Logan Reed
The topic of vaccine exemptions is a highly debated issue in the United States, with some states allowing exemptions for medical, religious, and personal reasons. Oregon and Washington are among the 17 states that allow non-medical exemptions for vaccines based on personal, moral, or other beliefs. While both states have witnessed measles outbreaks, Oregon has a higher rate of non-medical exemptions for kindergarteners, with a rate of 7.5% in 2018, compared to 4% of secondary school students in Washington. However, Washington has seen higher overall vaccination rates, with King County leading the state with over 81% of eligible residents ages 12 and older vaccinated. The debate over vaccine exemptions in these states has led to legislative efforts to address the issue, with Washington Governor Jay Inslee announcing a no-exception vaccine mandate for state workers in 2021.
| Characteristics | Values |
|---|---|
| States with higher vaccine exemptions | Oregon and Washington are among the states with the highest vaccine exemption rates. |
| Oregon's vaccine exemption rate | 7.5% of kindergarteners in 2018 were missing shots for non-medical reasons. |
| Counties with high exemption rates | Wallowa, Crook, Deschutes, Jefferson, Columbia, Clackamas, Clatsop, Multnomah, and Tillamook. |
| Washington's vaccine exemption rate | 4% of secondary school students have non-medical vaccine exemptions. |
| Counties with high exemption rates | King County (12% higher than the statewide average), rural counties east of the Cascades (50% or lower). |
| Reasons for exemptions | Religious, philosophical, and personal beliefs. |
| Legislative response | Oregon Sen. Elizabeth Steiner Hayward dropped an attempt to revoke the state's non-medical exemption in 2015. Washington Gov. Jay Inslee announced a no-exception vaccine mandate for state workers in 2021. |
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What You'll Learn
- Oregon and Washington have some of the highest vaccine exemption rates in the US
- Measles outbreaks in both states have revived debates over vaccine laws
- Oregon's non-medical vaccine exemption rate was 6.4% in 2013
- Washington's non-medical vaccine exemption rate was 4% for secondary school students
- Both states allow non-medical exemptions for personal, moral or other beliefs
Oregon and Washington have some of the highest vaccine exemption rates in the US
In Oregon, 7.5% of kindergarteners in 2018 were missing vaccinations for non-medical reasons. The state's high exemption rate is driven in part by low vaccination levels in scattered communities and at some private and alternative schools. Oregon's Wallowa County has the highest non-medical vaccination exemption rate in the state at 15.2%. Deschutes County is at 8.1%, while Jefferson is at 1.9%.
Washington has a similar law to Oregon, allowing non-medical exemptions for "personal, moral, or other beliefs". Four per cent of Washington secondary school students have non-medical vaccine exemptions. While King County leads Washington in vaccinations, with more than 81% of eligible residents 12 and older on their way to full vaccination, rural counties east of the Cascades continue to see vaccination rates of 50% or lower.
The high vaccine exemption rates in both states have sparked debate over "philosophical" exemptions to childhood vaccinations. Numerous studies have shown that vaccines do not cause autism, a common reason cited by those who don't want their children immunized. While some states, like California and Vermont, have stripped away personal belief vaccine exemptions, Oregon and Washington continue to allow them.
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Measles outbreaks in both states have revived debates over vaccine laws
Measles outbreaks in Oregon and Washington have revived debates over vaccine laws, with lawmakers in both states revisiting non-medical exemptions that allow children to attend school unvaccinated.
In Oregon, the rate of kindergartners with non-medical exemptions for required vaccinations rose from 5% in 2012 to 7% in 2013, with Deschutes County at 8.1% and Wallowa County at 15.2%. The Oregon Health Authority has conducted surveys to understand parents' reasons for exempting their children from immunizations, finding that parents often make decisions based on friends and neighbours rather than scientific information. Senate Bill 132 seeks to limit non-medical vaccine exemptions for school-age and daycare-age children. Oregon has the nation's highest statewide vaccine exemption rates, with 7.5% of kindergartners in 2018 missing shots for non-medical reasons.
In Washington, the measles outbreak centred in Vancouver, has resulted in a state of emergency being declared by Governor Jay Inslee. The outbreak has primarily affected children under 10 who were not immunized, with 37 confirmed unvaccinated cases and one case in a person who had received one dose of the vaccine. Washington has a lower exemption rate than Oregon but is still considered high compared to other states, with 4% of secondary school students having non-medical vaccine exemptions. A measure introduced by Representative Paul Harris aims to remove the personal exemption for the measles, mumps, and rubella (MMR) vaccine.
The debates over vaccine laws in both states reflect a broader national conversation. All 50 states have legislation requiring specified vaccines for students, but exemptions vary and can be granted for medical, religious, and personal reasons. However, exemptions from vaccines have been linked to lower immunity rates and higher disease incidence. California is notable for removing personal belief vaccine exemptions for children in both public and private schools following a measles outbreak at Disneyland in 2015. In contrast, groups like the National Vaccine Information Center and Informed Choice Washington oppose mandatory vaccination laws, arguing that individuals should be allowed to make informed decisions.
