When he signed Senate Bill (SB) 277, Governor Jerry Brown repealed California’s law allowing personal belief exemptions from mandatory school vaccinations. California now joins Mississippi and West Virginia as states that allow vaccine exemptions for medical reasons only. As SB 277 made its way through the California State Legislature, advocates for and against non-medical exemptions debated the challenges between protecting public health and sanctioning individual freedom. The genesis for these debates and the law’s repeal was the measles outbreak that originated at Disneyland last December, and while California’s response is notable it was not the only state to address non-medical exemptions this year.
In several state legislatures, bills were introduced to remove non-medical exemptions (i.e., personal belief and religious exemptions) or improve the process by which the exemptions are granted. Legislation was also proposed in many states to provide parental notification of vaccine exempted students and to make school immunization rates available to the public.
A number of states besides California recently considered the elimination of non-medical exemptions from school vaccination requirements. In both Maryland and New Mexico bills were introduced to repeal the religious exemption while bills in Washington and Maine sought the removal of personal belief and philosophical exemptions. In Vermont, a bill to eliminate that state’s personal belief exemption was signed by the governor in May.
Several state legislatures also weighed bills to improve the process for granting non-medical exemptions. Illinois legislature approved a bill requiring parents or guardians who request a religious exemption to receive education from a healthcare provider “on the benefits of immunization and the health risks to the student and to the community of the communicable diseases for which immunization is required.” The bill was signed into law in early August.
In Maine a bill requiring those who seek a philosophical exemption to submit documentation that they received information about the risks and benefits of vaccinations from a healthcare provider passed the legislature but was vetoed by Maine’s governor at the end of June. Similar bills mandating healthcare provider counseling or education for non-medical exemptions were also introduced in Minnesota, New York, Connecticut, New Jersey, and Texas.
Notarization requirements and parental notification that an unvaccinated child could be excluded from school were also proposed by state legislators. Connecticut’s legislature passed a bill that requires a request for a religious exemption to be notarized or acknowledged before a judicial or governmental official or an attorney. A similar bill for the notarization of religious exemption requests was also considered in New Jersey. In Delaware the state Senate passed a bill that would notify parents requesting a religious exemption that their child could be excluded from school during a disease outbreak.
Other aspects of school vaccinations that states considered this year include the public disclosure of school immunization rates and parental notification of unvaccinated students in schools. The Texas House passed a bill that would allow parents to request information about the school’s immunization rate and require the Texas Department of State Health Services to “make available to the public in electronic form, on the department’s Internet website, the required annual report of the immunization status of students for each school district and for each school campus.” Another bill in Texas would require schools to “inform parent[s] of the number of students enrolled at the school who have not obtained the immunizations required for that school year.”
Elsewhere, a bill in Illinois would require the State Board of Education to “publish on its Internet website the exemption from immunization data it receives from schools” while in Missouri, separate bills were introduced to provide parental notification that an unvaccinated student attends the school and allow parents to request notification whenever a student with a vaccine exemption attends a school.
Proponents of non-medical exemptions were also active this year with attempts to expand non-medical exemptions in several states. For example, bills and amendments to allow personal belief exemptions were introduced in New York and Montana, while in New Jersey bills were proposed to expand non-medical exemptions based on any reason, philosophical objections, and conscientious objections. Efforts were even made in Mississippi to add personal or conscientious belief exemptions and in West Virginia to create a religious exemption to school vaccination requirements.
Finally, opponents to California’s new exemption law remain vocal and challenges are in the works. On July 1, a proposed statewide referendum on SB 277 was filed and if the referendum supporters gather enough signatures the fate of the law will be decided in November 2016.
This blog post was prepared by Andy Baker-White, J.D., M.P.H., associate director for the Network for Public Health Law – Mid-States Region at the University of Michigan School of Public Health.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF