An Iowa House subcommittee moved forward with House File 2139, but it wasn’t unanimous and one of the supporting Representatives said the bill still needed work.
The bill provides that any information or communication provided by a school official, employee or nurse regarding immunization requirements shall include information regarding the exemption from immunization requirements that allow an applicant to state that the immunization conflicts with the tenets and practices of a recognized religious denomination of which the applicant is an adherent or member.
Representative Jeff Shipley authored the bill and served as the subcommittee chair.
“Obviously vaccinology is a very big topic in the world right now,” he said. “When I became a legislator, I noticed there was just a lot of incomplete information and people were operating on a basic level, but what do the laws say?”
Shipley said while Iowa has religious exemptions for vaccinations, he isn’t so sure that people know those exemptions exist.
“Iowa has had our cherished religious exemptions since the 1970s,” he said.
He said the issue isn’t likely being communicated properly to all the interested parties. And, he said, his other motivation for sponsoring the bill was an editorial written by the Des Moines Register.
“I thought (the editorial) was very irresponsible and inflammatory in kind of demonizing certain religious beliefs and it really struck me as odd given how far we’ve come as human beings in all these years on the planet that we still are not respecting the religious rights and beliefs of people,” Shipley said.
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Chaney Yeast of Blank Children’s Hospital spoke against the bill for a couple of reasons. First, from a health care perspective, Yeast said she worried about an unintended consequence of increased misuse of the religious exemption.
She added that Blank Children’s Hospital employs all the West Des Moines school nurses. As school nurses are screening which children in the building to see if they’re up to date on their immunizations, they’ll call or send a letter notifying parents of a child who is not up to date.
Yeast said busy parents who are overwhelmed will be told they have two weeks to get the immunizations and realize they’re scheduled to work the next two weeks.
“I think potentially we run the risk of then religious exemptions being used as more of a philosophical exemption, which is already a concern we have at Blank Children’s Hospital,” Yeast said. “In general, from a school perspective, I’m wondering why we’re placing the responsibility on the schools. It really seems like the appropriate place to have that discussion is with families and medical providers. So we just worry also additionally about the burden on schools this bill would create.”
Linda Tucker Reinders of the Iowa Public Health Association said she too believes it places an undue burden on schools.
“Schools are meant to be a safe and healthy place for learning,” Reinders said. “Vaccinations are a component of what creates a healthy environment for our children and staff who work at schools.”
Reinders said vaccinating children and staff helps protect against an outbreak and creates a sense of herd immunity.
“Asking schools to provide parents information and methodology for options out of vaccination mandates runs contrary to the concept that schools are supposed to be a safe, healthy zone for learning for children.”
Reinders went on to say only medical exemptions should be warranted.
“Any exemptions should be medically warranted and discussed between health care providers and that family,” she said. “If this bill proceeds and schools are required to provide this information, then additional information should be required to be given to parents on what are the consequences to their own children, medically vulnerable children and adults in the school when children who are not vaccinated for non-medical reasons are present.”
Amy McCoy with the Iowa Department of Public Health said the organization provides some materials that are included in kindergarten packets that include information about the religious exemption.
“So this is information that families are receiving at this time,” she said.
Brei Johnson spoke in support of the bill. She represents Informed Choice Iowa. She said the message throughout Iowa is typically no shot means no school, noting banners share that message.
“So that’s kind of the understanding that a lot of parents receive both when they take their children to get well-child visits as well as in the school itself,” Johnson said. “As it states right now, Iowa does allow for medical and religious exemptions. So I think this would just kind of support Iowa law as it currently stands.”
If there is concern that the religious exemption is misused, then Johnson suggested expanding exemptions so people can make decisions that more closely align with the exemption they fall under and not instead take away current exemption options.
Melissa Peterson with the Iowa State Education Association said the group opposes the legislation not only because of health concerns but she said there’s been a significant uptick in the number of religious exemptions despite no correlation in terms of an increase in religious practitioners.
“Additionally, an undue burden is placed upon our already overburdened school nurses,” Peterson said. “I think it’s frankly just not helpful. They should be spending more time one on one with students as opposed to processing additional paperwork. If for some reason you don’t like any of those arguments, if you place this requirement on a school district, make sure you’re also educating people about the medical option as well. I don’t think we should prefer one option over another.”
