Abolish the vaccine religious exemption

No major denomination has specific vaccination prohibition

VACCINES SAVE LIVES. Never has this been more evident than in the last year. Since the spring of 2020, the COVID-19 pandemic has claimed more than 15,000 lives in Massachusetts alone and is a leading cause of death in the United States. With the rollout of the COVID-19 vaccines in Massachusetts, we have seen our rates of COVID-19-related hospitalizations and deaths drop dramatically. Preventing future outbreaks and pandemics is critical to protecting the health and economic well-being of our state. This is why it is crucial that we pass H. 2411, an Act Relative to Vaccines and Preventing Future Disease Outbreaks, which eliminates the non-medical (religious) exemption for vaccine requirements for schools.

Vaccines have helped to nearly eliminate some of the most dangerous childhood illnesses.  In 1954, almost all children had measles before the age of 15 and there were close to 6,000 deaths yearly from this infectious disease.  The measles vaccine was approved in the United States in 1968, and after a nationwide effort, by 2000, measles was declared eliminated in this nation. However, as the anti-vaccination movement gained traction in the last two decades through sustained misinformation, including inaccurate claims of links between the measles, mumps, rubella (MMR) vaccine, and autism, as well as celebrity activism, the US has seen childhood vaccination rates drop and vaccine-preventable diseases rise. During this time, there has been a rise in the number of religious exemptions to vaccination claimed, without any concurrent change in religious demographics.

We see the deadly consequences in our daily work as physicians. We saw a healthy 17-year-old girl go into cardiac arrest because she developed myocarditis, an inflammation of the heart muscle. Tests indicated that her infection was due to influenza A, a vaccine-preventable infection. The virus acted so rapidly that, within a week, her heart had failed. She survived, but she needed a heart transplant and now, at age 20, she takes two handfuls of medications every single day to stay alive.

We saw a 70-year-old man end up in a nursing home because of Haemophilus influenzae meningitis. He had had a bone marrow transplant to treat multiple myeloma, a type of blood cancer, which left him with a weak immune system. A visit with his unvaccinated grandchild exposed him to this disease, and he ended up in the hospital. He suffered seizures as a complication of this illness and now requires long-term care. His grandchild’s parents had not vaccinated him, and he suffered because of their decision.

We saw an unvaccinated 4-year-old come into the emergency room with fever, cough, and a few spots on his belly. His family thought at first that it was a cold, but then he fell unconscious. The diagnosis: meningitis from varicella, the chickenpox virus. The preschool-age child spent two weeks in the ICU, with a tube in his windpipe and a ventilator breathing for him.

These stories are not unique. Almost every physician has a similar story of someone whose illness could easily have been prevented by a vaccine. In addition to these lives lost, billions of dollars in health care costs are lost every year–and this loss of life and these health care expenditures are entirely preventable.

Massachusetts requires vaccinations for school, with only medical and religious exemptions, and has higher rates of vaccination than much of the country. Even here, though, we still have a problem. In some parts of the Commonwealth, up to 14 percent of students are unvaccinated or under-vaccinated. Moreover, more than 75 percent of the exemptions claimed are religious exemptions.

A major study in 2019 found that states with both personal belief and religious belief exemptions had only one-fourth as many religious belief exemptions claimed as those that had a religious belief exemption only. Vermont was the first state to repeal the personal belief exemption to vaccines and in the subsequent years, the number of religious belief exemptions claimed increased from 0.5 percent to 3.7 percent. This trend was also reflected in testimony from many parents in opposition to H.2411 on July 12 in front of the Joint Committee on Public Health; the parents decried the elimination of the religious belief exemption as denying them the option to decline vaccination for their child for personal reasons.

Furthermore, no major religion has a specific prohibition against vaccination. While some have expressed concerns based on certain ingredients used in vaccines (e.g., concerns about the use of porcine gelatin in some vaccines), vaccination is still recommended. Even faiths whose members frequently decline vaccination (e.g., Church of Christ, Dutch Reformed Congregations) have no strict rules against vaccinations.

Meet the Author

Shela Sridhar

Internist and hospitalist/Co-chair of the health and public policy committee, Massachusetts chapter of American College of Physicians
Meet the Author

Zoe Tseng

Internist/Co-chair of the Health and Public Policy Committee, Mass. chapter of the American College of Physicians
Meet the Author

Meredith Haley

Internist/Violence prevention subcommittee, Mass. chapter of the American Academy of Physicians
Meet the Author

Elisa Choi

Internist/Governor, Mass. chapter of American College of Physicians
Thus, it is imperative that we pass H.2411 and close this dangerous loophole that parents are using to keep their kids unvaccinated. We must protect the most vulnerable among us and those who have true medical exemptions to vaccines. This bill is an important step to achieving a fully vaccinated community. Parents and children have a right to an education where they know they are protected from infectious diseases. While Massachusetts would not be the first, we can be a national leader in smart vaccine policies that protect our children and vulnerable communities.

This op-ed represents the opinion of the individual authors on behalf of the Massachusetts chapter of the American College of Physicians and not the hospitals the authors are affiliated with. Shela Sridhar is an internist and hospitalist and the co-chair of the chapter’s health and policy committee. Zoe Tseng is an internist and the other co-chair of the committee. Meredith Haley is an internist.  Elisa Choi is an internist and governor of the chapter.