Vaccine-exemption bill fails; pediatric ethicist weighs in

News Archive

Vaccine-exemption bill fails; pediatric ethicist weighs in

Physician is concerned that pro-vaccination wave of momentum will fade
Brian Donohue

A bill in the state legislature to narrow parents’ ability to avoid immunizing their children failed yesterday in the House. Rep. June Robinson, D-Everett, said she couldn’t muster votes, and the bill missed the deadline to be put forth for a vote.

“I wasn’t surprised by this decision, particularly in a state like Washington that has a larger group of individuals opposed to vaccination than most states do, said Dr. Doug Diekema, a University of Washington professor of pediatrics and clinical director of the Treuman Katz Center for Pediatric Bioethics at Seattle Children’s.

“This group is loud and politically connected. So when you put a bill forward that seeks to entirely eliminate the personal belief exemption, it gets these people angry and calling their legislators. But by not even presenting it for a vote, I think the legislators copped out on this.” 

Curtis Simpson/Seattle Pacific University
Dr. Doug Diekema favors making personal exemptions from vaccines harder for parents to obtain.
Picture of Douglas Diekema

Diekema hypothesized that legislators might have rallied more support for a bill that would make personal exemptions harder to obtain instead of eliminating them entirely.

Today in Washington state, to secure a personal exemption, a parent must visit a licensed healthcare provider once to get a signature on a form indicating they’ve received information about the value of vaccines.

“I think families who decide not to get their kids vaccinated should have to visit their physician every time a vaccination is scheduled, and get that paperwork signed every time,” Diekema said. “If I have to go to the doctor, take time off, maybe pay a co-pay to get my child vaccinated – which of course also benefits the population that chooses not to vaccinate – then those parents who oppose vaccination should face the same hassles to get a signature.”

“To me, not only is that fair, it is a little more feasible.”

Diekema, an ethicist who specializes in pediatric issues, addressed an audience of caregivers March 11 at Harborview Medical Center. One topic he discussed is the growing number of primary-care providers choosing not to accept unvaccinated children or families in their practice.

“Physicians are experiencing a significant number of parents who come into the office and say, ‘Do you see families who won’t vaccinate their kids? If you do, I’m going to find another pediatrician because I don’t want my child in that waiting room.’ This is part of what’s driving physicians’ decisions not to see these families.”

But Diekema opposes that strategy.

“I personally encourage physicians not to take that route. Some of these families will, over time, change their minds, but the only way that can happen is if the relationship is maintained. Turning away families doesn’t accomplish the goal, which is to protect children against vaccine-preventable diseases.

“It makes doctors feel better, but that’s not really the role of medicine.”

Diekema said about 30% of the population worries about vaccines, although many will get their kids vaccinated anyway. Of the 30%, he said, only about 1% is ideologically irreversibly opposed.

“The other 29% are worried about an array of things: potentially dangerous ingredients in vaccines, this link they’ve heard about with autism; it may just seem like too many shots at one time for a baby,” Diekema said. “A big part of our job, as doctors, is to provide these families information that is accurate. We need to be the debunkers and the educators – and to do that effectively, you really have to understand the concern.”

Diekema acknowledged his disappointment in state legislators’ lack of will.

“This was a pretty big thing. It looked like it had a lot of momentum a couple weeks ago, and now it looks like that might fade.

“The outbreak of measles at Disneyland was a big part of the little tidal wave of public outcry we’ve been experiencing over vaccinations. I think it was the Disneyland aspect that made this real for people; you know – you don’t get sick at the Magic Kingdom.

“But six months from now, people are going to forget about Disneyland and go back to where they were. They won’t worry again until the next epidemic, and that’s only if the next epidemic gets as much attention.

“Frankly, I’m more worried about the pertussis epidemic going on right now. It’s affecting a lot more kids and, given the numbers, much more likely to result in the death of a baby than measles is. Yet that doesn’t get the media’s attention.”