Local schools, state bill focus on ‘anti-vaxxers’
A new measure before the Legislature could help eliminate a controversial exemption used by families to avoid getting their child inoculated.
The bill, which has garnered support from health care officials in the state, specifically would prevent parents from claiming religious objections as a reason to skip vaccinations, which are otherwise a requirement for students to attend school.
“I believe we have an objective in the state to keep our children in our schools as safe and healthy as possible,” said state Rep. Stephan Hay, a Democrat from Fitchburg who is the lone Worcester County lawmaker listed as a petitioner on the bill. “I’m not telling anybody what to do with their child ... all I’m saying, is if you choose not to vaccinate your child, they can’t go to our public schools.”
In Massachusetts, students must have records they have received the DTaP/Tdap, polio, MMR, hepatitis B and varicella vaccines to attend school.
According to the state’s data, very few students have claimed religious exemptions from receiving those shots in Worcester County, although the number has slightly increased over the last few years. Last school year, 1.2% of kindergartners in the county sought an exemption, up from 0.9% five years prior.
In total, 1.4% of Worcester Country students were exempt from the vaccine requirement in 2018-19, same as the state average for that year; the other 0.2% of that total comprised students who had a medical reason for not getting vaccinated.
According to Dr. Richard Ellison, an epidemiologist at UMass Memorial Medical Center, a population typically needs to have “well above” 90% of its members vaccinated to prevent the spread of measles, a once virtually eradicated virus that has had a recent resurgence in communities with low vaccination rates.
So far, Central Massachusetts has not seen one of those outbreaks, but as long as there are unvaccinated residents, there is a level of risk, he said. Pejman Talebian, director of the state Public Health Department’s Immunization Program, also said while overall the state has low exemption rates, it’s not the case across the board.
“There are pockets of the state (Berkshire, Franklin, Dukes counties) where the exemption rate does potentially lead to overall immunization rates that fall below herd immunity levels,” he said.
Just last week, Boston health officials announced a Northeastern University student had been diagnosed with measles; the patient’s potential exposure to others was apparently limited to Boston as of Thursday. That case, along with another confirmed case in October, were the first incidents of measles in Massachusetts since 2013.
Locally, a post on social media in later December showed a purported notice from the Worcester schools indicating a case of pertussis, otherwise known as whooping cough, had been confirmed at Worcester Technical High School. Debra McGovern, the district’s director of nursing and health services, last week said it was an isolated incident.
“We’ve been very fortunate in Worcester County,” Ellison said, but he questioned the wisdom of allowing people to forego getting vaccinated because of a religious or philosophical objection. “I do think one has to question why there is a religious exemption to receiving a vaccine ... what’s the logic behind it?”
Other health care officials in the region also believe the religious exemption creates unnecessary risk, and is likely even being exploited by people who have no real religious reason to not get vaccinated. So-called “anti-vaxxers” make up a small percentage of the population, but they do exist, said Pamela Rivers, nursing/health services director for the Fitchburg schools.
“Every now and then we do (deal with them),” she said. “We respect where they’re coming from, and we notify them of (disease) outbreaks.”
But Rivers also said some of those families wouldn’t be allowed to have their children attend school without the religious exemption, which she believes they use to shield their mostly personal objections to vaccines.
“I think that’s where the religious exemption becomes problematic,” she said.
“There’s the law, and then there’s the spirit of the law,” said state Rep. Andres Vargas, a Democrat from Haverhill and lead sponsor of the bill that seeks to ban the religious exemption, which he also believes is “being used as a loophole” by some families.
“We’ve definitely heard from opposition” to the measure, he said, but he pointed out no major religions expressly oppose vaccinations; the religious groups who do are smaller offshoots.
“I’ve gotten plenty of calls and emails,” Hay said, adding he gets opponents’ point of view, but hasn’t been swayed by their argument – “they try to fight the science (behind the need for vaccinations), but I don’t think that holds up with me.”
In some cases locally, meanwhile, there isn’t so much dogmatic resistance to vaccines as there is unawareness or fear, according to officials. Particularly with the flu vaccine, which is not mandatory for school-attending children, it can be challenging to convince some families to get the shot, said Dr. Matilde Castiel, the city’s commissioner of health and human services.
“There is an idea that (some people) are scared of the vaccines,” she said. “Things have happened in the past, especially to marginalized populations – people of color are often not comfortable getting the vaccination.”
Increasing education about and access to vaccines, Castiel added, is one way to break those misconceptions. Her office has led a campaign the last two years in collaboration with local organizations to run flu clinics in the schools, for example, that have found some success: The number of students inoculated through that program has climbed from 1,174 in 2017-18 to 2,784 so far this school year, according to Castiel.
“I think certainly we’d like to be much higher than that,” she said, adding the Worcester schools have recently tried out an incentive program that provides Chromebooks to schools boasting the highest participation rates. “But the numbers are increasing, which is a good thing.”
In the area of mandatory vaccinations, meanwhile, last year the Worcester schools began cracking down on families who hadn’t gotten their kids inoculated, threatening to bar those students from school until they could produce records they had received their shots.
That approach has been successful, Superintendent Maureen Binienda said last week, who described the district’s new stance as being “nicely aggressive.”
“I’m happy with the numbers we have,” she said – the district reported 1.2% of students are not vaccinated – adding school officials have not yet had to resort to barring a student from school because they didn’t get their shots, instead preferring to grant extensions to families to vaccinate their kids.
Eight school facilities in the district also have on-site health clinics that can inoculate students themselves with families’ permission, which Binienda said has come in handy.
For some school officials, meanwhile, vaccinations, while important, are not exactly a pressing issue compared to other challenges facing public education.
“We don’t have a stance on it,” Thomas Scott, executive director of the Massachusetts Association of School Superintendents, said about the religious exemption bill. “Nobody’s really raised the issue among superintendents.”
Jeffrey Villar, receiver/superintendent of the Southbridge schools, also said vaccine exemptions have “not been an issue that has required a great deal of my attention.” But recent trends are still troubling, he said.
“The resurgence of harmful and deadly diseases such as mumps, measles and pertussis is to me an alarming public health issue,” Villar said. “While I have always believed it is important that we respect and support the needs and beliefs of all members of our society, in this instance, I have come to believe that we need to place a heavier emphasis on the well-being of our entire society and require immunization.”
Vargas said he believes his bill, which was discussed at a public hearing in Boston last month after being sent to the Joint Committee on Public Health, has a good chance of passing later this year.
“We’re just making sure we’re educating all the members on the issue,” he said, adding part of that message has been raising awareness about the “growing anti-vaxxer movement here in Massachusetts.”