Religious and medical exemptions claimed by Bay State parents as a reason not to vaccinate their children against potentially deadly diseases like measles have risen nearly tenfold in the past 30 years — and the state Department of Public Health says there's little it can do to reverse the "honor system" upsurge.
"A parent or guardian writes a letter to the school. There is no verification of that honor system. The exemptions are the rights of parents under state law. That's not second-guessed," said Kevin Cranston, director of DPH's Bureau of Infectious Disease.
There were 120 exemptions claimed on behalf of kindergartners during the 1984-85 school year versus 1,161 in 2013-14, according to DPH immunization records. Cranston noted DPH tends "to see higher exemption rates" in more affluent cities and towns, as supported by the latest kindergarten immunization survey results indicating that schools like Waldorf, a private school in Lexington; West Tisbury, a public school on Martha's Vineyard; and Morris, a public school in Lenox, have the highest rates of parents claiming exemptions for their children.
Boston Medical Center pediatrician Dr. John G. Palfrey, a member of the Massachusetts chapter of the American Academy of Pediatrics Immunization Initiative, said one step the state could take for the safety of all is to eliminate the religious exemption, which, according to DPH, parents of kindergartners turned to 837 times in the 2013-14 school year. Unlike Maine and Vermont, Massachusetts does not offer a vaccine exemption for philosophical objections, which Palfrey believes is what's usually behind the refusal absent a medical reason.
"Part of our problem is no one has seen it (measles), so they don't know they should be scared," Palfrey said. "I would suspect we're going to have some cases. My prayer is they're not in the communities that are under-immunized. ... Even for people who have had vaccines, you can still get the disease."
In addition to under-immunized kids being banned from school in the event of an outbreak, Palfrey said children with suspected cases of measles could be segregated in hospital or medical office waiting rooms to protect other patients whose immune systems are compromised.
"There's all sorts of consequences that parents need to hear — that these are real dangers, that this is not just some kind of personal whimsy," he said.
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