Vaccine policy change likely to lower Michigan waivers

Lansing — Health experts hope that a month-old change in Michigan’s vaccination waiver policy will ensure more kids are immunized in a state with the country’s fourth-highest percentage of kindergartners exempted from at least one vaccine.

The new rule, sought by Gov. Rick Snyder’s administration and approved by lawmakers, took effect Jan. 1 and was issued amid a concerning rise in whooping cough and measles cases.

It requires parents wanting a nonmedical waiver to first be educated by a local health department about the risks of not receiving vaccines and the benefits of vaccination to their child and community. Parents previously could get a philosophical or religious waiver without meeting with a health official.

“Right off the top, 30 percent of (those) parents are going to just get their kids vaccinated,” said Mark Largent, a Michigan State University associate professor who wrote the 2012 book “Vaccine: The Debate in Modern America.” ‘’We know if we make it more difficult, more parents will opt to vaccinate their kids than not to. But the remaining two-thirds or so, they’re going to harden their resistance.”

Roughly 7,000, or 5.9 percent, of the state’s kindergartners were exempted from one or more vaccines in the last school year — ranking only below Oregon, Idaho and Vermont. The median waiver rate nationally is 1.8 percent.

More than nine in 10 Michigan waivers were for non-medical reasons, mostly on philosophical grounds. Michigan is among just 19 states with philosophical waivers, but legislators seem unlikely to eliminate them.

“I don’t believe in mandatory vaccination,” said Rep. Mike Callton, a Nashville Republican and chairman of the House Health Policy Committee. “If a parent has serious concerns — and I don’t care if they’re valid or not — the parents are afraid, and I think we should respect that.”

Recent outbreaks have put parents who refuse vaccines for their children on the defensive.

In November, a Traverse City charter school closed for a week because of a whooping cough outbreak. More than 100 measles cases in at least seven states have been linked to people who visited or worked at Disneyland in December or exposure to infected people who went there.

And on Thursday, health officials said five infants attending a suburban Chicago day care center had been diagnosed with measles and about 10 more children, including some also too young for vaccinations, could have been exposed to the disease.

Snyder, a Republican, declined to say if immunizations should be mandatory but encouraged vaccinations.

“I am not going to dive in on the entire national dialogue right now other than to say that measles is a serious disease and I would hope that parents are getting their kids vaccinated unless they have a serious religious or other serious reason not to do so,” he said.

Despite Michigan’s high number of waivers, it ranks in the middle of states in the percentage of children who have been immunized. Kids who are fully vaccinated or who have received a specific vaccine are at record highs, Largent said, but so are waivers.

How can that be?

Public health officials are successfully pressuring school districts and day care providers to make sure kids are either vaccinated or have a waiver, Largent said. A third category of kids — who don’t have all their vaccines but also don’t have waivers — is shrinking.

He said there’s “angst” about the growing number of waivers for two reasons: unvaccinated children cluster together and, in a shift, now tend to come from more educated, affluent families.

Nine Michigan counties had double-digit kindergarten waiver percentages a year ago, ranging from smaller communities like Leelanau near Traverse City (19.5 percent) to Oakland in the northern Detroit suburbs (10.1 percent).

Vaccine schedules call for children to be inoculated 35 times by kindergarten, 25 times by the 18-month-old mark, Largent said. He said parents are choosing to delay immunizations, which can make kids vulnerable to diseases for a longer period of time.

“The vast majority of them, their kids have some vaccines,” Largent said. “What parents are doing is going rogue and deciding what vaccines to give their kids and when to give them.”

He said parents who choose not to vaccinate shouldn’t be dismissed as “lazy, selfish or ignorant” because public health officials must understand their motivations if they hope to reduce waivers.

Sen. Curtis Hertel Jr., an East Lansing Democrat who sits on the Senate Health Policy Committee, said the most important thing is educating parents. He will soon meet with state Department of Community Health officials to see how the new vaccine waiver rule is working and if further steps should be taken.

He may propose unspecified legislation that aims to safeguard kids who can’t be immunized for medical reasons.

“The largest group that’s at risk are kids that can’t get vaccines. … I’m going to do everything I can to find a place in law to make sure that they are protected,” Hertel said.

Kindergarten vaccination waiver rates in Michigan counties

Percentage of kindergartners with waivers from vaccination requirements, by county, as of February 2014:

Alcona, 2.2 percent Alger, 5.6 Allegan, 2.1 Alpena, 7.2 Antrim, 3.3 Arenac, 5 Baraga, 1.6 Barry, 4.6 Bay, 1.5 Benzie, 6 Berrien, 3.7 Branch, 0.9 Calhoun, 2.5 Cass, 2.6 Charlevoix, 4.6 Cheboygan, 18.5 Chippewa, 6.4 Clare, 3.2 Clinton, 7 Crawford, 6.4 Delta, 4.8 Detroit (city), 2.3 Dickinson, 7.1 Eaton, 5.8 Emmet, 13.7 Genesee, 5.7 Gladwin, 8 Gogebic, 3 Grand Traverse, 12.8 Gratiot, 2.3 Hillsdale, 3.2 Houghton, 15.4 Huron, 3.8 Ingham, 4.9 Ionia, 3.7 Iosco. 4.6 Iron, 4 Isabella, 4.7 Jackson, 4.2 Kalamazoo, 2.4 Kalkaska, 8.3 Kent, 3.7 Keweenaw, 0 Lake, 5.6 Lapeer, 12 Leelanau, 19.5 Lenawee, 7.4 Livingston, 11.3 Luce, 3.8 Mackinac, 4.7 Macomb, 6.9 Manistee, 5.6 Marquette, 6 Mason, 2.8 Mecosta, 6 Menominee, 3.7 Midland, 12.1 Missaukee, 0.5 Monroe, 5.7 Montcalm, 4 Montmorency, 9.2 Muskegon, 2.4 Newaygo, 3.7 Oakland, 10.1 Oceana, 3.8 Ogemaw, 7.6 Ontonagon, 3.3 Osceola, 5.1 Oscoda, 12.7 Otsego, 3.3 Ottawa, 3.5 Presque Isle, 6.3 Roscommon, 2.7 Saginaw, 2.7 Sanilac, 5.3 Schoolcraft, 3 Shiawassee, 6.9 St. Clair, 9.5 St. Joseph, 2.9 Tuscola, 3.4 Van Buren, 2.5 Washtenaw, 7.2 Wayne, 7.1 Wexford, 4.2

Source: Michigan Department of Community Health