Immunization as a Condition of School & Daycare Entry in Maine
In 2017-2018, Maine held the 7th highest immunization exemption rate in the country: 5.3%.

Outbreaks of pertussis and chicken pox have increasingly disrupted school attendance and caused unnecessary disease. From January – November 2018, there were several outbreaks, including:

• Pertussis: 13 schools in Cumberland, Hancock, Waldo, Penobscot, and York counties. This included Sanford and Cumberland schools, among others, and 3 daycare centers in York county.
• Chicken pox: 1 daycare in Westbrook and a case in a Waterboro middle school.
• Mumps: there were a slew of outbreaks among college students at University of Southern Maine, Bates, and Bowdoin colleges in 2016. Other than one person having the mumps in 2013, there had not been outbreaks of mumps in Maine since 2007.
• Measles: the first case since 1997 occurred in Farmington in 2017.

Outbreaks occur because our community immunity in Maine is waning. Currently Maine is one of 18 states in which school age children may request an exemption from school-required immunizations based on medical, religious, and philosophical beliefs. Only 0.3% of Maine kindergarten parents requested medical exemptions and 0.4% requested religious exemptions in the 2017-18 school year. Non-medical exemptions were requested nearly 17x more, representing 5% of Maine kindergartners.

---------------------------------------------------------THE SOLUTION----------------------------------------------------------
LD 798*** proposes immunization as a condition for school entry (including at child care, k-12 schools, and post-secondary schools)* by removing ‘philosophical reasons’ and ‘religious belief’ as allowable exemptions (called “exception” in current law) to school-required vaccines from both Maine State Statute and DHHS/DOE Joint Rule. This bill would retain currently defined medical exemptions. The constitutionality of immunization as a condition of school entry has been supported in numerous cases; specifically that this legislation does not infringe on rights to education, and in fact reinforces the right to education by protecting schoolchildren from disease, which is a precondition to receiving the education to which they are entitled. Evidence from other states shows that immunization requirements for school entry have been instrumental in achieving high immunization coverage rates and ensuring community immunity against infectious disease outbreaks.

The removal of philosophical belief and religious exemptions for school-required immunizations will:
• Ensure a safe learning environment for all children, including those who cannot receive immunizations and those who are at risk for severe side effects to vaccine-preventable disease.
• Fewer missed-school days from preventable outbreaks.
• Allow school administrators, school boards and nurses to adequately protect their students from preventable disease.

Ensuring that children are immunized as a condition of school entry is common-sense, constitutional, critical for protecting our public schools, and widely supported by the constituents of Maine.

-----------------------------------------------------------TAKE ACTION--------------------------------------------------------
Please join the Maine AAP and the Maine Immunization Coalition in making your voice heard on immunizations as a condition for public school entry by signing your name below. This letter is open to individual Maine Healthcare providers only (MD/DO/NP/NNP/PA, DDS/DMD, RN/LPN/APRN/CNA)

Should you wish to add your organization as a supporter of this effort, please do so at this link:
https://docs.google.com/forms/d/1rTckcEAOXs1tqUQvyCohS8PWg_3Wjiih1fsfkwttOI0/viewform?ts=5c4876a7&edit_requested=true

If you have any other questions about this or how to get involved please contact Kalie Hess at khess@mepca.org.

Our informational overview sheet about this effort is available here: https://drive.google.com/file/d/16UzZoHsOaojV-RlnBbUyffjNbLo_2_IE/view?usp=sharing

The National AAP letter to President Trump Supporting Vaccines is here:
https://www.aap.org/en-us/advocacy-and-policy/federal-advocacy/Documents/Trump%20Vaccine%20Safety%20Sign-on%20Letter.pdf

The attached list of studies demonstrating the safety of vaccines is here:
https://www.aap.org/en-us/advocacy-and-policy/federal-advocacy/Documents/Vaccine%20Studies%20Examine%20The%20Evidence.pdf

*Updated as of 1/25/19 and 2/12/19 to include more details about the types of schools that are covered (child care, K-12, and post-secondary public and private schools) as well as health care settings.
** Updated as of 2/10/19 to include nursing providers.
***Updated as of 2/12/19 to indicate the bill number, LD 798

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