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Experts say vaccinating children helps protect them from disease as well as other children in their community. Getty Images
  • Researchers say more parents are using religious exemptions against vaccinations as more states get rid of personal exemption statutes.
  • Experts are concerned this is leading to an increase in preventable infectious diseases, in particular measles.
  • The increase in these exemptions comes despite the fact that few major religions have official objections to vaccinations.

There are currently 45 U.S. states that allow parents to use religious freedoms protected by the First Amendment to exempt their child from the current vaccine schedules and still attend school.

There are only 15 states that allow those same exemptions for personal, moral, or other beliefs.

A new study suggests that “problematic, outdated” religious exemptions to vaccines are on the rise because fewer parents can cite personal beliefs for why they’re not vaccinating their children.

This is occurring even though few religions have stated objections to vaccinating children.

Nonetheless, some of the larger outbreaks of vaccine preventable infections in recent years have occurred in communities united in, among other things, their religious beliefs.

The use of vaccine exemptions is of particular concern as the United States is coming out of a problematic year for vaccine preventable diseases, namely measles.

According to the U.S. Centers for Disease Control and Prevention (CDC), as of October 3 there were 1,250 confirmed measles cases in 31 states, with the majority occurring in New York.

That’s alarming to infectious disease experts because measles was declared eradicated from the United States in 2000.

But now, nearly 20 years later, the CDC says this year’s measles cases is the highest since 1992.

Experts attribute the rise to growing numbers of unvaccinated kids with their parents typically grouped together in geographic location as well as around personal — or religious — beliefs.

The new research on exemptions, published in the journal Pediatrics, involved analyzing CDC data for patterns — namely to see if state laws limiting the use of personal exemptions had any effect on the invocation of religious rights.

The Colorado-based team of pediatricians and public health researchers found that from 2011 to 2018, in the 15 states that allow both personal and religious exemptions, kindergarteners were one-fourth less likely to have parents who cited religious beliefs for not vaccinating their child.

In other words, children were 4 times more likely to be unvaccinated because of their parents’ personal — not religious — beliefs.

One example is Vermont. It offered both kinds of exemptions, but in 2015 it became the first state to repeal its personal exemption.

In the following years, religious exemptions in the state went from 0.5 percent to 3.7 percent, or 7 times what they were when personal exemptions were available.

The researchers noted that Vermont ranked second to last in all 50 states when it came to strong religious beliefs the year before the policy changed.

But researchers don’t think people are suddenly converting to religions that prevent them from vaccinating their children.

Researchers say this suggests parents are simply switching what box they check on the state forms to obtain the same outcome.

They say this is evidenced in how exemption requests remained relatively the same geographically, but the stated reason changed with the laws.

“Religious exemptions may be an increasingly problematic or outdated exemption category, and researchers and policy makers must work together to determine how best to balance a respect for religious liberty with the need to protect public health,” the Colorado researchers concluded in their research.

The researchers don’t suggest abolishing religious exemptions, but say further research should be done on the personal level and look at what other exemptions are available and differentiate between religious and spiritual concerns.

“This important work will help school vaccine exemption laws evolve in our rapidly changing society, ensuring they remain a cornerstone of public health for decades to come,” the study authors stated.

William Schaffner, MD, is a professor of preventive medicine in the department of health policy and a professor of medicine in the division of infectious diseases at Vanderbilt University in Tennessee.

He said the study confirms in New England what researchers have learned in California and other locations.

If you take away parents’ ability to use personal exemptions, then religious exemptions will rise.

“Now that the personal exemptions are no longer available, they consider them religious exemptions,” Dr. Schaffner told Healthline.

Instead, parents are using religion for “personal religious exemptions,” meaning they personally believe their religion exempts them from vaccinations, he said.

And like-minded people typically live in close communities, meaning a single infection has the potential to spread quickly among the cluster of unvaccinated people.

“That’s terrible to those of us who think these diseases are preventable,” Schaffner said.

Most major religions — including Islam, Judaism, and major Christian denominations — have no stated opposition to vaccines.

According to Vanderbilt University, some members of Dutch Reformed Congregations decline vaccination “on the basis that it interferes with divine providence” while others do not.

Some Christians oppose vaccines on the belief they use cells from fetuses.

Some smaller Christian denominations do have documented opposition to vaccines, including the Church of Christ the Scientist, Endtime Ministries, and Faith Tabernacle, who the government ordered to vaccinate their children following a measles outbreak in 1991.

Still, more recent infections have been among the devout — no matter the fundamental differences in their beliefs.

The CDC attributes three outbreaks of measles in 2018 to unvaccinated people in Orthodox Jewish communities on the East Coast.

In 2014, another year that spiked, one large outbreak included 383 cases, occurring primarily among unvaccinated Amish communities in Ohio, according to the CDC.

In 2013, a Christian megachurch in Texas was the center of a measles outbreak. This occurred after 21 members of the Eagle Mountain International Church became infected after someone brought the virus in following a trip abroad.

The church soon denied accusations it preached an anti-vaccine message to its congregation and offered free immunizations to its members.

More states are passing laws limiting vaccine exemptions.

California, for example, began to crack down on measles exemptions following an outbreak at Disneyland in 2015.

Since then, the state adopted what Stanford University describes as some of the toughest vaccine laws in the country.

San Francisco authorities are investigating a prominent anti-vaccination doctor, saying he wrote un-medically sound medical exemptions for a fee.

Meanwhile the opposition to these restrictions has been strong.

Just this year, as California lawmakers were debating a bill that would further limit the use of medical exemptions, protestors threw blood down upon state lawmakers “for the babies” and staged days of heated protests at the state capitol in Sacramento.

Those protesters and others who oppose restricting vaccine exceptions typically don’t voice their concerns about vaccines citing scripture, but rather on whether the government has the right to force vaccines on children, or if the vaccine and the current vaccination schedule are safe.

The CDC and numerous medical organizations assure people that vaccines are indeed safe for the majority of the population and trained medical professionals can address any concerns.

Schaffner said religious and personal beliefs are often cited by those who oppose mandatory vaccinations.

“Anti-vaccine and vaccine hesitant come in many flavors,” he said.

While people against vaccines often cite debunked claims about links to vaccines and autism, Schaffner says vaccine hesitant parents don’t often understand the diseases they can prevent.

One reason is these diseases have been tamed by vaccinations and therefore have been out of the public mind for more than a generation.

But many parents, he said, are also concerned at the number of vaccines their small child receives in one sitting.

They want the shots to be spread out more, but experts disagree and say that’s not what’s most effective in protecting the child and the community at the same time.

Schaffner acknowledges seeing your small child pricked with a needle 3 times in one sitting can be hard to watch, but there’s an easy workaround.

“There are some moms who don’t like the pin-cushion effect,” he said. “And for them I have one simple piece of advice: Don’t be in the room. Let the nurse do it.”