AP NEWS

Connection between measles outbreak, federal ‘conscience rule’ disputed by health officials

May 6, 2019

A new Department of Health and Human Services rule to widen religious and moral exemptions to certain health care services is being cited in news reports as allowing measles outbreaks to increase amid low vaccination rates, with 60 new infections recorded in the past week.

But a Trump administration official says HHS’ so-called “conscience rule” does not create a new federal exemption and states can regulate vaccinations as they have previously.

“The final rule only provides enforcement mechanisms for Federal conscience and anti-discrimination laws that Congress has enacted,” the official said on background in an email. “It does not create new substantive conscience protections.”

U.S. health officials said Monday that 764 measles infections in 23 states have been reported this year the most since 1994, when 963 cases were reported.

Health and Human Services Secretary Alex M. Azar II on May 2 issued 440 pages of provisions that were bundled together as the conscience rule. It was intended to allow exemptions by medical professionals and parents of minors from federal health care services they find objectionable for moral or religious reasons.

In new reports, a variety of media outlets including CBS News and The New York Times quoted groups suggesting the new HHS rule could erode efforts to expand childhood vaccinations.

When the proposed rule was introduced more than a year ago, a blog post from the Guttmacher Institute listed vaccination with other services, including contraception and end-of-life care, as being affected by the new rule.

Federal and medical officials say the reaction is overblown and does not reflect a careful review of the new rule.

″[There’s a] lot of misconception out there on purpose about health care right of conscience,” said Dr. David Stevens, CEO of the Christian Medical Dental Associations.

He said while a small subset of people may object to vaccinations developed by fetal tissue harvested from abortions, as a medical professional and a Christian he would argue for herd immunization.

“It’s a faith-based obligation to take personal risk for the good of others,” Dr. Stevens said. “It’s not just about you.”

The 440-page HHS document refers several times to vaccinations and notes public comments on the proposed rule to expand exemptions, but the department said it did not incorporate those comments into the new rule.

“The Department received comments suggesting that the scope be expanded beyond pediatric vaccines to encompass all vaccines,” the document states on page 186, adding that HHS was “unable to expand the scope of this [rule] beyond such [state] programs.”

In addition, the document states that the federal government defers to the states on immunization rules.

″[T]his rule does not create a new substantive conscience protections concerning vaccination,” it states on page 212.

The American Medical Association has yet to take a position on the conscience rule, but AMA President-elect Dr. Patrice A. Harris told The Washington Times in a statement that protecting community health in today’s society requires “not permitting individuals from opting out of immunization solely as a matter of personal preference or convenience.”

All 50 states require school-age children to be vaccinated against various illnesses, including measles, tetanus and polio, though most states also allow for religious or philosophical exemptions. In 2015, California passed legislation ending those exemptions.

On Monday, Connecticut Attorney General William Tong essentially gave state lawmakers the legal go-ahead to pursue a measure that would keep parents from exempting their children from vaccinations for religious reasons, The Associated Press reported.

His formal opinion says Connecticut may “create, eliminate or suspend” the exemption. He says it is within the state’s “well-settled power to protect public safety and health.”

Also Monday, some New York health officials urged lawmakers to pass similar legislation to end that state’s religious exemption, given the uptick in measles cases, the AP reported.