Universities should offer limited vaccine exemptions: experts

The University is one of many schools across the country where students can file for a vaccine exemption for religious or medical reasons.

GW is one of many schools across the country that allow students to waive vaccination requirements for medical and religious reasons, but experts say officials should be more strict in their exemptions.

Officials require incoming undergraduate, graduate, non-degree and transfer students to submit proof of vaccinations or immunity to infectious diseases – like measles or mumps – but grant students medical or religious exemptions, University spokeswoman Crystal Nosal said. But vaccination experts said exemptions should be granted primarily to students with weak immune systems or severe allergies to vaccines to bolster college students’ overall immunity to infectious diseases and protect individuals who cannot be vaccinated.

2020 Democratic presidential candidates Pete Buttigieg, Elizabeth Warren, Cory Booker and Tim Ryan have voiced support for efforts to end religious and personal vaccine exemptions. Candidates have said exemptions should be allowed only for those with highly contagious diseases, like measles.

President Donald Trump recently expressed support for vaccinations in light of a recent measles outbreak in the United States but has said vaccines cause autism and promoted spacing out childhood vaccinations – both debunked claims – according to the analysis.

Nosal said the University complies with the D.C. Immunization of School Students Act, which mandates that students admitted in fall 2019 who are born after Aug. 1, 1993 and students admitted in spring 2019 who are born after Jan. 1, 1993 provide proof of immunization against infectious disease.

Students are required to be vaccinated against diseases like tetanus, polio and varicella to attend school unless they receive an exemption, according to the act.

“GW requires immunization records to maintain a healthy campus,” Nosal said in an email. “We monitor outbreaks and follow public health recommendations to minimize the risk of contagiousness.”

Nosal said that if incoming students do not provide proof of immunization, the University will place a registration hold on the student’s school account. Administrative holds can prevent students from registering for classes, adding or dropping classes, obtaining grades and graduating, according to the Office of the Registrar website.

She said students must provide a letter from a medical clinician or religious clergy detailing why an exemption is necessary and submit a copy of results for measles, mumps and rubella and varicella titer, a blood test that determines whether someone is immune to a certain disease.

“Medical reasons are usually temporary: students that are on chemotherapy or on an immunosuppressant,” Nosal said. “Students have to submit antibody titers to document their immune status.”

Nosal said incoming students are required to submit proof they have received one vaccine against tetanus and diphtheria in the last 10 years, two vaccinations against measles, mumps and rubella – given after age 1 – and three vaccinations against hepatitis B.

She said students are required to submit a physician-signed waiver request form if they are not vaccinated against meningitis – a potentially deadly bacterial or viral infection that causes inflammation of membranes covering the brain and spinal cord. She added that all international students are encouraged to complete a tuberculosis screening.

Five of GW’s peer schools state on their respective health center websites that students can request medical and religious exemptions for vaccinations.

The universities of Rochester and Pittsburgh and Northeastern, Boston and Tufts universities allow students to request medical and religious exemptions from vaccinations. The University of Southern California only grants students medical exemptions from vaccinations and does not permit vaccine exemptions on a religious basis.

At Tulane University, students can cite “personal beliefs” when requesting an exemption. Georgetown, Syracuse and Wake Forest universities did not clearly indicate vaccine exemption policies on their websites.

Vaccination experts said universities should grant a limited number of vaccine exemptions to protect students who are susceptible to infectious disease.

Walter Orenstein, a professor of medicine and the director of the Emory Vaccine Center at Emory University, said students with severe immunosuppression – weak immune systems – or severe allergies to vaccines have “legitimate” reasons to request an exemption because those students are medically unable to receive vaccinations.

He added that college vaccine exemption requirements should be restricted to medical reasons to protect individuals who cannot be vaccinated from catching deadly diseases.

“If I’m severely immunosuppressed and I get measles, it’s a killer,” Orenstein said. “My protection is dependent upon my not being exposed.”

Diane Peterson, the associate director for immunization projects at the Immunization Action Coalition, said students can use religious exemptions as a loophole in states where philosophical exemptions to vaccination – like the belief that vaccines cause autism – are prohibited.

A 1998 study conducted by British surgeon Andrew Wakefield suggests that the MMR vaccine – which protects children from measles, mumps and rubella – increased rates of autism in British children.

The paper, which caused widespread public fear about the link between autism and vaccination, has since been debunked by the scientific community because of procedural errors, ethical violations and undisclosed financial conflicts of interest. Wakefield has since lost his medical license, and the paper was retracted from The Lancet – the medical journal that published his research.

“Some states don’t allow the exemption that parents might want to claim on their own personal belief system, but they do allow religious belief exemption,” Peterson said. “So then they’ll just say, ‘OK, I’ll take the religious belief.’”

Erica DeWald, the director of advocacy at Vaccinate Your Family – an organization that promotes childhood vaccinations – said college students must receive vaccines to protect the larger university community.

“It’s really important to vaccinate not only yourself to protect yourself, but also start creating that community immunity so that you can protect the people that you live with in dorms, that you go to class with, that you’re dating and that you play sports with,” she said.

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