Pushing kids and families out of schools would do harm
COVID-19 pandemic school closures highlighted the importance of schools for social connection, mental health, and learning. Learning losses were worse for children from low-income backgrounds and communities of color and could have long-term, if not lifelong, impact. Proposed legislation to remove the religious exemption for vaccination would force children out of schools, leading to similar individual and community harm (“A microcosm of vaccine resistance at bucolic school,” Page A1, Sept. 24).
Religious beliefs are central to daily life and identity for many people. California saw a fivefold increase in homeschooling for kindergartners after removing nonmedical exemptions in 2015, and many children remain outside of the school system. It is likely that a large proportion of families currently using the religious exemption in Massachusetts (roughly 1 percent of kindergartners) would not disavow their beliefs and would be forced out of schools.
Students using a religious exemption include those from marginalized groups, single-parent families, and disadvantaged backgrounds as well as students with special needs. Effective homeschooling will be impossible for many families. Shutting the schoolhouse door would threaten economic prospects, increase the risk of poverty, undermine future participation in society, and jeopardize overall health and well-being.
At best, legislation removing the religious exemption might increase overall vaccination rates by a few tenths of a percent. Given our robust vaccination rates, the highest in the country, such increases would be outweighed by myriad harms.
The largest driver of pockets of undervaccination in Massachusetts schools is the “gap” population, a term the Massachusetts Department of Public Health uses for students who are undervaccinated and have no exemptions. “Gap” students are overrepresented in disadvantaged communities and outnumber those with religious exemptions by a factor of 3 or 4.
A myopic focus on marginally increasing vaccination rates at the expense of education epitomizes privilege, flies in the face of commitments to equity, and is simply bad public health policy.
Dr. Sylvia Fogel
The writer is a psychiatrist who specializes in autism.
It’s biased to suggest that people who seek the exemption are insincere
Jason Laughlin’s recent article regarding the religious exemption overlooked several crucial points I would like to highlight.
The religious exemption is used by roughly 1 percent of Massachusetts schoolchildren. According to the Massachusetts Department of Public Health, it is used most often to forgo one or two vaccines in children who are otherwise vaccinated. Because the exemption rate is low and is used for a variable subset of vaccines, it is not synonymous with population-level risk for illnesses. Rather, DPH data show that the largest driver of suboptimal vaccination rates, including for measles, is the “gap population,” a term that describes students who don’t have full vaccination records and don’t have an exemption. Nevertheless, Massachusetts still has the highest vaccination rates in the country.
State Representative Andres Vargas, sponsor of the bill eliminating religious exemptions, and previous Globe pieces suggest that people using the religious exemption are not sincere. There is no good data to support these discriminatory assertions. While use of the religious exemption is higher than it was 30 years ago, the number of doses required to attend school also has risen and includes vaccination for illnesses not spread in schools, such as Hepatitis B.
Parents may have religious objections to individual vaccines based on manufacturing techniques, ingredients, or other factors. Federal law and the Massachusetts Constitution provide that religious beliefs are not defined by organized religions but rather can be personal to the individual.
As Dr. Larry Madoff, medical director for the Bureau of Infectious Disease and Laboratory Sciences at the DPH, stated in Laughlin’s article, “You don’t want to push people away.” Denying school for the tiny percentage of Massachusetts residents using the religious exemption is antithetical to our history of religious tolerance.
Health Action Massachusetts