The virtue of vaccines

California is among the 18 states that make it easy for parents to refuse to vaccinate their children who attend public schools. All they have to do is sign a form saying that inoculations run counter to their personal beliefs. Most states require a religious-belief exemption, which results in dramatically higher vaccination rates.

A bill by Assemblyman Richard Pan (D-Sacramento), a pediatrician, would tighten the state’s rules. To claim the personal-belief exemption, parents would be required under AB 2109 to discuss the risks and benefits of vaccination with a health professional; then they would be free to make up their own minds. The bill is modeled on a new law in Washington state, where 6.2% of parents were taking personal-belief exemptions. During its first year, the number of such exemptions dropped more than 25%.

It’s less than ideal to require such discussions, which invoke comparisons to the intrusive laws requiring pregnant women to receive anti-abortion counseling before they can undergo the procedure. But neither pregnancy nor abortion is contagious, while the diseases prevented by vaccinations are. The actions of a few should not endanger the health of the wider community. AB 2109 deserves to become law.

Opponents of vaccination ask why their children should be inoculated when children whose parents seek this protection can receive it. The problem is that not all vaccinations result in immunity, leaving some children unprotected. And a small percentage of children cannot be vaccinated because of preexisting medical conditions. The health of these children relies on so-called herd immunity, meaning that enough children are immune — 90% to 95% — to keep the illness out of the community. Serious adverse reactions to vaccinations are exceedingly rare, and repeated studies have long discredited claims of a link to autism.

The consultations would not change the minds of determined vaccine opponents, but that might not be necessary to bring vaccination rates to healthy levels. The Washington experience shows that many parents are not dead set against inoculation. Some have vaguely heard something against vaccination but never researched the issue. Others simply don’t want to bother taking their children to the doctor; it’s easier to sign a form exempting them from vaccination. At 2.5%, California’s exemption rate is much lower than Washington’s, but there are wide disparities from county to county. In Marin County, the figure is 7%; in Nevada County, 20%. To protect public health, the anti-vaccination trend must be reversed.