Unintended Consequences? California Bill Would Eliminate Religious Belief Exemption to Vaccines

Today, California lawmakers introduced legislation (SB 277) that would eliminate the "personal belief" exemption for parents who choose not to vaccinate their children.

In the wake of a recent measles outbreak in Southern California, California lawmakers proposed legislation on February 4, 2015 that would require that all children be fully vaccinated before enrolling in school.

Under existing law, Health and Safety Code section 120335, California school children are required o be vaccinated unless they complete a "letter or affidavit stating beliefs opposed to immunization" as outlined in section 1203655 or there is a statement from a physician that the child has a condition rendering vaccinations unsafe (section 120370).  Similar "religious belief" exemptions are available in 46 states. However, parents who want to use a personal belief exemption must first talk with a "licensed health care practitioner" about consequences of not vaccinating to their children and community.

Over the past few years, many parents have opted out of vaccination because they question the safety of vaccines, they are philosophically opposed to vaccines, or on the basis of sincerely-held religious belief.

Senate Bill 277, introduced on February 19, 2015 by California Senators Richard Pan (Sacramento) and Ben Allen (Santa Monica) repeals the ability of parents to obtain a "personal belief" exemption from vaccinating their children.   It will require that children must be immunized for various diseases, including measles and Pertussis in order to be enrolled in school.

Senate Bill 277 will eliminate the "personal belief" exemption altogether.

Senator Pan, who is also a pediatrician, states on his website that "It is easy to forget what it was like before we had broad-based vaccinations and there was a lot of suffering and even death from serious infectious diseases," said Senator Ben Allen. "We cannot risk returning to those days.  Parents should not have to live in fear of their child contracting a potentially fatal disease at school or in the grocery store because of another parent's choice not to vaccinate their child."

Citing statistics that indicate that immunization rates have dropped below 90 percent in some areas, Senator Pan indicated that the protection of "herd immunity" may be at risk, thus causing more people to become infected.

There are very few religious groups that prohibit vaccinations entirely, and perhaps Christian Scientists are the only group that have a doctrine opposed to medicine. But there are others who have various levels of opposition to vaccines on religious grounds, and it is difficult to gauge the sincerity to which some have requested the religious exception. But then, when it comes to religion, the government has traditionally been loathe to engage in the process of vetting the strength of religious beliefs of citizens in deference to the relationship between adherents and their choice of deities.

If a person of a particular faith raises the spectre of religious objection to anything from joining labor unions to uniform requirements that violate particular garb rules, to holy day observance requirements, the government has traditionally tried to find ways of accommodating those beliefs and working out reasonable solutions so long as it does not pose an undue hardship or significant expense on the accommodator. The government does not investigate whether the faith is legitimate or the level of the believer's orthodoxy.

If SB 277 passes, California will have passed a law that will expressly forbid religious accommodation despite the fact that under existing law, herd immunity has until recently prevented diseases from spreading even among those who are not immunized.

Religious freedom often hinges on what happens on the fringes of society. In 1990, the U.S. Supreme Court dramatically restricted the free exercise clause because a state did not want to make exception for some people who smoked peyote as part of their religion (Employment Division v. Smith). Those who were concerned about the Smith decision did not have to use peyote to realize that it was necessary to pass corrective legislation in the form of the Religious Freedom Restoration Act.

Science shows that vaccinations work and are beneficial, and for the vast majority of people SB 277 is a good idea. But I also believe that California legislators need to carefully consider the ramifications to the free exercise of religion if they require vaccinations for those who object on sincerely held religious grounds. If SB 277 is upheld, the "health and safety" argument can be stretched to cover almost any incursion on basic freedoms, and present some very unpleasant unintended consequences in the future.

While those who do not vaccinate their children are not in the mainstream, and an even smaller number choose not to do so for religious reasons, a real question remains as to how far the government can go in forcing parents to vaccinate their children in violation of their religious beliefs.

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