Documents Refuting Vermont Public Health’s Support of Eliminating Philosophical Vaccination Exemptions United Health Foundation Healthiest State

Report VT 2010/2011 K-12 Require vaccine statistics with provisional admittance clarification VT Current Exemption Form VT K Provisional Graph VT NIS, County 1985 to 2010 Vaccine Expansion Graph & Cost see also http://www.scribd.com/doc/80383332/S199-Commitee-Submission-WithExhibits

UHF calculates VT at 91.2% immunization coverage 19-35 MO, only 4.8% behind state with highest coverage.

Clarification of "Provisional Admittance" versus Philosophical Exemption Rates

Vermont has Excellent coverage of the required vaccines.
Kindergartners start school exceeding 90% for DTP, Polio, MMR, HepB all , even though 10.44% of students enroll with Provisional Admittance, meaning they are coming into compliance. By 7th Grade Polio, MMR, HepB, are documented above 98%, even with 12.96% Provisional Admittance, because there is a DTaP booster required in 7th Grade. Families who do MMR don't skip DTaP, and the DTaP statistic paces the others in the following reporting year.

Commissioner Chen is misusing the temporary “Provisional Admittance” statistic, which is double the Philosophical Exempt rate in Kindergarten, (10.44% vs.5.08%), on his map to mislead Vermont Legislators, Press, and Citizens about the true vaccination status of students. Is this Ethical?

V. Provisional Admittance (2) A student may be admitted to school provisionally if a health care provider indicates a student is in the process of complying with all immunization requirements. Such provisional admission shall be for a reasonable length of time but shall not exceed one year. http://healthvermont.gov/regs/documents/imm_regulations.pdf

Students who are missing as little as one dose of a vaccine on the schedule require a "Provisional Admittance" to be enrolled in school. This report closes December 31 of each year, 9 months before the Provisional Admittance time period expires.

School Immunization Exemption Form
5.08% Exemptions
Vermont’s School Immunization Regulations apply to any students in attendance at any public or does not equal independent kindergarten, any elementary or secondary school and certain post-secondary schools. 5.08% No Shots Before school entry, students must have the required immunizations unless exempt for medical, religious, or moral (philosophic) reasons. In order to claim an exemption this form needs to be completed, signed and returned to the school. Please note that students who claim an exemption may be kept out of school during the course of a disease outbreak. The reason for this is that such students will be at high risk for getting that disease and in-turn transmitting it to other students. The length of time a student is kept out of school will vary depending on the type of disease and the circumstances surrounding the outbreak. This may be from The use of month. as little as several days to over aan exemption DOES NOT mean a student is opting out of all

shots- An exemption is required to opt out of a single vaccine, or even a single dose of a series. Most students who have an exemption on file are This document is not completely avoiding the full schedule but are only opting out selectively. being submitted on behalf of the following student: A 5.08% exemption rate in an area does not mean 5.08%Birth: are Name: Date of of kids unvaxxed- it means 5.08% have an objection to one or more doses, usually ___________________________________ ___________________________ _______/________/_________ Chicken Pox, because of the mildness of the infection and the fact it Last First increases MMR seizure rates, and Hepatitis B because it is an uncommon IV drug use /sexually transmitted infection that is difficult to contract casually. MEDICAL EXEMPTION From VT Health Website : Activities that can expose someone to hepatitis B include: The following vaccine(s) are medically contraindicated: •Having sex with someone who has hepatitis B DTaP/DTP Td/Tdap Polio Hepatitis equipment Varicella •Sharing needles, syringes or drug preparation B •Contact with blood or open sores of an infected person Measles Mumps Rubella Meningococcal •Sharing household items (razors, toothbrushes, nail clippers, and tweezers) Reason for exemption(s):_______________________________________________________ •Being born to a hepatitis B positive mother •Exposure to infected blood in any situation can be a risk for transmission This exemption shall continue until : _____/_____/__________ Hepatitis B virus is not spread through food, water, kitchen utensils, _________________________________________________________________ (_____)_________________ breastfeeding, kissing, coughing, or sneezing.
Print Name of Physician Telephone Date

_____________________________________________________________________
Signature of Physician

____/____/_________

MORAL (PHILOSOPHIC) EXEMPTION

RELIGIOUS EXEMPTION

I request that following immunization(s) be waived because they conflict with free exercise of religious rights and /or moral (philosophic) rights:

DTaP/DTP Measles

Td/Tdap Mumps

Polio Rubella

Hepatitis B Meningococcal

Varicella

_________________________________________________ (______)________________ ____/___/______
Signature of Parent (or student if 18 yrs or older) Telephone Date

The Vermont Department of Health Immunization Program 108 Cherry Street Burlington, Vermont 05401
School Immunization Exemption Form 2.8.2008

802-863-7638 or 1-800-464-4343 ext. 7638 healthvermont.gov

The real reason for the "Increase" in exemptions

Vermont Kindergarten Immunization Exemptions and Provisional Status
philosophic exemptions (%) provisional status (%)

Varicella (2 doses) and hepatitis B requirement added to school rules in 2008.

VT families are not rejecting the traditional vaccines. They are responding to an ever expanding schedule of vaccines for mild (Chicken Pox), and hard to contract (Hepatitis B) infections

14% 12% 10% 8% 6% 4% 2% 0%

'00-01 '01-02 '02-03 '03-04 '04-05 '05-06 '06-07 '07-08 '08-09 '09-10 '10-11

Year of Enrollment

P ercent o f S tu d en ts S u rveyed

Unimmunized Kindergarteners Vermont 2010-2011
12% 10% 8% 6% 4% 2% 0%
Example of inaccurate, misleading terminologyThe majority of students using exemptions are doing so to catch up or to be selective, and are not "unimmunized"

10.7%

5%

1%

0.2% provisional status (%)

medical religious philosophic exemptions (%) exemptions (%) exemptions (%)

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Fully compliant Low provisional High provisional Very High provisional 5% 36% 28% 31%

All shots, almost all shots & most shots

This Survey Does Not Measure VT K-12 Vaccination Rates! VT 19-35 Month Children Have No Vaccination Requirements*

*VT children
No Relationship between Exemption Rules and Vaccination Rates2 of the 3 Top Highest States on this Survey offer Philosophical Exemptions* LA- 82%* OH-82%* MA-82%
19-35 months old have no vaccination requirements unless enrolled in a state licensed daycare or pre-school.

States Offering Philosophical Exemptions Circled

Only 2 of the 7 lowest "69% and under" States offer a Philosophical Exemption. This Directly Refutes the False Assertion that Philosophical Exemptions Cause Low Rates

Do these numbers truly warrant a change in legislation?
# Practices County Addison Bennington Caledonia Chittenden Franklin/Grand Isle 3 4 2 9 4 4171 3915 4724 14719 2114 Total Patients Total Patients w/ Objection 76 53 32 151 20 % Patients w/ Objection 1.8% 1.4% 0.7% 1.0% 0.9%

Orange Orleans Rutland Washington Windham Windsor

5 4 2 3 7 1

4102 1387 2040 2314 4625 341

15 10 7 43 21 7

0.4% 0.7% 0.3% 1.9% 0.5% 2.1%

Counties Not Reporting: Lamoille, Essex

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