Childhood vaccines are a haven for conspiracy theorists. | Joe Raedle/Getty Images health care State lawmakers pushing for laxer vaccine rules despite measles outbreaks 'We still get messages that say these diseases are good for you,' says one Oregon lawmaker who opposes efforts to let more parents opt out.

Measles is spreading from New York to Texas to Washington state in the worst outbreak in years, but some state lawmakers want to take the vaccination debate in the opposite direction: Loosening rules covering whether kids get inoculated.

In Oregon, state lawmakers will consider a so-called transparency bill favored by the "vaccine hesitant." New York is simultaneously considering eliminating and expanding exemptions that allow parents to opt out. One bill in Texas would prohibit the state from even tracking exemptions.


The push to loosen the rules is occurring even as the U.S. has experienced more than 160 measles cases in 10 states since Jan. 1, including 74 in Washington state and Oregon linked to the outbreak in the Pacific Northwest, according to the states and the Centers for Disease Control and Prevention.

The outbreaks have turned 2019 into one of the most active years for vaccine policy in recent memory, inspiring several states to try to toughen their vaccination mandates with the aim of stemming future outbreaks. Yet some legislators are advocating giving parents more control over whether their children need to be vaccinated.

While few if any such bills will pass, the split underscores how divisive the issue has become during an era in which three 2016 GOP presidential candidates — including Donald Trump — made the false claim that vaccines cause autism. (Since his election, Trump has been silent on the issue.) And it dismays public health supporters who have seen childhood vaccines become a haven for conspiracy theorists, with Russian bots stirring up trouble on social media and some vaccine advocates enduring harassment and even death threats.

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"We still get messages that say these diseases are good for you. And that old 'What doesn't kill you makes you stronger,'" said Oregon state Rep. Mitch Greenlick, who is pushing for stricter vaccination requirements. He has introduced a bill, OR HB3063, to eliminate all vaccine exemptions except for those based on medical grounds.

Greenlick, a retired Kaiser Permanente research executive, said harassing phone calls drove him to send all calls to voicemail after he announced the legislation. He attributed the vitriol to the combination of misinformation online and the state's strong independent streak.

Vaccine policy isn't a red-state, blue-state issue. Mississippi and West Virginia — both GOP stalwarts — have the most restrictive policies in the country, for historical reasons, and have staved off legislative and legal efforts to loosen them. Exemptions in both states are allowed only for medical reasons, and even those medical exemptions are subject to review. West Virginia this session is considering a bill, WV SB454, that would add back the religious and personal objection exemptions.

Most states have religious exemptions for parents belonging to small sects that oppose vaccination — and some vaccine objectors have even created their own churches to opt out of vaccinating their kids. Seventeen states also allow parents to exempt their children for philosophical or "personal belief" reasons.

Across the country, lawmakers have introduced more than 130 vaccine-related bills in over 30 states, at a pace that could set a new record, according to the National Vaccine Information Center, a vaccine-skeptical group that closely tracks vaccine legislation. The center says legislators filed 160 bills in 41 states during 2015, setting a record later broken by 2017’s 184 bills in 42 states.

There's a "much more concerted effort" to push for anti-vaccine legislation, said Amy Pisani, executive director of Vaccinate Your Family. One big trend is the so-called "informed consent" bill, which would require doctors to provide more detailed information about vaccine ingredients.

In Arizona alone, 11 vaccine-related bills have been introduced this session, more than half supported by opponents of mandatory vaccinations.

AZ HB2470 adds a religious exemption to existing law, which already allows for a personal belief exemption, and gets rid of the requirement that parents acknowledge they understand the potential consequences of not vaccinating their children. Another bill, AZ HB2472, would offer parents an "antibody titer" test to see if their child has defenses to vaccine-preventable diseases. Such tests are often unreliable.

Oregon's OR SB649, authored by Republican Sen. Kim Thatcher and dubbed "Right to Know," would require state health authorities to create a central website with links to all vaccine package inserts, ingredient lists and other information.

Thatcher's constituents had a hard time getting information about mandated vaccines and needed "clear and valid information" to "help parents make the best decision for their families," said spokesperson Jonathan Lockwood.

But giving people lists of vaccines’ trace chemicals without context is "designed to scare," not inform, said Dorit Reiss, a law professor at the University of California Hastings School of Law in San Francisco who studies vaccine laws. By federal law, parents already get handouts with information about the tiny risks of vaccines.

While few of the bills watering down vaccine mandates will become law, that's also true of most measures designed to make it harder to avoid vaccination. A political standoff in many states underscores the clout of the anti-vaccination community.

In Texas, despite a measles outbreak in Houston, there's no serious effort to tighten exemptions. But Republican state Rep. Matt Krause introduced a bill, TX HB1490 (19R), that would prohibit the state from even tracking exemptions. He's part of a group of far-right lawmakers allied with the PAC Texans for Vaccine Choice. His bill is not expected to advance.

Barbara Loe Fisher, who founded the National Vaccine Information Center, contends the animosity about vaccines is "part of a larger culture war that's going on in this country. It's about the right to autonomy, the natural right to self determination. We have freedom of thought, freedom of religious belief."

More than a century of federal law has established that states can require vaccination, however. People also have the right to send their children to school without exposing them to preventable, serious diseases like measles, said California Sen. Richard Pan, author of the state's 2015 law, CA SB277.

Pan introduced the bill following the Disneyland measles outbreak, which sickened 147 people. Since it went into effect, the overall vaccination rate in California has increased to 95.1 percent, compared with 92.9 percent in the 2015-16 school year. But growing medical exemptions could threaten those gains, he said.

In response to a tripling of medical exemptions following the earlier law, Pan said he may consider further restricting its medical exemption by adding another level of review. That would give California the toughest laws in the country.

"Unfortunately there's a small number of doctors who are profiting," said Pan. "They're monetizing their licenses, they're selling vaccine exemptions. If you go online there's you go to anti-vax Facebook pages, they pass along lists of doctors."

Pan, threatened with violence as a result of his 2015 legislation, is girding for more abuse. But he considers it an issue of public safety. "I ran for office to try to solve problems and keep the community safe and healthy, and I'm not going to be deterred from that," he said.

In Washington state, Rep. Paul Harris, who represents a district at the epicenter of the measles outbreak, has introduced WA HB1638, which would remove the personal or philosophical exemption — but only for the combined measles, mumps and rubella vaccine. The state’s medical and religious exemptions would still stand.

"Measles are the most contagious of all the diseases we get vaccinated for, and I just thought it was a great start," said Harris, a Republican. He supports stricter policies, but even his limited bill drew protests when it was heard in committee earlier this month.

Another vaccine-preventable disease, pertussis, strikes by the thousands every year. But unlike measles, it spreads not only through unvaccinated people but also because of waning immunity produced by the current vaccines, whose efficacy is somewhat limited.

Renuka Rayasam and Angela Hart contributed to this report.