Legislative Overview
Overview
The immunization laws across the Pacific Northwest states of Idaho, Oregon, and Washington are, overall, relatively similar. Each state requires immunizations for school-age children, with exemptions for physical condition of child and for religious and other objections.
However, they do have some important differences. While stating that immunizations are required in the initial part of the law, Idaho actually invalidates this statute, in part, by requiring parents to be notified before immunization administration that they are not mandatory, and can be refused on religious or other grounds. Oregon takes a completely different tack, and in order to reject immunizations, Oregonian parents must first review benefits and risks with a physician, and if they still refuse them, must complete an approved vaccine educational module. The state of Washington also requires parents claiming exemptions to receive information from a health provider about risks and benefits, but Washingtonian parents can waive this requirement by showing proof of religious affiliation in a church or congregation that doesn’t allow members to receive medical treatment.
Understanding the legal differences across states can illuminate the differences in immunization data, and help to construct a more thorough picture of immunization information.
Idaho Immunization Laws
The Idaho Statutes codify immunization law under Title 39, Health and Safety, and under Chapter 48, Immunization.
Section 39-4801 sets out immunization requirements, which state parents or guardians of all school age children (preschool through twelfth grade) in Idaho, in public, private, and parochial schools, must provide an immunization record to school authorities. This record must be signed by a physician or other licensed health care professional, and must verify the child has received or is receiving required immunizations, or can demonstrate immunity gained through prior contraction of the disease.
Section 39-4802 outlines immunization exemptions, which include:
Physical condition of child prevents them from receiving immunizations.
Parent or guardian has submitted signed statement stating objections based on religious or other grounds.
Idaho also requires notification to parents or guardians (39-4804) of children receiving immunizations that:
Immunizations are not mandatory, and may be refused on religious or other grounds.
Parent or guardian is entitled to accurate explanation of complications known to follow immunization.
Idaho also has a voluntary immunization registry, explained in Section 39-4803, and a Childhood Immunization Policy Commission meant to increased Idaho immunization rates, explained in Section 39-4805.
Oregon Immunization Laws
The Oregon Revised Statutes (ORS) codify immunization law under Title 36, Public Health and Safety, and under Chapter 433, Disease and Condition Control--specifically under Section 433.267, Immunization of School Children.
Section 433.267 states that in any school or children’s facility within the state, all children must submit to the school administrator one of the following:
A document certifying immunizations the child has received, signed by parent, health practitioner, or health department representative
A document stating child should be exempted from immunizations because of indicated medical diagnosis, signed by physician or health department representative
A document stating that one or more immunizations are being declined, signed by the parent, which must also include:
A signature from a healthcare practitioner stating they have reviewed risks and benefits of immunization, consistent with the Centers for Disease Control (CDC), with the parent
A certificate showing the parent has completed an approved vaccine educational module
May also include reasons for declining immunization
If a child cannot meet the requirements above, they may not be permitted to attend school.
Washington Immunization Laws
The Revised Code of Washington (RCW) codifies immunization law under Title 28, which emcompasses education law. Specifically, immunization law is under Title 28A, Common School Provisions, in Chapter 28A.210, Health--Screening and Requirements.
Washington gives a broad overview of their laws, including that the main purpose of school health laws is to “adopt reasonable rules regarding the presence of persons on or about any school premises who have, or who have been exposed to, contagious diseases deemed by the state board of health as dangerous to the public health” (RCW 28A.210.010). The purpose of the immunization program, specifically, is to “protect the health of the public and individuals by providing a means for the eventual achievement of full immunization of school-age children against certain vaccine-preventable diseases” (RCW 28A.210.060) and has been in effect since September 1, 1979.
Title 28A covers various school health provisions, but the substance of immunization law is contained in 28A.210.060-170, and outlines the immunization program’s purpose, exemptions, records, administrator duties, prohibition of unimmunized children in school, and other rules.
As far as actual immunization requirements and exemptions, for a child to attend public or private school, as well as licensed daycare centers, in Washington state, they must either:
present proof of full immunization,
initiation and compliance with a schedule of immunization, or
a certificate of exemption (RCW 28A.210.080). In sixth grade, parents of students at public schools must receive information about meningococcal disease and human papillomavirus disease. At private schools, parents must receive notification that information on human papillomavirus disease is available from the department of health (RCW 28A.210.080).
As of 2019, any child can be exempt from the requirements detailed above upon presentation of at least one of the certifications, below:
A health care practitioner certifies that a particular required vaccine is not advisable for the child, provided that, if the vaccine is no longer contraindicated, the child will receive the vaccine.
A parent or guardian certifies that the vaccine is contrary to religious beliefs.
A parent or guardian certifies that the vaccine is contrary to philosophical or personal beliefs.
To claim the exemptions above, a statement must be included, signed by a health practitioner, that the claimant has received information about risks and benefits of immunization. To be exempt from this requirement, parent or guardian must show proof of membership in a church or congregation that doesn’t allow members to receive medical treatment (RCW 28A.210.090).
Legislative Tracking
Because vaccination data is informed by the state’s immunization legislation, the VaxStats repository would also include legislative tracking, in addition to curated datasets about immunization and vaccination. This tool would be modeled after GovTrack.us (GovTrack GitHub), and would allow for the ability to search legislation related to vaccination, as well as stay up to date by receiving notifications about proposed bills and upcoming votes.
Currently, each state has their own bill tracker (Idaho MyBillTracker, Oregon BillTracker, Washington legislative reports), but these tools are clunky, meant for legal personnel, and require logins. To be truly useful to its user community, VaxStats’ tool would have to be much easier to use.
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