HARRISBURG – After Pennsylvania tightened its rules in 2017 for admitting unvaccinated students to public schools, the number of children enrolled in kindergarten without a special exemption or being fully vaccinated plummeted – from 9,793 to 2,641, Department of Health data shows.

That change, though, hasn’t ended the controversy as anti-vaccine groups lobby to protect parents’ rights and lawmakers concerned about the nationwide outbreaks of preventable diseases like measles push to force more families to vaccinate their children, lawmakers said this week.

Under state law, a child can be barred from school if he or she hasn’t had any of the required immunization shots. But if a child has had at least one of the vaccines, the school can enroll the child provisionally until he or she receives the remaining required shots, according to the state Department of Health.

Pennsylvania allows parents to refuse to get their children immunized by claiming a medical, religious or philosophical exemption, the Health Department reported.

U.S. Centers for Disease Control and Prevention national data released this week showed there are thousands of children nationally enrolled in schools who are not fully vaccinated, but don’t have exemptions.

Of 27 states that reported data for the 2017-2018 school year, Arkansas had the highest percentage of kindergarten students enrolled without complete vaccinations while lacking a medical, religious or philosophical exemption. Ohio, had the second highest figure. Georgia and Hawaii were lowest, at 0.2 percent.

In Pennsylvania, that rate was 2.2 percent. Additional data provided by the state Department of Health this week put the figure slightly lower at 2.1 percent.

When all three exemptions are included along with students provisionally enrolled, 12,562 children attending kindergarten in Pennsylvania were not fully vaccinated in 2016-17. The next year, that number dropped to 6,097, with the biggest change being in the number of children enrolled provisionally.

Put another way, in a kindergarten class of 20 students in 2016-17, two students would not have had all their vaccines. By 2017-18, only 1 in 20 kindergarten students didn’t have all the shots required by the Department of Health.

But that doesn’t mean the controversy is over.

Pro-vaccine legislation

In response to growing fears over measles outbreaks nationally, there are increasing calls to further tighten the state’s law on vaccinating children.

This comes as the U.S. Centers for Disease Control announced Thursday that there have been more measles cases in the U.S. so far this year than in any year since the disease was declared eradicated in this country in 2000.

Thus far in 2019, there have been 971 measles cases confirmed in 26 states, including Pennsylvania. That includes an outbreak in Pittsburgh in early May that sickened at least five people, according to the Department of Health.

“Measles is preventable and the way to end this outbreak is to ensure that all children and adults who can get vaccinated, do get vaccinated. Again, I want to reassure parents that vaccines are safe, they do not cause autism. The greater danger is the disease that vaccination prevents,” said CDC Director Robert Redfield, M.D.

Legislation introduced on May 15 by state Sen. Daylin Leach, D-Delaware County, would eliminate the religious or philosophical exemptions to getting vaccines. In 2017-18, there were 2,897 children I kindergarten who weren’t vaccinated due to religious or philosophical objections raised by their parents.

“As we see the current massive outbreak of the formerly eradicated measles, we are reminded yet again of the importance of doing all we can to stop easily preventable diseases from re-emerging,” Leach said in announcing the bill.

“The law requires us all to get vaccinated to attend school because that’s the only way we can protect the health of students who are medically unable to get a vaccination,” he said.

Only three states – California, Mississippi and West Virginia -- don’t allow parents to cite religious objections to get out of immunizing their children, according to the National Conference of State Legislatures. Pennsylvania is one of just 17 states that allow parents to opt out of immunizing their children for other philosophical reasons.

Leach’s bill is not the only one aimed at increasing the number of children vaccinated.

State Sen. Judy Schwank, D-Berks County, has authored legislation that would mandate a standard form be used to seek an exemption and require that parents meet with a health care professional before seeking an exemption from vaccines for their children.

“There are too many” people seeking exemptions, Schwank said. Under existing law, parents can notify the school they are claiming a vaccine exemption by scribbling the demand on a piece of notebook paper, she said. “The intent is to ensure that parents get accurate information” before seeking an exemption.”

Schwank said she appreciates that some families may have religious objections, but the welfare of other students needs to be considered as well.

She said she’d already met with members of an Old Order Mennonite community to discuss the legislation. She will join Health Secretary Rachel Levine at another meeting with members of an Amish community to talk about the proposal.

Parents’ rights bills

Jeff Schott is an attorney and a director of the Pennsylvania Alliance for Medical Freedom. He called the idea that parents should need to meet with a doctor before claiming a medical exemption “crazy.”

The medical community has taken such a firm stance on the vaccine issue that parents who refuse to get their children immunized struggle to find doctors willing to even accept them as patients, he said.

“It’s a huge problem,” he said. “There are about only four practices in Central Pennsylvania” that will accept patients from families that don’t vaccinate their children.

Legislation introduced by state Rep. Daryl Metcalfe, R-Butler County, would try to solve that problem by requiring that doctors accept patients whether they’ve been immunized or not.

Schott said his group is focused on other bills –- including a measure that would ensure that parents are informed about their right to seek exemptions and another measure that would require that doctors disclose more information about the risks, as well as the benefits of vaccines.

Schott said that notices from the Department of Health and Department of Education often don’t prominently explain that exemptions are available.

“There is a big awareness problem,” he said.

Legislation introduced as House Bill 48 would require that notices about vaccines prominently mention that parents can seek exemptions. That bill was introduced in January but it has not yet been considered by the Education Committee.

In the state Senate, state Sen. Mike Folmer, R-Lebanon County, has announced plans for legislation to require that doctors discuss the risks associated with vaccines as well as the benefits. But that measure has not yet been introduced.