Connie Ryan of the Interfaith Alliance of Iowa opposed the bill. She shared facts about measles from the CDC. She stated in 2016, there were 86 cases. In 2017, there were 121 cases. In 2018, there were 375 cases. In 2019, that number jumped to 1,282 cases. And, she said, the CDC says the majority of people who get measles do so because they’re unvaccinated.
Ryan noted that the trend in the country is to remove religious exemptions or personal beliefs from the law.
“So, this legislation really flies in the face of the trend and that’s really because of the increases that we are seeing in different diseases,” Ryan said. “We have to make sure that our children are safe, that our children are healthy and immunizations actually help do that.”
Ryan said the legislation is asking the Iowa Department of Public Health to provide a rule that goes contrary to what public health is really about. And they’re asking for schools to implement the rules, she said.
“That is just simply wrong,” Ryan said. “Why would we run the risk of increasing disease by not requiring immunizations which have served to help eradicate disease over the years. It’s not in the best interest of our children, of our communities or in the best interest of the public. There is no scientific basis for this legislation.”
Shipley asked Ryan if she was aware of how many cases of the measles resulted in fatalities. Ryan said she could check. He followed up by asking how many fatalities have resulted from the vaccine, and she said she would have to check.
Shipley also asked if the Interfaith Alliance is aware of strong religious exemptions from the Jewish or Muslim community.
“Sure, there are religious beliefs that do not allow for those particular pieces,” Ryan said. “And we’re not arguing that religious exemptions should be removed. I’m not making that argument. I said that was legislation in other states. I’m not making that argument here.”
Margaret Buckton of Rural School Advocates of Iowa and Urban Education Network of Iowa said she grew up as a Christian Scientist. The church told families how to proceed with the law.
Lindsay Maher talked about the fact that even though religious exemptions have increased, so has vaccination rates. She speculated many parents opt out of one or more of the 69 doses on the CDC schedule because a lot of parents are opting out because they feel they’re unnecessary or go against their beliefs.
Maher said she believes many religions are behind on the facts of immunizations.
“Most people in those faiths do not have doctors and scientists there giving them advice on what they should be doing or preaching from the pulpit,” she said. “They leave those decisions up to the parents.”
Maher pointed to a 2018 report about genotypes. She said if someone actually has measles genotype a strain, it’s almost always caused by the vaccine.
“I would wager we really need to have a further discussion on this before we just strip people of their religious rights,” she said. “We should inform Iowans these exemptions exist. My school did not give those out. Leaving it up to the schools to decide and then not giving people full discretion of information.”
Bethany Steichen told a story about her 7-year-old son. He is vaccine injured and she used the religious exemption because most of the ingredients in vaccines go against her beliefs, she said. It took her seven years to get a medical exemption because the original doctor refused to report the injury.
“It’s important we keep religious exemptions because they’re protecting kids who are otherwise having issues. My son couldn’t go to public school if I didn’t have a religious exemption. I support this whole heartily.”
An amendment was suggested to alter a couple of words. Shipley said when he drafted the bill, he did so with the idea of no shot, no school in mind, which he called a draconian approach.
Representative Monica Kurth said she visited several websites and found easy access to the certificate requesting the religious exemption and realized it required no particular effort on the effort of the person requesting the information.
She said the wording in the current code is “perfectly adequate.”
Shipley pointed out outbreaks of pertussis in his area among children who had received the vaccine. He asked if anyone could comment on the medical thinking behind vaccinated people developing the illness.
Susan Cameron Daemen of the Iowa Association of Nurse Practitioners and Iowa Nurse Practitioners Society said her daughter had whooping cough as well.
“I now understand that that vaccination wears off after seven or eight years,” Daemen said.
The doctor did not tell Daemen that when her daughter was vaccinated as a baby.
Representative Skyler Wheeler said he is fine moving the bill forward, but there is work to be done.
“I think it’s fine that people know there’s a religious exemption in there,” he said. “The bigger question is adding a philosophical or conscientious objector, which is not what we’re talking about in this bill. I didn’t know this was such a hot topic.”
Kurth said she wanted to clarify that there is no effort to take religious exemptions away.
Shipley, though, said it did sound that way based on some of the comments made in the room. And, he added, the state’s largest newspaper ridiculed religious people who object to vaccinations.