Amid Measles Outbreaks, ACP Reiterates Opposition to Non-medical Vaccine Exemptions

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College launches campaign to help state chapters sway legislators

March 22, 2019 (ACP) – As measles outbreaks stack up across the country and the anti-vaccination movement refuses to wither, the American College of Physicians is emphasizing a simple message for policymakers, patients and parents: Vaccines are safe, they are necessary, and laws must reflect this.

“We believe it's imperative that we do what we can to discourage policies that would lower vaccination rates,” said Dr. Ana María López, ACP's president. “Increasing vaccination rates is in the best interest of our patients' health and in the best interest of public health.”

According to the Department of Health and Human Services, measles “used to be very common in the United States, but thanks to the measles vaccine, the number of measles cases in Americans dropped by over 99 percent.” However, the Centers for Disease Control and Prevention reports that 228 cases of measles have been confirmed this year as of March 7. Since 2010, annual measles cases in only two entire years, 2014 and 2018, have topped that number.

“This increase in outbreaks of preventable illness is likely directly correlated to weakened herd immunity,” Dr. López said. “Getting vaccinated helps the individual and supports the health of the community.”

The cases – including six outbreaks of three or more related cases – have been reported in California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington.

Nonetheless, legislators in at least 20 states this year – including Texas, Pennsylvania, Georgia, Missouri, and Illinois – have introduced bills that would broaden exemptions to vaccination requirements, according to the American Academy of Pediatrics.

However, in Washington State, legislators in the House “approved a measure that would remove parents' ability to claim a personal or philosophical exemption to vaccinating their school-age children for measles,” the Associated Press reported. The state Senate will consider the legislation next.

ACP's strong support for vaccinations is expressed in its 2012 position paper on strengthening the public health infrastructure. In 2015, ACP's board of regents approved a policy calling for “states to pass legislation to eliminate any existing exemptions, except for medical reasons, from their immunization laws.”

As the policy explained, “allowing exemptions based on non-medical reasons poses a risk both to the unvaccinated person and to public health, as intentionally unvaccinated individuals can pose a danger to the public, especially to individuals who cannot be vaccinated for medical reasons.”

In addition, there's now more evidence debunking any connection between the measles-mumps-rubella (MMR) vaccine and autism. In the March 5 issue of Annals of Internal Medicine, Danish researchers reported finding no sign of a link after tracking 657,461 children born from 1999-2010. The research was described by the authors of an accompanying editorial as “one of the largest studies published on MMR vaccine and autism.”

Now, Dr. López said, ACP is working with individual state chapters in states where legislation is being considered to help them advocate against policies that could increase non-medical exemptions. ACP's State Health Policy webpage will feature a campaign with background information and sample communications that chapters can use to let officials in their state know about their concerns.

“In addition to working toward policies that would improve vaccination rates, ACP also tackles this issue from a practical perspective,” Dr. López said. “Through our ‘I Raise the Rates' initiative, ACP provides resources and vaccine information to help physicians to increase the adult immunization rates in their practices.”

Her advice to all ACP members? “If your state is considering legislation related to this issue, consider weighing in with your legislators to share your perspective and expertise as a physician,” she said. “Hearing from physicians in their local community can help sway a legislator who may be weighing the evidence as they decide their stance.”

More Information

ACP's Chapter Action Tool Kit to Eliminate Non-Medical Exemptions from State Immunization Laws is available on the ACP website.

The new study and editorial on the safety of the MMR vaccine is available on the Annals of Internal Medicine website.

ACP policy statements related to the vaccine issue include a Board of Regents statement on non-medical exemptions and the position paper Strengthening the Public Health Infrastructure (position 6).

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