A bill to restrict “non-medical,” i.e., religious, exemptions from Hawaii’s vaccine mandates has properly been put on ice in the state House, due to constitutional concerns. But the serious problem House Bill 1118 sought to address — the threat to Hawaii’s infants, children and adults posed by growing numbers of keiki who are not receiving all of their immunizations — continues.
The responsibility for turning the tide on rising yet preventable risks linked to misinformed or misguided avoidance of vaccines now lies with Hawaii’s departments of Health (DOH) and Education (DOE), as well as parents, medical professionals and cultural leaders — all Hawaii “influencers,” for that matter, who claim to have the good health and best interests of our kids and families in mind.
On Tuesday, members of the state House voted unanimously to table House Bill 1118, which would have ended DOE recognition of non-medical exemptions for vaccinations. Despite the growing risks to public health making the bill well-intended and alluring, legislators voted correctly.
As it stands, Hawaii law allows the state to suspend non-medical exemptions under emergency conditions, when, “in the opinion of the director of health, there is danger of an epidemic from any communicable disease.” While uncomfortably vague, it properly requires the state to find that clear and present danger exists before halting exemptions, and this balance must be required.
Unfortunately, that leaves Hawaii in a stalemate, with limited legal options to get immunization rates up, which it must. DOH reports that risks are rising for exposure to potentially serious and contagious diseases — particularly measles and pertussis (whooping cough), which can be fatal to vulnerable infants, youth and adults. Yet these illnesses are wholly preventable, with vaccinations long proven to be efficacious.
Just Thursday, the New Mexico Department of Health reported that an unvaccinated adult died from measles. The deadly outbreak started in neighboring Texas, where an unvaccinated, school-aged child died last week — the first U.S. death from measles in a decade. And both deaths may have been avoidable: Although measles is terrifyingly contagious and spreads through the air, two doses of the measles vaccine are 97% effective.
Many observers feared a return of fatal measles infections as doubts about vaccines have risen in recent years, fueled by misinformation and fearmongering. Robert F. Kennedy, Jr., recently approved as head of the nation’s Health and Human Services agency, is a prime culprit for this misdirection — and Hawaii’s Gov. Josh Green, a medical doctor, very publicly spoke out in opposition to Kennedy’s appointment. In response to Thursday’s death, however, Kennedy reiterated, “The decision to vaccinate is a personal one.”
Let’s be clear: This “anti-vax” messaging and intentional nurturing of doubt over vaccines’ safety or necessity threatens lives. Low vaccination rates place Hawaii’s people at increased risk of infection, and this certainly applies to schools, where medically vulnerable children who cannot be vaccinated themselves may be exposed.
DOH reports that it’s working to educate families that where vaccines are required, it’s because they offer the best, and safest, defense against life-threatening diseases. These efforts must be matched with measurable results, or revised. The state must also increase access to critical vaccines at pharmacies and doctors’ offices, as it is working to do.
If law can’t universally require parents/guardians to vaccinate the state’s kids, Hawaii must rely on adults’ accurate knowledge and decision-making abilities to keep children and adolescents safe. That’s not a foolproof process, but widespread and intensive informational campaigns and advisements from trusted community members — including pediatricians, school and health officials, religious leaders and caring societal members — can certainly shrink the margins. That would surely save lives and prevent ongoing harm.