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Oregon's non-medical vaccine exemption rate was 6.4% in 2013
In 2013, Oregon's non-medical vaccine exemption rate for kindergarteners was 6.4%, an increase from the previous year. This rate varies across counties in Oregon, with Crook County at 7%, Deschutes County at 8.1%, Jefferson at 1.9%, and Wallowa County at the highest exemption rate of 15.2%. The Oregon Health Authority has conducted surveys to understand parents' reasons for exempting their children from immunizations, and the results indicate that parents' decisions are influenced by their social circles and not always based on reliable scientific information.
The rise in non-medical vaccine exemptions in Oregon is concerning, especially considering the concurrent increase in pertussis (whooping cough) cases in the state. Pediatrician Jay Rosenbloom, who leads the Oregonians For Healthy Children, emphasizes the need to curtail non-medical vaccine exemptions for school-age and daycare-age children through Senate Bill 132. This legislation aims to protect vulnerable individuals by maintaining sufficient community immunity.
In contrast, the state of Mississippi has adopted a different approach by allowing only medical exemptions, resulting in almost all young school-aged children being vaccinated. While most states allow medical exemptions, there is variation in exemptions for religious or personal reasons. For example, Arizona permits religious and philosophical grounds for exemption, contributing to a high number of unvaccinated kindergarteners.
The issue of non-medical vaccine exemptions is not isolated to Oregon, and other states are grappling with similar challenges. The increasing exemption rates have public health implications, with researchers warning about the potential for deadly measles outbreaks in several counties, including Portland, Oregon, and Seattle, Washington.
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Washington's non-medical vaccine exemption rate was 4% for secondary school students
Public health officials in Washington have also implemented additional strategies to increase vaccination rates. These initiatives include media campaigns, offering free vaccines for children, and mandating vaccines for preschool and childcare programs. The state's efforts align with the goal of enhancing vaccination coverage to protect children's health and reduce the spread of vaccine-preventable diseases.
In comparison, Oregon has experienced varying rates of non-medical vaccine exemptions across different counties. For example, Crook County had a 5% exemption rate in 2012, increasing to 7% in 2013. Deschutes County exhibited an higher rate of 8.1%, while Jefferson County had a lower rate of 1.9%. Wallowa County presented the highest exemption rate in Oregon, reaching 15.2%.
The varying exemption rates within Oregon have raised concerns among health professionals, particularly regarding the increase in pertussis (whooping cough) cases. The state has witnessed higher incident rates of pertussis, contributing to the overall concern regarding the rise in non-medical exemptions for vaccinations. Efforts such as Senate Bill 132 aim to address this issue by curtailing non-medical vaccine exemptions for school-age and daycare-age children in Oregon.
It is worth noting that nationwide, the rate of kindergartners receiving exemptions from vaccine requirements has increased from 1.4% in 2012 to 2.7% in 2022. This trend underscores the importance of states' efforts to enhance vaccination rates and prevent the spread of vaccine-preventable diseases. Washington's success in reducing exemption rates and increasing vaccination coverage serves as a positive example in this regard.
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Both states allow non-medical exemptions for personal, moral or other beliefs
Both Oregon and Washington have witnessed rising vaccine exemption rates, with Oregon reporting a higher rate of non-medical exemptions for kindergarteners at 7.5% in 2018, compared to 4% of secondary school students in Washington. These exemptions are permitted for "personal, moral, or other beliefs," as stated by the National Conference of State Legislatures.
In Oregon, the rate of non-medical exemptions for kindergarteners increased to 6.4% in 2013, with 17 counties surpassing the 6% threshold, compromising "herd" or community immunity. Wallowa County had the highest exemption rate at 15.2%. A similar trend was observed in Washington, with a measles outbreak near Portland, Oregon, affecting at least 44 people in both states.
The high exemption rates in these states are concerning, as they increase the risk of vaccine-preventable diseases such as pertussis (whooping cough) and measles. In response, lawmakers in Washington have re-evaluated non-medical exemptions, and Oregon introduced a requirement for parents to watch an educational video or consult a doctor before claiming an exemption.
While these actions aim to address the issue, some groups, like the National Vaccine Information Center and Informed Choice Washington, oppose mandatory vaccination laws. Efforts to strengthen vaccination requirements, such as in California and Vermont, have faced challenges, including death threats and harassment directed at legislators. Nonetheless, California's legislation led to a notable increase in the overall vaccination rate for kindergarteners, reaching 95% two years after its implementation.
The debate surrounding vaccine exemptions in Oregon and Washington highlights the complex nature of balancing individual beliefs with public health considerations. While allowing exemptions for personal or moral reasons respects parental autonomy, it also poses risks to community immunity and increases the vulnerability to infectious diseases. As a result, states are navigating the challenging task of protecting both individual rights and public health.
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Frequently asked questions
Both states have some of the highest vaccine exemption rates in the country, but Oregon has a slightly higher rate.
In Oregon, 7.5% of kindergarteners in 2018 were missing shots for non-medical reasons. In Washington, 4% of secondary school students have non-medical vaccine exemptions.
Low vaccination levels in scattered communities and at some private and alternative schools are contributing factors. In addition, both states allow non-medical exemptions for personal, moral, or other beliefs.
Yes, there have been attempts to revoke non-medical exemptions in both Oregon and Washington, but they have faced strong opposition. Washington Governor Jay Inslee has also announced a no-exception vaccine mandate for state workers.
High vaccine exemption rates can lead to lower immunity and an increased risk of disease outbreaks, such as the measles outbreak that occurred near Portland, Oregon, in 2019.
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