• Maria Duaime Robinson

[Patch] Senator Rausch, Rep. Donato File Community Immunity Act

Senator Becca Rausch (D-Needham) and Representative Paul Donato, Second Assistant Majority Leader (D-Medford) filed public health legislation today to reduce the threat of serious yet preventable diseases by creating standardized and centralized immunizations requirements and exemption processes for child care centers, all K-12 schools, summer camps, and colleges and universities throughout the Commonwealth. Currently, Massachusetts has no consistent process for obtaining or approving immunization exemptions. Multiple communities have fallen below medically established immunization rate thresholds necessary to protect the general population from certain infectious diseases. Further, since Massachusetts also has no mandatory vaccination data reporting, hundreds of schools did not provide immunization exemption figures for the 2018-19 school year, yielding incomplete statewide public health data.

The Community Immunity Act (SD. 2548/HD. 4470) is a comprehensive approach to fixing a serious public health system problem. The bill will authorize DPH to set a single immunization schedule for all covered programs (daycares, K-12 schools, summer camps, and colleges/universities); standardize the vaccination exemption process statewide; require immunization data reporting and publication while protecting privacy; support public health educational outreach, particularly to elevated risk areas; and vest appropriate authority in the Department of Public Health (DPH) to administer these initiatives. The Community Immunity Act will also assure that parents are notified about any decrease in immunization rates that render a community susceptible to an outbreak. The bill was crafted in collaboration with a broad group of public health organizations, constituents, and other legislators, including Representatives Maria Robinson and Denise Provost.

Public health experts from the National Institutes of Health (NIH) and other organizations expect outbreaks of life-threatening yet preventable diseases to continue and increase in severity until localized herd immunity is achieved and maintained. This is particularly important to protecting the health of immunocompromised individuals, the elderly, and young children. Recent outbreaks of measles in Massachusetts and at least 15 other states have been attributed to an absence of localized herd immunity, the critical mass of immunized individuals necessary to protect a population (or herd) from a disease.

"We must act now to prevent future outbreaks of dangerous diseases," said Senator Rausch. "We identified some major systemic issues with our immunization requirements and exemption processes. The Community Immunity Act fixes the system, and in doing so substantially reduces and hopefully fixes existing localized herd immunity problems. Since diseases do not follow school or district lines, it is imperative that we shift responsibility for immunization exemptions from the local to the state level. We cannot meaningfully address this crucial issue without statewide consistency. As a parent and a legislator, I am compelled to take action necessary to protect our children and other vulnerable populations. The way to get good results is through good process."

The Community Immunity Act does not alter the availability of both medical and religious exemptions. Rather, it makes structural changes designed to encourage more widespread adoption of immunization best practices. The Act mandates the creation and use of statewide medical and religious exemption application forms and ensures all applications are processed by DPH, rather than each individual school or district. The Act also standardizes the information required to obtain either exemption. Participants with complete immunization records would continue to submit those records to schools or other covered programs upon enrollment. Private programs would retain the right to have stricter standards than those established by DPH.

Leader Donato said, "As a father and a grandfather, it's important to me that we're able to keep children safe and make informed decisions about their health while also respecting the rights of families seeking exemptions for their children. This legislation preserves both religious and medical exemptions while raising overall immunization rates in communities across the Commonwealth, with the goal of comprehensive localized herd immunity."

Children gathering together daily need the protection of localized herd immunity. In the 2018-19 school year, 118 Massachusetts kindergarten programs reported that the student population fell below the required immunization rate for measles at which public health experts consider a community protected from an outbreak, known as herd immunity. This is nearly 15% of the kindergarten programs that voluntarily reported immunization data to DPH. More than 200 additional elementary school programs did not submit any vaccination information whatsoever.

Any program subject to the Community Immunity Act that falls below the herd immunity rates established by DPH or failing to report immunization rate data will be designated as an "elevated risk program." Elevated risk programs will be required to send a notice to the parents of participants explaining the designation and its significance. Information on immunization safety, immunization efficacy, and the importance of herd immunity will be presented to parents by DPH through written notices and targeted outreach programs.

"All communities have the right to know if they are at risk of contracting a deadly disease," said Representative Maria Robinson (D-Framingham), a cosponsor and contributor to the crafting of the Act. "This past year, over 400 schools did not provide DPH with data on immunization rates in those schools. I believe those parents deserve to know if their children are surrounded by others that lack immunity to deadly diseases. I hope that, empowered by this knowledge, more parents will make the decision to follow medical best practice and make sure their children are immune from preventable, deadly disease."

Reported decreases in immunity rates may be linked to fears associated with now widely discredited studies that mistakenly stated that vaccines may be ineffective or dangerous. According to the Centers for Disease Control and Prevention (CDC), vaccines are researched and tested extensively for an average of 15 years prior to use, with continued research and monitoring after approval, and vaccinations have not been linked to many of the serious side effects claimed. Conversely, the risk of re-emergence of preventable diseases, such as measles and polio, is serious and potentially deadly. The World Health Organization (WHO) estimates that the measles vaccine prevented more than 21 million deaths globally between 2000 and 2017.

Representative Denise Provost (D-Somerville) said, "I remember the time before immunization existed for such diseases as polio and measles -- I had measles as a child, and it was horrible. I'm grateful that science has given us ways to avoid subjecting our children to the risk of painful, and possibly deadly, diseases. This legislation is designed to help combat misinformation about immunization and risk, to give families and health care providers better information about population health, and to provide reasonable latitude for individual decisions."

As a system-focused bill, the Community Immunity Act creates necessary consistency and standardized public health processes that will benefit the entire Commonwealth.

Senator Becca Rausch represents the Norfolk, Bristol and Middlesex District, comprised of Attleboro, Franklin, Millis, Natick, Needham, Norfolk, North Attleborough, Plainville, Sherborn, Wayland, Wellesley, and Wrentham. Currently in her first term, Senator Rausch serves as the Senate Chair of the Joint Committee on Municipalities and Regional Government and the Senate Vice Chair of the Joint Committee on Elder Affairs.

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