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State must close the loophole that permits unvaccinated children into schools

The need to ensure our children are protected, not just from COVID-19, but also from all vaccine-preventable diseases is paramount.


Coronavirus has altered our lives forever. Public health experts agree that the only way past the current crisis is with widespread COVID-19 immunization and continued practice of COVID safety protocols. Currently about 146 million US adults, or 56 percent, have received at least one dose of a vaccine, and nearly 41 percent are fully vaccinated, according to the Centers for Disease Control and Prevention. While COVID-19 has shown us what life is like without one vaccine, there is still the issue of acceptance of other vaccines we have had for years.

Vaccines are safe and effective. They are the most thoroughly tested medicines administered across all fields of medical practice. They are more tested than insulin preparations for diabetes and asthma medications. According to the World Health Organization, we now have vaccines to prevent more than 20 life-threatening diseases, which has had a major impact on survival and quality of life. Immunization currently prevents 2 million to 3 million deaths every year from diseases like diphtheria, tetanus, whooping cough, influenza, and measles.


As schools are opening to all students in Massachusetts, the need to ensure that our children are protected not just from COVID but also from all vaccine-preventable diseases is paramount. After all, the resurgence of whooping cough this decade, the 2014 California measles outbreak, and the 1,282 cases of measles across 31 states in 2019 underscore the urgent need to strengthen protections against vaccine-preventable disease. The FDA has even authorized the COVID Pfizer vaccine for adolescents age 16 and older, and is expected to authorize its use in children ages 12-15 within a week, and potentially as young as 2-years-old in the fall, which will have a major impact on getting children safely back to school.


Relying on scientific studies, Connecticut, New York, California, West Virginia, Maine, and Mississippi have passed laws requiring children who attend school either be vaccinated or have a legitimate medical exemption precluding immunization. In fact, such a requirement is overwhelmingly popular, with previous polls showing that nearly 80 percent of New York voters polled supported this approach. Maine’s referendum passed easily, with over 70 percent of the vote. In order to best protect school-aged children and their families here in Massachusetts, House Bill 2411, introduced by state Representative Andy Vargas, deserves strong support.

Massachusetts law has an unnecessary loophole that is used to permit large numbers of unvaccinated children into schools, where many disease outbreaks can readily occur. This is because Massachusetts allows parents to exempt their children from vaccine requirements due to their religion or health issues. Vargas’s bill would remove nonmedical exemptions and require a physician to determine if vaccines are not suitable for a student.

Nationally, 2.8 percent of children enter kindergarten without immunizations, a level high enough to cause an outbreak of a highly contagious and potentially deadly disease like measles. Further, since children with non-medical vaccine exemptions cluster together in peer groups and schools, the rate for an individual school population can be much higher.

Laws that allow only medical exemptions are universally supported by medical organizations. The March of Dimes and the American Academy of Pediatrics support the Massachusetts bill because they know it will increase vaccination rates and prevent children from getting sick. High immunization rates create population “herd” immunity in schools and, importantly, protect those who cannot be vaccinated — such as school staff and children with cancer and other immune conditions. There are approximately 4,500 school-age children living with, or having recovered from, cancer in the states. There are also the 1 in 100 children who get immunized against measles but aren’t fully protected who must be considered. Further, there are thousands of other children receiving immune-modulating treatment for intestinal and rheumatologic conditions, or kids with organ transplants — many of whom cannot be immunized. Legislators must prioritize their welfare and support.


Vargas’s bill is a referendum on science and the consensus opinion of modern medical practice and public health. The first priority of any elected official is to ensure public health. We have done this with laws requiring seat belts, car seats, bike helmets, and hands-free cell phone use. After all the passion and rhetoric are filtered out, strengthening vaccination rules are a reflection of our most fundamental responsibilities to protect children and the people who teach them every day.

Drs. Jonathan Davis, vice chair of pediatrics and chief of newborn medicine at Tufts Children’s Hospital, and Shetal Shah, a neonatologist at Maria Fareri Children’s Hospital, are members of the national Pediatric Policy Council representing the American Pediatric Society, the Society for Pediatric Research, the American Pediatric Association, and the Association of Medical School Pediatric Department Chairs.