Nonmedical Exemptions for Vaccines Endanger Public, AMA Says

Marcia Frellick

June 09, 2015

CHICAGO — American Medical Association (AMA) delegates voted to support legislation banning nonmedical exceptions for immunizations, arguing that they jeopardize public health.

"This is an emerging public health crisis," said Charles Barone, MD, a delegate speaking for the American Academy of Pediatrics (AAP). "The AAP and AMA need to be firm in our opposition to nonmedical immunization waivers."

Pediatricians are hearing from families with children who have immune deficiencies or who are being treated for childhood cancer, "demanding to know if their children are at risk of being exposed to dangerous vaccine-preventable diseases in their daycares, schools, public places, and physician waiting rooms," he told Medscape Medical News.

The June 8 vote here at the AMA 2015 Annual Meeting was fueled in part by the measles outbreak in December 2014 that started in a California theme park and spread to several states. Most of those affected were not immunized.

Dave Cundiff, MD, an alternate delegate from Olympia, Washington, described the necessity for the AMA action in a prevote hearing, "It's like your decision on what speed to drive on your freeway," he said. "I'm not sure any of us want to have deeply held beliefs as an excuse for speeding."

Sandra Fryhofer, MD, speaking on behalf of the Council of Science and Public Health, pointed out that over the past 20 years, the number of school-immunization exemptions granted for philosophic or religious reasons has almost doubled.

I'm not sure any of us want to have deeply held beliefs as an excuse for speeding.

"In states that allow both, 90% were philosophic exemptions, and access to those exemptions has gotten progressively easier to obtain," she reported.

Public Health

Currently, only two states — West Virginia and Mississippi — do not allow philosophic or religious exemptions for state immunization requirements. However, legislation is pending in several other states to crack down on exemptions.

Sharon Hirsch, MD, a delegate for theAmerican Academy of Child and Adolescent Psychiatry,said she applauds the AMA vote and hopes it will help dispel myths about harm.

"There has been great disinformation spread about the harm of vaccines that is not scientifically valid," she told Medscape Medical News.

The AMA crackdown includes healthcare workers, the resolution notes. The policy states that health professionals who have direct patient care responsibilities have an obligation to accept immunization in the absence of a medical exemption.

Dr Cundiff, Dr Barone, and Dr Hirsch have disclosed no relevant financial relationships.

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