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Paul Offit Goes Off on Religious Vaccine Exemptions

<ѻý class="mpt-content-deck">— Mississippi "loophole" may allow people to avoid vaccination for any reason at all
MedpageToday

In this video interview, Paul Offit, MD, director of the Vaccine Education Center and attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia, discusses a recent law passed in Mississippi that allows for religious exemptions from vaccination.

Offit is also a member of the FDA Vaccines and Related Biological Products Advisory Committee.

The following is a transcript of his remarks:

So, an anti-vaccine group called Informed Consent Action Network, which is not a religious group at all, set about trying to establish religious exemptions in states that don't have them. This was their first effort in Mississippi.

The ruling was basically: If you can have a medical exemption, why can't you also have a religious exemption? And that was it. Now, there will no doubt be people in Mississippi who will choose a religious exemption, not necessarily because they have a religious exemption to vaccines, but because they just don't want to get a vaccine. And now this is a loophole that allows them to do it.

We'll see how it plays out, whether there's a standard that has to be met, like you have to have a letter from your religious leader that says that you feel strongly about this and point to statements in the Bible about not putting foreign things into your body, about why you shouldn't get a vaccine. Because the textbook of the three major religions were all written well before the first vaccine, which was in the late 1700s, so there's nothing in those texts that says you shouldn't get a vaccine. I think it's just used as a reason not to get it, which is I think exemplified by the fact that it was an anti-vaccine group that brought it.

If you look at California, for example, which never had a religious exemption but had a philosophical exemption, they suffered a major pertussis, or whooping cough, outbreak in 2010. In 2014-2015, a major measles outbreak that started in Southern California spread to 25 other states and spread to Mexico, the Philippines, and other countries.

Eventually what a state senator did was he eliminated the philosophical exemption. With that, immunization rates in California rose. So there is, not surprisingly, a direct relationship between being able to easily exempt yourself from vaccines and having vaccine rates decline and eliminating those non-medical opt-outs and having vaccine rates rise.

What the end result will be is that there will be children who will now not get a vaccine where they would've gotten it before. There will be an erosion of herd immunity. The only question is, will it erode enough that you'll start to see outbreaks of the most contagious of the infectious diseases that are vaccine preventable, which is measles?

All you can do is try and encourage vaccination as much as you can, which protects the child to some extent. I mean, no vaccine is 100% effective. If you're exposed to a vaccine preventable disease like measles, even if you've been vaccinated, it's possible you could get measles. So, all you can do is the best you can do.

But the thing that's most upsetting in this to me -- let me put it this way: the worst thing that an anti-vaccine activist can say as far as I'm concerned is, "What do you care what I do? You're vaccinated." This makes two incorrect assumptions. One is that vaccines are 100% effective, which is true of no vaccine. And two, that everybody can be vaccinated. I mean, there's 9 million people in this country who are immune compromised. They depend on those around them to protect them.

The best example is that story in California. I think one of the reasons that Richard Pan, who was the state senator, successfully eliminated the philosophical exemption was this little boy who kept showing up at the meetings trying to support his bill to eliminate the philosophical exemption. His name was Rhett Krawitt, and he had acute lymphoblastic leukemia. He would stand up at these meetings -- well, he wouldn't stand up; he would stand up in a chair so he could reach the microphone because he was little. He was only 7. And he would say, "What about me? I depend on you to protect me. Don't I count?" He was the voice of society.

And I think that's the tension. I mean, public health is about caring about your neighbor, which I would argue is also what religion is about. Which [is why] I think it's deeply disingenuous to say that, for religious reasons, you're going to put your child and those with whom your child comes into contact in harm's way. How is that a religious principle for any religion?

When children were separated from their parents at the southern border, who was there first? It was Christian relief societies that were there. I mean, Constantine, who was the first Christian emperor of Rome, at a time when child abuse was the crying vice of the great Roman Empire, established, essentially, organizations to help children. So I don't get it. I don't get it.

It seems to me like such the ultimate contradiction in terms to say that you have religious exemption to vaccination.

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    Emily Hutto is an Associate Video Producer & Editor for ѻý. She is based in Manhattan.