Dr. John Snyder is a pediatrician at Amherst Pediatrics in Amherst.
Amid a dangerous upswing in vaccine disinformation, exacerbated by the anti-vaccine rhetoric of US Health and Human Services secretary Robert F. Kennedy Jr., parents are increasingly turning to nonmedical exemptions to avoid vaccinating their children.
The use of such nonmedical exemptions is a loophole that endangers entire communities and must be stopped. It has resulted in outbreaks of dangerous preventable diseases such as measles and pertussis, with more outbreaks certain to follow. The United States is now on the brink of losing the measles elimination status it achieved in 2000. More than 90 percent of the children infected in the current outbreak have been unvaccinated or under-vaccinated.
I got measles in medical school in 1991, while caring for a patient who died from the disease. (I was vaccinated, but at the time, it was only recommended that people get one dose.) I developed pneumonia and was lucky to have survived the many days of high fever, relentless coughing, and semiconsciousness that followed. Many vaccine-preventable diseases harm and kill.
As a pediatrician in western Massachusetts, I have seen a steady increase over the years in parental vaccine exemptions for some or all of the vaccines recommended by the nation’s leading experts in infectious disease and public health. New state immunization data confirms that Massachusetts is heading in the wrong direction. The Commonwealth as a whole has a healthy immunization rate, but religious exemptions have increased from 0.9 percent of kindergartners in 2021-22 to 1.63 percent in 2025-26, continuing a steady rise over the last several years.
There are now several “hot zones” of under-vaccination in Massachusetts, where exemption rates are higher than what’s needed to achieve herd immunity. In some counties, communities, and schools, vaccination rates dip well below the threshold that can contain disease, making such places ripe for outbreaks that can spread to the wider community and beyond. If the rate of vaccine exemptions continues to rise, there will be a reemergence of deadly, entirely preventable diseases.
Though Massachusetts no longer allows philosophical exemptions based on personal beliefs, it continues to allow religious exemptions, despite the fact that no organized world religion prohibits vaccination. A bill in the Legislature would change that by eliminating all nonmedical vaccine exemptions in the state.
In the 1972 Supreme Court case Wisconsin v. Yoder, considering Amish parents’ desire to keep their children home after eighth grade, the court ruled that compulsory school attendance past that grade violated their religious rights. But Chief Justice Warren Burger also wrote, “the very concept of ordered liberty precludes allowing every person to make his own standards on matters of conduct in which the society as a whole has important interests.”
Burger’s reasoning distinguished between religious beliefs and individual personal or philosophical preferences, while arguing that “ordered liberty” requires a shared framework of conduct.
Burger was right. Multiple states — including Maine, Connecticut, and New York — have used similar reasoning, followed the scientific consensus, and eliminated nonmedical exemptions to childhood vaccination.
Decades of scientific research have shown vaccines are the best protection against the threat of deadly diseases.
A recent decision by a federal judge in Boston temporarily blocking the dangerous changes made by the Trump administration to the childhood vaccine schedule was a big win for public health. Not surprisingly, the administration has vowed to challenge the decision, as it has repeatedly attempted to undo policy backed by rigorous science.
The dangerous vaccine misinformation coming from the Trump administration has led my practice to reemphasize our commitment to vaccination, and to explain why we follow the guidelines supported by the American Academy of Pediatrics and other leading, science-based organizations. It is why I have worked with public health leaders in western Massachusetts to launch a website (ValleyVax.org) that serves as a source of reliable, science-based vaccine information for our community.
It is also why I support passage of the bill eliminating nonmedical vaccine exemptions in Massachusetts. If passed, this bill will protect entire communities from the increasing threat of vaccine-preventable disease. I can’t think of a better way to protect our children.