious regions, but the greatest increase by far is a third category, called personal-belief exemptions. Less than half of U.S. states allow parents to opt-out for philosophical or personal-belief reasons.  But those that do saw their opt-out rates increase by 150% between 1991 and 2004, while the rate remained the same for states with only religious exemptions. In the past 10 years, personal-belief exemptions have continued to rise at an even faster rate.

Institute for Vaccine Safety
Green states allow “personal belief” exemptions, in addition to religious ones (purple), as of 2012. West Virginia and Mississippi allow neither exemption.
These numbers matter because kids with personal-belief exemptions are much more likely to contract vaccine preventable diseases like measles and pertussis, or whooping cough. And that can harm people with compromised immune systems who can’t get vaccinated, infants who are too young for their shots, and the elderly.

It’s hard to figure out what kinds of people, exactly, are opting out of vaccinations. Whether exemption is more common among liberals or conservatives is also unclear. But scientists do know that parents who opt-out tend to be better-educated and wealthier than parents who vaccinate.

Ashland, Oregon, has gotten national attention for its high rate of unvaccinated kids. In 2011, the Centers for Disease Control decided to investigate why nearly 30% of kindergartners in this environmentally minded, well-educated town weren’t getting their shots. In her article for The 2×2 Project, Elaine Meyer asked Rebekah Sherman, who coordinates the Ashland Immunization Team, to explain the thinking behind the opt-out rate there.

They think “because we wash our hands, because we eat organic foods, because all our friends’ children are happy, because they go to these Waldorf schools that are really environmentally conscious, that they’re protected. They have the sense that I can control every encounter my child has. They don’t think about the fact that kids are leaving Ashland going to places with outbreaks and coming back,” says Sherman.

Now, Oregon and other Western states are starting to push back against parents who opt out for personal belief reasons. In the past five years, Oregon, Washington and California have passed laws that require parents to get a doctor’s signature or watch an online class before opting out. Colorado’s legislature is considering a similar law.

It’s too soon to tell how effective the laws have been in California and Oregon, because they just went into effect in 2014. But in Washington, exemption rates dropped significantly in the first year after the law was passed.

Even if the bill becomes law in Colorado, it will only affect the parents who send their kids to school or a licensed pre-school. Parents who home school, like many of those I met at the Trading Post, could continue to do whatever they want. 

 

Topics: Health
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