“In reaction to the outbreak, politicians in many states proposed bills tightening exemptions from school immunization requirements. This short article examines the law and legislative trends in this area.
Several states have exemption rates that are too high to preserve herd immunity. Oregon, at 7.1%, is at a high risk. California has a low rate of exemptions overall, but has areas where rates of immunization are low.Maine, Michigan, and Washington all have high exemption rates. These states all face a real risk of disease. At least tightening these exemptions is a powerful idea.
Religious exemptions are completely inappropriate due to their vulnerability to abuse and the unfairness of putting the child at risk for beliefs the parents hold and the child is too young to choose. On the other hand, however, a system that does not leave parents any way to refuse vaccination is too extreme.
At the very least, since the public health argument is not as strong for homeschoolers, it makes sense to exempt children who are homeschooled from immunization requirements. Offering a hard-to-get personal belief exemption is preferable to a religious exemption, but should be harder to obtain than even the educational requirement currently in place. Ideally, getting the exemption would require a daylong course with a short quiz at its end. The course requirement would help limit exemptions to only the very small set of parents with the strongest feelings against vaccines, parents who believe that asking them to vaccinate is akin to asking them to poison their child.”
Responding to the Childhood Vaccination Crisis: Legal Frameworks and Tools in the Context of Parental Vaccine Refusal
Dorit Rubinstein Reiss
University of California Hastings College of the Law
Lois A. Weithorn
University of California Hastings College of the Law
March 4, 2015
Buffalo Law Review, Vol.63, August 2015, Forthcoming
UC Hastings Research Paper No. 134
In spite of vaccines’ impressive record of safety and effectiveness, some families have failed to immunize their children, denying those children protection against vaccine-preventable diseases. In the last years, rates of nonvaccination, as well as rates of partial adherence to vaccination schedules, have been increasing. Predictably, this has led to outbreaks of vaccine-preventable diseases. This article examines potential legal responses to this crisis. It sets out the legal framework governing childhood vaccination policies, highlighting the strength of governmental authority when the state’s police power to protect the public health and its parens patriae authority to protect the health of children and other vulnerable members of society converge, as they do in this context. After describing the phenomenon of nonvaccination, the reasons leading to parental refusals and the effects of those refusals, the article provides a menu of legal tools that can be used to improve vaccination rates.
“So, what do we have here?
At this point, no charges for manslaughter were filed against anyone. What we have is the start of an inquiry into the girl’s death, following a complaint by her parents. We do not know who, if anyone, will be charged with anything in connection to this.
A four-year-old daughter of wealthy, well-educated parents – no doubt a well nourished child – was left unvaccinated against measles, a preventable disease. Vaccination rates against it in Italy are around 90% for one dose of MMR and less than 85% for the second dose. As a result, cases are high in Italy: 3,943 reported cases in 2013 and 1,680 in 2014. MMR protects 95% of those that get one dose and 99% of those that get two doses (pdf). See the CDC information on MMR vaccine effectiveness. Those left unvaccinated – like little Clara was – are substantially more at risk of getting the disease. Clara did.
Little Clara got a generally fatal, horrible complication of the disease described by anti-vaccine activists as benign, mild or “a common childhood illness”.”
In June 2012, a labor court in Rimini, Italy granted compensation to the family of a child named Valentino Bocca. The family alleged that the MMR vaccine Valentino received as part of his childhood immunizations caused his autism, and the court compensated them on that theory. The lower court’s decision was never on very firm grounds: it depended in part on testimony of an expert decision who relied, in turn, on Andrew Wakefield’s debunked study. But it was used by anti-vaccine activists as part of their claims.
On February 13, 2015, a Court of Appeals in Bologna overturned the decision–a decision that apparently lead to a decline in MMR immunization rates in Romagna, an historical district of Italy.
The Court of Appeal accepted the appeal filed by the Ministry of Health (ministero della Sanità). The expert appointed by the court of appeal highlighted that there is no scientific evidence supporting a link between vaccines and autism. The expert highlighted that the lower court expert was wrong to rely on the study by Andrew Wakefield, a study debunked and rejected by the scientific community.
The expert also highlighted that while there is some temporal link between Valentino’s MMR vaccine and autism, in the sense that the diagnosis of autism followed the vaccine, the temporal connection was not strong and does not itself support a causal connection.
The expert, Dr. Lodi, stated that “In the medical history of the child there is not an objective temporal correlation between the gradual emergence of autistic disorders and the MMR vaccine, there is only the fact that the two events occur one before the other, but as shown, this is not sufficient to relate the two events “.
The Bocca’s lawyer, Luca Ventaloro, claimed that he will appeal to the Supreme Court of Cassation (Corte Suprema di Cassazione), the highest court in Italy.”