Arizona was impacted by the recent measles outbreak at Disneyland, but a proposal to tighten the state’s vaccine laws failed to get a hearing during the state’s most recent legislative session.
In California, which bore the brunt of the Disneyland outbreak, legislators are considering a proposed law that would prohibit parents from exempting their children from school vaccine requirements, with the exception being children who have doctor-approved medical exemptions.
The Arizona law would not have been that drastic, and vaccine experts and legislators here say no one here is considering such action. Rather, the proposed Arizona law would have required all public schools, including charter schools, that maintain a website to post the rates of their pupils’ immunizations against vaccine preventable diseases.
The bill also would have required schools to post whether or not the school employs a nurse. And if school officials or employees other than school nurses provide health care to pupils, the qualifications of those people would have been part of the required posting, too.
HEALTH COMMITTEE’S HANDS WERE TIED
House Bill 2466 was assigned to the education committee and it never got a hearing. Committee chair Paul Boyer, a Republican from Phoenix, viewed the bill as an unfunded mandate.
“Districts have so many mandates as it stands. Nothing prevents a school from posting the information on their own,” Boyer said. “I have never once heard from a parent who wants this information about this issue.”
Boyer is also on the health committee, which is headed by Rep. Heather Carter, a Republican from Cave Creek. One of the health committee meetings included an informational presentation about vaccinations by the state health department, but no hearing was held because the bill had not been assigned to the health committee.
“Every year we have conversations on the state of vaccinations in Arizona,” Carter said. “We were not provided an opportunity to have those conversations (this session). Hopefully next session we will.”
EDUCATION, NOT JUST LEGISLATION
Registered nurse Gail Hock, a program manager for The Arizona Partnership for Immunization, said the proposed vaccine law would have been helpful. But improving vaccination rates is not all about legislation, she stressed.
Hock’s group, for example, is working with school administrators to help parents overcome any barriers that might be preventing them from getting their children vaccinated. Some parents are getting what she calls “convenience exemptions,” where they sign a waiver because they can’t get their children immunized in time to meet school requirements.
One problem is that not all schools have nurses, and having non-nurses enforcing vaccine rules can be problematic because they don’t always recognize the importance of herd immunity, she said.
Hock said education is the most important component of preventing measles and other outbreaks. Parents need to understand what the vaccination rates mean, for example.
“You need to understand herd immunity when you look at the rates. You might see 80 percent and think it’s OK — it’s a B,” Hock said. “But you almost need A-plus. To have a school protected from measles, it needs to be 95 percent.”
DIFFERENT VACCINE BILL FAILED IN 2012
Two years ago, another vaccination bill that added an extra step — a doctor’s signature — to the process of seeking a nonmedical exemption to vaccinations also failed.
Arizona is one of 20 states in the country that allow a “personal belief” exemption to school-mandated vaccinations. Most states, including Arizona, allow religious exemptions, though many advocates of vaccines argue that religious exemptions don’t make sense because immunizations are not a belief system, but rather evidence-based medicine.
Just two states in the country — Mississippi and West Virginia — do not allow religious or personal belief exemptions. The divisive California bill would not allow parents to claim personal belief or religious exemptions for their children.
The only exemptions allowed would be for medical reasons. The Disneyland measles outbreak infected 147 people from seven states, including 131 in California and seven in Arizona.
A LETDOWN FOR PHYSICIAN LEGISLATOR
The percentage of nonmedical exemptions in Arizona public schools, and in particular charter schools, increased significantly between 2000 and 2013, though the number of exempt children remains small.
In Arizona preschool classes, the rate of nonmedical exemptions quadrupled between 2000 and 2013 — in the 2013-14 school year the rate was at 4 percent. For kindergartners, it was 4.7 percent.
In charter schools, the rates were even higher — more than 9 percent of kindergartners and sixth-graders in Arizona charter schools had nonmedical exemptions from vaccines in the 2013-14 school year.
The biggest concern with the rising rates is that it leaves less protection for the children who cannot be vaccinated for medical reasons, said Arizona Rep. Randall Friese, a Democrat from Tucson and a trauma surgeon who is one of three physicians in the Legislature.
Children with medical exemptions often have compromised immune systems and are vulnerable to vaccine-preventable diseases like measles and whooping cough, he said. Friese co-sponsored the vaccine bill that would have required schools to post their vaccination rates.
Since the Democrats are a minority in the Legislature, Friese expected it would be more difficult to get legislation through, but he said it is unfortunate that so few Democratic-sponsored bills like the vaccine legislation even got hearings this session.
Committee meetings are a time for the public to be heard on issues like vaccines, but all too often the public did not get that chance, Friese said.