A House bill proposing an end to religious exemptions for school immunization requirements is making headway in the state Legislature.
House Bill 1118, which is part of the governor’s package, passed its third reading in the House Committee on Judiciary and Hawaiian Affairs on Friday, and is poised to cross over to the Senate in March.
The measure passed the committee on a 5-3 vote, including two votes with reservations.
Democratic Rep. David Tarnas, the committee’s chair, voted for the measure, saying he was concerned with the growing rate of nonmedical exemptions in Hawaii.
“While immunizations reduce risk of severe illness for everyone,” he said, “this trend is especially concerning for students with medical conditions who are unable to be immunized and must rely on their vaccinated peers to prevent the introduction for vaccine-preventable diseases in their schools.”
Republican Reps. Diamond Garcia and Garner Shimizu and Democratic Rep. Amy Perruso cast the three opposing votes.
Garcia said he thought the bill was “clearly unconstitutional” and that an overwhelming majority of the testimony received was in opposition to it.
Hawaii state law requires students to be immunized with a number of vaccines before attending public or private school, unless they have exemptions.
Required vaccines include those for diphtheria-tetanus-pertussis (DTaP), hepatitis A, hepatitis B, measles-mumps-rubella, polio, meningitis and chickenpox for those in kindergarten through 12th grade.
Starting July 1, 2020, the state added human papillomavirus, or HPV, vaccines to requirements for seventh graders. The vaccination requirements do not include the COVID-19 or influenza vaccines.
HB 1118 would still allow for medical exemptions but repeal any new religious exemptions for vaccines, which are allowed when a parent or guardian writes that it conflicts with their “bona fide religious tenets and practices.”
Any child already attending school with an already approved religious exemption, however, can remain exempt.
Heated debate
The vote came after hours of testimony, and debate over the safety and efficacy of vaccinations, religious freedoms, parental rights, bodily autonomy and constitutional rights.
The Aloha Freedom Coalition, a grassroots organization started by former Republican candidate for governor Gary Cordery, held a rally Thursday at the state Capitol in opposition to the bill.
The state Department of Health, which supports the bill, says its purpose is to provide a safe and healthy learning environment for all children in the state.
Advocates for the bill are concerned that the number of students seeking religious or nonmedical exemptions continues to grow in Hawaii.
In the 2023-24 school year, DOH said, the rate of nonmedical exemption more than doubled to 5.3%, compared with 2.5% in the 2015-16 school year.
Fifty-five out of 382 schools reported nonmedical exemption rates exceeding 10% of their student population.
This trend, which began during the COVID-19 pandemic, is also occurring nationally, according to KFF, a health policy research group — and public opinion on vaccine requirements is becoming increasingly bipartisan.
In its latest poll, KFF found 1 in 4 Republican parents skipped or delayed some vaccines for their children.
The bill also was supported by the Hawaii chapter of the American Academy of Pediatrics, Hawaii Pacific Health, State Council on Developmental Disabilities and American Atheists, among others.
Opposition to the bill came from mothers who testified in person that vaccines triggered autism in their child, as well as those who suffered from vaccine injuries.
Among those opposing the bill in written testimony were Kauai County Council member Felicia Cowden, along with groups such as the Hawaiian Islands Republican Women, Hawaii for Informed Consent and the Hawaii Christian Coalition.
Some testified that repealing religious exemptions was government over- reach and a violation of constitutional, parental and cultural freedoms. Some also said it would trigger legal challenges against President Trump’s executive orders.
Risk of measles
The bill contends that immunization requirements have been effective in improving coverage rates — and that vaccines prevent deaths, hospitalizations and illnesses.
DOH noted that all 50 U.S. states, including Hawaii, have school-entry vaccination requirements.
“If implemented now,” DOH said, “this measure can help us re-establish herd immunity to protect our community against life-threatening communicable diseases, hopefully before we experience a large-scale outbreak.”
Those diseases include measles, which is highly contagious and currently rising in the U.S., according to Health Director Dr. Kenneth Fink, after it was officially declared eradicated in 2000.
The recent outbreak of measles in rural Texas — among mostly unvaccinated children — has now infected more than 120 and spread to New Mexico.
Texas has a statewide measles, mumps and rubella vaccination rate of 94.3%, he said, and a nonmedical exemption rate of 3.6%. By comparison, Hawaii has an MMR vaccination rate of only 89.8% and a nonmedical exemption rate of 5.3%.
“While we’ve not yet had a measles outbreak in Hawaii, we are at risk,” he said. “And digging into the data from Texas, I’m even more concerned about our risk.”
Fink said he understood that the measure is controversial, with compelling arguments for and against it.
“While we may disagree on how, I would like to believe that we all share the goal of keeping our keiki healthy and safe,” he said during the hearing. “Too often, it seems a crisis happens and then we react. We might ask ourselves, What could we have done to prevent it? Now is the time to prevent a measles outbreak with the opportunity to be proactive and protect our keiki and community from vaccine-preventable diseases.”
