Mary Holland’s Testimony at West Virginia Vaccine Exemption Hearing

Thank you for the opportunity to speak with you today. My name is Mary Holland. I am a Research Scholar at New York University School of Law. I have been considering the problem of compulsory vaccination for several years.

Let me start by saying that I personally am pro-vaccine: pro-vaccine safety; pro-vaccine efficacy; pro-vaccine research. And I am also pro-vaccination choice and parental consent. I believe that individuals must have the right to prior, free and informed consent to vaccination as they have for all other medical interventions. This is the hallmark of modern ethical medicine. I do not believe that even infectious disease risks justify deviation from this fundamental standard. And this is the standard that the United States and 192 other countries have agreed to in the United Nations Universal Declaration of Human Rights and Bioethics, that informed consent is paramount.

You are considering an important issue – is it appropriate for West Virginia to compel all children to receive vaccination against certain diseases, providing only medical exemptions? I am not here to discuss whether the state has that right; I concede that the state may provide additional exemptions at its option. I want to ask whether it is sound public policy for this state to compel parents to vaccinate their children against those parents’ deeply held religious, moral or philosophical convictions. As you know, 48 states permit individuals to refuse vaccination on religious grounds; 20 states permit parents to refuse on philosophical grounds. I think the question before you is, what kind of state do you want West Virginia to be?

I have no doubt that every person in this room, regardless of his or her position on this issue, wants a state with healthy children – children free from avoidable diseases and health problems. So the question is how should West Virginia achieve this end – through compulsion to vaccinate, and criminalization for failure to comply, or through tolerance, education, and the requirement that unvaccinated children remain out of school during any disease outbreak. The overwhelming majority of parents vaccinate their children according to their doctors’ recommendations, state law and the public health consensus supporting vaccination. Yet a small minority dissent. I believe that we should look critically at the one-size-fits-all compulsion model.

Observers of many faiths do not vaccinate because to do so would violate deeply held religious beliefs. Religious organizations including Christian Scientists, the Amish and Seventh Day Adventists believe that to vaccinate is to defile the temple of the body that God has bestowed. For these believers, to compel vaccination is in effect to bar them from participation in this community. Is it wise for West Virginia to exclude such families from the state if they choose to exercise their religious beliefs? There are many other individuals who hold sincere, deep convictions opposing some or all vaccines. Is it wise for West Virginia to exclude them? Families from other states and countries, such as Canada, England and Australia, which permit exemptions, may choose not to relocate to West Virginia because of its rigid policies – is this chilly reception wise?

For some of you, I know the answer is “yes.” You believe that those who elect not to vaccinate put the larger society, ‘the greater good,’ at risk for selfish reasons. You believe that those who refuse vaccination are ‘free riders,’ taking advantage of the rest of the society members who dutifully expose their children to the slight risk of vaccination.

But let’s examine this response. First, are these families really ‘free riders’? They must agree to keep their children out of school during any disease outbreak that could last days or weeks or months. Most working families would not make this commitment lightly. It could cost thousands of dollars in childcare or might even cost a parental income outside the home. Second, can medical science today be certain that the risks of vaccination are truly slight for all children? By legal definition, all vaccines are “unavoidably unsafe,” like all other prescription drugs. Vaccines are not risk-free; no one here can reasonably deny that vaccines have caused death and severe injury to some children. The federal Vaccine Injury Compensation Program has compensated __ cases of vaccine-caused death and __ cases of severe injury. Are you sure that you want state health officials to be able to categorically preempt parents from making the vaccination decisions they believe to be in the best interests of their children?

And I want to raise another important concern. While I condemn bearing false witness, it raises a real problem with West Virginia’s current law. Can you be confident that parents in West Virginia are really so different than parents in 48 other states? When peoples’ deepest convictions are made illegal, people often find ways to evade such restrictions. They engage in what they perceive to be civil disobedience, violating secular laws while holding true to what they understand to be higher law. It is probably fanciful to imagine that some parents in West Virginia have not found ways to obtain false vaccination forms from sympathetic doctors. If this practice exists, it surely presents a far graver risk to the public health than a few identifiable families with valid and transparent exemptions. If a disease outbreak occurs, families with valid exemptions are required by law to keep their children home. Families with children having false papers may not keep their children away from school out of fear, possibly spreading disease further.

Our nation was founded on the principles of separation of church and state and freedom of religious expression. These are our nation’s first principles. Families in West Virginia who support this bill do not seek reckless or unfettered expression of their convictions – they seek to notify the state of their beliefs and to act on them, including the requirement that they impose quarantine on their children in the event of a disease outbreak. They seek the right to have this state honor their deepest convictions about their children’s health and their children’s best interests. They ask for the same right that parents in 48 other states enjoy.

And so I would like to ask again, what kind of state do you want West Virginia to be? A state that compels medical intervention on children against their parents’ beliefs? Or a state that, like 48 others, tolerates religious and philosophical exemptions for a minority. The choice is yours. Thank you.