Immunizations are a hot topic in Frankfort; comment on updated regulation ends Tuesday; shots-for-college bill looks dead

A bill to require all college freshmen in Kentucky to be immunized before starting classes is likely dead, but one that allows pharmacists to give immunizations to those aged 9 and up still has a chance in the General Assembly.

Elsewhere on the prevention front, the state has proposed a regulation to require two more vaccines and to change the rules for religious exemptions, among other things. The amended regulation is open for public comment through Tuesday, Feb. 28.

The college immunization bill is opposed by a tea-party group called Take Back Kentucky and the Kentucky Vaccine Rights Coalition around issues of personal rights and changes to the exemption requirements that are in the updated regulation.

Rep. Addia Wuchner

Rep. Addia Wuchner, R-Florence, said she had no idea that her bill to require incoming college freshmen to be vaccinated would meet such resistance. She said most of the resistance stems from misinformation.

Her concerns are reflected by recent spread of the childhood disease pertussis, or whooping cough.

Carolyn Callahan of Louisville’s WLKY-TV reported in December that the federal Centers for Disease Control and Prevention said Kentucky had nearly 450 cases of pertussis in Kentucky in 2016, up from 163 reported in 2015.

Another example is mumps. Lena H. Sun recently reported in The Washington Post that federal officials are looking at the benefit of an additional dose of mumps vaccine because of the increasing number of outbreaks since 2006. The U.S. had more than 5,000 reported cases of mumps in 2016, and the CDC reports that in the 2015-16 school year, several university campuses reported a mumps outbreak, with the two largest in Iowa and Illinois, each involving several hundred students.

Unlike outbreaks of measles and whooping cough, which occur primarily among unvaccinated people, mumps outbreaks are occurring among people who have been vaccinated, suggesting that a booster is needed.

Wuchner’s House Bill 147 would require incoming college freshmen to submit proof of immunization against measles, mumps, rubella (“German measles”) and meningitis. Only a few Kentucky colleges currently have such a requirement. The bill exempts students who have medical and religious reasons not to be vaccinated, as well as online and distance-learning students.

The bill passed readily out of the House Health and Family Services Committee, which Wuchner chairs, but was recommitted to the House budget committee, a likely death sentence.

Dr. Patty Swiney, former president of the Kentucky Academy of Family Physicians, who spoke for the bill in committee, acknowledged that its chances for passage were slim, but said her group would continue to support it.

She told a story about one of her patients who died from meningitis because it wasn’t recognized in time. She noted that even though meningitis cases are “sporadic,” 10 to 15 percent are fatal and that one out of every five survivors have a permanent disability.

“If you have ever seen a young person actually die in front of you and there is nothing that you can do, and you know it was preventable. . . . That shouldn’t happen to anybody,” she said.

Vaccination skeptics often note a study that linked the MMR vaccine to autism, but Swiney said the study “has been proven wrong multiple times, and the author has admitted that he skewed his data.”

Other skeptics have voiced concern that thimerosal, a mercury-based preservative, causes autism, but this was removed from vaccines in 2001, and autism rates have continued to rise.

“We are listening to people who have no background in medicine, who have no idea whether studies are scientific or not,” Swiney said, “and we are listening to what they are telling us about our kids. . . . All we really want, before you just claim an exemption, we want you to sit down with someone and be informed … of all the side-effects and all the benefits, just like you do before having any procedure done.”

Updated immunization regulation

The state Cabinet for Health and Family Services has proposed to update the state’s immunization regulation, adding a meningitis booster before 11th grade and the Hepatitis A vaccine, to align Kentucky’s requirements with the CDC and the American Academy of Pediatrics.

The amendment also consolidates the immunization certificate and medical exemption form, and revises the religious exemption certificate to include educational materials.

The religious exemption form would have to be signed by a parent or guardian, notarized and submitted to a health-care facility, or submitted to a child care facility or school upon enrollment. No physician signature or approval would be required.

This is a change from the current regulation, which allows Kentucky parents to write their own sworn statement claiming a religious immunization exemption.

In 2016, of the 99,805 students enrolled in Kentucky’s schools, there were 202 medical exemptions and 521 religious exemptions.

The bill would also require health-care providers to use the Kentucky Immunization Registry by July 1, 2018.

The cabinet also made changes to require home-schooled students who participate in any school sponsored activities or attend in-school classes to provide proof of immunization or submit an exemption.

The Vaccine Rights Coalition and Take Back Kentucky also oppose this regulation. Take Back Kentucky is encouraging its supporters to oppose HB 147 because “it would force” those entering college to get vaccinations, though the request for action mentions the religious exemption.

Take Back Kentucky also notes that during the April 20, 2015 Lexington Tea Party gubernatorial debate, Gov. Matt Bevin said he would oppose any form of forced vaccination.

Asked if Bevin supports his agency’s regulation, Amanda Stamper, his communications director, didn’t answer directly, but said Kentucky forces no one to be vaccinated and cited the religious exemption.

Written public comments on the proposed regulation changes should be submitted to Tricia Orme, administrative specialist, Office of Legal Services, 275 E. Main St. 5 W-B, Frankfort KY 40602. You can also call 502-564-7905; fax 502-564-7573 or e-mail Tricia.Orme@ky.gov.

Pharmacist vaccine bill still has a chance

The bill that would allow pharmacists to administer all age-appropriate immunizations to minors aged 9 to 17, still has a chance.

Sen. Julie Raque Adams

Senate Bill 101, sponsored by Sen. Julie Raque Adams, R-Louisville, moved quickly and unanimously through both her Senate Health and Welfare Committee and the full Senate and is in the House.

Current law allows pharmacists to administer flu vaccines starting at age 9, but for all other vaccines, pharmacists can only administer to minors starting at age 14.

Both immunization bills are supported by the Foundation for a Healthy Kentucky.

“By allowing pharmacists to administer immunizations to children beginning at age 9, the bill would give Kentucky moms and dads access to nearly 5,500 more professionals, who often have extended hours and nearby locations, to take care of important childhood shots and other immunizations. Thus, the bill will raise Kentucky’s adolescent immunization rates, which lag behind most surrounding states,” Ben Chandler, president and CEO of the foundation, said in a statement.