Is there a role for the federal government in vaccinations, or should it be left to the states as is the status quo?
Context
The recent trend of decreasing vaccination rates have caused, for example, a 2019 measles rate unsurpassed in decades — a deadly disease easily prevented by vaccines. This despite the CDC declaring the disease eliminated from the U.S. in 2000, on the presumption that people would still vaccinate their children.
Currently, all 50 states require vaccinations for children to attend school. However, 44 states allow religious exemptions, while 15 states allow exemptions for either religion or personal beliefs.
Five states — a mix of red and blue states — currently allow no exemptions except for medical reasons: California, Maine, Mississippi, New York, and West Virginia.
Medical experts agree that vaccines are safe, despite a small but vocal minority of the public who claim that vaccines are unsafe with no evidence.
What the bill does
The Vaccinate All Children Act would introduce a federal requirement on states: no state could offer vaccine exemptions for anything but medical reasons. In other words, no more religious nor personal exemptions, in any state.
It was introduced in the House on May 3 as bill number H.R. 2527, by Rep. Frederica Wilson (D-FL24).
What supporters say
Supporters argue that with surging rates of diseases easily prevented by vaccines, a public health crisis is being caused by the lack of strong public policy requirements.
“The health and safety of children must be our top priority,” Rep. Wilson said in a press release. “Vaccines play an important role in keeping all children safe, especially those with compromised immune systems who rely on herd immunity to safeguard against potentially deadly viruses.”
“The ongoing measles outbreak, which has spread to 23 states, is a national health crisis that requires a national solution,” Rep. Wilson continued. “We must allow science and fact-based research to guide us in making the right decision for our communities and our children.”
What opponents say
Opponents counter that such federal mandates are an infringement on personal liberty, and that the removal of a religious exemption may violate the First Amendment’s freedom of religion.
“Sometimes these vaccine mandates have run amok, as when the government a rotovirus vaccine that was later recalled because it was causing intestinal blockage in children,” Sen. Rand Paul (R-KY) said during a Senate hearing in March.
“I’m not a fan of government coercion, yet given the choice, I do believe the benefit of most vaccines vastly outweigh the risks. Yet it is wrong to say there are _no _risks to vaccines. Since 1988, over $4 billion has been paid out from the Vaccine Injury Compensation Program.”
It’s unclear where President Trump himself currently stands on the issue.
In a 2015 Republican presidential debate, Trump endorsed the (debunked) theory that vaccines cause autism. By April 2019, in the wake of increasing measles rates, Trump said: “The vaccinations are so important. This is really going around now. They have to get their shots.” But it’s still unclear whether he thinks parents should do so voluntarily, or whether there should be a federal requirement.
Odds of passage
The bill has attracted 17 House cosponsors, all Democrats. It awaits a potential vote in the House Energy and Commerce.
Even though many Republicans oppose removing states’ religious exemption from vaccinations, two of the states which have done so are among the most Republican in the country: Mississippi and West Virginia.
It’s also possible that even if this legislation doesn’t pass Congress, a federal agency could still enact essentially the same change on a national level.
Scott Gottlieb, President Trump’s Food and Drug Administration (FDA) commissioner, suggested to CNN in February that his agency might step in to introduce a federal requirement if more states don’t toughen up their state laws.
“Some states are engaging in such wide exemptions that they’re creating the opportunity for outbreaks on a scale that is going to have national implications,” Gottlieb told CNN. “If certain states continue down the path that they’re on, I think they’re going to force the hand of the federal health agencies.”
