End the religious exemption for school vaccinations, already

New York polio outbreak highlights the risk of letting kids come to school without standard immunizations.

Yechiel Teichman, who said he and his children had been vaccinated against polio, goes shopping with his daughters at a mall in Monsey, N.Y., on July 22, 2022. Health officials here offered pop-up polio vaccinations and urged the public to get shots as they investigated whether a known case of polio had spread to others.VICTOR J. BLUE/NYT

Polio is back. And, thanks to the inability of lawmakers to stand up to a tiny fringe of anti-vaccine activists, we’re not ready.

Last month, authorities in New York state announced they had detected the first polio case in the United States in nearly a decade. The victim, an unvaccinated man in a New York City suburb, developed paralysis, which is incurable. The virus, which can also cause death, has now been found in New York City’s wastewater, providing more evidence that the virus, which once seemed virtually extinct thanks to effective vaccines, has been spreading quietly in the past weeks.

The continued spread of polio, which happens through contact with feces from an infected individual or droplets from a sneeze or cough, has US public health authorities on alert. A senior official with the US Centers for Disease Control and Prevention told CNN on Thursday that the New York case is “just the very, very tip of the iceberg” that suggests there “must be several hundred cases in the community circulating.”

That’s because the majority of people with the polio virus don’t have symptoms and can spread the virus to other unvaccinated individuals unknowingly. In some cases, people who have been immunized with the oral form of the polio vaccine can spread the disease to unvaccinated individuals; the victim in New York is believed to have contracted so-called “vaccine-derived poliovirus” from a vaccinated relative.

That is a problem in Massachusetts with back-to-school season upon us. While students in kindergarten through grade 12 are required to be immunized with the polio, MMP, varicella, and other childhood vaccines, the state also allows families to claim a religious exemption to vaccinations. In the past few years, some lawmakers have tried to get rid of the exemption because its use has been on the rise. Essentially, the existence of the religious exemption functions as an open invitation to parents to label their views “religious” in order to avoid having their kids immunized.

This session, another attempt to eliminate the state’s childhood vaccine exemption never made it to the floor for a vote but, for the first time, the public health committee reported it out favorably. It is highly disappointing that lawmakers couldn’t get their act together to hold a vote on this bill. Given the polio threat the country is facing now, acting on the bill must be a priority for the next session. State Representative Andres X. Vargas, who has been one of the lead sponsors, should file it again in January.

Dr. Jonathan Davis, the chief of newborn medicine at Tufts Medical Center, feels very strongly about the threat that the polio outbreak represents for Massachusetts. “We require kids to sit in car seats, and we do all sorts of things like that to improve their safety, and yet we can’t” get rid of the religious exemption, Davis said. “The Legislature got a lot of pushback from the anti-vax movement [on the Vargas bill] and they are somewhat reticent to really commit to this bill, and that’s sad to me as a physician.”

Rockland County, N.Y., where the first polio case was detected, has a shockingly low vaccination rate at 60 percent and, perhaps not surprisingly, it was the same region that suffered from a large measles outbreak in 2018-2019. There are schools in Massachusetts that have that level of vaccination rates and where a polio outbreak is entirely possible. Additionally, doctors have warned that the COVID-19 pandemic has resulted in many delays in routine vaccinations for kids.

The polio vaccine came online in 1955 but has existed in several forms. Since 2000, the only version of the polio vaccine administered in the United States has been the inactivated poliovirus vaccine, which is delivered as an injection. It protects against vaccine-derived poliovirus, the type that was detected in New York.

Increasing the vaccination rate has become a life-and-death matter: Lawmakers should not go another year without addressing the unwarranted religious exemption to childhood vaccines. It’s an unnecessary loophole that only puts the health of the community at risk.

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